Okay, well that was a bit of an exaggeration on my part, but I do have a point I promise! It was just one of those rare occasions where I had some free time on my hands during my job as an intern in a public hospital so I decided it was a good day to get the HPV vaccine because why not, right? After all, I felt like I already got it from seeing all those posters and brochures advocating that all girls should get it. So I went ahead and asked one of the gynecology residents if it is still available in my hospital and her response was ‘are you married, why do you want the vaccine?’ in a condescending tone that made me feel uncomfortable. I was kind of dumbfounded by her question because that not only violates my right as a patient to receive the care that I want, but her inquiring about my quest to get the vaccine was absolutely out of line.
Saudi Arabia is an aspiring young country with a complex infrastructure heavily influenced by the social norms and traditions. Despite having a very small group resisting the advances in technology and medicine, Saudi Arabia has made tremendous efforts in building state of the art hospitals, training physicians and competing with the rest of the world in research and innovation, but why do social aspects and tradition hinder delivering optimum health care for all?
Saudi Arabia’s health care system is ranked number 26 among 190 countries, according to WHO1. It is mainly operated by the Ministry of Health (MOH) a government based organization responsible for financing health care services, formulating and implementing health care policies and providing Saudi citizens with free of charge health care access2. The government thought it was that simple, give them the money, buy lab equipments and pay for the staff and everybody would be happy. Unfortunately with every ambitious endeavor there is an emerging challenge that can set back the nation’s development. According to the Central Department of Statistics and Information, the 2012 official census placed Saudi Arabia at 29.1 million people compared to 22.6 million in 20042,3. The annual growth rate was 2.9%3. In order to compensate for the increasing population and to alleviate the financial burden on the MOH, in 2004 the government decided to establish the Council for Cooperative Health Insurance allowing insurance companies to operate and open offices in Saudi Arabia2. With only one company in 2004, today there are more than 25 insurance companies2. Private sector employers were forced to provide their employees with health insurance in order to access health care services, but the public governmental institutions have yet to implement this.
Okay, enough about the boring numbers and statistics, despite having hospitals, physicians, medications and state-of-the-art diagnostic tools, women still face social injustice and gender roles that make them not have the sole responsibility for their health especially in reproductive health related issues. This is a sensitive topic, I know! In a country where a woman can open up a human being with an exploding appendix in the operating room because she is a SURGOEN but cannot drive herself to work that seems kind of oxymoronic to me. Unfortunately, a lot of the times women have to seek their male relatives permission before they can go ahead and get a certain procedure done for example, tying the fallopian tubes, hysterectomies, removing an ovarian cyst or any procedure has to do with fertility. This discrimination stems from the fact that men want more children and, therefore, feel they have the right to have the upper hand in deciding what’s best for their spouse while she’s fighting for her life in the OR from a massive hemorrhage due to multiple births. Mind you there are no laws written in the constitution that says men have the right to be their wives health proxies, but this is to illustrate the powerful embedment of social factors and tradition in that community to a point where people believe it’s actually the law.
Richard Skolnik said “being born a female is dangerous to your health” in that your faith literally lies in the hand of other people4. That being said, I do believe in my heart that things will turn around for the women in my country. The time will come where we will reach social justice and equality. It’s just a matter of time and a little patience. After all they do say, “great things come to those who wait.”
1 The World Health Report 2000. Health Systems: Improving performance. Geneva, World Health Organization, 2000.
2 M. AlMalki, G. Fitzgerald and M. Clark. Health Care System in Saudi Arabia: an overview. Eastern Mediterranean Health Journal, 2011,17:784-793
4 Skolnik, R. Global Health 101. Burligton, MA, 2008. Print