Health Care

  Recently, I came to observe a strange phenomenon in Tunisian hospitals. After their shift work, nurses assigned to Covid unit remove their personal protective equipments and get together at the cafe next to the hospital. They sit tightly next to each other without any precautions: no social distancing and no mask wearing. It is winter, and in order to keep warm they sit near each other. It is under the watch of these nurses that Covid patients are experiencing the toughest predicaments. The sickest patients get admitted to the hospital. Each hospitalized patient needs to be isolated, needs oxygen and needs intravenous medications. Some overcome the viral infection and some die. If these nurses are so much involved with direct contact with these patients and are so much aware of these patients suffering and cannot comprehend the risk they are taking, there must be a problem. Worldwide, viral transmission within health care professionals (HCP) is high. It is the nature of the job: ...

 Dear followers I apologize for not writing this week. I am traveling and can not focus. My subject next week, if all goes well will be about reckless nurses in Tunisia!

10 days ago while I was on call, the phone rings. It is the emergency room. The resident on the other end tells me she has Covid patients in need of oxygen and requiring hospital admission. She makes a specific request:“If the person in charge of the call tonight is not going to admit the patients, please tell us so we could find another health institution that would accept them”. I was wondering; why would she ask such question. I went to the emergency room, I evaluated patients and I asked what was going on. Apparently this specific physician (in charge for the call this particular night) refused to admit hypoxic Covid patients in the past. And apparently there is an investigation going on against her. Emergency room residents are made aware to take special precautions when she is on board. To avoid any delay in patient care, they asked ahead of time. During my call, the patients that needed attention were admitted and thankfully the worst was avoided. I find it outrageous to refuse ...

 Ms. H is a patient of about 65 years old who contracted Corona Virus. Her condition is severe and she is dying as she is gasping for oxygen and requiring high oxygen flow. Her last wish is to die at home. Physicians who are taking care of her are refusing her this last wish pretending that is a security issue and it is unlawful to let go of her. Patient started being symptomatic on day -14. A week later on day 0, she went to the emergency room, a rapid test was done and it came back positive. She was admitted to same day to the hospital where she stayed for a week. Her condition continued to deteriorate. Because of her age, the country limited resources and the lack of any availability in all ICUs, she cannot be resuscitated. She knows she is dying. On day 14, I see her and she asks to die at home. According to WHO, a minimum of 13 days of quarantine is recommended. https://www.who.int/news-room/commentaries/detail/criteria-for-releasing-covid-19-patients-from-isolation?fbcl...

  One day, I was on call at the hospital. Around 3 pm, a coronavirus patient was discharged from the hospital to home. Patient has developed complications secondary to corona virus infection which caused him to be dependent on oxygen at home for an extended period of time. An oxygen dispensing bottle was delivered to him in the hospital to assure a smooth transition back home. Meanwhile, the patient has developed a phobia and anxiety to lack of oxygen because each time his blood oxygen level falls; he develops what he calls a « fit » which is an equivalent to asphyxiation. He was refusing to leave the hospital bed despite that his oxygen bottle was right next to him. Everybody tried to convince him with no success. I was getting ready to enter Covid Unit as I was putting on my personal protective equipment to try to solve the issue. However, doctor Monster was insisting many times on cutting him off the oxygen so he would leave the hospital. I had no hesitation what so ev...

Today, I am celebrating one year of blogging. It started exactly a year ago on November 22, 2019  when I finally had time to ask a dear friend to help me start it. My friend has suggested blogging prior to that when he saw my frustration mounting while working for the public health system in Tunisia in order to get my United States Training recognized. He saw the weekly posts on my personal account in Facebook. I  was appalled with what I was experiencing on a daily basis. Lack of professionalism was the main things I reported on. I continue to report because the 2 years of equivalency were extended by an other 6 months (an unfair do-over rotation). This do-over rotation is helping me find material for the blog. It seems like I am never running out of ideas for as long as I am in this closed system. The idea of writing this blog turned out to be brilliant. I discovered many talents I never thought I had. I am joining a pool of very few international physicians (US, Canada, UK,...

  Pour tous les Tunisiens qui ne font que suivre la France aveuglement, voici ce qui se passe en France. La France a une economie, une structure sociale, une population et beaucoup d`autres facteurs qui font que les solutions sur le terrains Tunisiens doivent etre adaptees au peuple. Chez nous tout les responsables doivent passer devant la justice y compris les ministres, les membres du parlement, le personel medical et toute personne qui a commis un crime vis s vis du peuple Tunisien. France: perquisitions chez le ministre de la Santé dans l'enquête sur la gestion de la crise sanitaire Paris | Une série de perquisitions s’est déroulée jeudi aux domiciles et bureaux du ministre français de la Santé Olivier Véran, ainsi que chez d’anciens membres du gouvernement, dont l’ex premier ministre Édouard Philippe, dans le cadre d’une enquête sur la gestion de la crise du coronavirus en France.   • À lire aussi:  Tous les développements de la pandémie de COVID-19 Ces opérations in...

Today November 11, 3202, Tunisia has recorded 148 deaths per million inhabitants secondary to corona virus infection, While in Algeria the death rate is of 46 per million. This makes the Tunisian death rate 3 times higher than the Algerian. Furthermore, Tunisia has 11 million people while Algeria has 4 times more people with its 44 million inhabitants. Algerians were able to halt the infection in a country larger than Tunisia (Algeria is the largest country in Africa). It is actually a harder task (controlling an infection in an extended country with a large population). Congratulations Algeria. The pride that I hold for our brothers in Algeria is unlimited. Algeria is the country most similar to Tunisia (we are almost one country and one people). We share the same ethnic background, the same 2 official languages Arabic and French, the same religion, the same history and the same traditions and customs. However they are far ahead of us on many levels; they are more patriotic, more nati...

  Dans le cadre de ce stage d`équivalence, on a insisté à me montrer comment on viole la loi. Et on a aussi voulu me montrer comment on obtient le silence des individus par les menaces et le harcèlement pour cacher ses crimes. Pendant cette pandémie au Covid 19, les Tunisiens   sont entrain de mourir d`une manière disproportionnée, le nombre de morts qu`on est entrain d`enregistrer dans les hôpitaux en témoigne. Même si on harcèle les gens en évoquant le soit disant « droit de réserve » qui n`existe même pas dans la loi tunisienne, il ya des lois qui priment tel que   la loi du 3 Juin 1966 punit par 5 ans de prison et une amende toute personne Tunisienne qui par son action cause un délit contre l`intégrité de toute personne. Les statistiques peuvent très bien ajuster des paramètres (âge, sexe, niveau socio-économique) et peuvent montrer l`excès de mortalité dues aux négligences médicales dans le secteur public. Même si les gens ne parlent pas, les chiffres von...

While working my way through this equivalency in Tunisia, I am discovering the intricacies of the Tunisian Medical Community. To me, although I am Tunisian, it has been a cultural chock. The issue that chocked me the most is this phenomenon of accusing each other of committing illegal deeds. I rotated so far in 5 hospitals and there was no exception. In every single hospital, I was accused of false accusations. It is a very common practice here to accuse each other of illegalities. Conflicts in the workplace are expected and I experienced some in the United States. However, the attacks oversees are far more sporadic, more polite and more sophisticated than in Tunisia. Dysfunction, mental illness, ethical and moral problems have reached severe unequaled amplitude in Tunisia. In my experience, the perpetrators of such accusations usually do not really know the actual current law. Ignorance of the law excuses not . What makes Tunisian doctors ignorant of the law? First the legal prin...