Nyangabgwe Referral Hospital is grappling with an erratic drug supply by the Central Medical Stores coupled with a dire shortage of specialists.
The hospital head honcho says the dire situation is true for vital essential and necessary medicines such as hypertensives, antibiotics and injections for blood disorders (coagulopaties) such as haemophilia factors VIII and IX.
“We have experienced some challenges in acquiring some of the medical items due to supplies chain systems problems. Often the supplier might be experiencing problems sourcing the required item because it has been discontinued by the manufacturer, the company has gone bankrupt, closed down or there is a single supplier who is slow in supplying the item,” says the hospital superintendent, Dr. Ewetse Mosweu.
Mosweu says CMS stock levels of medical supplies have been low. The government gives public hospitals funds to purchase emergency drugs. The hospital superintendent says Nyangabgwe has, until recently, been able to maintain the drug availability above 80 percent for all three categories of need, vital, essential and necessary
“Where possible, we would purchase the item(s) sometimes even from private pharmacies and issue it to patient. This, however, is limited by the availability of stocks and these pharmacies too because they cannot keep certain items in the quantities required for hospital consumption,” she says.
Mosweu adds that secondary to the problem above is that fact that the suppliers of the medicines are the pharmaceutical companies.
“So if Norvartis for example is experiencing problems with the supply of a certain item, the supply of the item will be limited regardless of who needs it,” she says.
Mosweu disclosed that the hospital began to experience erratic drug supplies from the Central Medical Stores towards the end of last year spiraling into this year and there seems to be no end in sight. If there is any end, it would appear it would be a tragic one where patients die because of unavailability of drugs with which doctors may have saved their lives. Mosweu says an estimated cost of drugs needed up to present is about P56 million. The hospital has used in excess of P28 million in the purchase of drugs.
“If we were to stock up on all drugs we required and not rationalize our stocks based on funds availability or drug availability from pharmaceutical companies, then we would need at least twice [P28 million] as much,” she says.
Added to the hospital’s drug woes, there is a serious shortage of specialists in all clinical areas.
“You can imagine we need pediatricians, pediatric surgeons, neonatologists, cardiologists, neurologists, general surgeons, urologists, obstetricians, gynecologists, orthopedic surgeons, neurosurgeons, euro-gynecologists, pathologists, hematologists, microbiologists. The list is endless,” says the hospital superintendent.
According to her, the hospital has a doctor to patient ratio of 2 doctors per 10 000 patients. The World Health Organization recommends a ratio of twelve (12) doctors per 10 000 patients.
The hospital has 82 citizen general medical practitioners and 50 non-citizen doctors. Of these, 36 are specialists in different clinical departments. The Ministry of Health recruits public health care workers, including doctors at least twice a year. While the government has sought help from medical personnel from countries such as the United Kingdom as well as from esteemed centres and university colleges, Mosweu says this has not mitigated the problem of shortage of specialists.
“There is generally a shortage of specialists as more and more young people opt for less demanding jobs with better remuneration packages,” she says.
The Ministry of Health received the fourth largest share of the recurrent budget delivered on Monday by Finance Minister Kenneth Matambo to the tune of P3.5 billion.
Efforts to reach the Minister of Health, Dr. John Seakgosing, hit a snag at the time of going to press.