Care of patients in health structures in Guinea, a sector in need of care

Facility-based care refers to the organization and services provided in healthcare facilities, such as hospitals, clinics and medical centers. It aims to ensure quality care and comprehensive care for patients. However, in Guinea, the medical profession often does not respect the principles of the Hippocratic Oath which prioritizes human health over profit and personal interest.

“To talk about care in general, it is necessary to take into account eight (8) essential points. These points range from patient assessment, planning, care, monitoring, emotional support of patient typology, patient education, coordination between health structures up to taking into account the social aspects of the disease“, explains Dr Seydou Sidibé, general practitioner. This care must be done in strict compliance with the Hippocratic Oath, which is a solemn declaration that doctors make upon entering their profession.

This oath clearly states that the primary duty of physicians is to treat patients with compassion and dignity, providing them with quality care, regardless of race, religion or financial status. However, in Guinea, these fundamental principles are not always respected by all health professionals. These discriminatory attitudes towards vulnerable people are very recurrent in health structures. This is the case of Hadjiratou bah, mother of 3 children who was hit by a biker as she went to buy her goods.

“I was hit by a motorbike while I was crossing. I fainted, my body was bleeding a lot, some even thought that I died in the meantime, I was transported to a hospital. After receiving first aid, the doctors referred me to Donka hospital. Given the state I was in with all this bleeding, my family decided to take me to a clinic in Cosa,”she testified.

From first aid to comprehensive care, some citizens go through the ordeal.

"Arriving  at  Cosa, the doctors rather thought about money instead of taking care of my injuries. When they asked for 4,300,000 fg for the operation on my foot, my family said that they do not have the means to pay all that. So, the doctors said to go to another clinic, my husband had to negotiate for a reduction. I suffered a lot because the doctors did not pity for a person without financial means“, adds Hadjiratou bah, mother of 3 children who almost gave up her life.

This testimony from Hadjiratou Bah like so many other citizens in distress is a perfect illustration of the ordeal of patients in health structures in Guinea. This precarious situation endangers the lives of the most vulnerable people and accentuates health inequalities.

Of course, health structures also encounter organizational difficulties, particularly the supply of medicines, consumables and inputs. But, responsibilities are very often shared between patients and the medical profession, according to Dr Seydou Sidibé, general practitioner..

“Sometimes in certain services, staff are forced to put their hands in their pockets to put in the bare minimum to keep the service running. Personally, I administered care to a patient to stabilize him in a local health structure and then I moved to resolve a need for just two minutes, when I returned I found that the patient had escaped. So, the processing fees were deducted from my balance each weekend of custody,”he regrets.

Sometimes, doctors may refuse to provide care to patients for reasons related to the fact that certain patients do not do what is asked of them or do not honor their commitment after treatment. “Thing that I find deplorable on both sides. If we stick to the Hippocratic oath, we are asked to offer care to those who do not have the means to care for themselves. Failure to do so is reprehensible even from the point of view of moral practices. The doctor has an obligation of means, not an obligation of results. What you do based on that, save life first,”adds Dr Seydou Sidibé.

In public or private health facilities, repeated cases of requests for payment of money before first aid even in an emergency are often reported. The most vulnerable patients, those who cannot afford to pay, are being denied essential care or sent elsewhere. Most of these patients are left with gaping wounds, others even lose their lives. The Ministry of Health must ensure compliance with the principles of the profession for better quality of service in the country's health structures.

Hawa Dine Diallo