REFLECTIONS : Let’s be superlative in health service, too!

For a country that is making progress in superlative terms in almost all fields these days, Rwanda can least do with people chocking its service industry. You’ve heard how recently the country has shot up to the number one position in the world in reforming its doing business procedures, so that starting a business hardly takes two days. Before that, it was named number one in the world as the country with the highest number of women parliamentarians. And then it was as the country with the highest rate of reforestation in the world. When you think you are going to exhaust those superlatives, you remember that it is the first developing country to introduce mass vaccination of its children for pneumococcal diseases. And that’s not all! Rwanda has made the greatest gains in life expectancy in Africa since 2000. And in health service provision, and combating corruption? When somebody next remembers to rank countries, they’ll find Rwanda perched up at the apex. That is why it is doubly sad when you get lukewarm service anywhere in this country of firsts. Remember when I was singing praises to this hospital, Kigali Hospital and University Centre (of the French acronym, CHUK)? Alas, the service was superb only through the emergency ward! On a repeat visit subsequent to the first, we were advised to be referred by a smaller clinic as an emergency case if we were to access the same service quickly enough. That was when I was taking my brother, who in the end expired anyway. No, it was not through anybody’s fault. Anyway, this time I was taking myself to a relatively more equipped and more costly hospital, King Faisal Hospital. I’d been referred by a neurologist to the Radiology Department for x-rays of my lower back, so that he could determine what rendered my feet numb when standing. I expected to be through within minutes, an hour at the maximum. The exercise of taking x-rays didn’t take long, alright, but I could very happily have done without that waiting! From 2 o’clock in the afternoon, I wore out my bottom in that department until 5.30 in the evening when I was finally called. Yet, we were only four people the whole day!And when it came to clearing the bills, it took eons. Still, the hospital is exceptionally clean, a feature that happily seems to distinguish Rwanda from other African countries. Also, when I asked a fellow patient, conversant with the hospital, about its doctors, the man rattled off names of young specialists in practically all fields that would be the envy of other hospitals. However, from the reception you’ll be lucky not to wait an hour for your file to be retrieved. Most times, if it won’t be their electronic system that will be down, it will be their ICT programme that has just been installed and is not yet mastered by the workers. As soon as your file is retrieved, you are sent to another reception where again you are required to wait for it. On its arrival and after answering questions, you are sent to a row of chairs next to your doctor’s cabin. Why you are never allowed to take your file, which would be much faster, and why the number of reception areas has doubled, search me! Still, you finally wade your way through a forest of legs in the corridor, to finally deposit your bottom on an empty seat, where you join the lively conversation of the sitting crowd. As you sit, the animated conversation is from a young lady. “You know how the hospital prohibits food from out and yet the food is too little and the menu gives only one option,” she chuckles in excitement of her own story. When the consenting grunts have died down, she resumes: “We beat that by smuggling in food for our young mother through the back doors! We made it look like we were bringing in new napkins.” She was talking about a woman who had newly given birth, but the small example was enough to teach one big lesson: as a hospital, offer only what you can. What you can’t, leave it to the discretion of the patients and those looking after them. Most importantly, however, identify your priorities and do them superlatively. The core duty of a hospital is treatment: give the best. To give the best, you need the best doctors and other staff, as well as the best equipment. King Faisal Hospital may not have the maximum number of doctors and equipment that it requires, but given the goodwill of government that it enjoys, it is capable of using them maximally to render better medical service. The first step towards this good service may be in reducing the size of departments to make them smaller so that they can be managed more effectively. ingina2@yahoo.co.uk