Good Medical Care

A senior doctor is doing his morning rounds in the Abu Ali Sina Balkhi teaching hospital in Mazar-e Sharif. An older man with a slightly worried expression looks at the doctor, who is carefully bending over his bed. He expertly feels the patient’s body, checks the infusion and discusses the treatment with the nurse. The accompanying junior doctors listen with interest to the senior physician’s explanations – business as usual in a hospital.

But until the beginning of 2012, everyday business in this provincial hospital was very different. In 2006, a fire destroyed the previous hospital building completely. Managing Director Dr Mohebullah Jawed remembers the situation well. ‘We had to look after patients in tents and containers,’ he says. ‘We even conducted surgeries there, too. The mortality rate was accordingly high.’ Yet the hospital serves many people, providing treatment for around half a million inhabitants of the city of Mazar-e Sharif, and it is the only referral hospital for the 1.25 million people who live in Balkh Province. According to Professor Mohammad Nader Alemi, the Head of Psychiatry, the medical care situation was becoming increasingly fragile: ‘The pressure on our work was rising all the time. The difficulties in caring for patients were getting more and more out of control.’ Then the German Government financed the construction of a new hospital with modern equipment.

The working conditions have improved greatly for the staff. The hospital has resumed its teaching activities and now trains around 50 young doctors on a continuous basis for three to five years. Dr Gholam Haider trains young internists. He is satisfied with the situation now: ‘The new hospital was finished in just two years. We meet the highest medical standards in terms of diagnostics and equipment. Now we have one of the best hospitals in Afghanistan.’ The medical specialists working on the eight different wards have seven operating theatres, an intensive care unit, an emergency department, an x-ray room and laboratories at their disposal. When dealing with complicated cases, they can use modern telemedicine equipment to consult colleagues around the world. The hospital has 360 beds, more than 20 of them in the emergency department. Dr Yawezi, who heads the training programme, says that this benefits not only the patients in the teaching hospital: ‘We now have the perfect conditions to train young specialists in a range of disciplines. After their training they move to other provinces and districts here in the north, bringing the required know-how to provide adequate treatment for the people.’

But the young doctors take more than specialist medical knowledge with them. In the Abu Ali Sina Balkhi teaching hospital, they also become familiar with efficient workflows and good hospital management. In recent years, over 400 employees at the hospital have received training and on-the-job practical instruction as part of the project financed by the German Government. The hospital personnel have streamlined workflows, reorganised the flow of patients, optimised space allocation, introduced electronic patient records and stock keeping as well as improved waste management and maintenance. A total of 14 well-qualified technicians ensure that the installations and devices function properly. They can carry out all necessary repairs and maintenance work themselves.

A place for mothers and children

Things are going well on most of the wards. The exceptions are the paediatric and maternity departments. Dr Malalai Laghman is a young doctor currently training in gynaecology and obstetrics. The situation here is still very unsatisfactory, as she describes ‘In the maternity unit we sometimes have to place three patients in one bed because we simply don’t have enough space. Additionally, we lack modern diagnostic instruments, which means we can’t provide the best care for mothers, unborn babies and children.’

The German Government is therefore supporting the new hospital’s expansion with a mother-and-child centre, which is scheduled to go into full operation at the end of 2018. It will then have 160 beds for expectant mothers and another 160 on the children’s ward. Modern medical facilities will ensure that patients receive the care they need. Laghman is aware of the new plans and is optimistic about the future. ‘The new centre will make our problems disappear,’ she says. ‘Then we will have enough space and the best possible treatment options. I am delighted that I will be able to continue my training there and work with the modern equipment.’

Publication: 09/2018
Programme: Rebuilding the Balkh regional hospital in Mazar-e Sharif, with construction of a new Mother and Child Health (MCH) Centre; capacity development at the regional hospital in Mazar-e Sharif
Commissioned by: German Federal Foreign Office (AA)
Partner: Afghan Ministry of Public Health
Implementing organisations: KfW Development Bank
Provinces: Balkh
Programme objective: To develop a well-functioning health system with a modern hospital infrastructure and qualified staff as a contribution to the country’s civilian reconstruction.

 

We now have the perfect conditions to train young specialists in a range of disciplines.
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