Why state healthcare needs to up its game
By MİNE RAMADAN
WHEN you’re a woman of a certain age, yearly mammographies are a necessity. Any woman who has had a mammography knows that having your breasts pancaked between two plates is no picnic. So when the time came to make an appointment for this torture, my mother and I discussed whether to book it at a private clinic or at a nearby hospital. Considering that a private clinic will charge 10 times what a state hospital would for what is now considered a routine procedure, I opted to go to a state hospital.
I am a Turkish Cypriot who was born and raised in the US. Before moving to North Cyprus last year, I had lived in Turkey, Dubai and Lebanon – over 40 years of my life has been spent in other countries. Therefore I do not have a lot of experience with medical services here in the TRNC.
My aunt said that she had to get some bloodwork done as well, as did my mother, so she said she would make our appointments together at Girne Dr Akçiçek Hospital. Her husband also had to go to the hospital for a biopsy so he would be joining us. The hospital gave us all an appointment on Wednesday (April 7) at 8.30am. I thought to myself how lucky we were to have been able to go together and that we would all be taken care of at the same time.
One day before I asked my aunt if we needed to reconfirm the appointment or not. She said she and my uncle would be going to the hospital at 5.30am to get a ticket number for each of us.
By the look on my face she could tell I was confused by what she had just said and clarified that the appointment she had gotten was so we could go to the hospital to get ticket number, not to actually get our procedures done. She said that if we went at 8.30am that, more than likely, we wouldn’t be seen on the day, so they would go very early in the morning, get a ticket number, and then come home. Then we would all go to the hospital by 8.30am. I was still perplexed by this explanation, she followed with the classic “this is Cyprus, what did you expect?”.
As my aunt and uncle had come back home by 6am but then left again at 7am to go and wait at the hospital, my brother came to pick us up at 7.45am. We arrived around 8.15 am to find that the parking lot was already completely full, so he said he would drop us off and look for a parking space and meet us inside (he never found a space and waited in his car quite a bit away from the hospital).
As we got out of the car and I took a look around, the first thing I noticed was that there were no disabled parking spaces anywhere to be seen, not one sign or the standard wheelchair symbol on the ground to indicate these spaces. How does a hospital not provide disabled parking spaces directly in front of the entrance for convenience of disabled patients? So if you are disabled and actually were able to find a regular parking space, you would be forced to park wherever you could and possibly go a considerable distance to reach the entrance. If you could not find any parking and had to drive around side roads searching for a place to leave your car, the distance you would have to cover to get to the hospital would just be that much further. This is totally unacceptable and should be addressed immediately.
The front entrance of the hospital was packed with people waiting outside. A man with an electronic thermometer was standing at the door. He politely greeted us and took our temperatures. While he was doing this, someone slipped around us and went inside without getting checked. In the time that I have been on the island I’ve discovered that I have a very expressive face and that shock and surprise are two emotions I can’t seem to hide very well. He saw the look on my face and replied that the person had already had his temperature taken so it was fine, don’t worry. I think I’m not alone in saying that when someone says ‘don’t worry’, you worry. I’m pretty sure he was saying that so we wouldn’t make an issue of it. Imagine how many others may have been wandering around the hospital during a pandemic without having had the critical temperature check at the door.
Even before the pandemic I was one of those people who, if I saw hand sanitiser available, especially in a medical setting, would squirt it on myself up to my elbows. A woman in front of us went to the sanitiser station in the lobby, began frantically pumping but found it to be empty. No sanitiser in a hospital lobby during a global pandemic? As we walked down the halls, I could not find any other sanitiser stations. This should have been our first clue that things may go downhill from here.
We found the registration window and got in line. Yes, I was still confused as to why we were waiting in any kind of line since we called and made an appointment and already had our number tags in hand. Despite there being spaces clearly marked on the floor to allow for social distancing, the guy behind us had his mask pulled down under his chin and was standing so close to us I could feel his breath on the back of my neck.
As he could tell by the look on my face I was not in the mood, the glare he got from me caused him to take a few steps back. I politely asked him to please pull his mask up, he complied. Unfortunately there were many others walking around in plain sight of hospital staff who also had their masks down below their nose or chin. When our turn came I gave my tag to the guy behind the glass who then entered me in their system, took my payment and gave me a handwritten receipt for the payment. If you have a computer and a printer, why are you still taking time to write receipts by hand? Upgrade your computer system and integrate a billing function, surely this can’t be that difficult?
