Azuria Medical Problems Essays - Medicine, Health Care, Free Essays

Azuria Medical Problems The state-run medical system has collapsed in Azuria, and only rudimentary care is available through NGOs (when they aren't being shot or kidnapped). Statistically there is supposed to be one doctor for every 4,640 people in Azuria. Diarrhea, communicable and parasitic diseases are rampant in the country. Chloroquine-resistant malaria is present in all parts of the country. Larium should be used for chemical prophylaxis. Cholera, dracunculiasis (Guinea worm), cutaneous and visceral leishmaniasis, rabies, relapsing fever and typhus (endemic flea-borne, epidemic louse-borne and scrub) are prevalent. Azuria is also receptive to dengue fever, as there have been intermittent epidemics in the past. Meningitis is a risk during the dry season in the savanna portion of the country, from December through March. Schistosomiasis may also be found in the country and contracted through contact with contaminated freshwater lakes, streams or ponds. A yellow fever vaccination certificate is required for all travelers coming from infected areas. There's also a pesky little problem with Tumbu Fly, a local maggot that burrows into human skin, munching on flesh all the way. The larvae grows big enough to rip out flesh before it turns into a fly. Hospital Resources No non-trauma medical care is being delivered at the hospitals. If the needs of those with chronic or acute medical conditions, such as diabetes, are being met, it is likely to be through the efforts of private physicians working out of their private homes in the community. Hospitals provide casualty care to heavily populated portions of the country. Digfer Hospital in Mogadishu has the capacity for about 650 inpatient beds, with an estimated current inpatient census of 1,000 patients. Benadir Hospital in Djibouti City has approximately the same capacity and current census. Medina Hospital in Mogadishu currently holds approximately 400 patients. Hospital needs in the north are served by a team of five Azuri physicians who set up the "Health Emergency Committee" on April 18, 2005. They work out of 27 converted villas, which have been combined to form what is called Karaan Hospital, where most of the emergency surgery takes place. An additional set of 16 villas in the north constitute a collective inpatient ward, Karaan 2, for patients who are convalescing from acute injury. The total number of patients hospitalized in these 45 villas is approximately 5,000 to 6,000 people. For medicines, the Karaan Hospital relies entirely on weekly supplies brought in by the ICRC. The physical condition of the acute care areas of these hospitals is uniformly austere and, with the exception of the casualty and operating areas of Medina Hospital, where the expatriate staff from Mdecins Sans Frontires-France (MSF) have taken over and renovated the most advanced of the city's surgical units, conditions are unsanitary. As the factional fighting prompted urban fighting and then as the intra-clan conflict broke out, makeshift casualty wards were set up in the existing entryway in the other two hospitals in the south during the course of the past year. During this year, both parties to the conflict have looted and destroyed public and private facilities. They have not spared hospitals. Digfer Hospital was particularly hard-hit and stripped almost bare of equipment, furnishings, and supplies. The ICRC had opened a hospital for the care of acutely injured casualties for the north in early February, but after one week of operations, was forced to close it abruptly in the face of active hostilities. (The hospital is operational again; see below). The surgical care structures on the north are even more minimal, since they were built as private homes. With the exception of the acute casualty and surgical areas of Medina Hospital, none of these hospital structures have screens over the windows to keep out flies and other insects. Electricity is available only to the operating areas on an intermittent, limited basis, from locally maintained diesel fueled generators. Running water is infrequent and unclean. There is no oxygen available in the city and no inhalation anesthesia possible. Surgical drapes are scarce or non-existent, depending on the site or hospital. Sterilizers occasionally work and are used according to varying routines and frequency. Much of the surgical equipment in most of the sites is re-used without interim sterilization over a 24-hour period. Casualty and operating areas are mopped down intermittently, depending on the volume of cases arriving in acute condition. Available antibiotics included penicillin and erythromycin; medicine for the prevention of tetanus was in short supply. Medical support can continue to be provided at its current rudimentary level only if the lifeline provided by the ICRC can be maintained. Medical supplies to both sides of the city and food rations for