According to the World Health Organization (WHO), Health is defined as complete physical, mental and social well-being and not merely the absence of disease or infirmity. Medical or health malpractice occurs when a health care professional or provider neglects to provide appropriate treatment or management, omits to take appropriate action, sends the patient unnecessary investigations to get more income or gives the substandard treatment that causes harm, injury or death to a patient. It’s even worse in Somalia because it’s unattended, uncompensated and ensued.
Medical malpractice is a common and major problem in Somalia but unfortunately, it is neglected and it seems the government and health institutions don’t care about it anymore. This is highly expected from a country recovering from civil war and still battling with poverty, violence, corruption and irregularities.
Medical malpractice severely damages Somali people in several ways as:
- Malpractice directly affects doctor-patient relationship in a way that patients will lose trust in doctors and that will make them opt to consult worse individuals including certain traditional healers with no morality and any health skills or will look for ways to go abroad which is costly and inconvenient
- Malpractice can lead to the death of the patient which is a devastating scenario for the family and relatives of the fallen victim or life long disability which makes the victim’s community contribution and human production impossible
- Drying up the patient pocket. Patients of malpractice pay a lot of money to get health services but end up bankrupt and they still suffer from the disease that troubled them. Now it is back to square one but this time without money
- Misinforming the masses. When malpractice persists for several decades, a patient will get used to it and won’t be able to differentiate right and wrong, legal and illegal which paves the way for public acceptance of constant malpractice and abuse.
Common examples of medical malpractice in Somalia
- Unprofessional health workers in hospitals and clinics that make day to day errors without any accountability.
- Licenses are not required to work as a health care provider in Somalia: This has caused a lot of patients to die at the hands of unprofessional, unskilled and unqualified health care workers. Errors from such individuals are very common and happen almost daily in Somalia.
- Antibiotic abuse: Antibiotic abuse refers to the misuse or overuse of antibiotics which later causes antibiotic resistance since the bacteria is now familiar with the drug and this causes serious health effects. Many health care workers overprescribe antibiotics without considering the health hazards from antibiotic overuse.
- Unnecessary bills: A lot of patients are sent unnecessary investigations and they have no choice but to trust the process. Remember ‘’the more the investigation the higher the price’’ and this is the unethical and unprofessional way of gaining income.
- Misdiagnosis: If a patient goes to 3 different hospitals for the same sickness, it is almost certain that he/she will be diagnosed with 2-3 different disease and this is because no one will be accountable for the diagnosis he concludes and without a proper diagnosis, it’s nearly impossible for a doctor to implement a successful treatment plan. Diagnostic errors harm patients as they lead to delays in treatment, lack of treatment and even death. Extended hospital stays and expensive, unnecessary treatments can also create an insurmountable financial burden.
- Surgical errors: Surgical errors can include many different complications, such as incorrect incision site, wrong surgery site or leaving a foreign object (like a surgical sponge) inside the body and most shockingly electricity failure during the surgical procedure. While some surgical errors are the result of a surgeon’s error, most are the result of poor preoperative planning. These mistakes can lead to infections, lifelong damage and death.
- Child birth errors: Both the mother and infant can be victims of medical malpractice. Negligence during childbirth can lead to complications infections and the best example is hepatitis which is high in Somalia and is acquired mostly during labour. Other complications include fetal distress, spinal cord injuries and postpartum hemorrhage (which is the number one cause of maternal death after delivery). Not all complications are unavoidable, but mothers and newborns deserve the highest level of care.
- Anesthesia Errors: Anesthesia can be dangerous if not administered properly or not done by the specialist. If an anesthesiologist doesn’t focus enough attention to a patient’s medical history or gives too much anesthesia, the consequences could be deadly. These errors are not relegated to operating rooms only. Anesthesia malpractice can happen in pre-operative and recovery rooms, during sedation for dental procedures and other outpatient operations.
Ways to combat medical malpractice
As we all know every responsible government should set up laws that protect citizens from any abuse or injustice. Therefore it is a must that the government should implement rules and regulations in the health system. Acquiring a license should be mandatory for any health care provider and should be revoked temporarily or permanently if found guilty of malpractice. This will reduce the neglect and carelessness of doctors. Victims of malpractice should get compensation depending on the degree of the damage. This will boost the morale and trust of patients in health and legal system. Institutions or universities that offer medical studies should be evaluated annually. This is very important because graduates from universities will somehow get the opportunity to work as health care professionals. Any institution that offers inadequate knowledge shouldn’t be allowed to continue producing incompetent doctors.
There must be continuous quality control, drugs that circulate in the country should be controlled to make certain that each drug reaching a patient is safe, effective and of standard quality obtaining products that are safe and effective through the structured selection and procurement methods and maintaining quality products through the appropriate storage, distribution, monitoring, and use by prescribers, dispensers, and consumers. Foreign doctors willing to work in Somalia should prove their academic credentials as a requirement and finally be examined before getting the green lights. This will ensure that only qualified and skilled doctors can work in Somalia and that will reduce medical blunders, malpractices and irregularities. The death certificate should be mandatory before any burial. This will make it easy for the government or officials to notice if anyone died due to negligence or other blunders.
Dr. Abdifatah Dahie