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Health
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Introduction
The UAE has a
comprehensive, government-funded health service and a developing private health
sector. Substantial government investment has enabled the UAE to make major
progress in health care, and the country is now ranked 43rd out of 174
industrial and developing countries in the latest UN Human Development Report.
Child mortality rates are 9 per 1000, comparable to most developing countries,
while preventive medicine campaigns have had a major impact on life expectancy,
now 76 years for women and 74 years for men. Endemic diseases have been
eradicated. The focus of a network of Government primary health care centers is
maternal and child welfare, school health and health education. The public
hospitals offer specialized services, including telemedicine links with major
hospitals abroad and state-of-the art surgery. The health care infrastructure is
upgraded regularly, with a central data base project being prepared. There are
plans to double bed capacity in public hospitals over the next ten years. The
Government finances 81 per cent of the cost of health care, but several
initiatives towards privatization have been launched recently.
Since its inception the UAE has
seen remarkable progress in health care. Over the past 28
years government health strategies have paid special
attention to the welfare of UAE citizens who are considered
to be the country�s major resource and the prime target of
all national development. To this end comprehensive health
programmes have been adopted to meet the needs of UAE
society, compatible with global objectives of achieving
health for all. Currently the UAE has a comprehensive,
government-funded health service and a developing private
health sector. This progress is clearly reflected in the
positive changes in health statistics which indicate that
the UAE has taken its place among the developed nations of
the world. In fact the latest United Nations Human
Development Report released in July 1999 ranked the UAE fort
y - third out of 174 industrial and developing countries, up
five places from the previous year. The UAE is also listed
as the fourth most developed Arab state The Human
Development Index (HDI), on which the report is based,
measures overall achievements in a country in three basic
areas of human development: life expectancy, education and
general standard of living. Preventive medicine
campaigns, which have been launched to combat and control
more than 36 infectious diseases in the UAE, have had a
major impact on life expectancy and constitute a key element
of health care strategy.
Preventive
Medicine
Nine preventive medicine centers have been established throughout the country in a major move
to widen immunization, health scanning, public awareness,
research and educational programmes. As a result of these
measures, as well as broader access to general health
services and sanitation the infant mortality rate has
dropped to less than 9 per 1,000 in 1998 and under fives
mortality to about 2.23 per 100,000. The UAE now ranks
second among developing countries which have achieved the
fastest progress in reducing mortality among children below
five years of age. The mortality rate among mothers has also
declined dramatically to 1 per 100,000 newborn babies. In
1998 figures showed the decline of tetanus to almost 1 per
1,000 infants while the incidence of diphtheria was
actually nil. Among the most important preventive medicine
strategies a re those briefly described below.
Fighting
epidemic Diseases
This programme is aimed at
protecting the country from introduced epidemic diseases,
such as pulmonary tuberculosis, AIDS, salmonella, intestinal
worms, hepatitis (B) and leprosy. Expatriates are not issued
with residence visas unless given a clean bill of health by
the relevant medical authorities. Fighting AIDs A special
preventive programme to combat AIDs has been adopted
since September 1984. AIDs tests are carried out in 16
laboratories throughout the country with about 5 million
tests being conducted between 1985 and early 1999. The
programme has been very successful in preventing the spread
of AIDS.
Fighting
Malaria
A central administrative unit set
up in Sharjah in 1972 to combat malaria has succeeded in
reducing the disease spread rate to less than 1 per cent of
the registered cases up to early 1999. More than 58,000
people were tested during 1998, of which 2,700 were
carriers. As in the previous years, 99 per cent of positive
cases came from abroad.
