Tunisia celebrates World Health Day: Reforming public hospitals is a priority!

While the world celebrates World Health Day, public hospitals in Tunisia are in bad shape. Their deteriorating condition unfortunately illustrates the failure of the entire healthcare system, from the quality of care to structural problems.

Last Sunday, Tunisia celebrated World Health Day. This celebration comes at a time when access to healthcare remains difficult and the situation of healthcare workers is still uncomfortable. How can a sector in distress be reformed in the midst of an economic crisis?

The public hospitals are in bad shape, indeed. The situation is such that healthcare facilities are unable to meet the needs of citizens, especially in the interior regions of the country, a fact acknowledged even by the authorities. While President Kaïs Saïed calls for speeding up the implementation of major projects to address medical deserts, numerous obstacles stand in the way. From land issues to lack of funding and bureaucratic red tape, the dream of seeing modern hospital complexes, at least in each district of the country, seems unattainable.

It is worth noting that the existing healthcare infrastructure is faulty, as the sector is starting to recover after the exhausting coronavirus crisis. Public hospitals in Tunisia are often overcrowded, with exhausted staff and dissatisfied patients. Long waiting times for treatments, angry patients, and faulty equipment have become chronic issues, just the tip of the iceberg.

According to several reports from civil society, Tunisian public hospitals suffer from corruption, regional inequalities in access to advanced equipment, and medical deserts where regions lack healthcare professionals. The sector lacks qualified personnel. This grim picture is compounded by issues of hospital debt and healthcare workers leaving the country.

However, authorities often consider these criticisms of the sector to be exaggerated. It is emphasized that various health indicators in Tunisia meet international standards and life expectancy at birth has increased from 66 to 73 years in just a decade, showing that the healthcare system is functioning.

In this regard, Health Minister, Ali Mrabet, highlighted that Tunisia is resolutely working to achieve new breakthroughs on a global scale and continues to move forward in achieving the goals that the healthcare sector in Tunisia aspires to in its various branches.

Should legislation be revolutionized?

This discrepancy between political rhetoric and the reality in hospitals is becoming increasingly evident, as citizens in some regions lack even the most basic healthcare infrastructure.

Even for healthcare workers, it is urgent to find a solution to address the failure of the Tunisian healthcare system, starting with legislation and legal frameworks. Contacted on this issue, President of the Health, Family, Social Affairs, and Persons with Disabilities Committee at the Assembly of the Representatives of the People (ARP), Nabih Thabet, confirms that the parliament is currently addressing this issue.

He mentioned ongoing legislative projects that should provide a starting point for addressing the deficiencies and dysfunctions in the healthcare sector. “The first draft law concerns medical liability and is a priority for us. This project will protect doctors and all medical personnel from arbitrary arrests and propose new legal frameworks to also guarantee the rights of patients. Another project will focus on a law to bolster the presence of healthcare workers in the interior and priority areas of the country by offering incentives and privileges to doctors,” he noted.

Asked about the lack of equipment in these areas, our interlocutor states that Tunisia has managed to mobilize numerous equipment covering the various regional hospitals in the country, but the real shortage lies in personnel and healthcare workers who prefer to work in Greater Tunis, coastal areas, or abroad.

The exodus of doctors, a chronic disease!

Indeed, in recent years, several thousand doctors, nurses, radiology technicians, and medical and paramedical professionals have decided to leave everything behind to join other countries that welcome them with open arms. France, Germany, Canada, or the Gulf countries are the preferred destinations for our doctors and healthcare workers, especially for financial reasons. However, specialists warn that the phenomenon goes beyond reasons related to salaries and financial conditions, as it seems that the working environment and lifestyle in Tunisia no longer attract these skills.

How can a Tunisian doctor be convinced to stay in their country despite catastrophic working conditions in certain regions? How can they be dissuaded from leaving a country that has invested significantly in their training and professional experience, knowing that abroad they are offered better socio-professional conditions? How can young doctors be encouraged to sacrifice everything to serve their country, which is unable to offer them even the basic rights?

Nabih Thabet believes that it is “perhaps high time to move from encouragement to obligation,” referring to legal frameworks that will require doctors not to leave the country prematurely. He also notes that Tunisia’s healthcare map encourages patients to be diverted to private clinics.