Tuesday, December 30, 2014

10 reasons why Erbil's maternity hospital needs urgent attention

I have come back from the Wlada hospital (the official, and probably one and only public maternity hospital in Erbil) whoever sees me asks me what's wrong. I haven't looked in the mirror, but I am told I look very pale.

This is not my first experience in this what so called hospital*. Various times close friends, relatives and loves ones have visited for gynaecological surgeries or delivery of their babies. I have been blessed enough to be part of these miracles and at times, sadly, part of nightmare experiences.

I thought of titling this post '10 reasons why Wlada (maternity) hospital has to close its doors' but then it is the only option for many women at the moment. However, it needs attention both as a building, as facilities, as staff, doctors and as an overall system.

Before I begin my list of bolla-bols (complaining) I want to point out in the Kurdistan Region, and in Erbil in particular there are some private hospitals making you feel like you are in five star hotel with great services and staff. However, I know a lot of people in my life who can never afford to go to those hospitals. Only because they are not financially better off they don't deserve the same services? It's not fair, it really isn't.
Picture: Google, healthcaredive.com

1. The staff are rude:
No one dares smile in this hospital. I got yelled at. Yes, a receptionist (or cleaner, I don't know, no uniform to show who is who) decided to raise their voice and scream at me because I entered the wrong room (after I asked a million times if this is the right room and I was told yes over and over again). A polite "this is not where you are supposed to be" would have made a huge difference. But no, just yell at your patients and shoo them away as if they are little chickens coming in your newly planted garden.

2. The Doctors become careless:
 To be fair some of  the best doctors work in Wlada hospital as their morning jobs (don't get me started on this morning job and private clinic in the evening business) but the amount of patients and disorganization that happens in that hospital doctors start to just go with the flow and fit themselves in with the chaos. This often leads to them not focussing well and not giving individual patients the time/ attention they need.

3. No privacy:
There is no such thing called privacy, walk in the corridors and it's easy to see a woman being checked with her legs wide open behind a curtain that can be seen through (you know, through the sections between the pole and the curtain).

4. Too many patients:
In a single room you can find up to six patients all at once, one being examined, one talking to the doctor, another one getting ready to be examined, another already taking clothes off waiting for someone to check her. There is no system in place, if you don't know anyone there or you don't know your way around you end up spending half your time pocking your head out into different rooms asking every passer-by whether they know X or Y place/ person.

5. Your private issues are public:
It's a women's birthing hospital, those even who aren't pregnant most likely have a very sensitive issue that they don't want to share with every single cleaner, other patient or receptionist they come across. My poor patient was asked a gazillion times in front of so many people "Whose the patient? You? What's wrong" what are you supposed to say? Ask, you have a right, but not in a loud voice in front of everyone.

What hurt me most is that a patient (let's say X) was called into the operating room (yes, I was standing two doors away from the operating room) one of the patients said there are two people with the name X and enquired  which one of them had to enter, instead of the receptionist calling out LOUD -very loud- the last name of the patient she shouted out: "X, the one who is getting her uterus taken out"... poor lady stood up, went red and began preparing to enter the operating room.

6. No men allowed:
After writing point 3, I realize very well why it is not allowed for any husband, brother or father to enter the hospital, but it doesn't make sense because some of the staff inside are males anyway. Plus, I will never understand why a father can't be the first person to hold his new born baby or hold his wife's hand after or during birth?

7. Working hours.
The entire time you are there it's all about rushing here and there before doctors leave by mid-day. It's as if when the clock strikes 12 all doctors are sucked into the ground and will come back out the next morning.

8. Lack of medication
I have witnessed this myself, if you leave an operation and you have pain someone you know must go and buy you pain relief needles from outside. So, if you are unlucky and no one told you before your operation to get pain relief. You come out, the anaesthesia loses it's effect and you can just put up with the pain until the said needle/ medication is brought to you from a family member.

9. Hygiene
Let's be honest, I didn't see dirt or rubbish on the ground. However, hygiene is not just about rubbish and dirty tiles. It is also when a woman lays down on a bed it has a piece of tissue over it and is removed before the other. Hygiene is not using the same glove to touch a patient's private area and using the same glove to hold your pen or put the curtain aside.

