Jordan Times
Thursday, August 26, 1999
Al Bashir improves but complaints still flow
By Suha Ma'ayeh
AMMAN — Mai Ya'akoub, 15, was gleaming with joy outside the maternity outpatient clinic of the ageing state-run Al Bashir Hospital that looks after more than 5,000 patients daily.
The teenager, a frequent visitor to Amman's main public hospital, said services and overall hygiene at the site had improved dramatically since His Majesty King Abdullah made three surprise visits to the institution since April.
The King asked the hospital's management to clean the institution, improve services and to maintain all of its 11 defunct lifts, especially those in the emergency wards.
“Services are fine, I only had to wait for one hour after the appointment,” said Ya'akoub, expecting her first baby in the next few days.
She said she found the ward cleaner than before, while nurses and doctors were in general politer and more attentive.
Her mother-in-law, Muna Abdul Fattah, who accompanied her, remarked that the hospital had changed after the King's visits exposed its mismanagement and other short- comings.
“There is no pressure,” said the mother of nine, sitting on a pavement with five other women.
“But another visit is needed to keep staff on their toes,” whispered her neighbour.
Despite the two women's upbeat assessment, many visitors and patients interviewed by the Jordan Times said most changes after the King's visit were cosmetic.
They still complain about administrative bureaucracy and favouritism, about test results still getting lost or confused and about a shortage of beds.
Al Bashir, which caters to impoverished and low-income citizens, has for years been at the heart of public and official criticism of national health services.
King Abdullah's unannounced stops helped highlight an appalling level of uncleanness and services.
He was shocked to realise that all of the hospital's lifts were out of order and that in many cases sanitation workers ferried emergency cases between wards.
The government formed a committee in May, chaired by Minister of Health Ishaq Maraqa, to oversee the running of Al Bashir, the capital's sole fully-fledged public located in the low-income and densely-populated Ashrafieh area of eastern Amman.
The committee dismissed Mahmoud Awad, former head of the hospital, and replaced him with Zuhair Teef, former head of the ministry's primary health care programme.
Though most patients interviewed said that the level of hygiene has improved, the majority still have complaints, depending on the seriousness of their case and the treatment they are undergoing at the 874-bed hospital.
Ismaeel Ahmed, 63, said doctors decided he needed to be hospitalised after he was taken to the facility on Thursday suffering from a blood clot in his right leg.
However, a shortage of beds meant he could only get primary treatment at the emergency unit, and doctors asked him to come back in two days to be admitted for further specialised treatment.
“We are waiting for God's mercy,” said his wife, who was sitting outside the internal medicine ward.
Safeyeh Deeb, 57, sitting next to the couple, with her back against the wall was also hoping to be admitted at the ward.
Deeb, whose frail face was etched with lines of misery, is suffering from cancer. Her leg was swollen from the growing tumours.
“I had my stomach removed last year, doctors only left me with a small piece,” said Deeb, eating a falafel sandwich.
Deeb, an illiterate, who has been receiving weekly chemotherapy sessions over the past year, said that during a routine check up doctors assured her that she was in a “good condition” based on an X-ray, even though she was in pain.
However, her relative discovered three months later that the X-ray did not belong to her.
Insaf Abed Hiyatiyah, whose 15-year old son suffers from albuminuria, said every year her son is admitted to the hospital to remove excess fluids from his body.
The tearful mother said doctors decided to run lab tests to determine if they needed to sample his kidney tissue.
“My son slept for four days and then the lab tests were lost,” lamented his mother who said the JD100 she had paid were wasted.
“People say that things have improved... but mean attitudes seem to prevail. Patients need their morale to be boosted, but we only get more frustrated,” said the mother of eight, who lives with her family on a monthly income of JD150.
Abu Maher, standing outside the X-ray department, said he obtained an X-ray five days after it was taken, only through networking with personal connections (wasta).
“Doctors are not available, and nurses don't treat us well,” he said.
Amal Hassan, 24, who complained her plastic slippers were stolen at the emergency ward, noted that hygiene standards improved noticeably, but still she had to wait for a bed.
Teef, who took over the hospital's management in June, said administrative reform remained the key to boosting the performance of existing staff and operations at the hospital.
In parallel, the government is also planning to upgrade, rehabilitate and expand the existing hospital with new buildings under a three-stage plan, with an estimated cost of $40 million.
The government has allocated $12 million of a $50 million loan taken in 1998 for the first stage.
Officials are also hopeful that once the Prince Hamzah Hospital is built near Amman, it will ease congestion at Al Bashir.
The government is expected to sign in October a loan agreement worth JD50 million with the Kuwait-based Arab Fund for Social and Economic Development to construct the 420-bed hospital.
“If there is no monitoring and supervision, the hospital cannot provide the right services,” Teef told the Jordan Times on Saturday.
Teef said he had improved the operations of existing teams monitoring food quality.
He said hospital employees were testing the water quality twice a week, a rarity in the past.
In addition, he said about 70 water storage tanks on the roof were installed.
Qasem Na'asan, director of the building directorate at the Health Ministry, said two lifts in the emergency ward were back in full swing while the rest will become operational by the end of this week.
Five lifts were installed in the internist, surgical, X-ray, maternity and children wards.
Teef added that the government has earmarked JD450,000 to provide the hospital with badly needed fixtures and medical equipment.
The hospital employs 754 nurses, assistant nurses and midwives. But this number is well below the needed staff.
Teef complained that half of the 1,200 patients who seek daily treatment at the emergency ward are not “emergency cases.”
The public sector's 22 hospitals and nearly 1,000 outpatient clinics charge nominal fees, well below the actual cost of treatment, according to health officials.
Nearly 1.3 million civil servants and their families-benefit from government-sponsored health insurance introduced in 1965.