Term Paper: Health System of Kuwait

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[. . .] According to International Science Review, there are 70 general area-specific clinics (or "centers"), and 141 specialized area-specific health clinics. The clinics do not provide surgeries and other more complicated services, however - they are primarily for "routine check-ups and preliminary examinations." There are five health-care regions in Kuwait, and in each region, there is one main federally-operated hospital (plus there is one additional hospital that has been built since these data were offered by the Kuwait government. The five hospitals are: Amiri Hospital in Kuwait City; Jahra Hospital in Jahra; Farwaniyah Hospital in Farwanijah; Mubarak Al-Kibir Hospital in Jabriya; and Adan Hospital in Fahaheel. The growth of the availability of doctors in Kuwait is quite dramatic. For example, there were only 362 doctors in Kuwait in 1962, but by 1997, thirty-five years later, physicians in Kuwait numbered 3,421 in government service and 324 doctors in the private sector.

As of three years ago, there were a total of 4425 hospital beds, 3,375 doctors, 7,757 nurses, and 3,396 other medical staff on board the government-run facilities. In the private sector, there are 8 hospitals (with 550 beds), 143 generalized / dental clinics. All told, 466 doctors and 960 nurses work in the private health care sector.

The doctors and nurses and medical technicians that implement hands-on health care in the clinics and hospitals are trained in the following facilities: the Faculty of Medicine University (established in 1973); the College of Medical Science and Allied Health (built in 1982); and the College of Pharmacy and College of Dentistry (established in February, 1996). These facilities are the result of an ordinance issued by the Amir in July, 1973; or, in other words, a decree.

Foreign expatriates who live in Kuwait are eligible for some of the medical services available to residents. The clinics spread throughout the country will serve foreigners, either at a nominal fee or free. At hospitals, foreigners may receive free outpatient and emergency services, but they are charged a fee that amounts to $3.34 in U.S. currency. Should a foreign patient need to be served by a medical specialist in a Kuwait hospital, the fee is about double, or around $6.70 U.S. currency.

There is a caveat to the fee structure for foreigners - and that is, all specialist doctors and hospitals have the right, if they wish, to "exempt their patients of all charges."

This is a key fact, because Public Authority of Civil Information reported (in 1999) that the population of Kuwait was approximately 2,274,000; and of those, only 798,200 were actually Kuwaiti citizens. Therefore, free, or nearly free, medical services, to about 1,475,800 foreigners, represent a substantial commitment to good and readily available health care by the government of Kuwait.

An Evaluation of the Health Care System in Kuwait

First of all, when presenting a case for evaluation, one looks at the commitment of the government. In the case of Kuwait, in 1986, the government was spending 5.2% of its GNP on health care, and ten years later, in 1996, with more than double the national budget, the government was allocating 2.7% of its GNP on health care (Burney, 1999). Today, according to the World Health Organization, 3% of GNP goes to health-related services. That is outstanding for any nation. The commitment of the Kuwaiti government is also shown in the growth of expenditures: for example, since 1970, the public expenditure on health care has increased nearly 18-fold. Between the years 1970 and 1996, the ratio of population to doctors declined from 958 to 597; in those same years, the ratio of population to nurses shrunk from 262 to 226. Other positives for Kuwait in the health delivery field? 1) The average life expectancy at birth (LEAB): in the aforementioned years, life expectancy increased from 69 years to 74.8 years. 2) The crude death rate (CDR): it declined from 5 per 1,000 population to 2.9 per 1,000 population in the 26 years between 1970 and 1996. 3) The infant mortality rate (IMEL): it declined from 51.7 per 1,000 live births, to 11.4 per 1,000. And the share of communicable diseases resulting in deaths dropped from 33% to 8% in those same years. All those data are courtesy Nadeem A. Burney, et al., in the International social Science Review.

Data supplied by the World Health Organization (WHO) provides dramatic evidence that there are many more "strong points" than "weak points" in Kuwait's health care system. For example, comparing Kuwait to nearby nations in terms of "government expenditures on health, as a percentage of all money spent on health" - Kuwait's government spends 87.2% of all health-related spending in the country. Oman is next, with 82.9%; Saudi Arabia is 79.1; Tunisia is 78.2; United Arab Emirates is 72.7; and way down at the bottom of the scale in neighboring nations to Kuwait is Sudan, at 21.2%.

