Dr Eugène Serdouma: "Everything is an emergency."
Dr Serdouma heads the 144-bed maternity ward at the Bangui community hospital. He works with six other doctors and 38 midwives, delivering 600 babies a month. Teamwork and devotion are all that enable the busiest ward in this busiest of hospitals to function.
"When you see somebody brought into the hospital, ill or dying, how can you send them away even if you know they can't afford the treatment? This creates a problem for the basic running of the hospital: without the necessary materials, how can you save lives?" Everything has to be boiled, including the old and rusty surgical instruments: there are no sterilizers.
The hospital's incinerator and the local water treatment plant have been out of order for two years. This poses serious environmental and health hazards to the hospital and its neighbourhood, as it affects the local river and water table, thereby adding more and more patients to the existing caseload, explained the hospital's director, Commander Joseph Kété.
Everyone is broke: the people, the hospital and the state.
As Dr Serdouma says: "Even the civil servants can't pay their medical expenses. […] If [he] receives a month's salary today, the civil servant who has run up debts during the period when he has received nothing is then going to pay back his debts [instead of] putting a little aside for any future health problems."
Despite his 20 years' professional experience, Dr Serdouma's (theoretical) salary is US$ 0.60 per day: less than US$ 20 per month. Auxiliary medical staff, including the Human Resources Director, are paid less than half as much. "Most of them cannot afford to take public transport to the hospital. They have to walk sometimes up to two hours to come to work and usually go without lunch to save money. They are exhausted," says a hospital regular.
In spite of these working conditions, the staff still manages to carry out their remarkable work – but the human costs are high.