Editorial
The most important asset of the health services are the people working within it. The question is, how can we make the best use of these staff? I have visited many health facilities over the last 18 months since I have been with the Health Systems Trust. In many cases I have been exceptionally impressed by the dedication and commitment of the staff I have met. Most are working in difficult situations, many of which I would find both depressing and demoralising.
I have visited health services with long queues and insufficient numbers of staff as well as inadequate supplies of drugs and equipment to provide the quality of care we would all wish for. Most staff know about the need to spend time with patients, and talk to them about their curative as well as preventative health needs. The question they put to me is, 'How do we do this when there is a whole queue of patients waiting behind the one we are with?'.
Just a few days ago I visited a rural hospital where I met a whole ward of nurses sitting talking while all around them was a filthy ward, even with buckets of blood stained linen sitting at the foot of patients beds. I really felt quite nauseated, not because of the stench, but also by the situation I was faced with. Who is to blame for this situation? It is too easy to blame the nurses for being lazy. However this is probably not fair, as there must be many external factors which have led them to feel so demoralised and demotivated.
In another hospital I visited a while ago, a doctor pointed to a private bed and commented to me, 'The problem with private patients is that you have tobe friendly to them and sit on their bed and explain what is wrong with them'.
All human resource planners whether at the district, provincial or national level have huge challenges facing them. How do we ensure that our human resources are fairly distributed? Is it fair that in the cities there is one doctor to every 700 people while in rural areas there is one to every 10 000 to 30 000 people? How can we improve the morale of staff, so that they can feel motivated to do the work facing them? How can we change the negative attitudes of health staff.
This issue of UPDATE considers these and other questions and we can clearly see that attempts are being made to improve the situation. Perhaps understanding more about care and a caring ethos will help. The short term alleviation of doctor shortages through the help of our foreign friends may also help. Addressing the skills needs of new health professionals as well as those already in the system is likely to help. However we need to learn from the experiences of other countries, where one message that has come home to me is that no single measure alone will solve our problems, but a combined strategy that integrates a number of approaches is more likely lead to a solution. We have a long way to go. |
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