Saturday, September 25, 2010
Doctors in Maldives....Job in Medicine & the Reality
First let me introduce myself. I am a doctor currently working as a Medical Officer in Maldives for their so called (because almost everything is only so called in this country of selfish lying stupids) Ministry of Health & Family (which has changed it’s name from Department of Health to Whatever for 3 times in last 2 years) .
So, for the sake of my still running contract, which is not ending any sooner than 6 months, I wont give my actual name up in this blog.
The whole purpose of writing this blog is to make people like me (doctors) aware of the things going on here before they decide about coming & working here, in case they are interested in coming here at all in the first place.
First let you clear any fogs if you have in your mind about this Republic of Maldives: This is actually no republic. A form of Anarchy prevails here. This a totally Islamic country and forbids you to talk about any other belief/religion with public or even carry out any ritual of your specific religion, other than ISLAM. They have even mentioned it in their contracts here that you can not bring any statue or picture of any Gods or any other religious books here, Can't show them in public even if you own any such thing and never tell anyone about any such religion or ritual. Even if someone enters your room where you live and sees anything in connection with any other religion than Islam on display, it's enough to start a legal proceeding against you in their local court which doesn't have any lawyers as such. These are unpardonable acts here and you can be prosecuted if found to be indulged in any such deed.
Now coming back to the topic of my blog......Just now when I am sitting in a small consultation room, waiting for a sillier than silly patient to come and literally tell me what he wants in the name of treatment, I can hear the laughs and jokes of the Maldivian staff sitting over the reception counter of our Hospital. Actually I would like to site you some examples from my experience here and let you enjoy it:
In-charge: As they call the community health workers here who are made in-charge of Health facilities and govern all the decisions of doctors or other issues arising in any health facility. Totally uneducated people. Mostly 9th class pass and then trained for some quackery in Colombo, Sri Lanka. They spend their entire time on duty calculating how can they eat up funds given to them for the health centre or the hospital.
Doctor: We. We the doctors (MBBS or MD or MS or whatever; this is not their botheration). A doctor is a doctor and can treat everyone, starting from a neonate to a geriatric patient including Gynecology & Obstetrics in between somewhere. This is the demand from you to treat them all and treat them well. No matter you are a GP, a specialist or a super specialist. They can say an Anesthetist to write prescription for a 6 month old baby with cough & cold and start shouting if the baby doesn't get well in a day or so.
Nurses: All the south India trained, majority of nurses who don’t know which drug has to be administered IV and which IM. You be watchful, they can put milk in IV line and put Diclofenac Injection as syrup anytime in anybody's mouth if you are not repeatedly asking about the administration of your prescribed drug.
Patient: It can be someone who comes at mid noon or midnight out of his sleep for getting his/her weight and BP checked or someone who will tell you lies just to get a medical certificate so as to avoid some duty or exams. They always tell the wrong stories. Majority of them don’t take medicines and throw away your prescription as soon as they get it.
Translator: Someone whom you tell a lot of sentences which are to be translated to the patients and she translates them all in 4 – 6 words. You are left looking like a stupid after she sums you up.
Scenario 1: Patient called the In-charge at around 01:15 AM one day. A call came to me that some emergency patient is coming. Run towards the health center. I reached there. The In-charge reached there. Now we are waiting for that emergency patient to come in half sleeping half awake state. Ultimately the In-charge decides to call back the number which had called him about that patient. We are informed that the patient is on the way. So we switch on the lights and all and wait.
A small child (3 years of age) is happily laughing in his mother’s lap and is being brought (this is the emergency patient by the way). Our conversation starts:
Me- What brings you here at such a time? What’s the emergency?
Mother of Child- He is having cough & cold.
--Since how long?
--A month…. May be more.
I try to keep my anger down. They woke me up for this when I have to get up and report for duty at 07:00 AM again.
--I write down medicines and the case is finished.
They don’t bother here that doctors are human. The general behavior of people towards doctors is as if they are using some slave as per their convenience and are surprised to hear that those slaves are human. The most of nonsense will wake you up at 02:00 Am like small abrasions or little pain over hand muscles since a week…. Things like that.
Maldivian population is not dumb. It actually is hostile towards anyone who is from outside. Be it a labor or a doctor. God forbid if you fall in a situation when you yourself need help, they’ll not help you. Even if help will come, it may be too late for you. So, if you can take a risk of guaranteeing your well being and no need of any sort of help for 1 year, then only think about coming here for the same period.
The first thing you’ll get from them is cheating. As a doctor you’ll approach some agent or even the ministry itself. They’ll send you an offer letter. And guess what, it will include the false promises to lure you in. As soon as you receive the work permit & reach Male’, go to the office of Health Ministry, you’ll come to know that a few things in the offer letter were wrong. Even the salary they have told is not right. It’s not easy for us who calculate our association with them in accordance with the promises they have made in their offer letter. As normal human beings, we calculate that this much we are going to get...this much we can try to save....so we will be back in our native place after this many years having enough for our that particular purpose for which we have set foot abroad in the first place.
