Lao Hospitals Underfunded, Understaffed, Health Care Workers Say


2020-11-09
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laos-hospitalcrowded2-110920.jpg A crowded ward is shown at an unidentified hospital in Laos in a 2019 photo.
Citizen Journalist

Hospitals in Laos are chronically underfunded and understaffed, with crowded conditions and equipment shortages resulting in substandard care for many in the one-party communist state, sources in the country say.

Lao Prime Minister Thongloun Sisolith on Oct. 27 called on the country’s state hospitals to “improve their quality of care,” saying in an address to the Lao National Assembly that poor treatment in the facilities has driven Lao citizens to seek medical care abroad.

Lack of funds for hospitals to purchase new equipment or to hire and train doctors and nurses has made better standards hard to meet, though, medical staff and hospital administrators told RFA’s Lao Service in recent interviews.

“How can we improve the quality of care?” one health care worker in Savannakhet province asked, speaking on condition of anonymity. “Our hospital is too crowded.”

“The old building is supposed to hold 16 beds, but we’ve squeezed in 20 beds. Similarly, the children’s building should have only 30 beds, but we’ve had to put in 50. We also have a limited number of doctors and nurses, and haven’t received any new recruits.”

“That’s why our service is not so good or fast,” he said, adding that the provincial hospital would like to train doctors and nurses in how to better relate with patients and speak to them, but has no funding to start the program.

“Every day, we have many more patients than we can handle,” added an administrator at the Mahosot Hospital in the capital Vientiane, saying that waiting for government funding and help has stalled improvements at the facility.

“If we were independent, we could improve our care more quickly and easily. For example, if we needed a particular piece of equipment, we could just buy it. We wouldn’t have to wait for the government to help.”

The country’s social security system also places burdens on state hospitals, the official said, also speaking on condition his name not be used.

“For example, someone who’s insured pays only 100,000 kip [U.S. $11] a year into the health-care system or hospital, but he or she may then have a major operation that costs a hundred times more than that,” he said.

“The hospital loses a lot of money that way.”

Slow service and shortages of doctors and nurses are a problem too in Xieng Khouang, one health-care worker in the province said. “We don’t have the money to hire new workers. One of our workers is now multitasking, doing many different kinds of jobs at the same time.”

“We have been waiting for years for the government to give us a new building and some more new equipment,” he said.

Rudeness, disparities in care

Rudeness from staff and disparities in care based on personal wealth also draw citizen complaints, with one resident of Savannakhet saying “the poor are not well taken care of at the [provincial] hospital.”

“When those of us who are poor go to the hospital, we don’t get the treatment that the rich receive. I’d just like to see everyone get the same treatment,” he said.

Also in Savannakhet, the mother of a one-year-old boy with a mental disability complained to RFA of impatient handling by hospital staff. “Maybe because my son is not normal, the nurses speak to us in a way that is not gentle or friendly.”

The hospital’s ward for seriously ill children “is the worst,” she added. “It’s overcrowded, and it has no fan. And there have been shortages of medicine here during the COVID-19 pandemic.”

The state health-care system in Laos is badly underfunded, with nearly half of total health expenditure financed by private spending, including out-of-pocket spending by households, according to a World Bank report in June 2020.

External funding sources meanwhile remain the main support for COVID-19 response measures in the country and for immunization programs against HIV, tuberculosis, and malaria, the World Bank said.

Laos ranked 140th out of 189 nations -- between Congo and Vanuatu, but above neighbor Cambodia at 146 -- in the UN Development Program's Human Development Index for 2019, although its index increased by 51.2 percent between 1990 and 2018.

Reported by RFA’s Lao Service. Translated by Max Avary. Written in English by Richard Finney.

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