Lal Aqa Sherin
KABUL, Aug 5 2009 (IPS) – Forty five-year-old Rahima thought she was going to die. Her family had checked her into Shenuzada, a private hospital in Makroyan in the Afghan capital, for an operation on her abdomen.
Patients say private hospitals and clinics charge exorbitant fees for sub-standard services Credit: Najibullah Musafer/Killid Media
Our mother was in a coma when we brought her there, says her son Janshid, who sells flowers in Kabul. But it wasn t the abdominal sickness that almost killed Rahima. It was the operation at Shenuzada.
During the operation says Janshid, bacteria infected the wound. Her left leg is now paralysed and may have to be amputated. She needs a great deal of treatment.
My sister can t walk, says Rahima s brother, Muhammad Ajamal Baraki. She just lies in bed. Doctors say that her leg should be amputated, or else her life will be in danger.
Rahima is now back home with her children in a two-storey building in the Kart-e-Parwan section of Kabul. She spends her days lying in a single bed on the second floor of the house. Her only activity is watching television. Her only respite is talking with her children.
Baraki says that the doctors at Jamhuriat Hospital and Aria City Hospital told the family that due to a blood clot and vein inflammation a complication from her surgery at Shenuzada her leg must be amputated.
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There are four doctor s named in Rahima s medical documents, but Dr. Sediqullah Dawari was chief among these and agreed to go on the record with Killid.
Her leg did not become paralysed during the operation, Dawari says. The patient might have gained too much weight. When a blood clot forms it blocks the main artery. It is not the fault of the operation.
Dawari says that if the blood clot was caused by the operation, it would have happened a week or two after the surgery. They are looking for an excuse this is a conspiracy.
But Baraki says that this is not a conspiracy at all. He blames the recklessness of the doctor on his sister s near fatal injury. I took my sister to Shenuzada Hospital, he says. She was in very bad shape. The doctor there said that it is not serious, and she will recover soon. But she did not recover. Then we took her to Jamhuriat Hospital and from there to Peshawar (Pakistan). Now her leg is paralysed.
There are currently 1,677 government-run hospitals throughout Afghanistan. There are 156 private hospitals and clinics, 67 of which are in Kabul. In addition to these facilities, there are hundreds of medical laboratories throughout the country. Many of these are poorly regulated and patients say, charge exorbitant fees for sub-standard services.
Janshid says that in addition to the worry of his mother s recovery, he also fears retaliation from the head of the hospital, Dr. Aminullah Khan.
Janshid claims that the doctor threatened him. He said, if you go to the attorney general, the doctor will defend himself and you will be in trouble, Janshid nearly breaks down in tears as he recalls the doctor s words. They said, We have your signature, we are not responsible .
Both Dr. Aminullah Khan and Dr. Dawari reject that they threatened the family.
Dr. Dawari says that doctors work with a patient to heal them. They should have come to me, he says. Instead, they announce their problems on the radio and on television. It is too bad to hurt a doctor s reputation this way. I never said that I didn t operate on her. These complications arise in every hospital in the world during important operations.
Rahima s operation was conducted in January 2009. The total cost of the operation, including rent for the room she recuperated in was 55,000 Afghanis (1,118 U.S. dollars).
The total expenditure in Kabul and Pakistan reached about 200,000 Afghanis (4,066 dollars), Janshid said. We spend and we spend but there s no improvement in her condition.
Gul Agha, a resident of Nangrahar, waits in front of Shenuzada Hospital holding an enormous bundle of papers, prescriptions and x-rays. The documents are for his mother, who is very ill. I am out of money and each time I buy a new prescription for her, the doctors tell me she needs more x-rays. Still, my mother s illness seems to be incurable.
I am not unhappy with the x-rays, he adds. But the cost is very high, 500 Afghanis (10 dollars) per x-ray. Where do I get such money?
They take so much money, said Ikramullah Aminzai, who was rushing from the hospital on a recent afternoon. Just to have a malaria or yellow fever test costs 900 Afghanis (18 dollars). It is some kind of looting.
Dr. Abdullah Khan says that people s objections to the cost are valid, but only to a point. He says that the hospital has many new, computerised pieces of equipment, which cost more to operate.
We have modern equipment, Khan says. If a test costs 50 Afghanis (1 dollar) on a normal microscope it might cost 100 Afghanis (2 dollars) here.
But Servis Khan is having none of it. He says that hospital owners force patients to rent luxury rooms at a much greater cost.
Hospital owners reject these claims and say that the kind of rooms patients rent is entirely up to them.
(This is the first of a two-part investigative series on private health care in Afghanistan by Killid Weekly. IPS and Killid Media, an independent Afghan group, have been partners since 2004.)
