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Out-Patient Clinics Being Brought Into Shape in the Samtskhe-Javakheti Region

July 21, 2008

Gulo Kokhodze, Akhaltsikhe

“An out-patient clinic in every village,” this was the pre election slogan from the National Movement. The winning party’s promise is now in the implementation stage. However, this process is accompanied with some problems and various misunderstandings. In Soviet times every village had its out-patient clinic. The doctors could offer not only full first medical aid but could also handle the delivery of babies.

Some of old out-patient clinics are either totally or partially destroyed. Medical equipment such as scalpels, pincers, squirts, and knives; medical materials: colourful posters with Hypocrite’s Oath and Healthy Life Calls were taken by children. They are now being used for games.

“There was a time when we all played “doctor game”,” recalls Lia Gogoladze, the inhabitant of village of Atskuri with a smile on her face.

The village doctors started visiting patients in houses. They did not break the Hypocrite’s Oath and provided medical services to everybody on an equal basis. 

On March 17, 2008 the Government of Georgia issued a Decree # 62 on Target State Program in Support of Private Practice of Village Doctors.  The decree was signed by Vladimir Gurgenidze, the Prime Minister of Georgia.

The Program aims at bringing the village out-patient clinics into order and equipping them with office furniture and medical equipment for first aid.

Bringing into order means that only minor repair of the clinics will be conducted. The Ministry of Healthcare and Social Security of Georgia apportioned 2,000 GEL for the repair of each out-patient clinics.

Village doctors will work in the out-patient clinics. However, only 57 people have village doctor license in Samtskhe-Javakheti Region.

16 doctors out of 57 work in 49 villages of Akhaltsikhe Municipality. This means that one doctor works in several villages.

Only a few out of all 16 out-patient clinics were repaired. The out-patient clinic in village of Uravli is one among them.

“The out-patient clinic of Uravli Village was built in 1955. The building is wrecking. We can not build the new one with mere 2,000 GEL. We managed to repair the roof, stairs and walls only,” states Maguli Ivelashvili, the district doctor of village Uravli. 

The money (2,000 GEL to each) has been transacted on district doctors’ private accounts. Some have not fully used the money. Some district doctors can not use the money for some reason.

Margarita Balakhashvili, the village Minadze district doctor states that she has not spent the money yet as “there are some details to clarify”. She talks about the doctors of Akhaltsikhe District Policlinics who work as village doctors at the same time. The village out-patient clinics where these doctors work subordinate to the Akhaltsikhe District Policlinic.

Vazha Chitashvili, the governor of Akhaltsikhe Municipality states that everything is clear in this case. He says that the Policlinic’s doctors who work as village district doctors at the same time can use the money similar to the doctors of independent out-patient clinics.

There are some problems regarding the out-patient clinic buildings in some villages. Guliko Tateshvili, the doctor of village Ani does not know where the clinic for 4 villages (Ani, Tskruti, Tira and Eliatsminda) will be placed. The building where the medical unit functions is wrecking. 2 000 is not enough for its mending.

“Probably we will receive further instructions from the ministry,” states Guliko Tateshvili.

The Governor of Akhaltsikhe Municipality waits that the village doctors will suggest the buildings for the out-patient clinics: “They can suggest the buildings where the out-patient clinic can be established and we will help them.”

There is one more problem. Some out-patient clinics were repaired earlier. The doctors who work in these clinics fear that the money (2,000 GEL) will be taken from their accounts. If it happens it will be bad as this money could have been used for other pressing purposes.

Nunu Labadze, the district doctor of village Kldis Ubani states that the village has new, repaired out-patient clinic. She wants to use 2 000 GEL for covering communal expenses (e.g. firewood, oven and so on). However, she can not do it as she does not know if she has right to this: “I was told in the Board of Administration that I have to wait for their instructions.”

Vazha Chitashvili considers that only the eligible Ministry can decide whether the received money { 2 000 GEL} can be used for covering communal expenses or not: “ They can ask this question either me or Dato Maisuradze, the representative of the Ministry of Healthcare and Social Security. However, I can tell you for sure that the doctors will not be able to spend money on taxis as one doctor asked me to.”

The governor assured us that the Ministry will not take the money back: “If the out-patient clinic has been repaired, the doctors will probable be granted the right to buy additional medical equipment.”

As for the office furniture and medical equipment they are kept in the building of Board of Administration of Akhaltsikhe District. The doctors are planning to take them after they repair their out-patient clinics.

 

 

 

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