Critical Issues in Healthcare Policy and Politics in the Gulf Cooperation Council States

Ravinder Mamtani, Albert B. Lowenfels, Ravinder Mamtani, Albert B. Lowenfels

• Publisher: Georgetown University Press
• Year: 2018
• ISBN:
  9781626165021
• Topic: Política y relaciones internacionales
• Subtopic: Políticas de Oriente Medio

This is the first book to examine challenges in the healthcare sector in the six Gulf Cooperation Council (GCC) countries (Saudi Arabia, Oman, the United Arab Emirates, Qatar, Kuwait, and Bahrain). These countries experienced remarkably swift transformations from small fishing and pearling communities at the beginning of the twentieth century to wealthy petro-states today.Their healthcare systems, however, are only now beginning to catch up.

Rapid changes to the population and lifestyles of the GCC states have completely changed—and challenged—the region's health profile and infrastructure. While major successes in combatting infectious diseases and improving standards of primary healthcare are reflected in key health indicators, new trends have developed; increasingly "lifestyle" or "wealthy country" diseases, such as diabetes, heart disease, and cancer, have replaced the old maladies. To meet these emerging healthcare needs, GCC states require highly trained and skilled healthcare workers, an environment that supports local training, state-of-the-art diagnostic laboratories and hospitals, research production and dissemination, and knowledge acquisition. They face shortages in most if not all of these areas. This book provides a comprehensive study of the rapidly changing health profile of the region, the existing conditions of healthcare systems, and the challenges posed to healthcare management across the six states of the GCC.

A Historical Overview of Healthcare in the Gulf cooperation council states

Nabil M. Kronfol

This chapter outlines the historical transformation of the healthcare systems in the six countries of the Gulf Cooperation Council (GCC). This analysis is based on published articles and annual government reports. In addition, personal reminiscences from people who have been instrumental in developing regional healthcare services are included. It should be noted that the history of regional healthcare development, as important as it is, lacks documentation and published literature. It is hoped that this chapter will encourage officials who are in a position to participate in the documentation and analysis of these historic events.

The chapter describes four phases. The first phase narrates the beginning of health services at the turn of the twentieth century in all six GCC countries. The second phase describes the beginning of the development of the region’s healthcare systems, which went on to become world-class modern systems by the end of the twentieth century. The third phase develops the current situation. The fourth and final phase is a discussion of the main determinants of the transformation of the healthcare systems and the current challenges faced by the GCC countries. This last phase draws from the perspectives of the chapter’s author, who has lived through this period and who was often an actor in the transformation of these systems.

Historical Overview

Considering the health problems during the 1950s and 1960s, we generally assumed that every patient had five diseases before he came to the hospital complaining of yet another problem. The five diseases were malaria, trachoma, intestinal parasites, malnutrition, and anaemia. But what brought the patient to the hospital was usually something else, such as a broken bone, a serious burn, pneumonia, meningitis, tetanus, strangulated hernias, obstructed labour, intestinal obstruction, serious trauma such as camel bites or fishing accidents. . . . We rarely saw cases of appendicitis, gallbladder disease, gastric ulcers or heart attacks. Obesity was virtually unheard of. If we encountered these diseases, it was in a patient who had been off-loaded from a ship in the harbour or an individual who was not an Omani. But as prosperity came to the country and eating habits changed, all these diseases became common.¹

The statement above was written by Dr. Donald Bosch, one of the first physicians to staff the American Mission Hospital in Oman, to describe many of the conditions that prevailed in the GCC countries at the end of the nineteenth century.

Bahrain

Health services in the Kingdom of Bahrain were established in the early twentieth century, with the American Mission Hospital in 1903. With a twenty-one-bed capacity (box 1.1), the hospital treated Bahrainis, and served other patients as well, many of whom traveled from the surrounding countries to seek medical treatment. Subsequently, the smaller memorial Victoria Hospital was established with a twelve-bed capacity and was “staffed by a general practitioner appointed by the British Government in India.”² In 1925, the first government-run clinic was established, and was “staffed by an Indian doctor appointed by the government to treat injured pearl divers.”³ Subsequently, the Public Health Directorate, a preventive care agency, was established.

In 1936, a small hospital was established for the Bahrain Government Police Force, which was subsequently converted into isolation wards. With the discovery of oil in Bahrain in 1932, the Bahrain Petroleum Company established the first planned medical provision and constructed the thirty-seven-bed private Awali Hospital, especially for its staff; and then, in 1942, the first official government hospital, Al Naim Hospital, became operational.⁴

Box 1.1The Arabian Mission in Bahrain

In 1888 at the Theological Seminary of the Dutch Reformed Church, in New Brunswick, New Jersey, a teacher and his three students had the calling to begin their work in Arabia. Dr. John G. Lansing had inherited his interest in Arabia from his father, a pioneer worker in Syria and Egypt. Born in Damascus, John Lansing had always felt the call back to Arabia. With the help of his three students—Samuel M. Zwemer, James Cantine, and Philip T. Phelps—he formulated a plan to create what was to become known as the Arabian Mission.

