Earlier this week, yet another tragic story about several babies dying at a hospital serving a low-income neighbourhood made the news. It is shocking, tragic and utterly unacceptable. The loss for the families and the loved ones is unimaginable and words can provide little comfort to them. Various theories have been circulated. Some news outlets blamed power cuts, others suggested lack of oxygen in incubators and some thought it was malfunctioning ventilators. While some in the media were quick to blame doctors and the staff, it is unclear if it is a case of medical malpractice. It may very well be, and all those who are responsible should face justice, but there is a bigger problem here that needs to be addressed, or else we will continue to face similar tragic incidents and continue to lose our future to preventable causes.
Functioning hospitals require a functioning eco-system. It is particularly important in hospitals that operate in environments that have high population density and poor supply chain and infrastructure. As our population continues to increase at an alarming pace, and funding for health infrastructure continues to decline, hospitals will find it hard to cope with the burden of disease. I am not suggesting that there is no malpractice or incompetence, certainly there is plenty of that, but there is a much deeper problem here that is often ignored in the hype and emotion. Even if every single hospital worker was conscientious and did his or her job with utmost dedication, failure of equipment due to power cuts or lack of oxygen in the tanks due to budget cuts, or malfunctioning equipment due to parts that never arrive will plague our systems and continue to affect the most vulnerable.
As our urban centres get bigger and bigger, the challenges faced by our hospitals are also going to increase substantially. Inquiry into a single incident or dismissing staff of a single hospital is not going to solve the problem that we face as a nation. Reactionary policy is not going to do us much good. The lack of oxygen, for example, is not going to be solved by a single staff member, but needs to be evaluated at a systems level. We do not need to just look at an individual institution but the system as a whole. Just because this tragic incident happened at a particular hospital does not mean that other hospitals are immune to dysfunction.
Here, there are two things that need to happen if we are to improve our system. First, an evaluation of the hospital system and performance at the provincial level. This should be done by impartial experts, ideally from another province and those who have no political, personal or financial conflict of interest. If we are to solve our problems, we need to first identify them clearly. A transparent analysis will go a long way in improving the function of our health system. Second, we need to involve a bigger group of stakeholders in solving our problems. Technological breakdown, lack of any local capacity to solve problems with technology and poor supply chain management are common problems even in our better functioning hospitals. Rarely do we engage experts from engineering institutions or schools of management to create local solutions to our stubborn and persistent problems.
Better functioning hospitals are a backbone to not only a healthy society, but also a safer and more prosperous society. We need to ensure that our hospitals are a gateway to health, not a highway to preventable deaths.
Published in The Express Tribune, June 10th, 2014.
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