Author: Denis Tahiri
VH, mother of three children, has been waiting for an orthopedic prosthesis for two years due to a health problem with her right leg.
"Every time I go, they tell me that there is none. We're waiting, but I've been waiting for two years and now it's my turn." says the 50-year-old woman, whose physical problem with her right leg has significantly affected her daily life. "I'm in pain, I can't move much", she says, adding that the doctors did not classify it as an emergency.
Meanwhile, the intervention she needs, if carried out in private, is expensive.
"I can't afford it, only the prosthesis costs around 1500-2000 euros. Only my husband works here, will he support the family, the children in school or my health expenses? Intervention in private costs about 5000 euros", she says, adding that there is no one to help her with the necessary monetary amount.
Meanwhile, similar interventions are also offered by private hospitals, but their prices are salty for the pockets of Albanians.
RC, 26 years old, is one of the citizens, who preferred to do this intervention in private, even though the price was high.
"I have damaged meniscus and torn ligament. The operation cost 4500 euros and it included the operation, two nights' stay in the hospital, food, check-ups with the doctor, the help of the nurses whenever I asked for them, etc. she says, adding that the choice to do the operation privately was influenced by the trust she had in the doctor, who had followed her since the beginning of her problem, but also the complete package offered by private hospitals. "I chose the doctor I trusted the most and the doctor I wanted was in private. When I analyzed the part of the benefits that I pay once and have all of them included, I felt more secure and calm". she points out.
The service with free orthopedic implants was trumpeted in 2016 as a health achievement in Albania, starting first at the University Trauma Hospital and then it would be offered in regional hospitals as well. But the statistics show the opposite.
"signal", addressed a request for information to the University Hospital of Trauma, a hospital structure in which the provision of free orthopedic implants was implemented for the first time, where he asked to know the number of operations performed within the framework of this initiative.
In response to our request, the Trauma Hospital officially stated that: "The number of surgical interventions (operations) over the years is very high and it takes a long time to process the required data as the statistics department at SUT has limited personnel and cannot process the data in a short time. several years".
For the years 2016-2018, the Trauma Hospital has made these data available to the association "Together for Life", according to which: "Regarding the number of patients who benefited from prostheses for the years 2016-2018, it turns out that there are 513 patients. Meanwhile, there are currently 891 patients on the waiting list. If for 3 years the number of patients who have benefited from prostheses was 513, with a simple division it comes to 171 patients with prostheses per year. If there are 819 patients on the waiting list, the line should be reserved for 4-5 years".
Meanwhile, when asked by "Sinjalizo", the University Hospital of Trauma announced that there are 900 people on the waiting list for orthopedic implants. Among other things, the Trauma Hospital says that: "The number of people on the waiting list is constantly being reduced. We inform you that patients admitted as emergency cases in SUT have received immediate service. The planned cases are in the process of dealing with their needs and their number is decreasing taking into account the gradual increase of funds available to SUT".
The University Hospital of Trauma states that the budget for the orthopedics service has been constantly increasing. "According to the information we have at SUT, the budget for orthopedic materials was as follows:
- the three years 2016-2017-2018 - two hundred million ALL without VAT;
- years 2019-2020 - two hundred and forty million ALL without VAT;
- the years 2021-2022 - three hundred million ALL without VAT", says the Trauma hospital officially, adding that at the end of 2022, a framework agreement was signed for the next 24 months with the fund: three hundred and fifty six million new ALL without VAT.
"Sinjalizo" also sent a request for feedback to the Ministry of Health regarding the program of free orthopedic prostheses in state hospitals, but until the publication of this article, it has not received a response.
High demand, slow service
Denisa Cenameti, manager of health programs in the "Togather for life" association, says that the need for free orthopedic implants is very great.
"According to our sources, the waiting list is about 1000, while according to the data of the Trauma hospital, about 280 patients benefit from orthopedic prostheses every year. So the need is many times higher", she says, adding that in the context of the decentralization of health Services, distribution to regional hospitals is a very good decision-making. However, in the conditions of the lack of budget for this service, the provision of the service remains difficult both for Tirana and for the districts.
"The supply of equipment should be planned according to the needs and not based on the previous year's budget", insists Cenameti.
European Commission Report: The health system in Albania is under-financed
According to the World Health Organization, in 2018, Albania spent a figure of 275 dollars per capita, this year, where the average of the Balkan countries was 500 dollars per capita, spending a total of 2.8% of the Gross Domestic Product, when the countries neighboring countries, the budget for this sector amounts to 5% of GDP.
Meanwhile, in 2020, the Albanian state for the primary service, municipal, regional, university and emergency hospitals would spend a total of only 113 euros per capita, not even justifying the amount of health insurance of 29.400 lek that an employee with a salary of 50 thousand ALL.
On the other hand, the European Commission in its final report in 2022, entitled "Progress of Economic Reforms of Albania, Montenegro, North Macedonia, Serbia, Turkey, Bosnia and Herzegovina and Kosovo", would emphasize that the health sector in Albania it is underfunded and there is a significant portion of uninsured people.
"There are about 600 uninsured people (about 21% of the entire population). They are mostly informal workers, low-income groups, minorities and people living in rural areas. The Albanian health system suffers from underfunding of primary health care". the report states.
But this underfunding has weighed on the pockets of Albanian citizens. "Albanians pay about 50% of the expenses for receiving health Services out of pocket and this is a figure calculated by the World Bank, while the Ministry of Health itself in the strategic document admits that out-of-pocket expenses are over 40%. says Denisa Cenameti, manager of health projects at the "Togather for Life" association, adding that this affects groups with low income levels the most as they have less opportunities to afford health expenses themselves.
"Free healthcare does not exist as a concept and cannot exist." says Denisa Cenameti, who adds that in the relations of citizens with the health system, the use of this term has brought problems, it has brought clashes between citizens and health personnel after they believed in free health care. Also, Mrs. Cenameti emphasizes the importance of the fact that health in Albania is under-financed, being ranked last in Europe and the region for the public expenditures that it agrees in relation to the Gross Domestic Product. "Even with a very deep difference compared to the average of the EU countries", she concludes.
