No Relief from Lebanon Burn Unit Bureaucracy
By: Nagham Tarhini
Published Monday, December 10, 2012
In the southern Lebanese city of Saida, the Turkish Emergency and Burns Hospital is fully equipped and would appear to be ready to receive patients. Yet the hospital’s doctors are not making their rounds and the doors remain closed to patients.
The problems keeping the hospital inoperable are numerous. A management board has not been appointed due to political reasons and there are concerns over the condition of the medical equipment at the hospital.
Several suggestions have been made on how to get the hospital up and running, according to Dr. Ali Abdul-Jawad, chairman of the management board of Saida Government Hospital. He proposed that his board temporarily take over the running of the new hospital on a voluntary basis until a management board of its own can be appointed.
This initiative was not received enthusiastically, but it remains on the table. “The process of getting the hospital opened and appointing a management board could take a long time,” Abdul-Jawad explained. “Accordingly, and given our experience in opening Saida Government Hospital, we proposed that we temporarily take responsibility for managing the hospital, without any financial return from the health ministry.”
Abdul-Jawad also worries about the effect of further start-up delays on the hospital’s medical equipment. “It goes without saying that with the passage of time, any equipment ceases to be new,” he said. “The passage of more than a year raises questions about how well the medical equipment will operate, and whether the cost of materials needed to operate some this equipment can continue to be covered.”
Mayor Muhammad al-Saoudi put forth an alternate proposal wherein the hospital would be co-run by the municipality and the American University of Beirut (AUB) Hospital in order to secure funds for two consecutive years. “Nobody could manage the medical administration better than AUB Hospital, while the municipality would be willing to manage the official paperwork,” he said. In fact, the municipality donated the land on which the facility was built.
An opening date for the Turkish Hospital is not merely contingent on the health minister agreeing on one of the two proposals. In addition to the deadlock over the appointment of a board of directors, there are also financial concerns. An AUB study estimated that the hospital would incur an operating loss of around $12 million in its first five years before it began covering the cost of the emergency and burn treatment it provides.
The situation seems better at the Nabatiyeh Government Hospital. The new burn unit there is not quite ready, but the patients’ beds are in place, as are the treatment facilities and the newly-built specialist operating theater. The official promise for an end-of-year opening date is believable and the hospital staff are optimistic that it will be functioning soon.
The hospital director Dr. Hassan Wazni spoke confidently of the final arrangements being made ahead of the opening. Many of these concern medical staff, he explained. Burn patients need follow-up treatment, such as plastic surgery, but there are no specialists in this field in the Nabatiyeh district. A solution has been found by making personal arrangements with various doctors to treat patients at the hospital or receive them at their private clinics.
There have also been official promises of financial support. The high cost of running burn units is the reason other government or private hospitals don’t have them. Wazni said that after talks with the health ministry, it sought to provide a “limited” amount of funding to ensure the unit has a successful launch.
For Wazni, there is only one way to guarantee the survival of a high-cost facility in a government hospital: to allocate the burn unit a separate budget from that of the hospital as a whole.
“The treatment fee paid by the ministry or health insurance funds remains very low compared to the cost of treating a burn patient,” he explained. “This means a financial loss, and the other sections of the hospital cannot be expected to subsidize it.”
This article is an edited translation from the Arabic Edition.