But for them it is so easy to cheat you. And that too shamelessly. Just now I have came here. They told in Male’ that salary will be 15% less than told in the offer letter. Can you imagine the situation when you were promised a salary of Rs. 50000 for example and suddenly it becomes Rs. 42500 and that too after you have left your original place of work and landed up here already. They know that after a doctor has reached Male’ it’s not easy to just back down and return that’s why they dare to do such things.
Their offer letter says that they’ll give us accommodation for free but after coming here it became’ we’ll give you a certain amount of money (MRF [Maldivian Rufiyaa] 1500/-) per month and you find a place for yourself to live’. I found the cheapest one available was costing me MRF 3500/- and no less. Now I live there only. A significant amount of total salary has to go in rent now.
Here as soon as you come, the first of horrible things will happen when the ministry will confiscate your passport and keep it with it for your entire contract period. Just to stop you from getting away from Maldives. They know that by the slave like treatment they’ll give us, we would like to go back immediately.
No one is happy here. Only a very few, who are here since long, are ok or tolerant of these people.
They change the clause; like ‘total working hour per week’, ‘accommodation rules’, ‘rules of leaves which you can get’, ‘rules of Over time’ and any other rule for that matter; all by themselves. Their contract is one way. They prevent us from showing this contract to anyone because it can expose them.
The most important thing is, you can never make them agree to any of your pleas. They will do as they’ll think. Their believe is supreme. This is another fact that they don’t know how to read English or can’t calculate anything properly as there is no proper education in this country.
Uneducated people ruling over us is the hindrance we have to cope with each and every time we do have any significant issues. I personally feel helpless.
Doctors posted over island health centers are the worse affected. There are no proper facilities available there. Water which comes in supply, you’ll be having difficulty distinguishing it from the toilet tank’s water as the same smell will be in it too. To drink; there’s stored rain water only. You can find a mosquito larva happily floating in it every now and then when you collect it in a transparent bottle. Even brushing teeth and gargling is difficult as the water you get is so smelly that it’s sometimes better not to wash face and brush than to do it. Nauseate as much as you want, there is no way out till termination of contract due to earlier described reasons.
The process of breaking a contract needs minimum serving of 6 months and so much of economic loss such as total refund of work visa fee + refund of ticket money which supposedly they give when we come here (I haven’t received the refund for my ticket even after 45 days of my arrival here) + 1 month’s salary as fine. This entire thing becomes so heavy that usually people control themselves and stay here for 1 year and go back swearing never to come back to work here again. Leave the issues of 24 hour electricity and cable TV things. Those are your luck.
It is not easy to feel humiliated & cheated every single morning and still carry on. Yes, I agree that there are some professionals who either get even worse conditions at home or are in fact very big hearted that they can continue here for more than a day. Very few.
So, in all this place is not easy to cope with. And when as an MBBS you get a salary effectively equal to 55000 in Indian Rupees and from there you have to pay rent and food as well, there is nothing much left as savings. Yes for specialists things are marginally better. But these people make you feel as if they own you. Modern form of slavery only.
Cases come from this to that. You need to consult a specialist sometimes. But these people start shouting over you that why don’t you treat from coma to seizures just because you are a doctor. And the basic population is full of incestuous relations. They marry between themselves without any feeling of close family and all. So, there are a lot of genetic pathologies which we don’t see anywhere else.
And most important of all, majority of them don’t have any small amount of respect for you. As soon as some sickness befalls them, they become aggressive towards the doctor. Quite a few instances of beating the doctors are there now.
At the moment 3 cases are in different courts of Maldives where the doctor can get a life term or even worse fates.
Here is excerpt from someone’s blog who lives in Maldives:
“Ok I live in Maldives, recently I got a mail from one of my friend asking where I am, I said I’m Maldives and he replied me he is also in Maldives and he gave me the address and company name so i met him. I was happy to see him in Maldives and he has come one day after getting married with his wife. Since he had a situation that he wanted to go some where he has come here without any ideas and any commitment. He is happy with salary but the company provides a very small allowance for both of them and cant even think about a private accommodation. By the time I met him it was 1 week in Maldives. For this one week they have moved to over 5 places. Finally they have got a jut a room with no bath room but the bath room is out side of the room and have to share with the people who live there. He has some Indian people living in the house. And all of them sleep and eat in the same hall, so they have to go home early. I was so worried about this issue since the day I met them. Other thing is finding accommodation in Maldives is not easy. Since this couple is newly married, they need some freedom to enjoy the life, need some privacy to have fun. Now we are searching for a better place for them, hope they will get it soon. I wish for them a good life.”
So, By all this you can imagine the things going on here.
Almost everybody has a similar story…’they cheated with the contract’…’they cheated with the salary…said it would be $1000 for example and now when we came here they are giving only $ 600/-‘….or things like that.
I will be regularly writing & updating this blog page. My sole concern is that no one should come here in darkness as I or a lot of my colleagues came in.