Priority Check

Budget allocated to the improvement of Kuwait’s health services (2007): USD 181 million (KWD 51 million)

Kuwait’s contribution to the Katrina disaster: USD 500 million (KWD 141 million)

Go figure.

The Health of Kuwait – Awake Yet?

Certain generalizations can be made from the analysis of our system. There seems to be a trend towards an ultraconservative approach to decision-making. Risk taking is discouraged and our policy-makers have adopted the “band-aid” technique to solve conflicts whereby essential rights are consistently being withdrawn when complaints are filed by both laypeople and uninformed politicians instead of engaging in educational campaigns. Dramatic examples include the withdrawal of the rights of emergency physicians to order important diagnostic tests such as CT scans or ultrasounds due to some past excesses and to unwarranted resistance exhibited by our more established radiologists. Paramedics, who in other nations perform life-saving procedures and provide critical medications, have seen their responsibilities downgraded following complaints by family members of transported patients. More recently, a new computer system introduced to a major teaching hospital to facilitate patient care was rapidly dismantled after components were stolen. This habit of bypassing core problems and placing a band-aid on a hemorrhaging wound is an example of passivism and poor judgment from the part of our leadership. The outcome is a system in failure due to repeated mistakes resulting from the lack of awareness.

So what solutions can we bring to this crisis? Well, to begin with, we should change our mindsets and refocus our efforts on finding solutions instead of lament over the problems. This is the quality that we should all strive to emulate. Taking a problem-solving approach instead of being inhibited by the challenges and obstacles will only impress positivism onto our system and promote creativity in this conservative environment. We should not fear taking risks as risk taking will lead to faster change. The sitting and waiting approach will only further widen the divide between us and the rest of the industrialized world.

The Health of Kuwait – A Wake up Call (Part III)

Many of you have noticed a number of newly refurbished departments in our hospitals. Their new design may be appealing in some ways but, in most instances, are not in-line with basic patient safety standards. It does not take a health care architect to tell you that slippery marble or granite flooring is hazardous, it is intuitive. When looking more closely at critical areas of a hospital such as emergency departments, where design can dramatically improve or, conversely impede, patient care, we notice that in most of our public facilities patient flow and access to life-saving equipment and medications are hindered by inappropriate architecture thereby defying their purpose. Despite being obvious even to the layperson, hospital administrators, departmental chairpersons and government officials seem to disregard major safety issues when addressing renovations or new constructions. It would only seem natural to involve experts in health care design when engaging in such activities. Furthermore, it is a well-established fact that ergonomics, cost-effectiveness and safety are not priorities when construction contracts are negotiated. Delegated contractors aim at maximizing their commissions by reducing the overall costs.

Foreign Medical Treatment - Health Care Sidetracked

The recent disputes over the responsibilities of the Foreign Medical Treatment Department at the Ministry of Health are further highlighting the misguidance of our health care system. While we focus on getting our patients out of the country to more capable providers, time has deepened our homeland’s health care crisis. Indeed, misinformed decision-makers and erroneous popular belief have shifted resources away from many of the basic foundations of a sound health care system. The solution is not to “outsource” health care but to establish our very own state-of-the-art system by training and recruiting leaders, launching nationwide prevention programs, building quality hospitals, reinforcing medical education and rendering the workplace safe for both providers and patients alike. We must set aside our pride, accept the harsh reality of the declining quality of care, and reallocate resources to reverse this. We cannot bow to misinformation that attributes our low death rates to a flawless health care system in a nation with a pyramidal population structure. Our neighbors have understood this and have now outpaced us owing to their forward-thinking and risk-taking behavior.

Let us analyze the shortcomings of our decision-making.

