Tag Archives: Hospital

Collateral damage: Police report policy delays treatment for accident victims in Malawian emergency rooms

You’ve been in an accident in Malawi – where do you go?  If you said the emergency department you could be wrong.

A few months ago my editor at Blantyre Newspapers Limited’s Sunday Times made this “mistake”, taking a small boy who had been in a traffic accident to Queen Elizabeth Central Hospital (QECH) for emergency treatment.  The boy, playing with a friend alongside of the highway, had run head-on into an oncoming SUV.  He was severely bruised, crying, and required treatment, but when they reached the hospital the staff at the registration desk turned the boy away on the basis of a policy that requires a police report before care can be administered to an accident victim.

Nurses and doctors affirmed the police report policy to the boy and the editor and it was only after they drove to the police station and were escorted by an officer back to the emergency department that the boy received treatment for the traumatic experience he had endured – nearly two hours after initially arriving to the ward.

Three weeks ago, that same editor witnessed a similar episode when a transport truck struck a small car.  At least one passenger was killed on impact, and when another bloodied passenger was brought to the hospital in hope of emergency treatment he was forced to wait in agonizing pain until a police report could be acquired.

When questioned on the policy, chief administrator of QECH Themba Mhango said a victim of a traffic collision would “definitely” be treated right away because “it is a human rights issue.”

“Now with the multi-party system, human rights came in and people started realizing their human rights.  You can’t do that to a person now – say ‘no I won’t give you treatment,’” Mhango said.

However, a subsequent visit to the hospital’s emergency room registration desk involved no mention of human rights.

In contradiction to Mhangos’s comments, a desk attendant said that while critical injuries are treated as soon as possible, “when an accident victim arrives a police report is required.”

While “there are serious cases in which you can’t do otherwise but treat the victim,” the attendant matter-of-factly said the majority of individuals who seek treatment following a collision have suffered “minor injuries” and therefore require a police report.

Southern Region Police Public Relations Officer Nicholas Gondwa also confirmed the hospital procedure of requiring a police report prior to treating injuries sustained in an accident and said the policy exists as a kind of collateral, because “hospitals fear that the person may not be an accident victim but rather a criminal who got injured while committing acts of crime.”

“It cannot be known whether the person was really involved in an accident or was injured while committing acts of crime,” he said.

The point is moot.  Under Article 16 of the African [Banjul] Charter on Human and Peoples’ Rights, which Malawi ratified in 1989, Every individual shall have the right to enjoy the best attainable state of physical and mental health” and, “States parties… shall take the necessary measures to protect the health of their people and to ensure that they receive medical attention when they are sick.”

The African Charter on the Rights and Welfare of the Child and the Universal Declaration of Human Rights contain similar clauses.

Because Malawi uses a socialized system of health care, “with the goal of providing access and basic health services to all Malawians” and to “raise the level of health status of all Malawians by reducing the incidence of illness and occurrence of death in the population,” it is the responsibility of the Ministry of Health to address this unjust policy – take necessary measures to protect the well-being of their people.

Considering the fact that it is already difficult to get necessary health care in Malawi – transportation to clinics and health centers is problematic, and when a person is able to reach a health centre or hospital it is not uncommon to find that there is no medicine – added delays to accessing appropriate care such as this hospital procedure of requiring a police report are undue, unjust and inhumane, and contradict the state of emergency for which the health department in question exists.

In the meantime, Malawians should be advised to keep a first aid kit on hand as well as a police officers’ phone number on speed dial – you will need both before you can access appropriate treatment for injuries sustained in an accident at Queen’s hospital.

With files from the Sunday Times’ Ruth Mputeni

Preferential treatment v. currying favours

[pullquote]There was about twenty people ahead of me. I took out my book and settled down to wait. One hour passed. Then two hours. Then three. The queue hadn’t moved by a single patient.[/pullquote]

I promised myself I would never knowingly take advantage of the preferential – if not at least differential – treatment foreigners receive in Ghana. Even though I fall into the rather ambiguous category of a dark-skinned obruni, I have, on occasion, been given more attention or faster service than usually afforded to locals. I can’t do anything about it – to refuse would have been rude – but I promised myself I would never illicit any special treatment.
Regrettably, I had to break that promise. I caught malaria despite taking regular medications and avoiding unnecessary exposure to mosquito bites. One weekend, while I was attending a colleague’s wedding, I started feeling especially sick. My temperature fluctuated, my joints ached, I was nauseated and my stomach couldn’t retain any food. Fearing the worst, I called one of my fellow interns’ colleagues at Kapital Radio. He suggested that I get checked, but he advised me to go with a local who knew the ins and outs of the system so I wouldn’t have to wait long to see a doctor.
He didn’t state it explicitly but what he meant was that I should go with someone who could help me jump the queue.
Remembering the promise I made to myself, I went to the hospital alone (My fellow interns Chris Tse and Leah Wong had gone out of town for their mid-internship break).
After asking around, I managed to get to the hospital, find the walk-in clinic, register myself and join the queue to see the doctor. There was about twenty people ahead of me. I took out my book and settled down to wait.
One hour passed. Then two hours. Then three. The queue hadn’t moved by a single patient.

I felt my nausea growing, my stomach threatened another visit to the loo and my fever was back with a vengeance. I glanced over to the man sleeping on the bench next to me – he had been there before I came – and decided I couldn’t wait anymore.

I called another friend who I thought might be able to help. He promptly instructed me to meet him at the hospital where his wife works. Once there, he ran around getting me registered and within twenty minutes, I was sitting in front of the doctor relaying my symptoms. There followed a flurry of activities – a blood test, another session with the doctor, getting my prescriptions – during which I saw my friend speak to this person or that in order to get me ahead of the line at every stop. The whole process took a little less than 3 hours.

As I curl up in my bed feeling calm and medicated, I saw the faces of the people I jumped ahead of. They were all sick and they still had to wait their turn. My stomach churned again with guilt. I reminded myself that I had gotten ahead of the line because my friend had connections at the hospital, not because my skin was a little fairer than the average Ghanaian. There is little comfort in that, but I’ll take it nonetheless.