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WEEKLY NEWSLETTER
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Saudi Arabia
Index
Saudi Arabia has committed vast resources (US$16.4 billion in
the years 1985 to 1990) to improving medical care for its
citizens, with the ultimate goal of providing free medical care
for everyone in the kingdom. In 1990 the number of hospitals
operated by the government and the private sector together stood
at 258, with a capacity of 36,099 beds. Of these hospitals, 163
were run by the Ministry of Health and sixty-four by the private
sector. In addition, other government agencies, such as the
national guard, the Ministry of Interior, and the Ministry of
Defense and Aviation, operated hospitals and clinics for their
staffs and families. There were also thirty-one teaching
hospitals attached to the medical faculties of universities in
the kingdom (see
table 3, Appendix).
King Fahd Medical City outside Riyadh was a US$534 million
project. It was to include five hospitals of different
specializations, with a capacity of 1,400 beds in addition to
outpatient clinics, and was expected to be completed in the early
1990s. To provide personnel for the expanding medical facilities,
which in 1992 were staffed largely by foreign physicians, nurses,
technicians, and administrators, the government has encouraged
medical education in the kingdom and has financed medical
training abroad. Four of the kingdom's seven universities offered
medical degrees and operated well-equipped hospitals. Saudi
universities also had colleges of nursing, pharmacology, and
other fields related to the delivery of medical care.
One objective of medical planning was to sponsor cutting-edge
research in the kingdom. There were some reported successes. The
King Saud University College of Pharmacology developed a drug
effective in stabilizing blood sugar in diabetics, and heart
surgeons at the Armed Forces Hospital Heart Center in Riyadh
performed innovative open-heart surgery on an infant. At the
College of Sciences of King Saud University, scientists have used
radioactive isotopes to determine the effect of antibiotics on
body functions. The King Khalid Eye Specialist Hospital, staffed
by foreign doctors, was a world center for the treatment of eye
disorders.
Whereas advanced medical research and some of the most
sophisticated medical care available anywhere in the world were
concentrated in Riyadh and a few major cities, medical care at
the most basic level was limited in the countryside. In the early
1990s, a key objective of the Ministry of Health was to
facilitate the delivery of primary care to rural areas by
establishing primary health-care centers that provided basic
services and dispensed medicines. For every four or five primary
centers, which numbered 1,668 in 1990, there was to be one
diagnostic and maternity center (there were ninety-eight centers
in 1990). The large specialist hospitals located in cities were
intended as referral hospitals for sophisticated medical
treatment such as transplants, cancer treatment, surgery, and
complicated diagnoses.
For the primary centers to be effective, health education has
had to become an essential part of the centers' mission. In some
areas, basic hygiene was unknown, as was the principle of
contagion. The rural population and others who had had little or
no exposure to observable benefits of modern medicine tended to
view preventive measures and medicines with caution. According to
a common traditional view, illness was not related to human
behavior, such as poor sanitation habits, but was caused by
spiritual agents, such as the jinn, the evil eye, or the will of
God. Prevention and treatment of disease, therefore, lay in
appealing to the spiritual agent responsible, using means such as
prayer to God, votive offerings, or amulets to ward off the evil
eye.
Before the introduction of modern medicine, local
practitioners specialized in a variety of treatments, such as
exorcism for mental illness, setting of broken bones, herbal
remedies for many ailments, and cauterization. Cauterization
involved heating a stick or nail until it was red-hot and then
applying it to the area believed to be affected; this procedure
was used to treat almost any affliction, from coughs to abscesses
to convulsions. Recourse to local healers was declining as access
to more effective health care and health education became
available.
Infant mortality rates for the kingdom remained high in the
early 1980s, with an estimated 118 deaths per 1,000 live births.
By contrast, based only on deliveries of infants in hospitals of
the Ministry of Health, the infant mortality rate (children
stillborn or died during birth) was low, declining in 1990 to 21
per 1,000 in 1990 from 25 per 1,000 in 1986. Death rates have
declined as well, from 20 per 1,000 in 1965, to 10.7 per 1,000
between 1975 and 1980, down to 7.6 per 1,000 between 1985 and
1990.
In 1990 the World Health Organization certified that Saudi
Arabia was free from the quarantine diseases of cholera, plague,
and yellow fever. Compulsory immunization of infants and young
children and the introduction in 1986 of an epidemic control
system to facilitate communication on outbreaks of communicable
diseases have contributed to the successful eradication of these
diseases. Poliomyelitis, however, has persisted, and the Ministry
of Health has set a target date of the year 2000 to eliminate the
disease.
Malaria remained a problem in the Tihamah southern coastal
plain, especially in Jizan, Asir, and Al Qunfudhah, which was on
the coast in northern Asir. In 1988 the disease affected 1.6
percent of the total population, down from the 4.2 percent
recorded eight years earlier. This drop was attributed mainly to
measures taken to eliminate breeding grounds for mosquitoes and
spraying with insecticides. Bilharzia was a continuing problem in
Jizan, Al Bahah, Asir, Najran, Medina, Al Jawf, Hail, and At
Taif. The incidence of the disease was lowered from 8.4 percent
in 1980 to 1.9 percent in 1988, but efforts to eliminate
infestations of the bilharzia parasite and to prevent
reinfestation were a continuing challenge. Cases of leishmaniasis
have occurred in almost every province with the expansion of
agricultural lands, which provide breeding grounds for diseasecarrying flies. In 1988 the reported number of cases (under
15,000) was small, but the disease was being studied to prevent
its spread. Trachoma was considered one of the main causes of
blindness in the kingdom despite programs designed to combat the
disease.
Data as of December 1992
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