Total government spending on health care, as a percentage of GNP, shows Kuwait at 3%, far below Lebanon's 11.8%, but one has to factor in the huge amount of money Kuwait has to spend, versus the relatively small GNP in Lebanon. As to immunization of children against diseases, Kuwait would appear to be doing everything correctly. For instance, there were zero reported cases of Diphtheria from 1990 to 2001, according to World Health Organization data, and only 206 cases of measles in that same time period.

Kuwait certainly faced a health care crises when Iraqi forces invaded Kuwait on August 2, 1990. According to a report by the Physicians for Human Rights (PHR) (Brennan, 1992), there were "mass arrests, torture during interrogation, summary executions...and the plundering of Kuwaiti institutions...[and] claims were made that medical care institutions had been abused, specifically that there had been stationing of military personnel [from Iraq] in and around hospitals." These invading forces, according to PHR, "interfered with the delivery of health care services, assaulted health professions, removed medicines, equipment and supplies from hospitals." Several doctors told PHR researchers they were prohibited from entering their hospitals by the soldiers. Some health care workers were reported killed for providing emergency medical care to Kuwaitis injured by bombs and gunfire. And many other health care personnel fled the country.

Despite these challenges, once the allied forces had driven Iraq out of Kuwait, the health care services in Kuwait returned to normal in remarkable fashion, according to the report. This fact alone sheds light on the quality of the managers and directors who oversee health care in Kuwait. And it would see, as long as the oil continues to flow, Kuwaitis will receive nearly all health care services at no charge - and that, too, says a lot about how effective management is supposed to function in the delivery of key human services to its citizens.

Works Cited

Al-Isa, Abdulwahab Naser, & Moussa, Mohamed A.A. "Nutritional status of Kuwaiti elementary school children aged 6-10 years: comparison with the NCHS/CDC reference population." International Journal of Food Sciences and Nutrition. 51 (2000).

Al-Jaralla, Khaled (1996). "History of Medicine in Kuwait." Center of Research

Study of Kuwait. http://hsccwww.kuniv.edu.kw/RESOURCES/history.asp.

American Red Cross (2001). "American Red Cross Responds Quickly to Kuwait

Training Accident." http://www.redcross.org/news/af/kuwait/010316accident.html.

ArabCountries/Kuwait (2001). "The Country and the People of Kuwait." Special

Arab Files. http://www.hejleh.com/countries/kuwait.html.

ArabMedicalCare.com (2002). "Environmental Health Libraries: Health Sciences

Library/Kuwait University." http://www.arabmedicare.com/envirolibraries.htm.

Brennan, Troyen A. & Kirschner, Robert. "Medical Ethics and Human Rights

Violations: The Iraqi Occupation of Kuwait and Its Aftermath." Medicine and Public Issues. Annals of Internal Medicine 117 (1992): 78-79.

Burney, Nadeem A., Mohammad, Othman E., & Al-Ramadhan, Muhammad A.

Assessing the Cost of Inefficiencies: The Case of the Public Health Care

System in Kuwait." International Social Science Review 74 (1999).

Children's Hospital Boston (2003). "International Health Services." http://web1.tch.harvard.edu/international/phone.html.

Columbus Guides (2003). "Travel Information." Kuwait/Health/Special

Precautions. http://www.travel-guide.com/data/kwt/kwt080.asp.

Energy Information Administration. "Kuwait Background on Oil Reverves."

U.S. Department of Energy. http://www.eia.doe.gov/emeu/cabs/kuwait.html.

Health Sciences Center - Kuwait. "Faculty of Medicine, Faculty of Allied Health,

Faculty of Pharmacy, Faculty of Dentistry, HSC Library, Computer Center." http://hsccwww.kuniv.edu.kw/.

Index Conferences and Exhibitions Organisations Est. "Health and Medical

Insurance Policy in Kuwait." Scientific Programme. 2003. http://www.indexexhibitions.com/imd_info.htm.

Kuwait Information Office (2003). "Health and Social Services: Health Care in Kuwait." http://www.kuwait-info.org/Country_profile/health_and_social_services.html.

Library of Congress Country Studies. "Kuwait:Oil Fields, Gas Fields, Refineries." http://lcweb2.loc.gov/cgi-vin/query/r-frd/csty:Afield (DOCID+kw0031.

Majeed, Hasan A. "Acute Rheumatic Fever in Kuwait: the declining incidence."

JAMA, The Journal of the American Medical Association. 269 (1993): 2376.

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