x Abu Dhabi, UAE Friday 21 July 2017

Advances in health care

Working in the heart of the system, Dr Saleema Wani is uniquely positioned to notice dramatic change in the quality of medical care, especially for women

Dr Saleema Wani (right), head of the maternity team, and Claire Gargaro with her two-day-old daughter Skye Sara Gargaro at Al Corniche Hospital.
Dr Saleema Wani (right), head of the maternity team, and Claire Gargaro with her two-day-old daughter Skye Sara Gargaro at Al Corniche Hospital.

ABU DHABI // Dr Saleema Wani is a familiar presence in the hallways of the Corniche Hospital, where the greetings and questions of nurses, doctors and hospital staff are like punctuation to her fast stride. By her estimation, Dr Wani, 53, has brought thousands of babies into the world over the past 20 years. But more than that, she has seen a dramatic change in the Abu Dhabi healthcare system, where, she says, both improvement and development are constant.

On April 15, 1989, the second day after arriving in the capital as a young bride from Kashmir with her engineer husband, Dr Wani took up her post as a junior doctor in one of the hospital's maternity teams. Today Dr Wani, an obstetrician and gynaecologist, is a consultant and head of one of the hospital's 10 maternity teams. Working in the heart of the healthcare system has put Dr Wani in a unique position over the past decade to witness the transformation of the country as it matured and expanded rapidly.

"There have been countless changes and differences over the years, whether in the patients, or the medical technologies available or simply the kind of life we lead in Abu Dhabi, but what hasn't changed is the feeling of this place as home," Dr Wani said. Her two sons, Mohammed Shariq, 19, and Ammar, 17, were born in the capital, at the hospital she calls "a home away from home". "Both my boys think of this place as home," she says, adding that although her sons attend Canadian universities, they want to move back to Abu Dhabi to raise families.

"One day, they will be the ones to really ask about the changes that the UAE has undergone in such a short time," she says. "I think the biggest change that should be highlighted is the growth of education in this country, because it is reflected in absolutely everything." It was rare to find fluent English speakers among her Emirati patients some 20 or even 10 years ago, Dr Wani says. "Now, most of my patients speak very good English, and most of my new mothers are also career women who hold jobs as well as raise families. This is a direct result of the rise in the level of education provided to all in this country."

Dr Wani credits Sheikha Fatima bint Mubarak, the wife of the late Sheikh Zayed, the founder of the nation, who was awarded an honorary fellowship by Britain's Royal College of Obstetricians and Gynaecologists earlier this month for the "admirable advances" women have made in the UAE in the past 10 years. "Sheikha Fatima has helped women get educated and pursue jobs; she has made it possible for women of the UAE to become an important part of the workforce.

"When I came here, there were very few nationals and even less women in the country specialised in obstetrics and gynaecology and no one in Corniche Hospital. But that's been changing with the years." An impressive number of women are currently training in obstetrics and gynaecology at the hospital. "Because of the development of education here, because of the high-quality universities available, like the medical school in Al Ain, we are noticing not only well-educated future doctors, but also very talented ones that will make their country proud," Dr Wani says.

The junior doctors currently training or doing their residency requirements at the Corniche Hospital are all "very keen to work, very ambitious and very impressive as doctors", she says. The ripple effects of education have also made been felt by the patients Dr Wani has treated over the years. "Because people are more educated and aware, or maybe because of the availability of the internet, our female patients, whether nationals or expats, have so much knowledge when they come to us, and they want to know details about their medical care.

"Women are involved in the decision-making process now. As doctors, we don't simply decide for them as we used to, or provide them with limited information. We give them their options, because they want to know what is happening with their lives or their babies, and they want to explore different solutions to medical problems." Health care, Dr Wani says, is much more patient-centric today than it has ever been in the UAE. There is a focus on patient rights, family rights and customer satisfaction, "which never existed before".

"It can no longer just be about a doctor doing his job, because we have educated patients and we need to provide patient satisfaction." It is also evident that women have developed a stronger voice. "Initially, we needed the consent of husbands for every health procedure a woman has to undergo," Dr Wani says. "Now, women discuss with their husbands, who are their partners, but they are the ones who ultimately understand and give their consent."

Despite all the changes in the advancement of women, Dr Wani says there remains a consistency she admires in both her Emirati and Arab patients: a pride in culture and an appreciation for family values. "Women have become more career orientated and good jobs are available to them, and they are still able to look after their families and haven't forgotten about their culture. I was lucky to be able to do that 20 years ago because of a supportive husband, and today, I see more and more women able to enjoy both a career and a family because of a network of support."

Support, says Dr Wani, can come in many forms, and for residents of the UAE, it has come in the form of health insurance. "Ten years ago, there was no such thing as insurance," she says. "People used to pay a nominal outpatient fee, which was Dh20 for a consultation plus investigation plus medication - I think that changed to Dh50 at most. Now, there is a much better way of doing things, called insurance, and that's maybe the biggest and most positive change to health care here."

Ensuring that all people who work or reside in Abu Dhabi have health insurance provided by employers or sponsors has actually improved the overall health of the population. "It makes people more able and more ready to come for regular check-ups because they don't have to worry about the cost, which helps us to detect problems earlier. People take care of themselves better because of insurance." Yet despite the myriad positive improvements, challenges abound, Dr Wani says.

When the Corniche Hospital opened in September 1984, it became the only true maternity hospital in the emirate. Al Mafraq Hospital was home to a small obstetrics and gynaecology unit. Corniche sees nearly 10,000 births a year - 40 per cent of the emirate's new babies - with about 25 births daily and 700 to 800 a month. The maternity ward opened with 180 beds and now has around 270, according to Dr Wani, as well as 58 baby cots in its well-regarded neonatal intensive care unit (NICU).

"Right now, there is just no more scope for further expansion unless we build another hospital. One of the problems we have is the constraints of space in this hospital, while the number of deliveries is progressively rising," Dr Wani says. "Although there are many hospitals cropping up, none of them have the facilities we have to look after small, pre-term babies, who need special care. One of the hospital's best achievements is its NICU, but we need it to be bigger."

Dr Wani has also seen changes in other aspects of life in the UAE in the past decade. Like many of her compatriots, she misses the quieter streets of the capital, where crowds and traffic jams were once nonexistent. Ten years ago, it used to take her three minutes to reach the hospital from her home on Salam Street. Today, the same journey can take up to 30 minutes. "When we'd visit Dubai as a family and then come back to Abu Dhabi, we'd always feel so lucky to come back to such a peaceful city, but now, the two are just as hectic," Dr Wani says.

During the summer months, she says, the capital used to be a ghost town. "People would go back to their countries for months. We had no malls in Abu Dhabi 10 years ago, and you can't take your children to the beach or the park as you usually would because of the weather." Today, she finds the summer months no different than any other time. "The weather doesn't stop you from living here any more, because year by year, life just gets richer in terms of things to do."