By: Endri Keraj and Telnis Skuqi
Once, hospitals in Albania were miserable and lacked even the basic medical equipment, but at least no one could give a patient a prescription, without first making the appropriate tests. Today, the opposite occurs; medicines are prescribed with no need for prior examinations. This is what happened to Elidon Xh., from Gjirokastra, father of two daughters, who, a week ago had her little daughter released from Ioanina Hospital (Greece). She was previously treated by a pediatrician in Gjirokastra, who diagnosed a disease she did not have.
“Personally, I trust doctors, but now I feel frustrated, because my 6-month-old daughter ended up in the reanimation department of Ioanina Hospital (Greece) for an overdose”, Elidon referred.
According to him, Erla (his little daughter) had high fever for two days. The fever was related to the teething period; however, the doctor in Gjirokastra, undergoing no accurate examination of the little girl, had concluded that the patient was suffering from angina. To be honest, at first, I trusted him. I went to the pharmacy and bought the medicines he prescribed, and started the cure following his advice”, Elidon said, adding that the fever did not go down, but instead continued to go up.
“That midnight I took a flight to Ioanina (Greece). I thought that was the only way, because I realized from the very beginning that I had chosen the wrong pediatrician”, Elidon said. For him, that night was a matter of life or death. “Unlike the pediatrician in Gjirokastra, the doctor in Ioanina did not haste in giving the diagnosis. He waited for three days for the results of the blood tests and other examinations, and spoke only then”, Elidon continued.
Elidon says he does not regret spending all that money, because as he says, there is no greater investment than spending to save the life of a person, whoever that person is. “Only god can decide at the end, if taking a life or not. However, it is unforgivable that a doctor contributes to death”, Elidon continues, emphasizing that his little daughter enjoys now very good health.
In Gjirokastra, it is almost impossible to officially identify medical mistakes, both intentional and unintentional, because there is no reporting by the medical personnel. Official sources of the branch of the Institute of Health Insurance in Gjirokastra, confirm that so far this institution has not registered any medical error. This is also related to the fact that no patient has ever reported such events.
“Even in the most developed countries, where the level of health services is very high, there are diagnostic errors, but the phenomenon observed in Gjirokastra is that there is even no denunciation of such errors”, a health insurance specialist, who preferred to remain anonymous, stated. According to him, medical errors are human, but it is not fair that they are instead categorized as “natural deaths” due to the lack of health records.
“If there were computerized medical records for every patient, it would be easier also for the doctors to cure them. Unfortunately, such a system does not exist”, specifies the specialist. The same official says that detection of medical errors will remain to the level zero, since the accusing body lacks specialized human resources to fight this phenomenon.
“The intention in identifying these human errors does not necessarily imply the penalization of doctors, but rather correction of errors in the future. I do not believe that doctors in Ioanina (Greece) are more skilled than our doctors in Gjirokastra, but at least in Greece, the system does not allow a doctor to examine a patient without first consulting the health records of that patient”, the specialist concluded.
Figali Kotuzi, Head of the “Chamber of Physicians” for the region of Gjirokastra, stated that during the past five years, only two critical cases have been identified in the entire southern area of our country, one in Gjirokastra and one in Përmet. “We have had only two critical cases. Particularly, the case in Përmeti left me with a bad taste. A 7-year-old girl did not make it. She did not survive a severe intoxication. In my opinion, in that case her parents were guilty, for not taking her to the hospital until the very last moment. Her condition was grave. Currently, the case is in the hands of the prosecution, and there is nothing the “Chamber of Physicians” can do at this point”, Kotuzi said and added that in the Gjirokastra hospital, there has always been a spirit of sympathy in the doctor-patient relations.
“Last year, the “Chamber of Physicians” conducted a survey. The results drawn were in fact positive. According to these results, the health services provided to the patients are generally good, but this does not exclude cases of contestation. Truth is the “Chamber of Physicians” according to the relevant law, is in charge of supervising doctors’ ethics and code of conduct. The other truth is that the hospital in question lacks proper lighting and water supply, and these cannot be a responsibility of the chamber or of doctors, but of the hospital’s administration alone”, Kotuzi added.
Further on, Kotuzi expressed her confidence that the health service does not only depend on the work of doctors, but also on the conditions provided by the system. “I do agree that there is a lot of dissatisfaction among patients, but I cannot say that there is less trust nowadays on the doctors, than it used to be in the past. We have already created our profile and our network of patients, who know us. Therefore, only the conditions patients find in hospitals would make the difference. Patients have various complaints, but they are all related to the administrative service, and have nothing to do with their trust in doctors”, Kotuzi said, adding that not all the doctors are money-oriented, calculating their patients’ pocket.
Kotuzi continued by telling us about her typical working day in the hospital. She said she had examined 12 patients that day, but she had only ALL 1000 in her pocket. “If I would demand money from my patients, I would have at least ALL 10.000 in my pocket. Can you imagine if every day was like that? I would have today a great vehicle, which I don’t have”, Kotuzi said, stating however that there are of course cases of abuse.
Elidon Xh., father of two, who was following the conversation, thinks the opposite. He admits that the infrastructure of the health system is now modernized, but still lacks human resources and a sense of openness between doctors and patients. “It is not my intention to personalize the problem. However, I can say that during the communist regime, hospitals were indeed miserable, but patients’ trust on doctors was blind. Today, we are experiencing the opposite. The patient has trust on the infrastructure in place, but not on the doctor, because, as they often say, doctors in Albania follow “primitive” methods to examine their patients. This is what happened to my daughter. Her pediatrician is an expert of traffic rules, but has forgotten medicine. They don’t read new medical literature, and have no idea how to manage modern tools”, Elidon accused.
Elidon does not agree with Kotuzi’s statement, Head of the Chamber of Physicians in the district of Gjirokastra. “About four months ago, Michael Jackson’s personal physician, Dr. Conrad Murray, was found guilty of involuntary homicide of the pop star and was sentenced to four years in prison. The Albanian health system does not even recognize such a process. Are we better than they are?” Elidon asks and stresses the fact that the current situation is unacceptable. Elidon thinks that the Albanian health system needs a cure, since there is nothing to brag about.
“I am really afraid of getting sick; the only thing I worry about is not the money, but the stress. For simple blood tests, I would have to knock on who know how many doors. The opposite happens in Greece. There is only one door to get in and out, and doctors don’t give you prescriptions without first ordering some tests and examinations. They (the Greek doctors) believe in the system, and their patients are the center of their attention”, Elidon concluded.
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