Hospital care

On World Health Day, 7 April, there were several articles that came up in the media; some very frightening stories about drug resistance due to the abuse of antibiotics.

Antimicrobial Resistance (AMR), which is considered to be the single biggest threat facing the world in the area of infectious diseases, is said to be currently on the rise in Sri Lanka. Health officials have warned that the trend in AMR was due largely to the misuse or abuse of antibiotics by the general public and doctors prescribing them.

Well, this is not surprising especially in the case of Sri Lanka, since we are a population known to dabble in self-prescription. Since almost every drug is freely available in most local pharmacies, the kind of abuse under discussion can easily happen. How this problem could be sorted out without a centrally managed system is something that must baffle even the experts.

Be that as it may and more on a mundane note, I came across some interesting observations made by Dr. Aruna Rabel, Director of Medical Services at Hemas Hospital.

He says that when a patient walks into a hospital, it is extremely important that he/she feels secure and assured that his/her life and health are in good hands. Isn’t this an obvious statement? But one can see that if he needs to state the obvious, then this matter must be in question!

Dr. Rabel says that this involves work on the part of the health-care provider, which includes assessing risks to patients and proper risk management so that risks to patients are minimised during the delivery of healthcare.

In other words, he says patients need to be assured that they are being diagnosed by professionally qualified persons, given the correct diagnosis and the correct medication or medical procedure, correct dosage at the correct times and more importantly, that the medication is not expired or contaminated.

He further stresses that patients should have the right to ask questions should they have any doubts or concerns, that they have a right to be treated respectfully and their consent should be taken prior to administering certain types of medication or exposing them to medical procedures. In other words, the hospital or healthcare institution has a responsibility towards the patient and is accountable to answer the questions they may have.

Dr. Rabel’s philosophy boils down to one thing and that is about the patient being empowered enough to have a right in the decision making process of his healthcare. Sri Lanka does not have the culture of suing when there is a medical mishap.

I know of a recent case where a hospital allegedly gave inaccurate reports on a highly contagious disease, which resulted in an inaccurate diagnosis. The accurate tests from another medical institution came too late to save the patient’s life. But no one sued the hospital, which repeatedly gave wrong test results.

Not that I am in any way advocating this practice, which actually puts all medical staff on a defensive mode and makes the entire process of cure rather legalistic, without the humanitarian factor which is still prevalent in our medical institutions. However, just because people don’t take legal action against hospitals (by far and large) here in Sri Lanka, it does not mean a careless attitude could be adopted by hospital staff.

On the same subject, something in particular that I have myself found, is the manner in which some senior nursing staff in private hospitals behave. Senior sisters act in a rude and arrogant fashion with absolutely no care for patients and their families who are more often than not already traumatised by the medical issue affecting them and need comforting rather than gruffness.

These are the important issues that need to be addressed in a National Medicinal Drug Policy for Sri Lanka. An article, which appeared in a local newspaper written on healthcare, asked a vital question: ‘Is Sri Lanka ready for the next step?’ And that next step was the setting of policies, standards and a framework as well as independent bodies to assess, monitor and certify hospitals and healthcare institutions in the country. Well done, Dr. Rabel!

(The writer, a PR consultant and head of Media360, was previously a mainstream journalist in print and electronic media. He also edits a new media website.)