Our healthcare system in Zambia points to one place, the University Teaching Hospital (UTH) on Nationalist road. You can go to the most expensive private clinic in the country, but if you are genuinely sick, you will end up at the UTH. This is of course for your own good. Zambia is a relatively small country populationwise. Preliminary 2010 census data puts our official population at 13 point something million.
|The University Teaching Hospital - Lusaka, Zambia|
The UTH is a teaching hospital, so all the specialists are found there, passing on their knowledge to the next generation of physicians. Being the referral centre means that staff here have the advantage of seeing every ailment known to this region. The common ailments and the rare and obscure diseases alike. Private hospitals tend to see patients within a very narrow disease spectrum. They don't handle the big stuff, unless it is one of these well funded and equipped mission hospitals out in the hills somewhere. But even these only benefit from one or two skilled expatriate surgeons in a particular field.
Back to my experience.
I am convinced that the state of our healthcare system says much about the state of our nation and about our social and economic development. I did not doubt the competence or skill of the staff I interacted with. In fact, I thought often of my hard earned Kwacha invested in private hospitals over the last one year. However, my situation was far from critical. I drove myself after popping into the office to check mail etc. I had thought I would be back by lunch time (but it turned out that I only left the UTH just before 5pm). I paid to be fast-tracked to the top of the doctor's list (next in line after admitted patients). I think that my professional attire, high heels and insistence on only speaking clear and sharp English ensured that I did not wait very long and was well attended to.
The doctor ordered a series of tests and x-rays. Some could only be done at our famous Nkanza Laboratories (where erring men are called for paternity tests and suspicious partners submit DNA samples). Mine was not so glamorous as this. My doctor insisted the x-ray be done at the UTH because she trusted them more than my having it done at a private hospital. Who was I to argue with her?
After being sent all over the hospital because one cashier didn't have a receipt book and the other was not accepting out-patient payments, I finally made my way to Radiology and immediately regretted my decision. The stench of death and disease was everywhere. As was the pungent aroma of sorrow and despair.
It is my privilege (and I try not to take it for granted), that I am one of the 5% who went to school and finished; then went to university; graduated and found a good job. I earn enough money that I go to UTH by choice, not by necessity. My appearance, voice and demeanor generally command respect (of course, depending on the situation - female gender and youth in Africa are frequent disadvantages). I can afford to pay to be seen at 11:30 and so not have to begin queuing at 6am as many do. I drive there and do not have to walk 21km to get to only see a disgruntled, overworked, underpaid brusque nurse instead of a doctor.
As I walked out of UTH holding my nose when I passed patients lying in waiting rooms or in corridors with gaping wounds everything felt SO WRONG. It shouldn't be like this. I was amazed at how cheap everything was. From the tests to the x-rays. People should not have to struggle to pay a dollar for a blood test. My x-ray only cost me K10,000 (two US dollars). More than ten times less than in some private hospitals.
Don't get me wrong! UTH is not as bad as it once was; but, neither is it as good as it has been. It is an institution that is clearly underfunded and under-resourced. Most people there know what needs to be done but not all departments have the capacity to do it. For instance, I went to get a blood test but they didn't have any bottles. So, I had to leave to begin looking for a pharmacy in which to buy one. The test was done and I was given my blood (in a vial) with a slip of paper and told to take it to the haematology department for testing. The other sample, I was to take around the corner to another lab department.
For my own convenience and safety, I was advised by friends who work there to carry my x-ray home with me, together with my out-patient card. This is just in case it gets lost or misfiled. Hence, it is safer with me. A relative who works in the hospital offered to follow up my test results for safe keeping. Once my review date comes up, all I need to do is dig out all my information and get in line to see the doctor.
If you have time, please have a read of this interesting blog from an American resident on placement at UTH.