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In sickness and in wealth – my experience of Piešt’any’s hospital service

on November 17, 2014

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It’s been a while since I updated my blog. The main reason is that I’ve been dealing with a severely sprained ankle which has sapped my energy, and left me in a painkiller-induced haze for most of my non-working hours. And this post is going to be a bit of a rant about my experience at the local hospital. My ankle was originally sprained when I fell off my bike about 6 weeks ago – I was cycling across a piece of rough ground and the front wheel hit a rut in the track, tipping me out to the side. I landed on my ankle, which made an ominous crunching sound, but it didn’t swell up and didn’t hurt too much, so I continued on my way. After a couple of weeks the pain subsided, so I thought the problem had been resolved. No such luck.

Because the daylight hours are getting shorter, and I don’t feel comfortable cycling after dark, I’ve been walking to school for my afternoon classes. Piešt’any’s roads and pavements are, to say the least, in a very poor condition, and while walking to school I stepped on something uneven and turned my ankle, which resulted in a further, severe sprain. For the next couple of days I used a compression bandage and painkillers, but the pain was so bad that I worried that I might have broken something, so I decided to go to the local hospital for an expert opinion (and hopefully, an x-ray). Having heard dire stories about how long you have to wait to be seen at Piešt’any’s hospital – my colleague whose child broke an arm was regularly kept waiting for up to 3 hours to see the doctor – I decided to go on a Friday, when I didn’t have any lessons. A colleague was on standby to translate for me via telephone as I don’t speak Slovak well enough to explain things in detail or to understand questions. So off I limped to the hospital.

I managed to locate the orthopaedic department without any major problem – helpfully, the Slovak for orthopaedic is ortopedické, which made things easy. And I followed the signs and ended up in the crowded waiting room – so crowded that people were queueing down the corridor. Having lived in the UK for 25 years one thing I know how to do is queue, so I stood behind what looked like the last person in line, and prepared to wait. However the man turned around and said something to me which I took to mean “you have to let them know you’re here and show them your medical card”. So I left the queue and went to the waiting room proper.

The next thing I had to deal with was that there was no-one to see – it’s rare for most doctors to have any kind of reception service, or appointment system, you usually just have to turn up and wait (my GP is an exception, as she offers appointments). I had no idea whether I needed to knock on the door – but anyway the door had leather padding on it so it couldn’t be knocked on, and there was no bell. In the absence of any better idea, or any instructions telling patients what to do (in Slovak or otherwise) I turned to the people in the waiting room and asked if anyone could speak English. After a pause during which everyone waited to see if someone else would answer, a man said that he did speak English and asked me what the problem was. I explained that I had never been to the hospital before and had no idea what I should do to let someone know I was there and needed to be seen. He said to wait until the door to the doctor’s office opened, tell the nurse what I needed and show her my Slovak health insurance card. That seemed reasonable, so I stood there and waited, practising the few Slovak phrases I would need to use to explain what I needed.

After around 10 minutes the door opened, a patient left and another was called in. I approached the nurse, who looked at me with the special kind of disdain that is reserved for unwanted customers. I managed to summon up enough Slovak to say “I’m sorry, but I don’t speak Slovak well, I’m a new patient, I don’t have an appointment but my leg hurts”, while holding out me Slovak identity card as well as my health insurance card. Her reaction – just one word “NO”, with an accompanying dismissive hand gesture. While I was trying to work out what to say next the kind man who had previously helped me stepped across the room and explained to the nurse that although I was a foreigner, I live and work in Piešt’any, I have a health insurance card and was therefore entitled to help. Thank you kind stranger! She grudgingly agreed that I could be seen, grabbed my identity and insurance cards and told me to wait. So I joined the people sitting on the benches, and waited.