Expanded
Immunisataion Programme
Established in 1981 the programme
to eradicate childhood communicable diseases, targeting
children under five, started with immunization against
tuberculosis, measles, diphtheria, polio, whooping cough and
tetanus. In 1986 measles, mumps and rubella vaccines we re
added to the list, followed by hepatitis B in 1991, and hemophilic
influenza B (HIB) in March 1999. As a result of
the programme, cases of measles dropped to less than 20 per
1,000 in 1998. A massive vaccination programme, targeting
the over-sixes, is under way with the objective of making
the UAE measles-free by the year 2002.Three other vaccines
have also been added to the immunization programme, namely
vaccines against meningitis, cholera and yellow fever,
the latter for those leaving the country on holidays or
business.
Polio Eradication
Programme
The Ministry of Health has
completed four anti-polio vaccination programmes, covering
250,000 patients annually and using about 1 million
vaccines. The strategy has been a total success and the
country has not had a reported case of polio since early
1993. The immunization programme against polio covered all
children and students from the age of 9 months to 18 years
(i.e. 750,000 from October 1998 to April
1999).
Maternity and
Child Care
Nine specialized centers, 95 clinics, four
specialized maternity hospitals
and 14 general hospitals provide medical services to women
and children throughout the country and more than 97 per
cent of births now take place in hospitals. This has helped
greatly in reducing newborn mortality rates to 1 per 100,000
births, an achievement matching that of developed countries.
Ninety-five per cent of pregnancies are checked regularly
at the maternity,
child care and medical centers. Post-natal services include
checking infant growth, immunization, fighting hereditary
diseases, early detection of cancer and encouraging breast
feeding.
School
Health
The UAE is a regional pioneer
with regard to school health. The school health services
commenced in 1971 with only four physicians, two dentists
and 30 nurses providing medical services to about 40,139
students in 129 schools. In 1986 the number of physicians
rose to 83 with 14 dentists and 319 nurses. In 1996, with
the expansion in school health services, the number
rose to 87 physicians, 22 dentists and 365 nurses
providing services to 295,000 students. T h e re are also
plans to extend school services to private schools, which
accommodate 195,000 students in 388 schools. During the
academic year 1997�98 the number of students visiting school
health clinics reached 250,000.
Health
Education
The Ministry of Health has paid
special attention to health education as an effective tool
to alter those forms of behavior that might have a negative
impact on the safety and health of individuals and society
at large. To this end, it has established a central health
education department with branches in all medical zones.
Within the framework of the Ministry�s training programme,
eight graduate citizens were sent abroad for post graduate
studies in health education. This was complemented by the organization
of 15 general training courses and 10 specialized courses attended by more than 750 trainees. More
than 600 students participated in health education training
courses during the summer vacation.
No-Smoking
Programme
One of the prominent programmes
in the field of health awareness is the no-smoking campaign
which includes the issuing of legislation to regulate the
tobacco trade. A special committee was formed for this
purpose and it has already prepared an anti-smoking draft
law which will be submitted to the competent authorities for
approval. A key element of the campaign is the establishment
of Quit Smoking units at the departments of preventive
medicine in each of the nine medical districts throughout
the country. The aim is to reduce the prevalence of smoking
and associated illness and death and to encourage people to
adopt a healthier lifestyle as well as to support smoke-free
policies. Initially, a Quit Smoking unit was established in
October 1998 in the Abu Dhabi Preventive Health Department
providing assistance to 100 people monthly. Sharjah�s
anti-smoking clinic was scheduled to commence operations in
September 1999. The units, which will be provided with all
necessary personnel, equipment and auxiliary materials, will
target all smokers in the community who are willing to quit
smoking. There will be a particular emphasis on the
prevention of smoking in adolescents. Strategies for the
units will include clinical smoking cessation techniques
which will be used through group counseling sessions, as
well as nicotine replacement therapy. The UAE actively
participated in the Gulf No Tobacco Week in October 1998 as
agreed by the Gulf Anti-Smoking Committee. The Ministry of
Health has also launched a nationwide study of smoking
habits and attitudes in the country in cooperation with the
Ministry of Planning which will cover 1,500 UAE national
households. Research is under way on whether to
include lessons on the dangers of smoking in the school
curriculum, and to ban smoking in public places. As a
further disincentive, the UAE raised import taxes on
cigarettes to 70 per cent, with plans to further increase it
over the next few years, as part of the GCC health plan to
curb the smoking habit in the region.
