OUAGADOUGOU, 28 August 2009 (IRIN) - The Burkina Faso government has shut down more than 20 health clinics that operated illegally in the capital Ouagadougou and is launching a nationwide campaign to eliminate any others, according to the Ministry of Health.

The country has more than 400 private health centres, half of which are based in the capital.

Prosper Djigmdé, the regional health director who oversees Ouagadougou medical facilities, told IRIN the government has sent a team to root out any clinics operating without licenses. “The quality of health care [in these clinics] is not guaranteed.”

Suzanne* told IRIN she barely survived a miscarriage after seeking care at a neighbourhood clinic that turned out to be illegal. “I was weak and could not go alone to the maternity ward or any hospital in town.” She lives in Prissy neighbourhood, 10km from the nation’s primary referral hospital located in Ouagadougou.

She said her brother took her to Yalgado Ouédraogo hospital after she nearly lost the use of her legs following what she said was a protracted illness. “At first I was getting better, but all of a sudden I started bleeding and losing consciousness.”

A doctor in the hospital’s maternity ward, Christian Darga, told IRIN some patients develop infections after receiving treatment in unlicensed clinics. “When patients arrive, we do not even ask them where they sought care because they will never tell where they have been before coming to the hospital.”

He said uterine cancers and pregnancy complications worsen while patients seek inappropriate care, often coming to the hospital only when it is too late.

“Most deaths happening here are patients who arrive terminally ill after they spend their money elsewhere,” Darga told IRIN.

Operators of illegal clinics may be licensed doctors, but do not employ licensed staff, said Théophile Tapsoba, chairman of the national association of doctors. “We have appealed to doctors to stop transforming their homes into medical hubs.”

But most of the time people illegally offering medical care are not licensed, Tapsoba added.

Gap-filler

Many are drawn to any place offering health care – regardless of licensure – because public health centres are overflowing, maternity ward doctor Darga said. “The clinics are warm, inviting [and] clean and patients do not have to sleep in the alley because of insufficient space, unlike the situation in some public health centres.”

Long waits and poor services lead patients to seek what can be dangerous care, said nurse Adama Korogo, who also works at Yalgado Ouédraogo hospital. “Most of the time patients have to wait up to four hours to see a doctor. And what can one nurse alone do to face 30 patients?”
''What can one nurse alone do to face 30 patients?''

Based on the most recent government statistics, Burkina Faso had one doctor for every 29,000 residents in 2005, about one-third the World Health Organization (WHO) recommendation. The country has one nurse for every 7,800 residents versus WHO’s recommended threshold of 5,000.

Regional health director Djigmdé told IRIN the public health system is not meeting patient needs, which leaves a large gap for private licensed clinics to fill. “The government needs to make sure that the services at private clinics are of quality.”

Burkina Faso had 10 private clinics in the 1970s versus more than 300 in 1994, according to the country’s current health development plan. Though the average distance for residents to reach a public health centre is 10km, there are wide disparities across regions, according to the Health Ministry.

The ministry aims to build primary health centres in communities of at least 10,000 and within 10km of areas with fewer than 10,000 residents.

But finding workers for those centres will be another challenge, according to the health development plan. “On average 30 doctors, 15 pharmacists and some 800 paramedics graduate annually, which is insufficient for the Health Ministry’s needs, but budgetary constraints do not permit even employing those who are trained.”

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