15 minutes later I was called in to see the doctor, which made me feel a bit strange, as most of the people in the waiting room had already been there when I arrived and I was expecting them to be seen before me. But I wasn’t in a position to argue or object, so in I went. I had my phone in my hand ready to call my colleague. But I didn’t get a chance to call her. Neither the nurse nor the doctor could speak English, but both started barking questions at me in Slovak, in a very hostile manner. This took me completely by surprise, but I managed to get across that the problem was my ankle, and I mimed falling off my bike, and then tripping. The doctor then examined my ankle, none too gently, and the pain of this nearly lifted me out of my chair. He then barked “Radiography” at me, which I interpreted to mean that I needed an x-ray. They gave me a piece of paper and off I went.

My experience in Radiography could not have been more different. I gave my piece of paper to an x-ray technician who told me to wait. A few minutes later she called me in – thankfully she spoke a little English, and she was friendly and chatty while she did the x-rays. This made me feel a lot better. But then I had to go back to Dr Charming and his nurse again. Back I went, and the doctor just said one word “distorcia”, which I took to mean sprained. I mimed something being broken, just to be sure, and he snapped “No”. This time I was allowed to call my colleague so that the nurse could speak to her. So we established that my ankle was severely sprained, that I would need to be put in plaster, which meant that they would be sending me home in an ambulance because the plaster would be wet, and that for the next 10 days I would have to inject some medication into my stomach. And with that I was directed into the plaster room, where a technician put my right leg in plaster. I was then wheeled out to the main entrance to the hospital where I waited for an hour and a half for the ambulance to take me home.

It was a huge relief to get home. My colleagues were very helpful and brought me some groceries, as well as picking up my prescription, and crutches from the pharmacy. I was incredibly glad to be away from the hospital, and quite shaken by the rudeness with which I was treated. I cannot believe that anyone working in a public health service is allowed to be so rude, and to provide such poor treatment. Interestingly, it seems that the doctor who treated me was once a Deputy Minister for Health in the Slovak government. Presumably he had more charm as a politician than he does as a doctor!

Two days after my visit to the hospital my plaster seemed to be crumbling. It wasn’t providing any support for my ankle, which continued to be very painful. And as for the medication which they prescribed? They didn’t even ask me if I was on any medication already (which I am) so they could check if it would react with what they prescribed (which it does in some cases). And no instructions were provided as to how to go about injecting myself in the stomach, apart from those obtained by my colleague from the pharmacist and relayed to me. So I went on the internet, determine that the medication was to prevent deep vein thrombosis, and made an informed choice about taking it. Injecting myself in the stomach was no fun, and left me with 10 bruises – one for each time I had to inject it. I did some further research on the internet about treatment for a sprained ankle, and established that the normal treatment is to strap it up rather than plaster it. So I removed the plaster on the Sunday night and bought a support bandage from the orthopaedic chemist for 22 Euros. Money well spent! This supports my ankle properly, has made it much easier for me to get around than the plaster, and meant that I could go to work.

One good thing about the experience is that it provided me with plenty of material for discussion with my colleagues and students for the next week or two. And something became clear very quickly – my experience was not unusual, but rather typical of the service provided by this department in particular, and Piešt’any’s hospital in general. I heard stories of people being subjected to long waiting times, rude doctors and nurses, dirty conditions etc. I was told that I had probably been seen more quickly and received a better service because I was a foreigner. If this is the case I shudder to think what the local people have to tolerate.

And the one anecdote that really shocked me – if you want to get a better service from a doctor at the hospital you have to give them a “present” – in other words, a bribe, which will get you operated on quicker, or which will get you a better service. What the heck? This kind of behaviour would be totally unacceptable in other countries, and would lead to the doctor in question being subject to disciplinary action, and possibly removal from the medical register. While corruption appears to be endemic in Slovakia, it horrifies me that ordinary people are expected to come up with a “present” for a doctor, presumably a couple of hundred euros, for a treatment to which they should be entitled. Given the low level of salaries generally in Slovakia – I think the average monthly salary is around 500 euros, this is a huge amount of money for ordinary people to have to find.

