Kuwait Times

Published Date: January 25, 2009
By Dana Khraiche, Staff writer

PART III

In the early hours of the morning, most Polyclinics in Kuwait  are packed with patients, all waiting for an answer to their health concerns. And the only people who could help them are the doctors.

Medical care may stand on the shoulder of nurses, but doctors provide the care and carry the burden of any flaw in the health system. Those who answer the questions, diagnose the problem and try their best to relieve any pain, think the problem sometimes lies in miscommunication.

"There is no adequate health education; the expectations of doctors are wrong," said Dr Ebi Dambo who has been working in the industrial medical field for almost 13 years. He also noted that patients flood the hospitals on a daily basis with various minor problems thinking that at hospitals "they will get better treatments than polyclinics."

In a recently published article, Dambo noted that the clinics are not as bad as we might believe. "One can get the best out of them if there is a good understanding of their capabilities and limitations as well as relating properly with the health staff, especially those attending to you."

What patients don't realize, however, is that the health care system in Kuwait is designed in such a way all health issues start at major clinics and move on from there; "Doctors could refer you to the hospital or to a specialist clinic" depending on the case at hand."

Dambo admits that there might be a problem especially in terms of  language barriers. In his article, he writes about misdiagnosis by a doctor due to misunderstanding the patient.

"Sometimes it is difficult to communicate with someone when you don't speak their language, but there should be translators so the doctor could understand what is wrong with the patient," one women said noting that perhaps the misdiagnosis for her maid was due to the doctor not understating "what was wrong with her".

"A proper understanding of what is being communicated is essential to receiving adequate attention and the right medication. Present your symptoms in an audible, clear, and slow speech," Dambo writes.

Dr Madhava Rao agrees with Dambo, saying that the proper mechanisms are necessary to deal with the miscommunication problem. "The language barrier presents sufficient communication difficulties," Rao said. He added that, in his view, the solution lies in looking at other countries such as the United States with multiple nationalities where language presents itself as a problem. "We don't need a translator or health professionals that know many languages, but we need an elaborate system that puts people in a position to understand the popular language," said Rao, who has been working in Kuwait for 10 years. He added that an in-depth study of what the residential groups are could be a start.

Unlike Dambo, other medics find many disturbing issues that come across them every day in their treatment rooms.  "The patients sometimes tend to act as if they know more than the doctor and tend to be overbearing, especially when it comes to their kids," said one dentist, who's been working at the public health sector for 20 years.

Some patients don't stick to the drug dosage prescribed by the doctors and other show disrespect for the time and effort sacrificed by those trying to help them.  "I get people that take a number and just leave afterwards they come back and ask to be attended to," said the dentist.

A doctor's visit relies heavily on a give-and-take policy. "Explain exactly what you want in a coherent way and I will try my best to figure out what the problem is, and if I don't then I'm cheating the oath I've taken," said one public hospital doctor.
What the health care system needs to improve itself is adequate distribution of resources.

"There needs to be better budgeting, more equipment and a better understanding of the patient-doctor ratio," said Rao who also believes that the system is there to serve the patients and doctors are merely part of that system.

For Rao, the problems are a natural part of the job. "Interacting with patients is difficult and the job of a doctor is hard, but with the proper mechanisms, they can make the job easier."

For doctors like Dambo, the health care system in Kuwait is good.  "Every person can get to a clinic in 10 minutes, " Dambo said. He also praised the referral system in clinics and hospitals.

"The health care system here is one of the best in the world compared to other countries," said Rao. But increasing the number of doctors, better budgeting and overcoming the language problem could definitely improve the system because it is initially designed to serve the patients and provide "the best proper care".

This is the third part of a three part series examining problems facing the health sector in Kuwait. The first part discusses patients' opinions of the medical sector and the quality of treatment and the second examines the issue from the perspective of nurses working in the public and private health sector in Kuwait.