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رداءة الخدمات الصحية لمستشفيات مقديشو

شهدت الخدمات الصحية في الصومال تخلفاً كبيراً كماً ونوعاً خلال السنوات الماضية على المستويين الوقائي والعلاجي، وجاء هذا التخلف، نتيجة الحروب الأهلية التي أخذت الأخضر واليابس، والفساد الأخلاقي للأطباء الذين ليس لهم علم بالمعايير الطبية، كل هذه الأمور أدت إلى إفتتاح كل فرد مركزا صحيا لا جودة فيه ولا مقاييس صحية. 

إن الكفاءة المستشفيات في مقديشو متدنية بدرجة كبيرة، وتحتاج إلى دراسة علمية أعمق بغض النظر عن الظروف البيئية المحيطة بالمستشفيات في مقديشو، قد حاولت الوقوف على حالة بعض المستشفيات في مقديشو وقابلت بعض الأطباء في نقابة الأطباء الصوماليين الذين لهم دراية في هذا المجال ، وأخبروني أن الكفاءة والجودة ضعيفة للغاية، والكوادر في مجال الصحة ضئيلة أيضاً، والعلاقة بين وزارة الصحة مع المستشفيات معدومة، ولا يوجد طبيب لديه شهادة تثبت أنه مؤهل للمهنة من الوزارة، وأن دور الوزارة محصور بالهيئات الصحية العاملة في مقديشو لتشارك معهم الميزانية، وليس عندهم برنامج موجه كيف تراقب جميع المستشفيات في مقديشو، وتعاقب الأطباء الذين لايعرف أحد مؤهلاتهم العلمية، لتحقيق أيضاً الأدوية التي يصفها الأطباء للمرضى، هل صالحة أم هي غير صالحة ؟

يعتقد الكثير من المحللين الصوماليين أن القطاع الطبي أكثر تضرراً بالقطاعات الأخرى في الصومال ويعاني ضعف الفاعلية، ولا يوجد في المستشفيات بعض الآلات الضرورية لفحص بعض الأمراض القاتلة، والبيئة غير صالحة، لأن جل المستشفيات في مقديشو أفتتح لجمع المال، وليس الأخلاق الطبية عند الأطباء، التي كانت ملازمة للطبيب، والممرضين الذين يعملون مع الأطباء يتعاملون مع المرضى معاملة قاسية، ولايتلقون تدريبات لارتقاء مهنتهم، الهمّ الأول عندهم إيجاد دخل في عملهم.

نذرة الكوادر في المستشفيات:

الكوادر الطبية في الصومال نسبة ضئيلة، ولايوجد بعض التخصصات في مقديشو مثل أطباء الجراحة، والتوليد، وبعض المستشفيات تستورد هذه الكوادر من بعض الدول العربية مثل السودان ومصر العربية وغيرها، والنسبة الموجودة في الصومال ليس كلهم كوادر يستحقون أن يعملوا في المستشفيات، بل جلهم يجرون وراء الرزق بدون علم، وهي كارثة تحتاج إلى تصحيح، أما نسبة المتخصصين في مجالهم بالمستشفيات في مقديشو لاتتعدى عن 5% من نقابة الأطباء الصوماليين في مقديشو، هذه النسبة قليلة جداً، بالنسبة للأطباء العاملين في المستشفيات في مقديشو، وهذا دليل قاطع أن الكفاءة والجودة في امستشفيات مقديشو متدنية، وأكثر العاملين في المراكز الصحية غير مؤهليين لعملهم (سعيد شيخ محمد، مقابلة معه في مكتبه في مستشفى ابن سيناء التخصصي، في مقديشو، بتاريخ/7/7/2015م).

الأدوية فاسدة وغير صالحة:

