Infrastructural and system barriers to Universal Health Coverage: get in my patient’s shoes

healthcare__

(Olga Guryanova, Unsplash)

This article was exclusively written for The European Sting by Dr Zayithwa Fabiano, a  medical doctor from Malawi with over three years working experience in clinical medicine and public health research, focusing on improving health service delivery. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


Universal Health Coverage (UHC) means that everyone have access to the health services they need, when and where they need them, without financial hardship (WHO). As a young energetic passion doctor I was excited about my work. In 2018, as a medical intern, I was rotating through pediatric surgery.

Malawi had less than 10 practicing pediatric surgeons; the pediatric clinic was busy, the wards full and the theatre lists long. Everyone worked hard to provide optimal care to each one of these children who needed surgical care. 9 months after my pediatric rotation, I was doing some public health evaluation work across the country. This took me deep into the rural areas of the country. Places with poor roads, no bridges, poor network, no electricity and no efficient transport network.

One rural health center evaluation visit took us to one of the most difficult places to access I have ever been. We left Blantyre, the city with the surgical pediatric ward I interned at, at 5:00am, we arrived at this health facility at about 3:00pm. The distance is about 280 kms/1740 miles from Blantyre city.

However it took so long to get there because the dirt roads were muddy and slippery to navigate. We found one bridge had been washed away with the heavy rains, Malawi was experiencing floods due to Cyclone Idai during this time, as such we had to find another road to get to the health center. Eventually we made it.

Upon arrival, we carried out the evaluation. A woman carrying a baby called out to me “Doctor, what are you doing her? Do you remember me?’ After a chat and looking at her baby, I remembered who she was and my heart sank. This mother and her baby had been coming to the pediatric surgical department in Blantyre during my time there. Her baby had Hirschsprung’s disease.

The initial surgery had been done but she had had her babies subsequent surgeries cancelled at least 3 times, because the theater list was too long and we did not have the capacity, both human and material to operate on her baby. When I thought about how difficult it was for our team; young, healthy, with a 4 wheel drive vehicle and no baby, struggled to reach the facility…my heart broke…how much more had she suffered to come to the hospital in Blantyre city and had been sent back without assistance.

Her situation and experience was the very opposite of what universal health coverage was. I suddenly realized that in all the clinical work I had been doing I had to think about all the non-clinical factors that are barriers to people accessing health services, and that in my practice as a health worker and for all health workers we must think broadly about what UHC is and the barriers to UHC in our contexts and generate innovative solutions to address them.

About the author

Dr Zayithwa Fabiano is a medical doctor with over three years working experience in clinical medicine and public health research, focusing on improving health service delivery. Currently Zayithwa is working as a Clinical Trial Study Coordinator at John Hopkins Research Project in Malawi. Zayithwa holds a Bachelor of Medicine Bachelor of Surgery degree from the College of Medicine, University of Malawi. She is a Mandela Washington Fellow and African Changemakers Fellow. She is the founder of Health
Access Initiative Malawi which works to improve access to health information and services to the populace.

Advertising

Advertising

Advertising

Advertising

Advertising

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Somalis ‘will not be deterred’ by Friday’s terror attacks – UN chief

The Catcher in the Rice

Heat stress spike predicted to cost global economy $2,400 billion a year

Brexit and migration dominates the debate on October’s EU summit

Plans to keep EU budget funding in 2020 in the event of a no-deal Brexit

EU car manufacturers worry about an FTA with Japan

Brexit: EP Group leaders support a flexible extension until 31/1/20

The Europeans with a job diminish dangerously

Turkey needs to step up investment in renewables to curb emissions

In Afghanistan, attacks against schools have tripled in one year

As human caravan moves through Mexico, ‘full respect’ needed for national control of borders: UN chief

Independent UN rights experts call for ‘immediate investigation’ into alleged Bezos phone hack by Saudi Arabia

Parliament makes it easier to organise a European Citizens’ Initiative

Young activists do the talking as UN marks World Children’s Day

What makes America the world’s most competitive economy?

4 things President Trump could learn from Jimmy Carter

Climate emergency: City mayors are ‘world’s first responders’, says UN chief

North Sea fisheries: MEPs back EU plan to sustain stocks of demersal species

Six months into DR Congo’s deadliest Ebola outbreak, top UN official praises ‘brave’ response effort

Global Citizen-Volunteer Internships

Wednesday’s Daily brief: Day 3 of anti-hatred summit, UNFPA turns 50, Ben Stiller #WithRefugees, updates on Abyei

Mankind’s first tool to fight malaria also kills

UN relief chief urges Security Council to back aid delivery, more funding for millions of Syrians hit by harsh weather

Mali facing ‘alarming’ rise in rights violations, warns UN expert

The future of manufacturing is smart, secure and stable

When is Berlin telling the truth about the EU banking union?

Wednesday’s Daily Brief: Guterres in Kenya, Prisoners sick in Iran, #GlobalGoals, Myanmar, Ukraine updates, and new space partnership

Don’t let smoking steal life’s breathtaking moments, urges UN health agency

Millions of Bangladeshi children at risk from climate crisis, warns UNICEF

Somalia: UN urges steps to ensure future elections not ‘marred’ by rights abuses seen in recent polls

THE ROAD TO GANESHA

Why income inequality is bad for the climate

OECD strengthens co-operation with Morocco – Renews Morocco Country Programme Agreement

How quantum computing could beat climate change

Why do medical students need to emigrate to become doctors in 2017?

Malaysia can show the way towards a holistic model for human rights

Eurozone: Retail sales and inflation point to recession

When it comes to envirotech adoption, NGOs can lead us out of the woods

Have we reached peak smartphone?

Africa: Urgent action needed to mobilise domestic resources as tax revenues plateau

Why do US presidential elections last so long? And 4 other things you need to know

We can save our ocean in three steps – if we act now

4 bold new ways New York is going clean and green

Denmark plans ‘Silicon Valley’ on 9 artificial islands off Copenhagen

Joint EU-U.S. statement following the EU-U.S. Justice and Home Affairs Ministerial Meeting

A win-win strategy for private equity deals

Humanitarian visas would reduce refugees’ death toll

5 libraries doing innovative things to help their communities

A Young student assesses the Programme for International Student Assessment (PISA)

UN condemns Syrian ‘war on children’ as up to 30 reportedly killed in clashes

Smart devices must come with trust already installed

Reusable packaging: 6 benefits beyond sustainability

Commission: Gifts of €6 billion and free trainees to ‘help’ poor employers

Air pollution could be responsible for 1 in 7 new cases of diabetes

Mergers: Commission opens in-depth investigation into PKN Orlen’s proposed acquisition of Lotos

Community Manager – 1289

Alarming level of reprisals against activists, human rights defenders, and victims – new UN report

How to turn Africa’s manufacturing sector into a high-tech powerhouse

5 lessons for the future success of virtual and augmented reality

What makes a great CEO? The people they surround themselves with

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s