Health
Conferences
The Health Education Department
has organized several conferences, seminars and training
courses on cancer, nutrition and chronic diseases, among
other topics. The first Gulf conference on health and
awareness held in Abu Dhabi in 1997, was attended by a
number of distinguished experts from the Gulf countries and
abroad. Its recommendations have helped significantly in the
development of health awareness in the Gulf
region.
Infrastructure
Health care infrastructure has
kept pace with other health care developments over the past
28 years to ensure that adequate services are provided in
the Emirates. For example, the number of government
hospitals has risen to 30, with 4,681 beds, compared with
only seven hospitals and 700 beds in 1971. The number of
physicians has also risen to 1,535 and nursing staff to
4,664. These hospitals are furnished with the latest medical
equipment.
Specialized treatment centers,
such as open heart surgery and transplant units, have also
mushroomed throughout the country: the total number of
operations in the various specializations rose to 66,000 in
1998. Al Mafraq Hospital open heart unit performed some 298
open heart operations in 1998, 106 of which were performed
on children. In addition there are now 67 dialysis machines
distributed in six centers nationwide, used by 272 patients.
Diagnostic services have also improved and the
Ministry of Health has provided its laboratories with
sophisticated equipment to keep abreast of the latest
developments in conducting a wide range of tests. It also
introduced international standards in the fields of virology
and blood transfusions in 1997�98, in cooperation with
Germany and also in the field of biochemistry, in
cooperation with Saudi Arabia. In 1964 there was only one
X-ray machine in Abu Dhabi emirate, operated by a team of
six specialists and technicians. By 1981 a radiography
department was established at the Ministry�s premises and
all hospitals had made remarkable progress in
radio-diagnostic services. In 1978 the first CT SCAN machine
was installed at Al Jazeirah Hospital in Abu Dhabi and by
1998 radio-diagnostic services covered all medical
zones.
Other specialized services
operating across the country include specialized laboratories, such as the in-vitro fertilization laboratory
in Tawam hospital in Al Ain: some 82 in-vitro deliveries
have been successfully conducted in this department. Al
Tawam is also the site of a major oncology treatment center which cooperates with other AGCC states. So far the
center has received about 380 cases from outside the state for
treatment at the center.
The Zayed complex for herbal
research and alternative medicine has also been established
in the Mafraq area. It utilizes advanced technology to
conduct research into herbal medicine with the purpose of
establishing an advanced pharmaceutical industry, wholly
dependent on natural remedies.
New hospitals Developments in
infrastructure are ongoing. The construction of 17 public
hospitals including extensions to existing hospitals will
add 1,800 beds in various medical disciplines, nearly
doubling the bed capacity of public hospitals in the UAE
over the next 10 years. Landmark projects already completed
include Sheikh Khalifa bin Zayed Hospital for surgery and
emergency cases in Abu Dhabi, a general hospital at Medinat
Zayed in the Western Region, and the Sheikh Khalifa bin
Zayed Hospital in Ajman. All have been provided with the
latest in medical equipment. Primary health care centers An
increased emphasis on the provision of primary health care
throughout the country has seen the number of primary health
care centers rise from 12 in 1971 to 98 by early 1999. In
addition, as many as 10 new primary health care centers are
scheduled to open in the Northern Emirates in
1999.
Telemedicine
The UAE has always been eager to
adopt the latest in medical technology and so a wide-ranging
telemedicine service has opened at Al Mafraq Hospital to
improve patient care and reduce the cost of foreign travel
for patients. The system links Al Mafraq Hospital to the
Mayo Clinic in Minnesota and enables the exchange of digitized
data and high-resolution, diagnostic video images.
