Qatar's healthcare crisis

DOHA // Feeling ill? You might not want to be in Qatar.

The country has about 1.4 hospital beds for every 1,000 people – the lowest total in the GCC, one-fifth as many as Turkmenistan and Slovakia and fewer than poor countries such as the Democratic Republic of Congo.

“It’s not a good situation,” said Moza al Malki, a writer and family therapist. “Sometimes people go to be hospitalised and they can’t find an open bed.”

Despite a spike in government spending and the hiring of thousands of health-care workers, Qatar’s few hospitals and clinics are under severe strain because of a tripling of the population in the past dozen years.

“This huge increase in the population has put a huge load on our public health facilities,” said Jamal Khanji, head of the government’s medical licensing department. “There is a definite need for expansion, and that expansion is happening.”

Qatar has four public and five private hospitals, but the lynchpin is Hamad Medical Centre. The country’s primary health facility, it receives more than 80 per cent of public health-care spending.

Since 1999, that spending has risen from QR850 million (Dh858m) to QR4.3 billion, and the number of both nurses and doctors has tripled. Yet no major new health facilities have opened since 2004, and relative to population, the numbers of doctors, dentists, nurses and pharmacists fell anywhere from 15 per cent to 40 per cent during the past five years.

On a recent afternoon in Hamad’s emergency room, dozens of workers sat waiting for medical attention. Several limped, two held their stomachs and one held a bandage to his bleeding face.

Hamad’s bed occupancy rate, in the low 70s a decade ago, has hovered around 90 per cent for two years. A March study from the University of Michigan Health System found that occupancy rates above 80 per cent increase the risk of in-patient death by nearly six per cent.

Qatar’s foetal death rate, at 4.8 per 1,000 births in 2005, is now near eight per thousand, its highest in a decade. This is similar to rates in the UAE and Saudi Arabia.

Many residents have turned to pricey private providers or travel outside Qatar for health care, abandoning essentially free services at government-run facilities. Zakia Ali Malallah, a Qatari poet and commentator, recently wrote a column in the local Arabic language daily Al Watan about her three-hour wait to see a doctor at Hamad, vowing to never return.

And when Ms al Malki’s son was seriously injured in a motorcycle accident, her family sent him to Germany for treatment despite the high costs. “Nobody trusts Hamad now,” she said. “Even if I had to sell my house I would’ve sent him.”

The government is spending billions to alter that mindset. Set to come online in the next few years are paediatric and orthopaedic hospitals, a cardiac surgery centre and, at a cost of US$3 billion (Dh11bn), the Sidra Medical Centre. Construction is to begin this year on three hospitals exclusively for male labourers.

Qatar’s 2.25 doctors per 1,000 people is higher than Germany (2) and the UK (1.8) and just below the United States (2.43), according to the Organisation for Economic Development’s annual health data report. Yet specialists are rare.

Qatar has one specialist in tropical medicine, for instance, despite the presence of hundreds of thousands of people who hail from and regularly return to the Philippines, India, Bangladesh and Sri Lanka.

The Supreme Council of Health recently gave all primary health centre employees a five-per-cent salary rise, in an effort to increase retention, and began a recruitment drive for doctors and other health staff from across Arab countries.

“If you look at the need for nurses in this country, I would like to tell you we are talking about thousands,” Mohammad Fathy Saoud, the president of Qatar Foundation, said at a recent event.

A new policy allows the wives and adult children of resident healthcare professionals (except physicians) to work as trainees until the fulfillment of the experience required for licensing.

Last month, the government created the Qatar Health Practitioners’ Council to monitor medical licensing. The new body appeared shortly after the licences of 32 general practitioners were revoked because they were found to be practising without medical doctorates. All were given three years to earn a post-graduate degree, failing which their clinics would be closed permanently.

Health-care staffers could also use certification training. As a western expatriate was being rushed to the hospital in an ambulance this week, an emergency medical technician tried to take his blood pressure but failed to use the electronic machine properly. The machine constricted the patient’s arm until his fingers turned blue.

“The nurses and some other staff, we have to admit it, are mostly unqualified,” said Ms al Malki. “They don’t know what to do.”

That may be starting to change. Last month, the University of Calgary-Qatar graduated the country’s first university-trained nurses, the result of a programme nurtured by Qatari First Lady Sheikha Mozah bint Nasser Al Missned.

“There is a huge move to improve health services here,” said Mr Khanji. “The leadership of this country wants Qatar to be a hub for medical services in the region and you cannot achieve that without competent staff, a high level of safety, and recognised accreditation systems.”

originally appeared in the july 9 2010 The National (www.thenational.ae)


Building an art culture from the sand up

Doha// Call it the fourth power.

