Rampant corruption in health sector irks Faryab residents
MAIMANA (Pajhwok): The residents in northern Faryab province complain about rampant corruption in health sector and the inappropriate behavior of medical staff with patients.
But health officials insist patients are being provided with better health services. They blame the district chiefs of negligence in discharging of their duties.
Faryab is among northern provinces bordering Turkmenistan. It has around 1.7 million populations.
Although the health sector had considerable achievements in the last decade in the province with construction of many hospitals and health centres, residents and district chiefs complain the services provided are not satisfactory.
Abdul Razaq Kakar, Garzewan district chief, said the district had five health clinics with proper buildings. He claimed the personnel and officials of the hospitals were in connivance of mafia groups for themselves who were equally backed by influential and did not work properly.
In his chat with Pajhwok Afghan News, he said: “The doctors don’t come to work on time. They have opened their own clinics in front of the hospitals, charging high fees and selling counterfeit drugs.”
Kakar said ambulances charged extra money from residents and officials’ behavior with patients was a matter of serious concern. If officials tried to investigate, he said, they would face opposition from some powerful local elders who were supporting these doctors.
Garzewan district chief claimed Dr. Najib and Dr. Munir were extremely corrupt persons in the district. He had evidence of their graft and said had written letter to the health department many times.
Imam Yaar Taqwa, Kohistan district chief, said the district had 200,000 inhabitants with only two health clinics. Experienced doctors and professional services were non-existent, he added.
Taqwa added due to lack of professional doctors and quality medicine, residents took their patients to the provincial capital, which is located at a distance of 150 kilometres. Sometimes, he said, due to heavy snowfall and road blockade their patients lose lives on way to hospital.
He added construction work of a 20-bed hospital had started eight years ago, but still hasn’t been completed.
Ahmad Farhad, an elder in Qaisar district, said some wholesale dealers had monopoly on medicine in the district.
He claimed some of the chemists had brought doctors from Helmand and Pakistan and had opened private clinics, which had become a lucrative business.
Farhad added these doctors could not deal with emergency patients and were referring them to Maimana hospitals. For some patients, he said, they were prescribing 6-month long medicine courses.
But Dr. Abdul Ali Halim, director Faryab public health, said the district chiefs were also to be blamed for problem because they were not using their legitimate authority to stop such acts.
“Some doctors establish links with local councils and influential figures to gain their support. In the face of these problems, we sacked Dr. Munir, a senior health official of Garzewan,” he added.
Halim admitted due to insecurity, health inspection teams could not evaluate the performance of health centres in far-flung areas.
Halim added that cooperative health organizations were responsible for providing health services in districts and the health department was just supervising their performance. However, district chiefs were also responsible to oversee health affairs and enforce law to grill corrupt officials as well as share a report of health activities with the public health department.
He said that insecurity, interference of local health councils and autonomous health organizations were problems in districts.
“My monthly salary is 18,000 Afghanis, but an employee of an organization that works under my authority takes $3,000 to $5,000 each month. These employees never observe my rules and they don’t feel accountable about their tasks,” he said, adding the health organizations get fund from the ministry of public health but they were telling people in remote areas that they were working with their own fund.
However, Sibghatullah Silab Maulvi Zada, a member of provincial council, expressed concern over health services in Faryab districts and said that health personnel were not treating patients in a professional way. People in remote areas including Balcheragh, Kohistan and Garziwan districts completely deprived of health facilities, he rued.
Maulvi Zada said health officials charge patients heavily and a woman should pay at least 5,000 afghanis for a delivery case. Some powerful individuals support doctors who have private clinics in exchange of money, he said, adding the government should oversee these kinds of health centers and bring reforms.
Health director confirmed existence of arbitrary clinics and non-professional doctors in some areas and said that some individual supported by some powerful people and local influential individuals started their campaigns against health personnel to attract patients to their own clinics.
Dr. Halim said he issued directives through the provincial government to district chiefs and security officials to report him about the performance of doctors and clinics, but the orders could not be followed.
About the 20-bed hospital of Kohistanat, he said the contract of this hospital was inked with unidentified firm in Kabul six years ago and the construction of the vital hospital turned into some wrangling among different officials.
Besides existing issues being faced by the public health sector, the Afghan-Turk Hospital treated over a hundred women and children and provided them with necessary medicine on daily bases.
Jamila, the resident of green city in Maimana, said she always referred to the Afghan-Turk Hospital whenever she or any other member of her family got ill.
“We are happy that at least there is a facility where we can examine our ill and get medicine, although, there is too much rush and mismanagement,” she added.
Sahila, the resident of 8th municipality district, said her daughter had stomachache and referred her to the hospital. She said she is poor and did not have enough money to pay doctors’ fee, therefore, she brought her daughter to Afghan-Turk Hospital where she was treated free of cost.
Despite all facilities being provided, the personnel of the hospital sometime got threatening messages from rebels as a result the employee of the hospital had staged a protest last year.
They said whenever a suicide bombing or any other sort of attack took place security officials forced their way into the hospital and interfered in the affairs of doctor, created mess and insulted doctors.
On the other hand, the public health director said delay in construction of 20-bed and maternity hospital at a cost of $5.5 million in Faryab had put them in trouble. He said patients suffered due to lack of beds and services in current hospitals.
He said the hospitals under construction should have been completed in one and half year and transferred to the public health department, but three year had passed and the construction work could not be completed yet.
He criticised the construction companies and accused them of being supported by some figures in the centre. Halim said the owners of construction companies had been playing with the lives of the people and urged the president to cancel current contracts and open investigations against delay in the projects.
The public health department statistics showed that 99 health centers were active in Faryab, including, large hospitals in which 900 doctors were discharging their duties.
Halim said around 1.5 million people had been living in Faryab with 70 percent of them having access to health facilities and the remaining 30 percent could not reach to hospitals due to dilapidated roads and mountainous terrain.
Halim said the total salaries of public health department staff reached to $4.5 million paid by the Public Health Ministry and aid organizations.
He said the Turkis Cooperation and Coordination Agency (TIKA), and Agency for Assistance and Development of Afghanistan (AADA) have been supporting 51 clinics in 14 districts of the province.
He said the donors had agreed to provide 800 afghanis in next three years for health sector in Faryab.
Director public health said in addition to Afghan lady doctors, four Tajikistani midwives had been discharging their duties in Almar, Qaisar, Garizwan and Kohistanat districts. Every midwife gets $600 to $1,500 salary monthly.
Halim noted local doctors did not work for $1,500 in local hospitals because they earned more in private hospitals or if they opened their own clinics.
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