I don’t know the specific details of this story, but the allegations do not surprise me. There are problems at all levels of the ER. Often, it starts with the first responders, who are poorly equipped and lack the proper training, which means the victim will arrive in an even worse state. Hospital procedure requires the patient to be first checked out by a doctor, during which time relatives must fill out administrative documents. Afterwards, the doctor gives a prescription to the nurse, who passes it on to the family. At this point, the family must pay to obtain the medication, blood pouches, radiology procedures, and the associated equipment [gloves, cotton swabs, etc.] needed to care for the patient. Often, families are unable to pay, and sometimes there is a shortage of medication.
In this young woman’s case, it’s very likely that the personnel saw that she had no relatives present to pay for her care. They probably put her to the side as a result. If you’re alone in the hospital and unconscious, the system is such that you probably won’t receive care in time because you will not be able to pay for it. This is particularly the case when you’ve just been attacked, because you probably don’t have any money on your person anymore.
There is no social security in Côte d’Ivoire. Hospitals are organisations that must generate revenue. It’s hard to admit, but since the ER is always overflowing, doctors must make decisions based on which patients are likely to be able to pay for their care.
“Doctors aren’t the ones that should be condemned; it’s the system as a whole that needs to be overhauled”
The president [Alassane Ouattara] had enacted a policy of free healthcare after the post-electoral crisis. However, he reneged on his commitment and instead introduced “targeted free care” [outlined in more detail here
, this policy covers the first 48 hours in medico-surgical emergency rooms]. But hospitals aren’t following suit. There aren’t enough emergency doctors, there isn’t enough training in this speciality, and the ERs are under-equipped. Just think — there is only one functional MRI machine in the entire country!
Another important point to keep in mind is that specialties are not accounted for in salaries: ER doctors that work at night and generalists that only work day shifts both get paid the exact same salary. And the budgets are so tight that very often, the staff isn’t paid at the end of the month. In this context, even though the staff wants to save lives, they inevitably lose much of their motivation.
When a woman in Awa’s state is dropped off at the ER, people expect her to be treated, but the state of Ivorian hospitals is such that her care cannot be ensured. Doctors aren’t the ones that should be condemned; it’s the system as a whole that needs to be overhauled.