On May 23, 1888, the group signed their plan, arranged for their own funds. The Board of Foreign Missions passed their acceptance, and the Arabian Mission was born. Through the personal donations of several people, the Arabian Mission finally had enough money to send their first missionary out.

Samuel Zwemer stopped over in Bahrain and rented a room, which led to the opening of a medical dispensary in the Old Souk in 1883. This is how one man, Samuel Zwemer, ignited the vision of a health service for Bahrain with a single step. On January 26, 1903, after much hardship, the Mason Memorial Hospital in Bahrain was dedicated.

One hundred and eleven years later, the tradition of the missionaries and their service to the island of Bahrain still embodies the principles on which they serve the people of Bahrain.

Source: American Mission Hospital, www.amh.org.bh/history/.

Kuwait

Kuwait’s first healthcare facilities date back to the early twentieth century. At the invitation of Sheikh Mubarak Al Sabah the Great, medical practitioners from the Arabian Mission of the Dutch Reformed Church in the United States established a hospital for men in 1911, and another for women in 1919.⁵ In 1934, Olcott Memorial Hospital opened with thirty-four beds; and in 1936, the Ministry of Health (MOH) was established. Along with increased revenues from the oil industry, the government expanded the healthcare system, and in 1949 it opened the Amiri Hospital, and the Kuwait Oil Company established its own, smaller, facilities, so that “by 1950 general mortality had fallen to between seventeen and twenty-three per 1,000 population and infant mortality to between eighty and 100 per 1,000 live births.”⁶

Oman

In the nineteenth century, the British operated early medical facilities in Muscat, mainly in relation to port quarantine services for Muscat Harbor.⁷ The Muscat Charitable Hospital, the first hospital in Oman, was constructed by the British Consulate in 1910, and was operational until 1970.⁸ In the early twentieth century, the British government—along with a branch of the Reformed Church of America, the Arabian Mission—invested in larger healthcare facilities in Oman, establishing the Mutrah medicial clinic in 1904. In 1913, the American Mission opened a women’s hospital in Muscat, and in 1934, a large general hospital called the American Mission Hospital. This was the only hospital in the country that was equipped with a functioning surgery unit, including an X-ray machine installed in 1940, with the capability to perform ten to twelve daily operations by 1950. Periodically, the American Mission was capable of sending physicians to travel around the country to visit, treat, and operate on patients in the interior regions. Over the course of its operations, several notable physicians—including Dr. Paul Harrison (1925–39), Dr. Wells Thorns (1939–70), and Dr. Donald Bosch (1955–74)—worked in Oman’s growing healthcare field.⁹

Qatar

In Qatar, healthcare was mostly administered using traditional medicines and methods before the discovery of oil, where “barbers performed circumcisions and other minor procedures, and herbalists dispensed natural remedies.”¹⁰ In 1945, a small hospital was established, where only one physician oversaw operations; and later, in 1959, Rumailah Hospital, the first state hospital, was established, with 170 beds. A 165-bed maternity hospital opened in 1965.¹¹

Saudi Arabia

Similar to the other Gulf states, Saudi Arabia’s oil revenues enabled it to develop a modern healthcare system. Before the discovery of oil, healthcare mainly revolved around traditional medicines and practices.¹² In about the early twentieth century, in 1926, both the Ajyad Hospital in Mecca and the Bab Shareef Hospital in Jeddah were established, and the newly formed MOH oversaw eleven hospitals and medical dispensaries all around the country, as well as the first nursing school. In the same year, even though the country was still in its very early stages of development,¹³ King Abdulaziz Al-Saud (1880–1953), formally decreed that the Saudi Arabian government was establishing a Health Department, which was named the General Directorate for Health and Aid and was under the supervision of the Bureau of the Attorney General.¹⁴ Even though traditional healthcare was still practiced by much of the population, this directorate oversaw the construction of a series of medical facilities in many urbanizing areas that aided in controlling disease and raising the standards of the kingdom’s available health services.¹⁵

In 1925, a royal decree by King Abdulaziz led to the establishment of the first public health department in Me...

Table of contents

• Cover
• Half title
• Title
• Copyright
• Contents
• Foreword
• Acknowledgments
• Introduction
• 1 A Historical Overview of Healthcare in the Gulf Cooperation Council States
• 2 The Politics of Healthcare in the Gulf Cooperation Council States
• 3 Human Resources for Healthcare in the Gulf Cooperation Council States
• 4 Mental Health in the Gulf Cooperation Council States
• 5 Substance Abuse in the Gulf Cooperation Council States
• 6 A Chronic Disease Profile of the Gulf Cooperation Council States
• 7 Lifestyle Diseases in the Gulf Cooperation Council States
• Conclusion
• List of Contributors
• Index