The Health of Kuwait – A Wake up Call (Part II)

Following the 2000 WHO report and to respond to the needs of their population, our neighbors have engaged in large scale upgrades of their systems. Increasing financial prosperity allowed for the creation of new, state-of-the-art health care facilities thereby increasing the availability of care. Qualified professionals were recruited from Western nations to spearhead the advancement of several deficient specialties. Attractive, tax-free packages were offered to promote incentive. More importantly, collaborations with leading institutions were initiated to help uphold self-sustainable developments. Examples, discussed previously, include Weill Cornell Medical College in Qatar, the world-renowned Joslin Diabetes Center of Boston in Bahrain, attracting much-needed expertise in diabetes treatment to the area, the Clemenceau Medical Center in Beirut and the Tawam Hospital in Abu Dhabi, the new affiliates of Johns Hopkins Medicine International, or the collossal King Fahd Medical City in Saudi Arabia and the Harvard-affiliated Dubai Healthcare City. Such ventures not only introduce healthy competition to the region but also provide the work environment needed to motivate health care professionals. These projects will help avert reinventing the wheel by introducing approved standards and protocols, implementing a modern clinical practice, and enhancing medical education in the region.

So why does Kuwait lag behind? The reasons are many.

The Health of Kuwait – A Wake up Call (Part I)

Health is neither a luxury nor a commodity; it is an unquestionable right of every human being. Governments must strive to provide the best possible care to their people. The public must be informed of advances in health care and have access to a scope of quality services. In an altruistic realm this could probably stand as a moral statement. Truth be told, health must also be looked upon as an investment as a healthier population is a more productive one. Illness impedes on the socioeconomic progress of our nation by reducing productivity through the lack of manpower. This may seem to be a moot point knowing that Kuwait’s economic expansion has been unprecedented in the last couple of years. Thanks to our desirable resource, we have achieved a growth of close to 20% in 2004 alone, continuing to fair well to this day. So, what is the point you may wonder? Well, with health being the third largest budget, you would expect our health services to flourish accordingly. They do not. People in the business will tell you that, in the recent decades, the quality of services has been steadily declining. Can we objectify this? Standard markers of a population’s health such as infant and maternal mortality rates or life expectancy can be deceiving as they do not adequately highlight certain deficiencies in primary, secondary or tertiary prevention throughout life creating a false sense of well-being despite a high prevalence of chronic diseases with worsening courses and trauma-related injuries in the country. The reasonable life expectancy underscores a trend in our disease profile, also seen in the rest of the industrialized world, towards more chronic conditions such as heart disease or diabetes from the more acute, life-limiting infections previously observed in our young and middle-aged populations. A caveat to keep in mind is that devastating infectious disease crises remain plausible if entities such as HIV continue to be neglected and prevention programs for threats like the Avian Flu or, worse, the deadly XDR-TB

Regional Success Stories

After backing the privatization movement, let me begin this post by highlighting one of the region’s most commendable achievements in the public health care sector:

Oman’s hike to the WHO’s 2001 top 10 list of global health care systems.

In the 1970s, Oman’s health care system was struggling with high infant mortality rates, low life expectancies and a poorly-developed vaccination agenda. With the arrival of highly trained and motivated health care leaders who refocused the MOH’s resources into prevention programs, the nation reversed its deficits and now boasts the most efficient health care system in the Middle East, placing Oman at the 8th position on the WHO’s overall best performing systems worldwide. Our neighbors continue today to lead the way in preventative medicine and medical education.

Privatizing Health Care

what holds true of financial or educational institutions holds equally true of the health care sector. the benefits of privatization in reversing the negative effects of a cumbersome public administration, with its complex and, far too often, outdated regulations, lack of incentive or efficient quality assurance measures, have been clearly proven time and again in select nations.

the Saudis, who already operate some of the most advanced health care facilities in the region, have recently announced that in the next year all 200 public hospitals will be turned into for-profit corporations. this is part of the Kingdom’s vision to raise the standard of care and attempt to standardize the quality of care throughout their health care system. click here for more info

following in their footsteps is Dubai’s Department of Health and Medical Services (DOHMS) which plans to privatize its four hospitals to overcome massive losses incurred from years of (dys)functioning as not-for-profit organizations. per the Gulf News report, the hospitals generated revenues covering a mere 20% of their total expenditures. click here for more info

ways governmental agencies can undertake such privatization activities are numerous and include: