By Teshome Wolde
I understand you had a meeting with Ethiopian Woyanne Ambassador to United States to discuss about the establishment of referral hospital in Ethiopia. We would be very grateful if you can spend few minutes to elaborate the idea behind establishing a referral hospital. The following questions may only help guide your response.
In one of the world poorest country, Ethiopia, where the health care service already facing daunting challenges to deliver minimum standards of health care, what good is referral hospital doing? Is it referral hospital or regular health care facilities that will benefit the people of Ethiopia most?
When answering these questions think about what a health care specialist said: “referral hospitals should be seen as the capstone of the health care pyramid.” Do you guys think the pyramid (lower level healthcare facilities) is firmly established to hold the capstone?
I understand you guys can do whatever you want to do with your hard earned money. That is your absolute right. You have all the rights to establish a fancy referral hospital for the powerful and wealthy people of the country and save them a trip to Europe, United States, or Asia. Make good money too. If you are interested in elaborating your idea about your prospective investment, tells us what you are up-to. Implicitly or explicitly, saying “none of your business” is also your right.
The general view is that referral hospitals are often too costly and make very limited contributions to improving the health of the whole population. This is because referral hospitals are usually located in urban areas and are intended to provide costly specialized health care to patients referred from lower levels of the health care system. In a general sense, referral hospital is mainly to the wealthy.
If a referral hospital is established in our country, it does not take a telepathist to predict that the powerful government officials and wealthy urban dwellers would dominate the facilities for regular health care visits when they could be assisted by general practitioners at lower-level clinics. Poor people would not get the chance, because it would be congested with the powerful and wealthy unnecessarily occupying beds and other facilities for long periods.
The other concern associated with referral hospitals is a health care equity issue. Doctors may find it attractive and rewarding to work in referral hospitals, depriving rural health facilities of the expertise they desperately need.
That said, referral hospitals have positive impact on health care system when established at the right place and at the right time. For instance, beyond providing high quality health care, referral hospitals perform broader functions in the health system such as training doctors, conducting research.
(I can be reached at [email protected])