PHM-Exch> Universal health coverage (4)

[Claudio Schuftan]

From: massimo serventi <ser20 at hotmail.it>


I agree with what Remco van der Pass has written. It depicts well the
situation here in Nyala, South Sudan.

There is a war from years, people are poor,agriculture that was florid
because of enough rain is abandoned,food is distributed in camps.....
Children malnutrition is a problem every year. Maternal mortality is high,
vaccination coverage is 31%(!).

So, in this scenario one is surprised to see that most of health care is
provided through *private *medicine. *Inside* the main governmental hospital
of Nyala there is a 'second' hospital, totally private, where you may find
all laboratory and investigation facilities including CT scan and specialist
consultations performed by the same doctors of the hospital.
Antenatal care in Nyala is not free:mothers have to pay for the examination
AND for tablets of ferrous-sulphate. Delivery is also not for free. Most
mothers opt to deliver at home...but also here they must pay the midwife or
TBA.

This situation is well known to Sudanese doctors, they are professional and
skilled. But....their salaries do not allow them to maintain decently their
families, therefore private medicine becomes the 'obvious' source of income.
I was told that 70% of the government budget goes to military spending, and
less than 2% goes to health. Is it true? What to do? what to say?which is
the role that NGO should play? I wrote to them(all) this kind of letter but
none replied to me.

One point is clear to me: can I ,Massimo, who gets a salary that is 10 times
higher than that of my Sudanese colleague blame him because of conducting
private health businness? I cannot! but also my international colleagues,
working in UN agencies and international NGOs...CANNOT!
So.....

Thanks
Massimo
Pediatrician
Nyala
------------------------------

From: *MMI Executive Secretariat* <office at medicusmundi.org>
 From: remco.van.de.pas at wemos.nl
There is some shift in health systems thinking, both for the good and the
bad....
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