There is bitter criticism of private health care in Afghanistan. Some say it is far too expensive, others say it is not able to match the quality found abroad.
Obaidullah from the Campani area in the Afghan capital ended up paying 2,000 Afs (30 USD) to a private hospital for dressing a wound his cousin got when a mirror fell on her. An additional 300 Afs (4.5 USD) was paid every day they went back to change the dressing. On day 4, convinced that it would cost him not more than 100 Afs (1.5 USD) if he were to do it himself, he says, “I bought all the things and changed the dressing for (the next) 10 days.”
Hospital bills have wiped out all Munir Payenda’s savings. A resident of Logar province, he brought his sick wife to Kabul two months ago. “She was first admitted in Ibn Sina Hospital, but the doctors were a bit careless, and I took her to a private hospital,” he says. The hospital, which he did not want to name, could not diagnose her condition, but charged him 200,000 Afs (3,000 USD). “She was given one type of medicine, then another. Sometimes I was told she had cancer; other times that she had tuberculosis. Her condition only worsened (in the hospital), and I spent all my money,” he says.
Families that have the means simply go abroad for treatment.
Kabul-resident Amena Mayar took her husband to Pakistan after he had a heart attack. “He was in a private hospital in Shahr-e Naw,” she says. “Then we took him to Peshawar, where he was operated. Thank God he is now healthy.” Amena admits a “lot of money” was spent on his treatment in Pakistan, but the difference, she feels, is that the treatment is “effective” abroad.
Ahmad Fareed Niazai, another resident of Kabul city, has a similar story. His mother had been in and out of private clinics and hospitals in Afghanistan with lumbago for five years. “There was no orthopedist that she had not seen. She had bags of medicines, but the result was zero. Some doctors would say she has to be operated, others that she would become better with medication.” Finally, Fareed took her to doctors in Peshawar. “We went to a doctor working in Dabgarai. He prescribed some medicine, and my mother is so much better. She has continued with the medication; the doctor said there was no need for surgery in her case.”
Popping pills
Yet another serious problem is over medication. Many people feel that a majority of private hospitals and clinics over prescribe medicines to make more money. Akbar from Mirwais maidan in Kabul recounts the time he took his wife and grandchild, who were both running fever, to a private hospital. “They filled this bag (with medicines) telling me both were sick with flue. Earlier, doctors would simply prescribe a paracetamol and cotrimoxazole (antibiotic). But now they gave me a bag full of medicines and took 3,000 Afs (45 USD),” he says.
Sayed Sheraqa had taken his sister-in-law to a private hospital because she was complaining of a stomach ache. “They prescribed a medicine which she took in the hospital. Then they said she had to have a blood test, which was also in the hospital, followed by an ultrasound. I kept saying she had a stomach ache but they would not listen. I think all she needed was a bottle of antacid syrup. By the time we left the hospital I had spent 5,000 Afs (75 USD).”
If this is not bad enough, some patients feel they have been operated on for no reason in private hospitals. Killid interviewed Shafiqa who had taken her daughter to a hospital a year ago. She says that before her husband and son could reach the hospital, her daughter was whisked into the operation theatre. “The doctor said her appendix was taken out. We stayed one night in the hospital, and the total bill was 15,000 Afs (225 USD).”
A person in charge of a hospital pharmacy told Killid off the record that he knew of nurses who coerced women in labour to agree to surgery. It is well known that it is more lucrative for hospitals to conduct cesarean-section deliveries than wait for a natural birth.
Under Article 52 of the Constitution, the government is obliged to provide free health care to all people. “I don’t say that treatment is cheap abroad and expensive here,” says Ahmadullah from Paghman district, Kabul province, “the rates are not so different. The problem is that services don’t exist considering the money spent.”
In defence
Salem Yesrab, head of Kabul Delhi clinic in Qala Musa says people need to put pressure on the government to ensure quality of imports of pharmaceuticals and medical equipment. He insists his hospital strictly enforces the charges laid down by the government.
Dr. Qamarudin Sidiqi, advisor of public relations in the Ministry of Health, insists the quality of services in private hospitals is monitored. “We have inspected 85 clinics and so far closed five,” he says. In 2016, the ministry shut down nine private hospitals. There are 319 private clinics and 185 government hospitals registered with the Ministry of Health.