I sat down in the waiting area, it was now after 9am. My mom and aunt had finished up with their tests already, it seems the department that assisted them was running better than radiology. My aunt went to the registration window and asked how much longer we would have to wait. She was handed a form and said I needed to fill this in. Since it was known that I was getting a mammography, as that was what he had registered me for, why would he not just hand me the form with the payment receipt? This may be nitpicking at this point but these kinds of simple common sense practicalities save time.
An over-caffeinated technician then popped her head out and yelled “Number 1” so I jumped up and followed her. She directed me into a very small room (a closet really) with just the X-ray machine inside and asked me to fully undress from the waist up. I made a joke that usually I would need you to at least buy me dinner or a few drinks first, but she was not amused. I asked for a gown, she told me they didn’t provide one and that it would be fine “don’t worry” (again don’t worry, cut to me worrying). She then shouted to the guys at the registration desk that she had someone in the room and not to come back here. As I stood there with my hands covering my breasts waiting for her to return, I started to wonder why she would even need to inform them of this in the first place. She said “don’t worry”, the hamster in my brain jumped in its wheel and started running. Could it be that if she stepped away from in front of the door that one of them would just pop in? She came back and we got started. It’s a painful procedure indeed, at one point I screamed so loud my mom said she heard me in the waiting area. It was over fairly quickly and the technician was kind, despite her hyperactivity level being somewhere between eight out of 10 or a cricket on crack. I told her that I did not receive a barcode tag like my mom and aunt did. She informed me that my results would be given over the phone and that I would receive a call either the same day or the next day at the latest.
The following day I called the hospital in the afternoon, as we hadn’t heard back regarding my results. The operator’s line rang and rang but there was no answer. I called back four times, still no answer. I called five times on Friday, between 9am and 4pm, no answer. The same on Monday. I finally got the call on Tuesday, almost one week after my mammography, that my results were ready to be picked up before 2pm. Picked up? I was supposed to get them over the phone, now I have to make a trip to the hospital again. This time we went around 1pm. The parking lot was half empty, only a couple of staff smoking in front of the entrance and the hallways were empty (as was the lobby hand sanitiswer again). We went to the first window to ask where to get my test results. A lady directed us down the hall and to the left. While we were walking down the hallway we were speaking English, a woman dressed in scrubs pulled her mask down (not sure why she needed to do that to speak to us) and asked in English if she could help us. I replied that we were told to go in this direction. She said we were going the wrong way and said to follow her. She took us to another window and said it would be here. We thanked her and asked for my results. A man said we were at the wrong place and sent us to radiology. So at this point we had been walking around for 15 minutes and still were no closer to getting where we needed to be. Guess what they said at the radiology window? Wrong place again, we needed to go back to the lobby and ask for my results from the information desk (my brother said he could literally hear my eyes rolling into the back of my head). So we went back to our starting point and waited at the information desk for someone to come and help us.
Someone finally came and the results were actually at the information desk, the one place you would never think to ask for something like that. I opened the envelope to find two half-sentences written in what looked like hieroglyphics on the form I had previously filled out and a CD. When I got home I took a photo of the scribbles and sent them to my aunt who is a physician. She said everything was normal. I was unable to send her the images because the CD wouldn’t fit in the player on my almost three-year old laptop (which isn’t Mac Air or anything even near that modern or sophisticated, just your basic Acer model). I’m fairly certain that CD was left over from when the dinosaurs still roamed the Earth.
I then remembered what my aunt had said: “This is Cyprus, what did you expect.” We expect efficiency, professionalism and empathy. It’s 2021, not 1921. Streamlining a few of your operational issues would help. If I have already called and taken an appointment then don’t make me have to come and take a number too, it’s the height of redundancy. If this is the third-largest hospital in the TRNC, we would believe that we would receive a higher level of service. Why couldn’t I get a barcode and receive my results online as well? If you make someone wait almost a week to receive test results, you should understand that every passing day stresses us out and causes us to panic. If I had chosen to go to a private clinic rather than a hospital, the mammography would have been taken exactly the same way but everything else we experienced most likely would have been different. The additional money I would have spent would have bought me peace of mind, which begs the question: was the money saved really worth one week of mental anguish? Maybe, maybe not. For those who cannot afford to ask this question, we ask that you please do better.
I’m sure that you all have your own experiences with medical services here. Even if it’s just a couple of sentences, we would love to hear from you. We won’t use your name, only initials, but please include the city you live in and your age. Kindly send your stories to firstname.lastname@example.org.We look forward to receiving whatever you would like to share with us.