Generally, healthcare encompasses the diagnoses, cure and prevention of disease, sickness, injury and other physical and mental impairment in humans and animals. The structure and delivery system of healthcare systems varies. Certain countries distribute healthcare plan among market accomplices whereas other countries’ healthcare system is centrally structured. Notwithstanding its varied planning and delivery methods, effective health care system requires sufficient funding; highly-trained and adequately paid staff; reliable information to make decisions; facilities and means to deliver drugs as well as equipment.
Alas Somaliland lacks the entire aforesaid essential aspects of healthcare system. Across the indicators of effectiveness, Somaliland’s healthcare system is ranked woefully the lowest in the world even in relation to other countries in sub-Saharan Africa, save Somalia. This renders our healthcare system one of the worst healthcare systems in the world with tens of thousands dying each year from effortlessly curable diseases as well as burgeoning medical malpractices. Although the significant underlying factors that have caused, and/or contributed to, the malfunctioning of our healthcare system are varied and numerous, four crucial factors will suffice: 1) insufficient healthcare funding from the central government; 2) chronic shortage of qualified health professionals; 3) burgeoning malpractices; and 4) unregulated medications available throughout the country.
First, the primary factor that plays pivotal role for the malfunctioning emanates from the insufficient healthcare funding from the central government due to Silanyo’s widespread corruption and inept administrative savoir-faire. The problem stems largely from the mismanagement and the mounting misappropriation of public fund. If government’s budget is managed properly, Somaliland’s government would have succeeded provide the required sufficient fund for its deteriorating healthcare, as the former Finance Minister Eng. Mohamed Hashi Elmi had succinctly articulated. Mr. Elmi disclosed that in 2011 the treasury’s revenue was US$83m and after three years of improved management the total sum should have reached US$500m. This vividly demonstrates that the problem lies primarily on the devious manner in which our government handles the public fund. If this trend continues, our healthcare system will, in due course, collapse.
Secondly, the chronic shortage of all cadres of qualified healthcare professionals is yet another lethal blow tearing the entire healthcare system to shreds. The reluctance of the government to pay adequate salaries for healthcare professionals de-motivates numerous employees. Some of these demoralized employees abandon government facilities altogether and start their respective private clinics. Others who remain in government facilities are forced to engage in an unlawful practices, e.g., charging patients more for services rendered and medications, coming-in late or leaving early to find additional source of income in order to make ends meet while abandoning seriously injured or ill patients. Again, Silanyo’s government failed miserably provide the funding required to deliver state-of-the-art medical trainings but also provide adequate salary for medical practitioners.
Thirdly, the scariest aspect of our healthcare system is the mounting malpractices. Medical malpractice implies an omission or negligent performance by medical professionals, e.g., medical doctors, osteopaths, dentists, nurses, etc., which causes personal harm to a patient. Malpractice occurs when the acceptable standard of medical practice are not satisfied by medical professionals. Under Silanyo’s administration, the subsequent aspects of medical malpractice are rampant in Somaliland: misdiagnosing a condition, reporting inaccurately on test results, executing surgery without proper knowledge or care, treating the condition inappropriately, providing inadequate caution, failing to notify patients for alternative treatments.
Fourth, another alarming aspect is the unregulated medications available throughout the country. The imported poor quality medications, abuse of drugs and, above all, an immeasurable unregulated pharmaceutical industry jeopardize public health in Somaliland. Although all Somaliland citizens’ health is in peril, the most vulnerable segment of the society are pregnant women and children. The so-called Somaliland Quality Control Agency (QCA) failed miserable ensuring the quality of food and drugs imported into the country. QCA has not even a laboratory for inspecting drugs. No one knows, even the QCA, what kind of medications are imported, the expiration date of these medications, its quality, etc. Therefore, most “pharmacies” supply expired medications and sell freely to anyone. Pharmacies become synonymous with local stores. They simply sell medications without any prior training. In addition, there is no distinction between prescribed medications and over-the-counter medications. Anyone can purchase any medicine without a doctor’s prescription. To add insult to injury, Silanyo’s administration failed again to regulate health care industry through various regulatory bodies protecting the public from a number of health risks and providing programs for public health and welfare.
Under Silanyo’s administration, our health care system has been, and will continue to be, broke provided Silanyo and his crooked cronies remain in power and continue to openly misappropriate public fund. Certain camps repeatedly assert that Somaliland’s government is incapable of funding healthcare, and other essential social services, due to its limited budget. This erroneous contention falls to the ground when one closely examines the reality on the ground. Somaliland’s budget is sufficient enough to cover almost all the desperately needed social services, including healthcare. In order to rescue of healthcare system, we – the people – should vote Silanyo out of office.
We owe it to ourselves and to the next generation!
Abdi Hussein Daud
Minneapolis, MN, USA
The author has obtained BA in Political Science & Global Studies at University of Minnesota, Masters in Health and Human Services Administration at Saint Mary’s University of Minnesota and currently pursuing PhD in Clinical Psychology. He can be reached at: abdihdaud@yahoo.com