10. Respect
I love going to place where I feel I am treated right and respected. No matter if you are rich or poor, whether you are a lawyer, builder or a cleaner. I feel because most of the people who opt to the public hospital are usually middle or lower middle class citizens they are not treated well or respected by the staff at the hospital. When it comes to our health and bodies we all deserve respect, time and affection. The way staff speak to patients frustrate me, there is no please or thank you. you are a patient you need explanation, you need someone to treat you with care. In Wlada, dream on. I posted something on this on Facebook a friend of mine replied he borrowed money just so he can take his wife to a private hospital, why should this be the case?!


It is always easier to complain then come up with solutions. I am no doctor, I am no professional in the medical field, I am sure there are many confrontations in fixing this issue. As much as it is the staff's fault it might also be the patient's fault too. But why not...

- Train the staff. Every single staff members there needs to learn how to deal with patients, how to talk, and how to be polite. Do them a one week training, after the training who ever is caught not implementing what they learned cut off their salary for a month or two, fire them if need be.

- Bring in a system to the hospital, there are room allocations but it's not well designed  and organized. I guess the building is ancient and needs major reconstruction.

- Provide a huge pharmacy with all the medical needs outside, people don't need to go to Erbil Medical Road just to buy a needle then come back to the hospital. Okay, if you must, buy the medication, you might as well buy it in the hospital itself. We are talking about pain here, body/ physical pain.

- If need be, maybe we need to make our medicine schools bigger, take in more students, bring in profession professors from abroad. I don't know. I am sure there is a solution and it won't cost half as much as building a new mall.

*I would like to point out that services in this hospital are entirely free unless certain medications are needed. It is also not only a birth hospital but women who have pregnancy issues or other gynaecological health matters visit here.

* I did not take any pictures inside the hospital for ethical reasons.

Tags: Hospitals in Kurdistan, hospital in Erbil, Erbil birth, giving birth Erbil Kurdistan


Ranj Kana'an said...

You have a very unhealthy and pure nest Sazan, I am so sorry but this is the reality. You are right, it needs a very urgent attention, but who cares and listens???
ufffff zor shukur xwaya gyan

Anonymous said...

I was part of that tragedy one day, this is why I stopped thinking of having more kids. The hospital is the reason, no kids any more

zakaria said...

There is another public maternity hospital, called Mala fandi in Erbil. What you have discussed here is only socking for those who have never heard about these things before. To me, these things are not new. The staffs' being rude is just typical of the
them. If one day by chance you see me, I may make you forget what has happened to you in the hospital. my experience is a lot bitter.

Erin Wilson said...

Just an observation about the maternity hospital in Slemani...

I work with a number of IDP families (and a handful of pregnant women). Their experience at the hospital here has been consistently terrible. Inability to communicate seems to be the cause of much of the trouble. No one expects hospital staff to be able to speak multiple languages/dialects. But if staff had a little compassion, and if the hospital had one or two multi-lingual advocates that could help these IDP women, it would significantly reduce suffering.

noor hasan said...

ALL what you said is true n not only in wilada Hospital,, all the governmental hospitals are like that unfortunately :(

noor hasan said...

ALL what you said is true n not only in wilada Hospital,, all the governmental hospitals are like that unfortunately :(

Lilan Bazaz said...

Here you are..
Th staff r rude!.its according to th person who u r and who u deal wth,.its not somethng that u generalized on..some patients r sooo respectful that make u to respect them much more and others r just coming to fight wth doctors!.how could u answer them!.its first..second ur talking abt reception room!.its 2 bed for 2 patient to be examined..may be for milion times th doctor shoutes that only 2 patient shd enter but who cares!.2 patient and relative of them and many forcing themselves in wth one perminant dr and one rotater dr!.how could rh dr stand all these crowd!!

Abt th second point that u meantioned above of being careless..am sorry but its not true..doctors shift in th maternity hospital is like ths: th perminant doctors shift is 12 hrs and 4 perminant will stay..and they will change every 12 hr..for better explanation every 12 hrs new 4 peminant will come..and for rotater drs shifts are applied for 8 hours 3 drs..mean always there are at least 8 drs there and always availabe...
And for th privacy issue its because there r tooo many patients,.from hawler and around,those arabs came here in everywhere,syrian,refugees and many more..that huge load on th hospital how it work!.i thnk dor these two point and for th hygine one You better ask th government for it!.this old old exhausted hospital wht few numbers of bed how could stand that nimber of patients who at leat in one day there r around 200-250 birth recorded there..you tell me all these patients where to put!?!.its not doctors problim..its governmental problim..and for th same reason its not allowed for males or husbands not to enter the delivery rooms..cause in th same room and th rooms around there r other females that about to deliver!.would u agree if u r abt to give a birth and other male present in th room!.for sure no..ethically its not accepted..and also lack of medication its govermintal issue cause drs are not going to buy medication and put it in pharmacy,.th goverment ministery of health will decide amount,quantity and quality and type of medication to send to th hospitals every months,.so if you want to criticize,don't criticize blindly..

