Sunday, December 30, 2012

Maldivian Health System has come under the active control of the MOHF Again.


THIS PIECE WAS WRITTEN IN AUGUST _ SEPTEMBER '2012 BUT DUE TO MY INABILITY TO POST IT ON TIME, I AM POSTING IT NOW. After all what has been written should be published by large. So, with due apology here is the piece....

Hello All Viewers of this blog,

By reading this blog's posts someone may have the notion that only bad things I write about here. But rather some good news (or supposedly and apparantly good news)are coming from Maldives as well. 
Here is the current news from Maldives regarding their health Services. The Ministry of Health Has again become the direct governing body for the health Services here once again. They have scrapped the Regional Health Corporation System and MOH is taking over. Although this time they have formed a centrally operating Health Services Corporation for the entire Maldives. This corporations are only a way to control the flow of money by influential people in any government. Earlier this Mr. Naseedh (their earlier President till Feb-March 2012) Government wanted to eat money through regional corporation bodies posting all the party people in boards of all these corporations. Now another government has come and they want to do the same through this central corporation. But at least now the MOH, which has experience of dealing with the 
Job Visa issues, which had become the headache for every expatriate working here, should get resolved. 
Should be a welcome news for expatriate work force in Health Sector. The problems with not getting Job Visa Card timely and all were never there in MOH times.

People are hoping to take a breath of relief again in this sense. Although it will again become difficult to convey your any message to the governing body as in MOH days these community Health Workers were the naughtiest thing around. These so called community Health Workers were posted as managerial heads of the health centers and hospitals and it was very annoying sometimes. Even a small thing which you have to ask for, can take a long time to reach to MOH and then back to you.
But yes, in those yesteryears when MOH was working nicely, there were less problems as a whole. Let us see what this returning back to MOH brings. 
Although the gist of all experiences in Maldives says "It will always be worse than before in this God damned country". 
If there will be any salary restructuring etc, which is inevitable, I'll keep informing you all on these pages. Keep looking or better subscribe to the posts...

But in general Maldives has changed for the worse over these few years. I am talking about the general behavior and perception of public towards any person who is providing any kind of service to these monkeys. They ask such stupid questions and present such varied situations like;

1. ...if a patient has come with weakness and giddiness then don't forget to ask 'Are you drinking enough water now a days?'. Their answer will amaze you. Most of the times they will themselve tell you that now a days they are not drinking even 3 glass everyday. 

2. ...Then the complaint of 'urine having yellow color since last few days'...and the same should be your question..'Are you drinking enough water now a days?'...answer will come 'No'.

3. ...Complaint: 'I am having severe pain over right foot'..and stop. they will stop talking or will keep blabbering that this kind of things happened in past as well. Now you start asking and after three or four questions the cause will be clear. Actually the fellow got hit by someone's foot yesterday while playing football and as this could have happen umpteen times in the past so that's what he was telling in the way that this has happened in the past as well. They will almost never tell you the supposed cause of their trouble first.

4. ...persons will be brought as a 'least bit away from dying' cases, on the stretcher, bellowing like an injured animal with howls and tears. 90% of them are cases of 'Breathing Difficulty with Chest Pain with Giddiness and generalized weakness with occasional Blackouts'. And almost all of them are actually 'Acute Gastritis' and have not taken any food since quite a few hours or may be whole day. But they won't tell you 
all this. You will bang your head into the dead intellect pea brains of these neanderthals and then only will find this great Diagnosis out.

5. And the biggest of all questions...'Why you are writing this or these medicines?', 'Are you sure of these medicines?', Can you guarantee that this will solve my problem?.

6. There is a quite frequent question which is posed by Maldivian of all size and shapes and across the ages if they are consulting for some chronic condition. 'What have I got?' It is a serious question and as a noble clinicist that you may feel at the time of posed question...it becomes your responsibility to tell the sick fellow that he/she has got such and such condition.

.....Now you, by all your known expertise, will take at least 15-30 minutes in explaining. They will listen to it like some eager student is trying to absorb his/her master's knowledge. You become glad after ending your speech. Everything properly translated. Now will come the greatest sentence of all...'Ya, the same/similar thing the doctor told many times whenever we asked in Male' (Maldive's Capital) or in Trivandrum (In India, another medical hub for Maldivians who are willing to travel abroad for their gastritis to MI) or in Colombo 
(in Sri Lanka, recently adopted medical hub for Maldivians) It becomes very heartening to see that you are as well an expert over the disease as are those sitting in multi-speciality hospitals. But it becomes very irritating that the fellow just now wasted your time unnecessarily and actually was.....may be testing you.

Things like this are common. The commonest of common sense is not available in these fish-brains  And joking apart, sometimes when a real tough complicated patient will come, then you as a clinician will suffer.

Still, we are going there to earn a salary which has been promised in the offer letter. With some lies, they are mostly the same what you will actually get. So, if you can behave detached from these people personally then you can nicely live here, work and earn.
When I was working in Maldives, a few doctors seemed very happy here. I always posed then the question "what is the secret behind your cool demeanor?"
"Just don't try to be attached with these locals, no matter how close to you they are living or working. Their behavior is different than ours and they respond to the similar stimulus differently than us." they use to tell. True indeed...

There is one more thing. Somehow, as a result of this blog, or due to the current troubles in sending dollars from here or due to some other reason, Indian doctors have decreased in number in reaching Maldives. It is very disheartening to see that a country which is and always will need health professionals from outside, is being lost as a working ground for Indians. Now a days there is a flood of Specialists from Russian speaking countries. They get a meager salary of USD 200/- or 300/- per month there in their own countries. So, getting ten times more here is like a dream come true. Although the English they speak in, is always pathetic without exception. Even if someone among them thinks hat he/she is very good in English  it is simply funny when you listen to it. They are coming here to stay for long. Where else they'll go? Here or middle east only.

So, fellow Indian Doctors, if you are reading this blog, Don't hesitate in coming here now. MOH is back and hopefully the same sense of security will come back with this change here. Keep your eyes open about Maldives. It was a nice working place till recently. It can become good again if the authorities take care of it. Cultural differences are not a problem. The Job Visa Card and money sending process should not be complicated. 
That's it.

23 comments:

  1. Any thing may happen to the elders when they are alone in the home. So need to have some precautions . So Doctors time is the best one to give

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    ReplyDelete
  2. I left MOH specialist job in 2011 as things were pretty bad at that time. Majority of points raised in your blogs are true. Your blog of Dec2012 appears to be encouraging. But in my opinion, there are many issues which must be resolved before someone decides to come back here--like arbitrariness of contract, Cut/stagnation of salary/regular increment in salary, overtime issues, noninterference in doctor's clinical, work, providing free accommodations, Hotel charges in Male to be born by Ministry, providing physical security at work place as well as in residential area etc. Unless these issues are resolved in a satisfactory manner, you can not say things have improved there ( i.e. Maldives)

    ReplyDelete
    Replies
    1. This comment has been removed by the author.

      Delete
    2. I got a contract as " Medical Officer" with the following
      Salary per month is 7875 Rf
      Allowances per month is 5202
      over time pay : pro rata " I do not how much I ll get "
      I do not know if i ll work in Male or in an Island " its written the principal place of work is IGMH "
      also there is nothing about the accommodation, which means that the salary includes it ..
      shall I sign or not ?

      Delete
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