Guellec
In
duk magungunan Amurka, wurin da Dokar Tarayya ta ba wa Amurkawa garantin
hakkin likita 24-7 yana cikin dakin gaggawa. Wannan shi ne saboda
1986 dokar "anti-dumping", Dokar Jiyya ta gaggawa da Dokar Ma'aikata, wanda aka sani da
EMTALA. Hukumar Kula da Kudi ta Kiwon Lafiya ta tilasta shi. An gwada wannan doka
kwanan nan a cikin 9th Circuit a California. Kwamitin da aka raba ya ce asibitoci
ba zai iya kawar da motocin daukar marasa lafiya wadanda asibitoci ba mallakarsu ko sarrafa su ba bayan rediyo
ana tuntuɓar su, sai dai idan ba su da ma'aikata, kayan aiki ko kayan aiki zuwa
yi wa mara lafiya magani. Yana tunatar da ni gidan ma'anar Frost a cikin Mutuwar
Ma'aikacin Hayar "Gida shine wurin da, lokacin da za ku je can, dole ne su ɗauka
ku a ciki." Saboda yawan cunkoson jama'a da damuwa da aka sanya a kan
tsarin kiwon lafiya a duk faɗin ƙasar, an kira taro na musamman May9 2001 da kyau
"Safet net mai warwarewa."
Suka
ana kiransu da "boarders", waɗannan majinyata waɗanda suka makale a cikin limbo na kula da lafiya. Su
ba za a iya tura su gida ba saboda sun yi rashin lafiya. Ba za a iya motsa su zuwa marasa haƙuri ba
naúrar saboda asibitin ya cika. A wani bincike da aka yi na daraktocin dakin gaggawa 575.
fiye da kashi 90 cikin dari sun ruwaito cunkoso a matsayin matsala, a cewar wani bincike da aka yi
masu bincike a Jami'ar California ta Davis Medical Center. A cikin
al'ada labari, hallways cike da boarders, jira dakunan suna cike da
Ana karkatar da marasa lafiya da wadanda suka jikkata da motocin daukar marasa lafiya zuwa wasu wuraren saboda
babu likita, babu ma'aikacin jinya, babu inci na sarari don mu'amala da wani
haƙuri.
The
halin da ake ciki yana da tsanani a kowane nau'in asibitoci - ilimi, jama'a da masu zaman kansu - a ciki
birane da karkara. Ma'aikatan gaggawa cike da "masu kwana a cikin marasa lafiya… su ne
gama gari a duk faɗin Amurka,” in ji likita Mark C. Henry na Jihar
Jami'ar New York. Wadanda suka yi hasara sune marasa lafiya marasa lafiya waɗanda suke son "marasa ƙasa
'yan gudun hijira, ana ajiye su a cikin matsuguni a cikin ER," ba tare da kaɗan ba
mutunta sirri, mutunci ko tsaftar mutum.
The
Kasancewar masu shiga cikin guraren ER shine sabuwar alama ta rushewa
tsarin kula da lafiya. Dakunan gaggawa sun kasance cikin rikici a baya. Amma a yau
matsalar cunkoso ba ta kebanta da maganin gaggawa. Wani sabon abu shi ne
duk tsarin likitanci yana kan hanyar gridlock saboda rashin ma'aikata
da gadaje da ake da su, karancin ma’aikatan jinya da ka’idojin aiki da suka dade
tabbatar da cewa kowa zai yi aiki a kan ɗan gajeren fiusi saboda rashin barci.
Of
kulawar kulawar kwas na iya ɗaukar alhakin babban ɓangare na wannan hargitsi. Su ne
guje wa biyan kuɗi don hanyoyin gaggawa, gami da intubations da
farfaɗowar zuciya, kuma ba sa bin dokokin jiha da tarayya
tsara don tabbatar da ɗaukar hoto ga marasa lafiya a cikin yanayin gaggawa, barazana
Cibiyar lafiyar lafiyar Amurka, a cewar Annals of Medicine gaggawa.