Along with diplomacy, media and sport, Qatar is promoting culture as another facet of its budding regional and international reach, and as part of a long-term plan to diversify its economy.

This small, wealthy emirate has in recent years organised successful negotiations on Darfur and Lebanon, built Al Jazeera into a leading global news source and, after hosting the Asian Games in 2006, is now bidding to host the 2022 World Cup.

Spearheading its cultural ambitions is the Qatar Museum Authority. The brainchild of Sheikha Mayassa, the US-educated, 26-year-old daughter of Qatari Emir Hamad bin Khalifa al Thani and his second wife Sheikha Mozah bin Nasser al Missned, QMA was created in December 2005 to oversee the museums of Qatar, rediscover the country's national heritage and transform Doha into a regional arts hub.

“They see culture as a leading aspect of their vision for the growth and development of this country,” Roger Mandle, QMA executive director since July 2008, said in a recent interview.

Their flagship is the Museum of Islamic Art, a $1.6 billion, I.M. Pei-designed, cubist masterpiece set on its own island across from the skyscrapers of Doha's West Bay. The museum's 700-object collection is worth hundreds of millions and includes an amulet of Mughal ruler Shah Jahan and a 9th century white earthenware bowl from Iraq.

In the 18 months since it opened the museum has had more than half a million visitors, or nearly a third of the country's total population. Half of them have been Qatari. “We've established a very high level of quality and expectations,” said Mr Mandle. “Out of that is a challenge, in that every building we build has to be that good or better.”

Up next is the Qatar National Museum, set to begin construction later this year. Designed by another Pritzker-winning architect, Jean Nouvel, the building reflects a strong sense of place: its shape mimics that of a desert rose, small, naturally occurring formations of gypsum found in arid deserts.

When the museum opens in 2013, interactive displays will detail Qatar's history, geology, and cultural life, from Bedouin times to seafaring and pearl diving, and from contemporary Qatar to the near future. At 40,000 sq metres, it will be larger than the Museum of Islamic Art.

QMA is looking to build a dozen new museums and expand its cultural education efforts. There has been talk of photography and contemporary art museums, but plans have yet to be finalised.

With the future museum designs Mr Mandle hopes to move away from international names and nurture young local talent. “They're not limiting their search to exclude well-known architects,” said Mr Mandle. “But surely one of our responsibilities is to promote artists, architects and designers from this region.”

Qatar has some company on that score. Abu Dhabi is spending billions to create its own cultural mecca on Saadiyat Island, with four museums and a performing arts center. Local versions of the Louvre and the Guggenheim designed by Jean Nouvel and Frank Gehry, respectively, are set to open in 2013.

Wooing similar crowds, the two cities often appear headed in the same direction. Phillipe de Montebello, the former director of New York's Museum of Modern Art who is now a special adviser to New York University Abu Dhabi, has been in talks with Mr Mandle, an old friend, about contributing to QMA in some capacity.

And while Mr Mandle has often described his mission as “building a Smithsonian from the sand up,” the Smithsonian Institute, based in Washington, DC, is a key adviser to Abu Dhabi's Bedouin Heritage Museum.

Yet rather than competition, QMA sees opportunity. It has hosted two conferences for Gulf arts and cultural leaders. The most recent, held last month, was attended by cultural representatives from all GCC countries but Oman. “We've taken the initiative to invite our colleagues to discuss how we can work together, not how we're competing but how we can cooperate,” said Mr Mandle.

The group hopes to create a joint cultural calendar so events complement rather than collide and develop joint training and education programs.

“Anywhere in the world, you have the best result if people collaborate rather than compete,” said Antonia Carver, who has been working in the UAE art world for nearly a decade and will take over Art Dubai next month.

“There's a huge difference between Doha and Abu Dhabi,” she said. Doha has focused on heritage and Islamic art and uses the emir's family collections, says Ms Carver, while Abu Dhabi's museums reflect greater international influence.

She envisions Western tourists visiting museums in both Doha and Abu Dhabi on a single trip. “If they start to replicate then it's maybe self-defeating,” said Ms Carver.

One advantage Abu Dhabi might have over Doha is the proximity of major arts shows like Art Dubai and the Sharjah Bienniale. Still, despite the presence of highly regarded international universities like NYU and Carnegie Mellon, the two cities have few art schools, curators, writers and studios.

“Building a complex and beautiful building is nothing compared to connecting to the local population and building a vibrant arts community,” said Ms Carver. “That's infinitely more challenging.”

originally ran in the July 2, National, www.thenational.ae