Ahmed Al-Salihi said...

Right on all accounts, except when it comes to the doctors working hours, you have no idea what the hell they're through, you haven't checked their shifts schedule, I'm sure you don't know that they work in excess of 60 hours a week, being paid for only half of those hours. And by the way doctors are present 24/7 in hospitals, all urgent cases get attention as much as possible in the chaos you mentioned, it is the cold cases "non-urgent" cases who wait to be seen in the consultation unit in the morning by a senior consultant, while the out-patient clinic is running till 12:00 a.m. to receive cold cases that do not require a consultant's opinion.
Get your facts straight, then criticize other's work; otherwise that is just prejudice

Anonymous said...

You forgot to mention the poor doctor who works like a robot

Sazan M. Mandalawi said...

@ranj Kanaan - indeed we do, while some places are amazing, others need great attention. Lets hope for the best.

Sazan M. Mandalawi said...

@Anonymous - that's a shame! Let's hope you can bring another little one into a safer, healthier world in a better place. I have been told if you look into the private options there are some that are less costly than others.

Sazan M. Mandalawi said...

@zakria - I haven't had any positive experience in this hospital in the past, I have heard of Mala Fandi before but didn't know it was also a maternity hospital.
Xwa kura nazdarakat le nasene!

Sazan M. Mandalawi said...

@Erin Wilson - Thank you for the comment. Indeed true for Erbil patients as well. I had the chance to work with some refugees who also had complaints regarding this. In general there isn't enough care, let alone being a refugee or an IDP.
Most doctors however do speak English/ Arabic. But yes, you are right. It's a shame.
By the way, there are health centers/ clinics (I know they aren't capable of doing a lot, but still better than nothing) in the refugee and IDP camps at the moment. Usually there is a doctor there as well.
Thanks for the comment.

Sazan M. Mandalawi said...

@Noor Hassan -
It will reach a day when these times become bitter memories only. The Rizgari is still better than Wlada. I think I am most frustrated about the maternity hospital because they are all vulnerable women and new borns both prone to diseases, sickness and require a lot of attention and care... in particular a pregnant lady or a young woman who has just given birth for the very first time.

Sazan M. Mandalawi said...

@Lilan Bazaz,
Thank you for your comment. I think it is also clear in your comment that you also believe there is something wrong in the system - maybe not so much the doctors but the system in which they work in, and I clearly mentioned that in the post as well.
The system works in such way where all doctors have no option or are forced to be part of it.
As for the privacy I agree with you, and as mentioned, reconstruction of the building is necessary to allow for more comfort for both the patient (mother or mother-to-be) and her family.

Thanks again

Sazan M. Mandalawi said...

@Ahmed al Salihi,

No one criticizes blindly, but we all see different perspectives. I go there as a patient so I criticize as a patient I don't go and see the doctors shifts and working hours, nor do the hundreds of women who visit everyday. A doctor would criticize and complain differently because they see it from a different perspectives- the overall point that we all agree on is that there is an issue that needs to be addressed.

I also believe (from a blogger and a patient's perspective not an expert, not a student of medicine, not a doctor) one of the best solutions might be giving doctors a much better salary and less strenuous working hours so they won't need to go and open private clinics or have more than one job. Then again I might be wrong.

by the way, I have nothing against doctors. I have so many doctor friends and we sit and talk about all these issues.

Thanks again for your comment.


Sazan M. Mandalawi said...

@Anonymous - I feel even doctors aren't happy in the current system. Medicine and people's health shouldn't become a business. Let's hope 2015 will bring some great changes to our health care system.

dema waleed said...

I have to say, may God bless you!!!

Marnisa said...

A sister's friend has lost her baby twice in that hospital. She was on full term and then the baby died because of the OB's carelessness.