As I have mentioned on the blog many times before, I have been spending Mondays at Mbabane Government Hospital (MGH), trying to help out however I can. There are many problems facing the eye department there.
To start off, I must say that before
I even left Siteki for Mbabane this morning, one of the optometrists called me
on the phone and asked if I had left Siteki yet. She was in a panic
because Dr. Msiska (ophthalmolgist at MGH) had run out of viscoelastic and had
no way to obtain more. Without this precious viscoelastic, he cannot do any
cataract surgeries. I called Sister Senani, who agreed to give them what she
could (3 boxes, 15 total viscoelastics—enough for only 15 surgeries). I stopped
by the clinic and picked them up. As Dr. Pons and Sister are aware, we have
been “bailing out” MGH on their lack of supplies. We have given them numerous
drops, viscoelastic, etc over the past months.
At any rate, I have been trying to
solve several problems while there. I know it isn’t my job, but it is a way to
establish rapport with them and also for me to see the problems facing the eye
clinic at MGH. Jono is very agreeable to letting me spend Mondays in Mbabane.
Today, Angela (the clinic
administrator) accompanied me. She wanted to talk to the MGH administrator
about numbers (salaries for optometrists, what is needed to start a new optometry
clinic, etc). This information will be useful when Jono visits with CBM Canada
in early November, so he can make a coherent presentation regarding funds
needed for an optometry unit here at GSH.
So there are many problems facing
MGH, the biggest right now, as I see it, being supply of goods. It is a very
convoluted, complicated problem and is not as easy to “fix” as it might
initially seem. First off, they have the funds to purchase drops and surgical
supplies. However the funds have been
FROZEN for over ONE year, secondary to an audit of the department. That’s right,
all funds to purchase these items cannot
be accessed until the audit is over, and it is still going on one year later.
So, they turn to us (GSH) in times of need, but we don’t really have enough to
keep them in stock. I asked why we couldn’t just insist that the government
give us some supplies for surgery (despite the frozen funds), and I was told
that Dr. Msiska has tried repeatedly to get these items, to no avail.
Apparently the government hospital owes a lot of money to the supplier, and the
supplier will NOT give anything more to the hospital until the bill is at least
partially paid. (An aside: this is at least what I have been told. It is very
difficult to piece together the whole problem because the departments seem so
fragmented).
Yet another issue is regarding MTN.
MTN (the ONLY cell phone company in Swaziland) has agreed to donate a
significant sum of money over several years to the eye program/cataract surgery,
etc. However, they will not give
these funds until someone has been hired to oversee the use of the funds to
ensure that they are being spent correctly and honestly. Apparently they had
gone so far as to interview people for this position, but then the government felt
they didn’t have the funds to pay this administrator, so the post went
unfilled. Now, the MTN funds sit unavailable until there is someone hired to
look after the money.
I have been trying for several weeks
to get meetings with anyone in the Ministry of Health, and today I finally
succeeded! I got the number of Dr.
Zwane, the Principal Secretary to the Minister of Health. I tried calling him,
but he was in a meeting. So I got directions to his office, took Angela with
me, and showed up at his office! I think he was quite surprised, but being that
emails and phone calls to others in the ministry were not working out (many
emails unreturned), I decided to grab the bull by the horns. (Angela and I found it funny that we were even able to walk into the Prinicpal Secretary's office and meet with him without a standing appointment...this certainly would not be possible in the U.S.!)
I was extremely nice, as was Angela.
He was very nice, and said he was really glad we stopped by to talk to him (we
had to wait an hour to get our turn, but at least we got our turn!) He said
that many of these supply issues were being brought to his attention for the
first time, which I believe to be true. We talked at length and I told him my
concerns. That GSH is having to bail out MGH all the time, and this is not
feasible or reliable. That they have a great ophthalmologist on hand at MGH,
who cannot do his job due to lack of supplies and frozen funds. I also
discussed how I am here for another six weeks and am trying to make change
however I can….
He said he understands. When I said
I’d be in touch, he suggested we meet again next Monday! When I asked how best
to contact him (via secretary, etc) he said his personal email or cell phone,
both of which he provided to me and Angela.
I am not naïve enough to think that
this will solve the problem. I think we still have a long way to go. But if I
can even fix the problem a little bit, or get them thinking, I will feel like I
have done some good. It is a difficult issue here (I could go on forever about
other issues that I am trying to sort out…) Some days it is very frustrating,
but I am trying. I am not sure if talking to Dr. Zwane will even make any difference, but I feel like I am
doing MY part and can leave feeling like I did “everything I could” to make
them listen. If I had never spoken to them, or just let the emails go
unreturned to others in the MOH, I think I would always wonder if I had really
given it my all.
At any rate, one small step forward
today, and it felt good :-)
Jono is away in Cape Town this week
at meetings for eye development, etc. I am holding down the fort here with the Patels.
I hope this gives you a small insight into the current "supply" problems here in Swaziland. There are SO many other problems (such as having no pathologist, etc), but I feel like I can only tackle one or two at a time, or people will quit listening.
I hope this gives you a small insight into the current "supply" problems here in Swaziland. There are SO many other problems (such as having no pathologist, etc), but I feel like I can only tackle one or two at a time, or people will quit listening.
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| Dr. Zwane, the Principal Secretary to the Minister of Health |
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| Ministry of Health in Mbabane |
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| Ministry of Health Building. I made it! |
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