DUHOK, Kurdistan Region – In a bid to get patients in the Kurdistan region to a seek treatment in local health centers, instead of rushing to hospital emergency wards, three Kurdish physicians have set up a health center in Duhok using the Dutch medical blueprint. “The Dutch health system is known internationally to be one of the best, if not the best,” said John van der Zande, the Dutch Consul General in Erbil, who attended the facility’s opening with Duhok Governor Farhad Atrushi and the Kurdistan Regional Government (KRG)’s Minister of Planning Ali Sindi. An impressive turnout was on hand for the launch of the new health center, set up with local and Dutch support, in the Duhok compound of Avro City. The opening was billed as an important step in the KRG’s aims to upgrade the healthcare system with a bigger role for family doctors, or general practitioners (GPs). The new center in Avro City is a pilot project, which if it works out, will be copied in other locations, Van der Zande announced at the opening, after VIPs and the press had been shown the center’s modern treatment rooms, laboratory and pharmacy. In this center, the Kurdish practice of doctors treating more than one patient at a time in the same room will be left behind. As in the Netherlands, a doctor will handle one patient at the time, assisted by specialized nurses and laboratory staff. A patient will only be referred to a hospital if the ailment demands a different treatment than they can offer. “This will be the first line of healthcare for the family. All family members will go to this center, instead of going to the first aid,” said Nezar Ismet Taib, director general of health in Duhok. “Even if the center is not open 24 hours a day, they will be able to contact their doctor who can advise them where to go.” He aims for strong primary healthcare “with less referral cases, more healthy people and less costs” such as in the Dutch system. If GPs handle more patients and less specialists are involved, the cost of the medical system is reduced. Taib even urges Dutch-Kurdish doctors to come home “to bring the best of Holland with their knowledge and experience and adjust this especially for Kurdistan.” Dr Raghib Mustafa, one of these three founders and who worked as a GP in the Netherlands, said his colleagues will need to build trust with incoming patients. “The family doctors should be the base of the health service. But here, at the existing medical centers you will hardly find any - only nurses referring people the hospital,” Mustafa said. “People know they are not experienced enough so they don’t go there.” One of the first things the new center will do is to set up patients files, so doctors know the medical history of a patient. “We will be making files on all our patients, but that is only the start,” he added. People have to change their habits for the system to work, according to Mustafa. “We will have to promote our system, and use the media to convince people to come to the health center with their complaints. And the hospitals should also tell people that they should first go to the GP.” In the Netherlands patients are insured for healthcare and doctors get paid by the insurance companies for treatment delivered. The Kurdistan region does not have any such system. Doctors and staff are paid a basic salary by the government and patients in the new health center will pay a small amount for treatment and medicine. Although the doctors in the new center are male, it has mainly women working there: six nurses and four receptionists. The four GPs are in the last phase of their specialization and will, once they have finished, man the new centers that are planned. “Every neighborhood should have its own center,” Mustafa said. He hopes building for the next center will start soon, but cites the economic recession that has hit the region as a major hurdle. “The government has no budget, and we depend too much on donations.” The head of Duhok’s Health Department, Nezar Taib confirmed the problem, but remained positive on the project’s future. “Duhok is open to new ideas, and it is really making things happen.”
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