Monday, 9 December 2013

Medical Misadventure in Saudi Arabia

Medical Misadventure.
I love that term.
It sounds so...oooooo.  Like Dr Jekyll and Mr Hyde, body part smugglers and morgue miscreants!
The definition of the term is worded with far less deviant excitement - 'Medical Misadventure', according to insurance blurb, 'is personal injury caused by medical error or mishap'.  Lately, there seems to have been a lot of medical misadventure in Saudi Arabia.

A number of stories in the papers over the last few months tend to indicate that the standard of care in Saudi hospitals is a bit questionable.  A girl being given HIV tainted blood, a teen dying after simple surgery from an allergy to antibiotics, fake doctors being hired, a child being given chemotherapy by accident and, the latest, surgical tools left in a woman after a cesarean section and a baby with a dummy taped to his mouth.  These  events, though shocking, are hardly surprising say a few nurses I know, who often comment on how things have been changing in Saudi hospitals over the last couple of years.  And not necessarily in a good way.

They feel there has been a push, lately, to get rid of western nursing and practitioner staff from many hospitals largely, presume the ladies I know, for cost cutting and Saudization reasons.

It seems a bit of an oxymoron to say Saudi Arabia has to cut costs.  Saudi is generally viewed, out in Average Joe West, as the richest country in the world - all that oil money lining the streets, (and funding questionable activities), is also presumed to provide the best health care (well, top of the line equipment anyways) along with its high paying nursing jobs.

But Saudi is entering a new age.
And cost cutting in the health system appears to be the new buzz.
Though I get the impression that cost cutting here is not out of need, like in good ol' NZ where we aren't rich (even though we had a boat recently competing in an event only three countries in the world can afford to be in!)  Cost cutting here is more about making money for the blokes at the top of the 'I Own A Hospital' pie.

Western nurses cost more, so for purely accounting purposes it makes sense to limit their numbers.
However, with the cancelled contracts of western nursing staff is going quality care, and it's being replace by attitude.

According to my friends, life in Saudi hospitals currently goes something like this, generally speaking:
The trend for the new breed of nurses coming out of Saudi medical schools is to be choosy about their working hours, the patients they will care for and the jobs they will, and definitely won't, do!

The trend for the new breed of doctor taking up positions in Saudi is to want hand maidens who will idolize, pander to and generally treat doctors like god's gift to medical science, but never question them.  Those doctors who have spent a large amount of time (note: LARGE amount of time) training, interning and working in the West tend to be better doctors say my friends.

The trend for western nurses is to question everything - they were trained that way, and, as you can imagine, they get on the wick of doctors who want nurses meek and mild.  Other ethnicity's can't afford to rock the boat, so don't.  Plus they become so used to the handmaiden role here in Saudi that critical thinking skills, if they ever had them, are lost in the mists of time in.  Truly, I've seen it.  My current doctor who worked in the UK for 20 years prior to moving here, was attempting to train the attending nurse (as you do) by discussing my symptoms and asking her basic questions.  The shock of having to participate in something more in-depth than taking my blood pressure or handing me a referral slip was too much and she sat motionless on her stool with big round eyes making 'Ahhh, Uh' noises and looking like a stunned mullet!  The doc looks at me, puts his hands on the desk, heaves a sigh and, shaking his head, says in the tone of a man watching mold grow on bread, 'She knows nothing!' I got the impression he was finding adjusting to this country's quirky ways a tad difficult.

Anyway, I'm wondering where in this melee of personalities and posturing and politics is concern for the patient?

Here's a story:
The western nurse has prepared the room for a medical procedure.  The doctor enters and the nurse steps aside indicating the prepared equipment.  The doctor says something along the lines of 'I don't need all that' and begins the procedure without even putting gloves on. (The procedure is a lumbar puncture folks, not putting band aid on scratched knees!)  The nurse cajoles the doctor into using standard aseptic technique.  The doctor grudgingly does so.
The doctor thinks the nurse is 'too fussy' and likes to say so every time they have to work together. 
Says the nurse to me, when wanting to dump her frustrations about the declining standards she's noticed over the last year or so in the hospital, 'These are doctors and I have to treat them like children to get them to do basic things properly.  They just don't care!, she says'.
'And do you know what', she added, 'this same doctor had a family member come in for a procedure and insisted that I be the assistant because she knew I'd make sure the attending doctor did things correctly'
With the country building new hospitals and medical centers around the country, there is a huge need for medical staff, preferably well trained.  But Saudi seems to be taking all comers at the moment and with that comes the risk of getting medical staff whose professionalism in the job is questionable.  If things aren't taken into hand soon, say the nurses I know, more lives will be lost or patients injured unnecessarily in Saudi Arabia from very preventable medical misadventure.

Ka Kite,

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