Piešt’any hospital has recently been in the news for another reason – a CT scanner was bought for the hospital for 3 times what the same scanner would normally cost in the Czech Republic. Apparently the normal cost is 500,000 Euros, but 1,600,000 Euros was paid- to a company which apparently has links with the current Speaker of the Slovak Parliament, Pavol Paška (update 18 Nov – The Speaker of Parliament has now resigned). So far, this case has led to the resignation of Health Minister Zuzana Zvolenská and Renáta Zmajkovičová, an official from the SMER political party, who was on the hospital’s supervisory board, as well as being the Deputy Speaker of Parliament. Reports on this story can be found on the Slovak Spectator website. So while ordinary Slovaks have to find large amounts of money to bribe doctors to provide treatment, someone’s getting rich. It would be very interesting to know whose pocket the million-plus Euros overpaid for the CT scanner went into. But we’ll probably never know.

One thing’s for sure though – that million euros could have made a huge difference to the hospital if it was used for refurbishment and staff training (especially in customer service), not to mention employing a few receptionists. The place is grim, to say the least, the waiting rooms are shabby and dirty and the furniture is old and uncomfortable. It’s like travelling back in time to the 1950s. When I visited a colleague in the maternity ward a few months ago visitors were not allowed to enter the ward but had to see the person they were visiting in the corridor leading from the stairs/lift to the ward area. It would be an understatement to say that the place is off putting, and hardly the place to celebrate the arrival of a new person into the world.

And Piešt’any hospital continues to hit the headlines. The local paper ran a story today in which the husband of a deceased patient alleges that his wife, who seems to have suffered from a combination of psychiatric problems and terminal cancer, died in the hospital. He describes seeing her tied to a bed, delirious and shouting. The story, which is in Slovak, is here. Google translate is very poor when it comes to translating Slovak, but the saddest part comes at the end of the article, when he says “Do you understand why I am so very outraged at the doctors approach? I am experiencing the trauma that a man can not help his own wife. That suffering, screaming, raving. That it did not allow a dignified exit from this world. Had I then known that these were the last days, I would have endured it better at home. And she would have died in my arms.”

Having read this, it seems I may have got away lightly. But I won’t be going anywhere near that hospital again if I have any choice in the matter.

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6 responses to “In sickness and in wealth – my experience of Piešt’any’s hospital service

  1. Crikey 😦 I’m sorry you’ve had so a horrible experience 😦 I hope you repair well and quickly and don’t need to go near the place again! I guess reading it made me realise how lucky we are here xxx

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  2. 71sophie says:

    Hope that ankle gets better soon! Experience of another countries health system makes you realise how good the NHS is despite it’s problems

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  3. LaVagabonde says:

    My husband had to go to the ER in Bratislava for a severely sprained ankle. Horrible, horrible experience with the “medical professionals”. Seriously, they’d be better suited to working in a slaughterhouse than a hospital. Thankfully, there were a few kind Slovaks in the waiting area who helped really helped us out without us even asking. They were ashamed of how my husband was treated.

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    • Well that rules Bratislava out of my list of alternative hospitals! Sorry your husband had such a bad experience. Most of my colleagues, students and friends have been very apologetic and ashamed about the local hospital. Slovaks can be very kind and helpful. I love living here, but it could be so much better if they’d just sort out the customer service side of things 🙂

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      • LaVagabonde says:

        People have told me that, if it’s very serious, to go to Vienna. If possible. Sorry to hear about your experience as well and wish you a speedy recovery. If you need follow up treatment, I know a very good, honest physiotherapist in Bratislava who speaks English and is not expensive. My husband’s foot didn’t heal properly, so he’s been going to him for a few weeks.

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      • Thanks! My ankle has healed up a lot in the last week or so, which hopefully means I won’t need physio. But thanks for offering the contact 🙂

        Like

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