Happy Birthday Free Health Care!
on Shona in Sierra Leone (Sierra Leone), 01/May/2011 11:01, 34 days ago
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Wednesday 27th April 2011 also marked a year since the introduction of free health care for all under-5s and pregnant and lactating women in Sierra Leone. It’s a year which has seen a lot of changes in the health service. The doctors and nurses went on strike for an increase in their salaries to make up for the loss of income from charging patients. The number of admissions to the hospital more than doubled in 2010 compared to five years ago. There have been many teething problems with the initiative. For example, there is still a drastic shortage of drugs in many areas up-country. Or they got sent unsuitable drugs e.g. anaesthetic drugs being sent to peripheral health care units. There is a drastic human resource crisis. There are no where nearenough doctors, clinical health officers or nurses working in government services to provide the care that increased access demands. Some doctors and nurses, alas, still try to charge patients. Education is a massive issue; many patients still ask me how much the drugs and tests will cost.And there’s a question of sustainability. Free Health Care is mostly being paid for by DfID (the department for international development). The means you – the UK taxpayer. DfID pay for me to be here too. The Salonean government can’t pay for this by itself – and despite diamonds and iron ore, it will be many many years (if ever) before the government will be able to pay for it. And no matter how many patients I see while I am here, when I leave there will be one fewer doctor in government service. I could stay in the hospital 24/7 and I could not save every child in Sierra Leone. Which is whyI far prefer teaching, training and capacity building (sorry for the NGOish language!) I teach 27 medical students – they will graduate next year and I just hope that most of them will stay working here, and go on to become paediatricians.Despite its problems, I think that Free Health Care is a great scheme. It clearly has a long way to go. Increasing access to basic health care can only be good for the long term public health of the country. I continue to have great hope for the future of Sierra Leone. I think that, in the long run, it will be worth the investment.