Al Mafraq Hospital is also purchasing an electronic medical
records system which will make it possible to establish
physician-to-physician contact via the telemedicine
link.
The telemedicine system will
enable physicians at Al Mafraq Hospital to consult 1,600
physicians and scientists at the Mayo Clinic and its
associates in Minnesota, Arizona and Florida. Consultations
will initially focus on cardiovascular diseases, but the
scope will quickly be broadened to cover microsurgery, orthopedics, dermatology, oncology and other disciplines.
The Ma yo Clinic will also establish similar links with Al
Jazeirah Hospital in Abu Dhabi and Tawam Hospital in Al
Ain. The Ministry for Health also plans similar links at
other hospitals including Al Qasimi Hospital in Sharjah, Al
Baraha Hospital in Dubai and Al Ain Hospital.
Information
Technology
Fully aware that information
technology can be of major assistance in improving
efficiency, the Ministry of Health is engaged in a project
to develop a central database at its premises in Abu Dhabi
linking all hospitals, health centers and medical zones in
the country. In1999 Dh 120 million was spent on the project.
The Ministry has also implemented a Dh 70 million plan for modernizing
its computer network and a Dh 4 million project
to replace medical equipment incompatible with the year
2000. It has also modernized medical registration services,
particularly in Al Ain hospitals, laboratory testing
and administrative services at a cost of Dh 40 million. The
Ministry also prepared a database on psychiatric services in
all medical zones in preparation for developing these
services.
Pharmaceutical
Services
Progress in other areas of health
care is also reflected in the pharmaceutical services. In
1998 more than 5.2 million medicines were prescribed by 154
government pharmacies, employing 742 pharmacists and
assistants compared with only nine pharmacists in 1973. The
total number of pharmacies and stores administered by the
Ministry of Health reached 683 in 1998, employing 1,294
pharmacists and assistants.
Training
Developments in healthcare
infrastructure necessitated the recruitment and training of
health care professionals. As a result the total number of
nursing staff increased from 1,900 in 1978 to 5,854 by the
end of 1998, about 3 per cent of whom are UAE nationals. In
line with the Ministry of Health�s efforts to improve
nursing services a central department was established in
1992 to deal with nursing affairs. The number of nursing
schools has risen to five in the past few years and a
special strategy has been formulated to upgrade standards
and improve services during the period 1994�2004.
The first class of national
medical students has recently graduated from the Faculty of
Medicine and Health Sciences at UAE University and several
public hospitals have obtained academic recognition from
internationally-recognized scientific establishments such as
the British Royal College of Internal Medicine and the Royal
College of Surgeons in Glasgow.
Privatization
of Health Care
At present the UAE Government
finances 81 per cent of the cost of health care. The federal
Government and Abu Dhabi emirate have taken steps to begin
the privatization of healthcare and several initiatives are
taking place as a joint effort between the Ministry of
Health and the UAE Offsets Group (UOG). As a first step, the
offsets group is launching the Emirates Health Care Company
to provide healthcare management, healthcare investments and
healthcare consultancy services. Several other projects are
planned including a day surgery center, sports
rehabilitation facility and a diabetes and heart surgery center. The healthcare division has launched one project,
Associates for Advanced Care (AAC), which recruits
healthcare workers. On a wider national scale the subject of
adequate healthcare insurance coverage will be
addressed.
Award
One of the most prominent aspects
of cooperation between the UAE and the World Health Organization
(WHO) is the UAE Health Award, created through
the initiative of Sheikh Zayed. This award is presented
annually at the World Health Assembly to international
scientists and experts in recognition of their contribution
in different fields of medicine. On the occasion of the
fiftieth anniversary of the WHO, Sheikh Zayed was awarded a
gold medal and certificate of appreciation, received on
his behalf by the UAE �s Permanent Representative to the UN,
during the fiftieth session of the WHO Assembly in May
1998.
