6-26-08 – Esmeraldas, Ecuador
My head says to avoid politics, my heart tells me I cannot. Not when the hospital is in the shape that it is: lacking both equipment and staff, having leadership but without direction, personnel without intuition - having patients but lacking healthcare. The finger pointing is relentless, but it makes little difference because if you pick any hole and look through it you can see all the others. Most people fault the director, who runs the hospital like the warden of Shawshank Redemption – crooked and unpredictable. They do this for a number of reasons, the top three being it’s easy, it’s fun and it’s true. My vote is with the majority; I carry a chip on my shoulder from the night we wanted to use the OR and couldn’t. A few weeks ago he also docked ten percent of the salary of a friend as a fine for something stupid. And then last week, in front of patients, he started name-calling and bullying, telling a doctor he was stupid. He’s the guy everyone loves to hate - that’s why I am excited to tell this story.
It was about mid-morning on an average day when Falcones, an intern, pulled me aside. “The Minister of public health is here – go tell her what you think about this place”. Falcones knows I want to see things improve – he works with me on guard number one (of a four-guard rotation) and was there for the Morbidity and Mortality meeting. So I stepped out – but only to step into a roomful of doctors jumbled around a Chinese woman, the Minister, who was going from bed to bed getting the low down. In the back of the room were some official looking people, well dressed and with mustaches –government types with clip-boards and pleated pants. I still didn’t understand who this lady was, but she must have been important because everyone was there, so I wiggled my way to the front where Safadi was diplomatically letting loose. Our friend the director was clearly nervous, or pissed – it was hard to tell the source of his unease – but his knees were wobbly and he tried to counter what was said. The Chinese woman couldn’t believe there wasn’t a laryngyscope in the ER apart from the one Safadi brings from home, or that when the surgeon is in the OR, there isn’t the staff to cover and patients wait for hours to get stitched. Suffice it to say there were a lot of things she couldn’t believe – and before she left we had a verbal commitment for a million dollars.
Safadi bought some suds for his pals and we celebrated that night: Pilsener, the national beer of Ecuador...
“So who is this lady anyway,” I asked.
“The minister”
“Yeah, but I mean, who does she report to?”
“The President”
“Of what?”
“Ecuador”
“Oh, so she’s like the Surgeon General of your country?”
“Yeah,” they laughed. Then with glasses raised: “Here’s to the Minister of Health, the Surgeon General of our country” – and they drank. It was a good night.
My head says to avoid politics, my heart tells me I cannot. Not when the hospital is in the shape that it is: lacking both equipment and staff, having leadership but without direction, personnel without intuition - having patients but lacking healthcare. The finger pointing is relentless, but it makes little difference because if you pick any hole and look through it you can see all the others. Most people fault the director, who runs the hospital like the warden of Shawshank Redemption – crooked and unpredictable. They do this for a number of reasons, the top three being it’s easy, it’s fun and it’s true. My vote is with the majority; I carry a chip on my shoulder from the night we wanted to use the OR and couldn’t. A few weeks ago he also docked ten percent of the salary of a friend as a fine for something stupid. And then last week, in front of patients, he started name-calling and bullying, telling a doctor he was stupid. He’s the guy everyone loves to hate - that’s why I am excited to tell this story.It was about mid-morning on an average day when Falcones, an intern, pulled me aside. “The Minister of public health is here – go tell her what you think about this place”. Falcones knows I want to see things improve – he works with me on guard number one (of a four-guard rotation) and was there for the Morbidity and Mortality meeting. So I stepped out – but only to step into a roomful of doctors jumbled around a Chinese woman, the Minister, who was going from bed to bed getting the low down. In the back of the room were some official looking people, well dressed and with mustaches –government types with clip-boards and pleated pants. I still didn’t understand who this lady was, but she must have been important because everyone was there, so I wiggled my way to the front where Safadi was diplomatically letting loose. Our friend the director was clearly nervous, or pissed – it was hard to tell the source of his unease – but his knees were wobbly and he tried to counter what was said. The Chinese woman couldn’t believe there wasn’t a laryngyscope in the ER apart from the one Safadi brings from home, or that when the surgeon is in the OR, there isn’t the staff to cover and patients wait for hours to get stitched. Suffice it to say there were a lot of things she couldn’t believe – and before she left we had a verbal commitment for a million dollars.
Safadi bought some suds for his pals and we celebrated that night: Pilsener, the national beer of Ecuador...
“So who is this lady anyway,” I asked.
“The minister”
“Yeah, but I mean, who does she report to?”
“The President”
“Of what?”
“Ecuador”
“Oh, so she’s like the Surgeon General of your country?”
“Yeah,” they laughed. Then with glasses raised: “Here’s to the Minister of Health, the Surgeon General of our country” – and they drank. It was a good night.
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