“We don’t need only to think about the security, but also need to worry about the health services in Somaliland and we should know that it can’t be relied on!” Mohamed Jibrill
Weeks ago, my cousin had suffered an evil eye illness in Borama, and she fell down to the ground unconsciously, my young sister was with her and she called for emergency assistance and they were brought to one of the hospitals in Borama. Shortly after she was admitted on a ward, the doctors had been asked for help, who were on shift on that day. They came hours later and all that time my cousin was unconscious. When the doctors came, without identification of the nature of an illness and the problem, without sending the patient to the examination boardroom and without asking for her health history, they injected her with insulin. The patient has been given few minutes Break and when they came back she was in a coma and they gave her an injection for the heart.
After minutes, the doctors left the ward. She got up, and asked the people who were there and why she was there. Without answering, she has been asked if she was able to stand up by herself. She was okay and she was able to stand up and walk around the ward. My family asked the doctors’ permission to take the patient home and she was discharged and allowed to go home.
When my cousin arrived home, she fell down again, my family realised there was nothing in the hospital and there wasn’t any medical opportunity available there. This time, they understood they didn’t need to take her somewhere without examination treatments.
My family decided to call for on this occasion Sheikh’s from Masjid for reading Qur’an and Evil Eye Expert. When the Sheikh’s and Evil Eye Expert came home and started reading Qur’an my cousin shouted different voices from her own inside which was not her normal voice. The words she were shouting included “we are going out, stop reading Qur’an” the Evil Eye Expert took out his bag reading Qur’an facility include; microphone, speakers and electronic devices, he normally uses for Evil treatment.
When the Sheikh read the Qur’an again, my cousin started yelling and the Sheikh took conversation with the Evils and mentioned to the Sheikh, they were moving from and going out. The sheikh did make covenant with the evils and asked never come back to her. After that day, my cousin has got relief and never again got any problem.
When the issue was sorted out, I asked my mom, why she didn’t take the doctors who did those medication errors to the court? My mother asked me whether there was a Criminal prosecution of medical professionals. But, I couldn’t answer that question because even I didn’t know litigation system and patient protection policy in Somaliland.
I tried to find some information related to the legal aspects of Somaliland, but I couldn’t find, I tried to ask some questions to my friends in the homeland, but I felt that everyone was disappointed overall the country’s legislation and particularly the improvement of the medical practice articles. I asked if they knew somewhere, I could quote any article in our constitution which related to the health conviction and human protection. Unfortunately, no one knew whether in our constitution are available a detailed information that I was looking for let alone special by-laws for health services.
I tried if I could find some information in the public domain, and I downloaded the constitution of Somaliland from the Somaliland parliament.net and read more but I haven’t seen something further than article 17 which talks about the health and it was mentioning the following two statements; “In order to fulfil a policy of promoting public health, the state shall have the duty to meet the country’s needs for equipment to combat communicable diseases, the provision of free medicine, and the care of the public welfare.” and “The state shall be responsible for the promotion and the extension of healthcare and private health centres.”
When I finished, the skimming of the all constitution’s articles and I couldn’t find the ones that I was looking for, I recalled the words coming from the mouth of the opposition party leader Mr Faysal Ali Warabe who says, “our constitution is draft and every article says, there will be another detailed annex will mention further details but it doesn’t exist.”
I went back to my thinking position and I asked questions for myself, including the following questions;
What Somaliland government has been working for the last 21 years? Do the ministries have their own ministries’ task outline? When a new ministry is being appointed, is he/she being defined a job description or just he/she does whatever he/she likes? When the minister is being nominated, does he/she think about how government works? Does he/she make a mentor for the developed countries minister who is like his/her position? Are there a benchmarks or standard being marked for the ministries in order to control the performance of the ministries? When the ministries come together in the ministries meeting do they ask emphasising the continuation of the services improvement and monitoring performance is important?
When, I asked for myself these questions and more, I experienced, it can’t be answered for only days or months unless you/we are in a manic days. Therefore, I assured to give a time and simply to let my friends if they are able to answer gradually.
I glanced at the western countries sources, I always make my reference, and I put in the Google, “how UK government works?” I went directly to the department I was focusing on, which was the department of health; I knew the department has got 23 agencies and bodies include; National Health Services Litigation Authority, National Health Services Business Authority, Medicine and Health Care Regulatory Agency and Care Quality Commission.
All these agencies are showing, how the human capital is very important on this community and how its rights protection are emphasised. Not only government there is also independent organisation regulated to the doctors and health centres which review every year the skill of the doctors, age of the medical equipment and validation of the professional and health business licences.
On the other hand, there is a misfortune, which I have experienced from my community, if I talk something about the development and make comparison with my homeland and the developed countries, straightaway, it arises confrontation among us. When I ask why they are against, they answered that I am talking about something irrational. When I asked more, they say that I am talking about countries old enough age and our country is fragile and its age only is 21 years.
Therefore, my argument is, when the developed countries start for the development? We know they started revolutionary age and we know, we are today in the information age, we can import a complete system from every country that we are interested to practice its system. Just, we only need to understand while in the revolutionary age wasn’t information sharing atmosphere, even if you would like to gain knowledge, you were compulsory to travel around months or more.
However, I don’t mean that the western countries don’t make mistakes but there are institutions accountable to other institutions those are responsible for the protecting of the human rights. Last week, the UK Health Secretary Jeremy Hunt was complaining that UK National Health Services spends £2.5 billion on payouts every year after being sued by patients over care errors. Four areas of poor patient of safety highlighted by the UK Department of Health include falls and trips, bed ulcers, urinary infections caused by poorly fitted catheters, and deep vein thrombosis.
In the contrast, the spokesman of the Royal College of Nursing said mistakes were the results of understaffed wards.
Do you think, can the Colleges and School of Medicines in Somaliland be sued for the poor quality doctors and nurses produce?
In summary, the Awdal community include; elders, politicians, social activist, educators, barristers, regional officers should think about one thing, overall, the region depends on economically the education and health services provide to the neighbour communities. Therefore if the quality and performance of those two sectors go down the economics of the region itself will go down. In addition, the region stakeholders should compare with the actual medication errors which their doctors are doing and the expected consequences will be affecting their economic health.
- Somaliland parliament should review, the constitutional article 17 for health, and it should be added an extra annexes will be supported the article and should issue a new medical acts can be implemented easily, quickly and automatically.
- The government should establish an independent body which can take the responsibility of the evaluation and licensing to the doctors, public and private health centres.
- The health schools in Somaliland should take the responsibility for producing doctors equipped with the professional ethics include; professional competent, professional capacity, objectivity, integrity and confidentiality.
- The independent body mentioned in recommendation “2” should assess every year doctors; the medical equipment and the health care centre’s quality of services and risk management. They should be provided every year a revalidated licence and continuing professional development.
- The government should control and audit the services is being provided by the independent body and it should visit physically to the health care centres and ask the patients whether are being delivered the services expected accordingly quality and quantity.
- The government should set up a judiciary department will take the responsibility for the medical prosecution and barristers will assist patient protection and appeals against the doctors/patients.
- The government should establish a medical awareness campaign group, will organise public health awareness, publish patient/doctors protection rights, and guide the patients and doctors.
If all these recommendations are available in Somaliland, government should facilitate the implementation of these points and should acknowledge the importance of these points.
Mohamed Jibrill Elmi