Our Third World healthcare

Here are some extracts from reports on hospital conditions in developing countries: "The South African Human Rights Commission has expressed concern that hundreds of sick villagers are forced to queue for treatment at Limpopo's notorious Tintswalo hospital from before dawn every day.

The queues, which often stretch out the hospital's gates, shocked SAHRC inspectors who visited the hospital last week as part of their first ever tour of rural eastern Limpopo and Mpumalanga. 'There are queues everywhere', they said, 'for admission, for treatment and even at the dispensary for medicine'."

The Nkhota-khota hospital in Malawi is "permanently overcrowded, forcing many patients to be accommodated on the floor. The two wards are linked by dark, filthy hallways filled with more patients waiting to be admitted and family visiting their kin."

One Malawian politician complains: "Our hospitals are themselves in a critical condition - overcrowded, under-staffed, under-equipped and infected. Admission in a public hospital, in some places, is itself a health hazard."

In Harare: "Zimbabwe's crumbling health sector, with its under-funded and overcrowded hospitals, is an eloquent testimony to the more far-reaching decline of a nation."

In Malaysia, an outraged patient writes: "I had no idea the hospital was so busy; the queue was a long one. Some became desperate. One man got angry and tried to jump the queue. Casualty ward is not an ordinary ward; it is meant to be a quick-in quick-out place, but nowadays it is overwhelmed by large queues and the inevitable delays and long hours of waiting and waiting. The girl next to me with a crushed foot wanted to pee and someone said she could try use a chair to go to the toilet! In the end some good-hearted nurse went hunting and found a wheel chair for her. But anger soon gives way to impatience, and after many hours to an acceptance of things as they are."

In Abu Dhabi "medicines are quite expensive. People used to bear the long queues because of the low cost. Now they will most probably opt for private healthcare, as they will get better service quicker."

In Zambia, a critical report on one of the main hospitals notes in horror: "Many patients were dissatisfied and spoke about long queues and the interminable wait before being seen by doctors/nurse practitioners, etc."

The casualty care units in many Kenyan hospitals, a local medical report notes, "could themselves be viewed as approaching casualty status. Operating conditions are grim. Facilities are disorganised, often unclean. Chaos and congestion reigned in the casualty unit and arguments often broke out over who should be treated first."

Worst of all, though, is Sierra Leone. A devastated patient interviewed by the local radio station reports from the casualty ward of a Freetown hospital: "My step-father died on Sunday night. He was in casualty for four days before he was taken to a room. The four days he was waiting there my mother had to bring him to the toilet because the nurses were so busy and so overwhelmed, and she brought him back from the toilet, with bleeding from the bowel and his trolley was gone. So she got him a chair, but she felt really bad because she had to steal somebody else's pillow. I just don't think it's right."

Actually I lied about the last bit. The speaker wasn't from Sierra Leone, though her story wouldn't be out of place if she was. She was a woman called Maria Darcy interviewed by Noeleen Leddy last week on Morning Ireland. She was talking about Dublin's Mater Hospital now. If she had been talking on a television documentary about the sheer savagery of life in some God-forsaken place, where people are mired in hopeless poverty and governments can't provide the basic necessities for human dignity, there would have been a free-phone number for urgent donations at the end. We would have shaken our heads in horror and thanked God we live in a rich, civilised country.

How much is too much? How low is too low? What does it take for us to understand the depths of self-delusion to which we have sunk in order to maintain our self-image as a great little country altogether. Here was a man who had worked all his life as a psychiatric nurse caring for his fellow human-beings and paying his taxes and his social insurance. Such a man - any human being - is owed at the very least a dignified death. What does he get? Four days in bedlam. Stumbling back from the toilet to find even his trolley gone. Someone who loves him forced to steal a pillow from some other sick, desperate patient.

This is the depravity we are visiting on our citizens in their hour of need. We are also turning good, caring people into monsters. One of the most haunting things I have read in recent years was the description of an A&E nurse watching through the night over a young man who had been in a car crash and realising that she was thinking about how she would have to nip in fast when he died so she could claim the bed for another of her patients. The State, which is supposed to civilise our society, has made it obscene.