إن الأدوية التي يستخدمها الأطباء ليست لها كفاءة صحية، لأن كثيراً من الشركات التى تستورد الأدوية لايدققون كفايتها، وليس لدى الوزارة فحص لهذه الأدوية، أخبرني أحد الأطباء وهو (سليمان صالح عمر، طبيب له مركز طبي في مقديشو بتاريخ 10 يوليو2015م،) إن الأدوية التي يداوي بها الأطباء للمرضى بالية، يعني غير صالحة للاستعمال، أو أن الغرامات الكيميائية فيها ضعيفة جداً، وبعض الشركات ذهبوا إلى الهند وطلبوا من المصانع أدوية دون التأكد من فاعليتها، تظهر أحيانا أن الكابسول الذي قدر له 500 غرام، فيه 50 غرام أو أقل من ذلك، وأن علاقة هذه الشركات والأطباء علاقة ودية، وأن هناك تفاهم بينهم وبين الشركات، ويأخذ بعض الأطباء نسبة معينة من الأدوية إذا كتبوا إلى الناس، ولايبالون المرضى تضر أم لاتضر، والدليل أن بعض الأدوية التي يصف بها بعض الأطباء غير متوافرة في جميع الصيدليات بالمدينة ، ويقول لك أحياناً إذهب إلى الصيدلية فلان لتجد هناك هذه الأدوية، واستفاد بعض الأطباء العلاقة المعدومة بينهم وبين وزارة الصحة. في هذا الإطار أشار(طاهر محمد نور، صاحب صيدلية الإحسان في مقديشو بتاريخ 12/7/2015م)، وأخبرني أنه رأى بعينه أدوية انتهت صلاحيتها، ثم تم الختم عليها مرة ثانية بختم التجديد، وقال هذه الأدوية يصنع في سوق بكارو أو في أحد احياء المدينة، ولاشك أن هذا التزوير منتشر في مقديشو، وأصبح هذا الخبر متداولا في كل أسواق الأدوية، ويعاني الشعب الصومالي من أضرار هذه الأدوية التي لا صلاحية لها، وانتهى وقت التداوي بها، وتضر جسم الإنسان. كل هذه الأمور ليست بعيدة أن يقوم بعض المفسدين الذين لايخافون الله. 

الأخلاق الطبية معدومة:

إن جل الأطباء في مقديشو لا يتصفون بأنهم أطباء لهم أخلاق طبية، ويتعاملون مع المرضى معاملة لائقة، قبل فترة زرت أحد المستشفيات في مقديشو الذي يعتبره الصوماليون أجود المستشفيات في مقديشو، وهو مستشفى زمزم المصري، مع أحد المرضى من أقربائي، وقابلنا مسئول غرفة الإسعاف، لإعطاء المريض أدوية لتهئية أحواله المضطربة، وبعد مدة قدرت بساعة  جاءنا أحد العاملين وطلب منا أن تقوم بفحض المريض، وأخذ عينة الدم للفحص، وأظهرت النتيجة بعد 24 ساعة، وسألت أحد الأطباء، وهو دكتور مصري للأمراض العامة، كيف يمكن أن يستغرق الفحص لـ 24 ساعة، وحالة المريض تتعقد ساعة بعد ساعة، وأصبح المريض مغمى عليه، وقال ما مشكلة، وناقشت الدكتور، حتى قال: الآن نأخذ دماً آخر لنفحص مرة أخرى، وقررنا الإنسحاب من المستشفى، وعلى كل حال إن الفساد منتشر في مستشفيات مقديشو، ولايوجد معايير طبية صحيحة، وليس عندهم الأخلاق الطبية، ولايبالون شعور الناس، ويفتحون متى شاء ويغلقون متى شاء. واصبحت المستشفيات مصدر إقتصادي فقط، ولاتحاسب وزارة الصحة ، وليس عندها أي استراتيجية قومية تستهدف خلق جو صحي أحسن مما هو اليوم في الصومال.

لذك أرى أن على الحكومة الصومالية خاصة وزارة الصحة أن تقوم بإصلاح هذا القطاع الصحي الذي يمر في مرحلة سئية للغاية، وأن تضع قيودا وشروطا عامة  تحدّ من أن يفتح من شاء من الناس مركزاً طبياً، لتسأل هل هذا الطبيب مؤهل أم لا؟ وتقوم أيضاً بمراقبة الأدوية البالية التي يستخدمها بعض الأطباء، والبائعين بعد انتهاء مدة صلاحيتها، وأن تقيم مراكز الفحص في الميناء لتحقيق صلاحية الأدوية الطبية. وأن هذا القطاع لايصلح إلا بمراقبة الوزارة، وعلى الوزارة أن لا تسمح إفتتاح المراكز الطبية إلا بعد منحها رخصة مزاولة المهنة.  

صالح علي محمود

• حصل الشهادة الجامعية من جامعة مقديشو كلية التربية قسم العلوم الاجتماعية عام 2011 م. • حصل الدبلوم العالي في العلاقات الدولية بأكاديمية السودان للعلوم عام 2014م • الآن يحضر درجة الماجستير في التاريخ الحديث والمعاصر بجامعة سنار في السودان بعنوان" الطرق الصوفية ودورها في الدعوة والثقافة الإسلامية في جنوب الصومال 1889-1960م دراسة تاريخية حضارية " • حصل الشهادة الثانوية من معهد محمد بن نصر المروزي في مقديشوعام 2006م

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