Monday, March 22, 2010

The Mountain of Health – Inside, Outside, Emergency

There is one major resource that I know is truly scarce in Haiti; Medical services. This will probably be my most controversial post, please read carefully. This is One area where foreign influence should make a swift and significant change.

I volunteered at a hospital, to start the process of “informatiser”; converting the all-paper filing system, to a database of documents with unique file numbers. This helps patients access their medical history if/when they return to the hospital for additional care, saves time for the workers in the office, and may even help nurses and doctors do a better job because details about patients are more accessible..

It is a private hospital, where existing patients have a membership card entitling them to service, and each new patient usually receives a file and file number. On January 12, with thousands coming to the hospital with emergencies, the admissions office stopped creating files and file numbers. March 17, the day I arrived at the hospital, the Founder of the hospital had just discovered this problem, by speaking with employees in the Admissions Office.

There are many other technical difficulties at the facility.  The hospital does not have a way for employees to share documents and work on databases at the same time. Everyone has a jump drive, which they use to copy files back and forth on their computers. The internet is VERY slow and goes down frequently. There are two 2 mysterious satellite dishes (noone knows what they are for), and one or two heavy-duty medical database servers, which are totally unused in a jumble of wires in a corner of a closet.

There are many horrible rumors about this hospital before AND after the disaster, which I cannot speak about since I was not there. I will say that I read signs at the hospital, stating staff attempted to extort money from patients (which is forbidden, obviously) but the system of administration itself causes economic segregation…

As I mentioned, starting on January 12, standard hospital procedures went out the window. All hospitals still standing after the earthquake, were told to open their doors to the public and offer free care. But there was not enough staff and supplies to serve everyone, so wealthier patients probably ended up getting better care. Eyewitnesses told me that Haitian nurses did not clean wounds, which turned into gangrene on limbs that were later taken off by foreign doctors.

When foreign medical professionals started arriving, they set up a clinic outside under tents, to treat the overflow of suffering patients. This “outside” hospital eventually began to be used as a place to send patients that cannot pay, unless they have an emergency and/or require surgery, which must be done inside the hospital building.  The hospital is clearly billing whoever they can (I saw the payments spreadsheet be calculated in front of me), and affording privileges to them. This is not necessarily wrong! But it IS hypocritical, if you are supposed to be serving the entire community with the same standard of care.

In the meantime, I observed dozens of visitors from the United States and Europe take strategically guided tours through the building. I suspect they were potential or existing donors. Despite all the donations sent to the hospital after January 12, the hospital has supposedly run out of money. There is a constant stream of medical supplies from abroad, which are continuously picked away by various people (staff does not keep anything especially valuable in the pharmacy, for example). The situation is much better than it used to be, and I am sorry if I sound too critical.

Within a few days, I created a file code system for the hospital and started an excel spreadsheet for unfiled documents. The Chief Administrator was pleased I took the initiative to create it, and will make sure employees keep using it. So I am glad I came, but more glad to leave.

1 comment:

Unknown said...

Good article, glad you were able to assist and create a difference. Hopefully the administration does adhere to your spreadsheet so they can be more consistent.

However, I am confused by your last words. 'more glad to leave'?