Way back in 1974, when my parents were briefly posted (five years) in Bahrain, there was just one private hospital – the AMH. The overall health care network was being built and still not much beyond the primary care post. Any treatment more than the basic was referred to hospitals abroad but that was not an option for emergencies. Mothers expecting normal deliveries and suddenly faced with life-threatening emergencies at childbirth had to face life-or-death situations for themselves and their babies.
When my husband and I came to Bahrain in 1982, the Salmaniya Hospital and BDF Hospital were fully equipped to handle major surgeries and I even recall helping to write a UN report on Bahrain’s improving maternal health indices which calculated how safe pregnancy and childbirth were for mothers and babies. My own second-born was a premature baby and spent 10 days in the neonatal ICU at Salmaniya. By the 2000s, private hospitals were augmenting the excellent health care delivery system in Bahrain and while Indian medical groups dominate the sector, a welcome development is the entry of highly-qualified Bahraini specialists who have established their own private hospitals that offer world-class care.
All of which makes the decision of the government to gently move normal deliveries and maternal care to private hospitals, a logical outcome of the sector’s growth. Mind you, although not explicitly mentioned, the press reports seem to suggest that critical emergency maternal care and childbirth will still receive top priority and the attention of experienced doctors at Salmaniya, if the parents so choose. That is really the underlying philosophy of Bahrain’s health care system as it evolves – first priority for Bahrainis and equal attention for health emergencies regardless of the patient’s nationality and a gradual shift towards a calibrated pay-per-treatment approach for expats.
Having paid top dollar for health insurance when travelling to Europe and North America only to find that the policy is a fig leaf which covers hardly anything, I think the Bahraini approach is practical and humane. Nothing has been said so far about vital follow-up care such as immunisation and I presume that there will be an option of private versus public health centres for this too.
Some of my friends who are active in community volunteering have been a bit worried about the financial impact of the move – after all, a basic maternity package can start at around BD300 and there are so many extras that may unexpectedly come up. At the risk of sounding elitist, I must point out that Bahrain’s visa regulations do not encourage families to set up home here for a family income that will not amply cover living expenses. And, while we know that some pregnancies are unplanned, Bahrain has no restrictions on planned parenthood, so couples must think hard and save for their childbirth and parenthood. Can they afford the monthly check-up and delivery of their baby at a private hospital? Setting realistic limits on what private hospitals can be charged for maternity and immunisation services is an option.
Finally, the government must keep in mind that while expats are just a step behind Bahraini nationals in care expectations, they do deliver equally in the task of nation-building. And childbirth heralds the dawn of a new generation that holds our future in their tiny hands. Priority must be given to ensure safe and affordable maternal and childbirth care to one and all.
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