Out of Medicine

The local newspaper advertised that we are out of medicine.  For the last couple of weeks, we have been low on medications in the hospital.  We are now out of all IV and oral antibiotics along with many other medicines.  What?!?  How can this be, especially at a large referral hospital for Western Kenya?

There are so many problems within our system, corruption that extends throughout all levels of the hospital and government.  Everyone blaming each other for the problem.  There are concerns that the money distributed by the Ministry of Health is being used for things other than medicines.  Others argue that the Ministry of Health isn't giving us enough money for medicine.  The newspaper article discusses how suppliers are threatening to stop deliveries of medicines to MTRH due to lack of payment:  "Health Gap International, points out how medical suppliers had threatened to stop deliveries to the Moi Teaching and Referral Hospital over a Sh75 million debt. It says funds from the Treasury are not adequate to cater for the needs of the referral facility.  Some suppliers had stopped deliveries due to non-payment, a move that does not augur well for a referral hospital”  Not sure how we're supposed to care for patients without medicines.

One report in the article blames medical personnel for the problem stating, "The patients accused nurses and other medical personnel of hoarding the drugs and secretly supplying them to private pharmacies, a practice they cited as a key contributor to the shortage of drugs."  Sadly there is truth to this statement as well.  Some hospital personnel will sell the medicines to pharmacies or private offices to make money.  If you go to the pharmacies in town, you may receive a medicine with MTRH stamped on it, identifying it as medicine that belongs to the hospital. 

So now what?  In several other resource-limited settings, patients receive scripts for medicines to buy and bring to the hospital for their treatment.  One pharmacy tech actually did this and things didn't go well for him.  He was pulled into the director's office and asked why he told a patient we didn't have medicine here.  He was then fired.  Now, no one will write scripts for patients to bring their own medicines.  I'm investigating developing my own stash of medicine...a pocket pyxis.  I'll add it to the other supplies/equipment that I haul to work every day since things mysteriously disappear if left at the hospital. 

In the meantime, what about the patients?  Amidst all the bickering and finger-pointing, it's the patients that suffer.  They come to the hospital trusting that we will do our best to care for them.  How is that possible without life-saving medicines?  Do you send them somewhere else?  If so, where?  I thought we were supposed to be the referral center.