New measures to improve emergency room services in Tunisia

2009-02-04

Emergency rooms in Tunisia are ill-equipped and lack human resources. The government hopes that new measures, including new ER units and more personnel, will improve services.

By Nidal Abrouk for Magharebia in Tunis – 04/02/09

[Nidal Abrouk] The Tunisian government seeks to improve emergency response services.

Tunisian President Zine El Abidine Ben Ali signed off on new measures on Friday (January 30th) intended to develop emergency response services in the country.

The medical emergency sector is currently ill-equipped and suffers from shortage of specialised physicians and overcrowded emergency rooms, doctors and officials at the ministry of health said.

"With the huge number of daily incomers," said Nour El Din, a physician in the emergency unit at Charles Nicolle Hospital, "we are unable to offer service at the necessary speed and with the required quality. However, we are trying our best to tend to all cases, despite the sharp rise in workload."

And because of this shortage of service, Nour El Din said some of the physicians and medical staff members have to endure harsh treatment from drunken people or relatives of patients. "But we got used to that; it is our duty."

The new measures include access to emergency response and first aid departments under one phone number, increase the staff in emergency room departments, and building a new emergency room unit at the Charles Nicolle Hospital.

The government will also establish regional centres to receive emergency calls, and co-ordinate the intervention of concerned parties and link them to the emergency response and first aid line.

Mobile medical facilities for first aid and relief will be available in every hospital in the country before the end of 2011. Already, 14 new mobile medical facilities have been introduced.

Ministry of Health records show that urgent care facilities are currently training 400 emergency room physicians, 38 in-house physicians and four specialists. There are currently 182 emergency room departments in the country.

A visit to any urgent care department in Tunisia reveals the huge numbers of cases arriving each day.

In the Rabita hospital emergency room, the hallway is crammed with patients, doctors, nurses and workers. Because of the overload, doctors have only few minutes to look at each case.

"We receive nearly 200 cases every day at the urgent care unit," said Jalal, a physician at Rabita hospital, "most of whom do not call for immediate intervention. Some come in on account of a simple flu. This reduces our speed in attending to serious cases."

Jalal said that because outpatient clinics at hospitals are closed on Friday and Saturday evenings, people opt to go to emergency rooms when they feel slightly sick.

Figures released by the Ministry of Health show that only 20% of urgent care patients require immediate check-in to hospitals.

"I could not find a wheelchair to take my mother to the treatment room," complained Murad, who was accompanying his mother to Rabita hospital. "I have been waiting for half an hour, but my mother cannot keep standing for long."

Mahmoud, an elderly man with asthma, was lying on a stretcher for one hour at the Habib Tameur hospital, waiting for doctors provide him with oxygen.

At the Trauma and Severe Burns Centre, which opened in June last year, the scene is different. The centre is equipped with the latest medical equipment and supplies. Unlike most other small-sized urgent care units, the seven-storey centre was built on six hectares.

"There is hardly any crowd in the centre," said one of the physicians.

"The objective is to promote the profits of the health sector, enhance urgent care services, and bring them closer to the citizen," said the centre's admittance manager, Ridha Bou Zid.