The grimy reality of Morocco’s public hospitals

The Mohammed V hospital in Meknes, Morocco. With no spare beds, sick people are forced to lie on the dirty floor. All photos published on the Facebook page 'Health sector scandals'.

Blocked pipes, mouldy walls, wet blankets and a shortage of supplies: this is what users of Morocco's public health system have to deal with. Dozens of photos published on Facebook have shed light on the grime reality of the country's public hospitals. According to our Observer, it reveals a disastrous state of affairs that the government's privatisation plan won't be able to fix.

Al Farabi hospital in Oujda. The video shows wet floors and a blocked toilet (0:12).

The Facebook page 'Health sector scandals' was created in December 2014 by a group of Moroccan doctors. At the outset, the group's aim was to counter claims made by the country's health minister, El Houssaine Louardi, who blamed doctor absenteeism for the falling performance of public hospitals. The remark sparked outrage amongst doctors, who say that the real reason for the country's crippled health network is its insufficient budget.

The page quickly set off dismayed reactions across Morocco. The health minister reacted by dispatching teams of inspectors tasked with fixing the stomach-churning sanitary problems laid bare by the photos. The inspectors have yet to publish any report.

Maternity section of the Mohammed V hospital in Tangier.

"We had to a close an operating block because water was leaking from the ceiling"

The hospital in which I work is badly maintained, although we nevertheless keep a minimum standard of hygiene. We have two operating blocks, but we had to close one of them at the start of winter because snow had caused water to start leaking through the ceiling. And the other block hasn't been repainted for years. In the operating department, there are two wards without doors. The hospital isn't up to normal standards.

On top of that, the operating blocks aren't properly equipped. In the department of traumatology, there isn't even an operating table. So even if there are enough doctors, we still can't do our jobs. We carry out smaller operations that don't require many supplies, by using local anaesthesia, for example.

A broken operating table in Ibn Sina hospital.

I arrived in this hospital three years ago. The first year, I only carried out a total of six minor operations despite having carried out at least a dozen such operations per day during my internship in France.

A broken life-support machine in Ibn Sina hospital.

 

"Moroccans who are well-off go and get treated in private clinics"

Doctors don't even have the means to practice. But above all it's a problem for the patients. Those who have to be operated on for a bone fracture in the department of traumatology have to buy or rent all the equipment that's needed for the procedure. That can include screwing plates and even the instruments needed to fit plates or a prosthesis.

That could cost 700 euros if it's a femur fracture. If it's a hip prosthetic, it could cost up to 2,000 euros [Editor's note: the minimum wage in Morocco is roughly 200 euros per month]. They have to pay for everything, even though they're supposed to be examined and operated on for free. Very few patients have the means to pay these exorbitant charges. Getting access to healthcare becomes very complicated as a result, especially for the poor. Moroccans who are well-off go and get treated in private clinics instead of with us.

 

Babies on the floor in the provincial hospital of El Mokhtar Soussi in Taroudant.

The other major problem is the almost total lack of heating. We have oil-fired radiators, but they're never turned on - not even in winter - except during official visits. For example, a few weeks ago they were turned on just before the arrival of inspectors sent to our hospital in light of the photos published on the Facebook page 'Health sector scandals'. Although there are five or six electric radiators in the hospital, it's still not enough.

These problems affect hospitals right across the public health sector, even if some large institutions are better equipped than others. What's worse is that according to the health minister, it's all our fault! He reckons that doctors are lazy and corrupt.

His remarks anger us, even if it's true that corruption does exist, due in part to the low level of salaries in the public health sector [Editor's note: according to Transparency Morocco, the public health network is one of the sectors worst-affected by corruption]. In the public sector, a general practitioner earns 700 euros whereas a specialist takes home 1,100 euros at the start of his or her career. A specialist's salary can reach a maximum of 2,100 euros.

In the maternity ward at the University Hospital of Casablanca, cats roam the corridors while babies can be heard crying.

 

"I intend to join the private health sector as soon as I can"

The situation doesn't look like it's going to get any better. The state is investing less and less money in public health [Editor's note: in 2012, 6% of GDP was put aside for investment in the health system. According to the World Health Organisation, that's the minimum amount a middle-income country should aim to invest in the sector].

On February 4, Law 131-13 was ratified by lawmakers: it allows private investors from anywhere in the world to buy up healthcare clinics. That means that investors from Gulf Arab states who have nothing to do with Morocco's public healthcare can own clinics. [Editor's note: Morocco's health minister claims that the move will boost foreign investment in the country's healthcare sector and balance out regional inequalities. Doctors and certain NGOs dispute this claim.] Healthcare is becoming more and more privatised, much like the education sector that has already been completely broken up.

 

It's for all of these reasons that I intend to join the private health sector as soon as my eight-year public health contract comes to an end three years from now.

The problems laid bare by our Observer and the Facebook page 'Health sector scandals' are not new. Back in 2011, Doctor Simohammed Zaari Jabiri began a blog called 'The memoir of a schizophrenic neurosurgeon' in which he wrote of his daily experiences at work.

France 24 made several attempts to reach Morocco's health ministry for a response to these allegations. If and when a reply reaches us, we will publish it in this article.

Essaouria regional hospital.

Post written with France 24 journalist Chloé Lauvergnier (@clauvergnier).