Yaoundé - 17/06/2019

Journal africain d'informations sanitaires, environnementales et de développement durable

Interview: « L’hôpital de district d’Awae ne répond pas aux normes d’un hôpital de district »

Dr  Eric Valentin Evégué Mimboé, Directeur de l’hôpital de district d’Awae parle des méandres de sa formation sanitaire.

Dr Eric Valentin Evégué Mimboé, Directeur de l’hôpital de district d’Awae.

Monsieur le Directeur, pouvez-vous nous présenter votre formation sanitaire ?

Merci d’abord pour l’intérêt que vous avez pour cette formation sanitaire. L’hôpital de district d’Awae est un vieille hôpital créé il y a de cela un peu plus 25 ans. A la base, c’était un centre de santé intégré  et il est devenu district de santé en 1995. Sommairement, l’hôpital fonctionne avec les services minimums malgré certaines difficultés liées à l’environnement,  aux ressources humaines et  également au plateau technique. Sur le plan géographique, l’hôpital est situé dans le district de santé d’Awae, département de la Mefou et Afamba , région du Centre. L’hôpital  couvre une population estimée à environ 2953 habitants, avec une densité de 14 habitants au kilomètre carré. En général, l’hôpital est situé dans une zone géographique accessiblement difficile et où la pluviométrie est assez importante. Nous sommes situés sur la Nationale n0 10 entre Akonolinga et Nkoabang.

L’hôpital  de district d’Awae compte combien de personnel ?

Actuellement, l’hôpital compte 15 personnels régulièrement affectés ici avec trois personnels d’appui, ce qui fait un total de 18 personnels.  Nous avons cinq médecins, 4 infirmiers diplômés d’Etat, deux techniciens médicaux sanitaires (Tms), 6 aides-soignants et parmi eux, il y a trois qui sont maladives donc ils ne sont presque pas toujours là. En plus de cela, il y a la direction, le Directeur qui est lui-même médecin, il y a  l’économe,  et également le surveillant général.

Parlant de fréquentation, vous recevez combien de malade par jour ?

Nous recevons en moyenne quatre à cinq malades par jour. Ce qui peut expliquer ce taux de fréquentation est que les gens sont encore encrés dans les traditions et préfèrent se soigner à l’indigène. Awae est gangrenée par la prolifération des centres de santés privés et aussi le fait que l’hôpital de district est un peu excentré hors de la ville, vous constatez même que le bitume n’arrive pas ici. Or les centres de santé privés se trouvent en plein centre-ville. Donc, les patients parviennent difficilement à l’hôpital à cause de son éloignement et également à cause du manque de bitume. En période pluvieuse comme c’est  le cas actuellement,  l’accès est très difficile pour les malades.   En réalité, il ressort que les gens lorsqu’ils sont malades préfèrent la médecine traditionnelle, se soigner à la maison, il y a des femmes qui accouchent même à la maison.

Comment se présente le plateau technique ?

Vue de l’unique bâtiment de l’hôpital: vieux de plus de 25 ans.

En ce qui concerne le plateau technique, nous avons le service administratif qui est fonctionnel. On a un service d’accueil et d’orientation, un service de laboratoire, un bloc opératoire et chirurgie, un service de pédiatrie, un service de médecine interne, un service de maternité, un service de prise en charge des personnes vivant avec le Vih/Sida, un Centre de traitement pour la tuberculose et  la pharmacie. Par contre, nous n’avons pas de services d’urgence. Ce qui fait que quand le malade vient en urgence, par exemple en réanimation, on se débrouille à l’extérieur.  Nous n’avons aucune  possibilité de créer un espace pour la prise en charge des patients en urgence. Au niveau du laboratoire,  les examens se font vraiment de façon rudimentaire. Nous n’avons  pas d’automate d’hématologie. Au bloc opératoire, la majorité des équipements sont pannes.    Pour les autres services, nous avons l’essentiel du matériel pour la prise en charge des patients. C’est vraiment le strict minimum pour travailler. Actuellement on a 17 lits parmi lesquels trois ne sont plus du tout fonctionnel y compris les matelas. Il faut dire de façon générale qu’il est difficile de faire la différence entre les services parce que de temps en temps, les services se passent le matériel. Par exemple en chirurgie et en maternité, ils se passent le matériel. Parce que la maternité n’a pas de matériel. Il faut à chaque fois aller en chirurgie prendre du matériel.  Quant au personnel, il fait l’effort d’être présent mais ce n’est pas facile. Bien plus, il faut dire que le bâtiment est construit sous le modèle d’un centre de santé intégré et est vraiment vétuste.

Payez-vous régulièrement des quotes-parts au personnel ?

Vous savez, c’est un sujet très délicat. Même-ci ce n’est pas énorme, je fais l’effort pour que le personnel ait ses quotes-parts. Malgré les difficultés que l’hôpital traverse,  il est nécessaire de verser à chacun ses quotes-parts. J’évite ce genre de problème. Cela ne doit pas être utilisé pour résoudre les problèmes de notre formation sanitaire.

Quelles sont les autres réalités auxquelles votre hôpital doit faire face?   

La morgue inachevée.

Pour un arrondissement comme le nôtre,  nous n’avons pas de morgue. Au cours des séances de travail  avec le président du comité de gestion, nous échangeons sur la relance  des travaux de constructions de la morgue de l’hôpital de district d’Awae en arrêt depuis plus de deux ans. Pourtant le service mortuaire devrait permettre à cet hôpital d’avoir un peu plus d’entrées et par ailleurs soulager les populations qui sont obligés d’aller garder leur corps à Yaoundé.

Quel sont les principaux motifs de consultation ?

Le principal motif de consultation c’est le paludisme,  la fièvre typhoïde,  les cas de gastroentérologique, les accidents cardiovasculaires qui viennent en quatrième position. Actuellement, il y a une  épidémie de choléra mais ici, c’est un peu plus calme ; mais bien entendu on surveille.

Comment gérez-vous les évacuations sanitaires ?

Pour les cas à évacuer, nous levons l’urgence à notre niveau, puis  on adresse une lettre de transfert à un hôpital de référence et maintenant la famille du malade se débrouille à trouver une voiture qui va les amener vers cet hôpital-là. Car ici, nous n’avons pas d’ambulance, ni de voiture de service.

Espace reservé aux urgences.

Qu’attendez-vous des pouvoirs publics ?

Dans cette formation sanitaire,  tout est  à refaire. L’hôpital de district d’Awae ne répond pas aux normes d’un hôpital de district. On  a eu des cas d’accident ici avec des corps qui n’étaient pas identifiés  et doit-il fallait mettre à la morgue. Malheureusement, elle n’est pas fonctionnelle. Et parfois le fait que les espaces soient réduits et le manque des espaces appropriés, on est obligé parfois de mettre les accidentés à la maternité. Donc il faut nécessairement étendre l’hôpital pour permettre d’avoir au moins le service d’urgence qu’on n’a pas. Mais, avec le peu de moyen nous essayons de faire des efforts pour assurer la santé des populations. Pour toutes ces difficultés évoquées, il est important que des solutions soient apportées afin que les populations puissent bénéficier des soins d’une meilleure qualité.

Désiré Dieudonné EFFALA

 

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