26 June 2017

The perils of a Sudanese doctor

Haj Al Safi Teaching Hospital in Bahri, Khartoum. (Photo by Rugia Omer)

Haj Al Safi Teaching Hospital in Bahri, Khartoum. (Photo by Rugia Omer for 500 Words Magazine)

 

I am a doctor in Sudan. This statement automatically means that I am working 2 to 3 jobs, I make less than $200 a month, and I am extremely exhausted and demotivated.

You see when I graduated two years ago my plan was to change the world, and more specifically, Sudan. The main reason for me being here was thinking that I could fix the country that I love. Work hard and change lives.

I talked the talk. Then reality struck, it struck hard and late – a few weeks ago. I came to the realisation that the health system as well as the Sudanese mentality won’t change just like that. The issues here are deep-rooted. But then again, how can this mentality be improved when the average doctor can barely get by? When she or he is barely living? Eventually, their main goal will (and already does) revolve around fixing their own lives rather than that of others, at which point medicine will become about money rather than helping people. It loses the humane side. Doctors take jobs based on the pay rather than on what they can excel in. They don’t challenge themselves and seek further knowledge, justifying the infamous claim: “That doctor doesn’t know anything.” In fact, this can be applied to anybody in the medical field. Everyone is miserably trying to get by on their “minimum” wage and multiple jobs. As a result, doctors do not give their best; the hospitals are dirty, the nurses don’t do their jobs properly and the supply of medication is always limited, if available in the first place.

So as a consequence of doctors being money oriented, an essential part of medicine is lost: community medicine. Through illness prevention and education, community medicine is believed to be the key to the future. Why wait for a disease to affect someone then treat it when you can think one step ahead and prevent it from affecting a large group? This simple theory was how polio was eradicated in Sudan. As a result of the money craze, there aren’t many doctors dedicated to raising awareness and educating the masses. This directly affects the whole population, not just in terms of illness but also health taboos, such as female circumcision, will not be corrected and girls will continue to be wedded off at a young age. Preventive medicine eventually becomes unheard of.

The only way all of this can change is through strong community work such as out-reach programs, awareness groups and health education classes. This must be started not only in rural areas but also in Khartoum, spearheaded by specialists in public and international health. This country needs fresh, open minds. We need re-education at a national level. Doctors must learn to feel the responsibility that comes with their title, and the country needs to give them the support they deserve.

5 Comments on this post.

Leave a Reply to Marwa Cancel reply

  • Marwa
    2 February 2015 at 9:11 pm - Reply

    Well written! I couldn’t agree more. And I would like to add, for the reasons you stated above, is why many doctors are leaving Sudan and looking for a fresh start to their career in America, UK, or Middle East. I am from Canada but I gradated from a med school in Sudan almost 2 years ago and I was looking forward to staying in Sudan … basically to “help”. But so many senior doctors advised that I go back to Canada and look for a medical career here because Sudan is a helpless case when it comes to practicing medicine. Very sad reality.

  • Dalia
    3 February 2015 at 9:30 am - Reply

    This is a great read. I appreciate your frustration but you must understand that Sudanese doctors DO care and they DO work hard at helping those in need. Countless medical staff have reached into their own pockets to aid a financially challenged patient for an (overpriced) investigation or medication. Preventative medicine is great but that is a step that we have not reached yet. You have a shaky health system, not much medical coverage for your basic population, unsanitary conditions, terrible hospital infrastructure, and an overabundance of private hospitals and clinics. I believe that we must work on our system before pointing fingers at doctors and their drive (or lack thereof)

  • mishyshehata
    3 February 2015 at 8:48 pm - Reply

    Thank you Amira for putting those words out there to be read in order to shed some light on what reality (or shall I say, facade) the public health system is in Sudan. I agree with both Marwa and Dalia, however Dalia, the demotivated and nonchalant attitudes of medical doctors on ‘minimum’ wage in Sudan is an important factor not to be overlooked. We can say that we should not point fingers at x, y and z but there needs to be some holistic approach to placing relevant stakeholders in positions where they are both responsible and accountable, medical doctors and other staff included. I am a registered medical doctor, specialising in public health in Copenhagen, and I took that route because I realised just how broken the Sudanese health system was during my internship. If we assume that you have a health system bar motivated service providers, then, in fact, you have no health system. I agree with Dalia pertaining to her comment on how Sudan is far behind when it comes to preventative medicine, but we shouldn’t be because we have a double epidemiological burden of communicable and non-communicable diseases overwhelming the country and many social issues that determine health and inequalities. If the allocated resources do not suffice, initiatives must be taken by those who care with grassroots movements and other relevant third-party stakeholders to bring about change. If we ourselves can’t be there, surely we can find ways to coordinate actions within and without Sudan that positively impact the health system.

  • Ahmed
    4 February 2015 at 8:45 am - Reply

    Nicely written especially nice ambitions; the attempt to bring about some change to our medical system. The fault isn’t MEDICAL system, and I don’t want to talk politics but the fault is in our economics. Hailing down dragging everything with it. What would one expect when 86% of budget goes to defence leaving the remainder 14% to be shared between health and education amongst many others. But note that health and education are the only yet the most two important components to a well built nation, wealth comes in the process of achieving these, nevertheless, atleast living becomes much more less stressful than it is now for everybody not just doctors.
    If you are a two years graduate and would like to implement change, find yourself success in PLABs or USMLEs!
    with luck,
    Ahmed Kamal

  • riham sami
    5 April 2016 at 11:22 pm - Reply

    Well with much respect dear writer I know how heardo it is hear in Sudan when you want to do your best but everything else is pulling you back bit you know something you have to be happy cuz you have faced hard times but you got through you have done your best in the worst situation and I do expect to act way better in better once so my friend do not feel bad about any thing things try to think about it and keep on smiling not just becouse of the humanity of your job but also because God is blessing you each day in each moment while doing your Job knowing how heard it is on you.

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