Bisa ga wannan binciken da yawa marasa lafiya da aka hana ɗaukar hoto ba su sani ba
bukatar kafin izini. Kusan rabin waɗanda aka ƙi ɗaukar hoto ba su yi ba
sami madadin kulawa a cikin sa'o'i 24. A lokacin karatun watanni 7 a babban
asibitin birni (na gaggawar gaggawa na shekara-shekara 36,000) an hana 151 izini
don kulawar gaggawa ta hanyar tsare-tsaren kulawa da kulawa kuma sun zaɓi barin ba tare da
samun kulawa, Wannan na iya canzawa, amma kar ka riƙe numfashinka. Wannan (2001) ne
Majalisa ta hudu da aka gabatar da kudirin doka da ke bukatar tsare-tsaren lafiya
biya don ziyarar ER "idan mai hankali" yana tunanin yanayinsa yana buƙata
shi. Daga cikin mutane 104 da suka shiga binciken, 86 daga cikinsu (83%) sun ce
sun zo ED (sashen gaggawa) saboda sun yi imanin cewa matsalar su ce
gaggawa, kuma 63% sun ce ba su da masaniya game da buƙatar su na riga-kafi
don ɗaukar hoto. Akwai irin wannan lalacewar sadarwa, wanda ba haka lamarin yake ba
kulawa da aka riga aka sarrafa.
We
rayuwa kowace rana tare da kusan cikakkiyar gazawar tsarin don saduwa da asali
bukatun da ake bukata don yin aikin. Ma'aikatan jinya sun lalace, ba a biya isassun kayayyaki ba
sun rasa - ICU na tiyata ba tare da wani tef ba kwata-kwata akan kayan
cart." Hargitsi shine ka'ida" kamar yadda wata ma'aikaciyar jinya ta fada kwanan nan. "Na yi aiki a fannin ilimi
bincike a duniya tare da ɗimbin ɗaliban grad da takardun aiki na shiga da fita da shi
bai rike kyandir ga rashin kulawa da rashin kulawa daga mafi yawan
ma'aikatan tallafi na ancillary. Muna gudanar da asibitin gado 300+ tare da phlebotomists 1-2
yawanci. Muna tsammanin mun yi sa'a don samun kididdiganmu a cikin sa'o'i 2. A matsayin ma'aikaciyar jinya, I
yi aiki tuƙuru don ƙulla alaƙa da wasu sassa ta yadda idan na yi kira ga wani
gaggawa ake saurare, kuma ba na dame su ga abubuwan yau da kullun."
Wata ma'aikaciyar jinya tana barin aiki saboda (1)" ba ta iya samun abubuwa lokacin da ake buƙata cikin gaggawa,
buqatar keken guragu. Dole ne in gano daya ta hanyar yawo kusan benaye da yawa da
lokacin da na sami daya falon bai so ya bari ba. Gurneys, tubes, masks,
safar hannu, kayan aikin kowane nau'i sun kasance masu ƙarancin wadata da aiki mai ɗaukar hankali
a samu. "Babu wanda ya mayar da komai, kuma babu isassun kaya."
(2)
Ma'amala da kantin magani. Ana aika miyagun ƙwayoyi a lokacin da ba daidai ba. Magunguna ba a can lokacin
ake bukata. Pharmacy yana son ma'aikacin jinya ya yi hulɗa da docs, yana zubar da wannan a saman
ayyuka na yau da kullun tare da kulawar haƙuri. Da wuya zan iya ba da kwayoyi a lokacin da aka umarce ni.
Dole na jajanta wa kaina. To, ina tsammanin yana da kyau a rasa ta awa daya.
(3)
Ana sanya majinyata masu tsananin bukatu a kan benayen kiwon lafiya na yau da kullun." Suka aika
mu majinyata da bututu da iska da kuma magunguna na lokaci da kowane irin buƙatu na musamman.
Kamata ya yi a ajiye su a cikin ICU.
(4)
Dokokin banza marasa ma'ana da yawa. Misali, na yarda BOTH damu iyaye su
zauna a dakin da wani mara lafiya yaro dare daya. Washegari sai wani ya tauna min
babban ma'aikacin jinya saboda dokokin sun ce, "Iyaye ɗaya ne kawai ke iya zama a cikin ɗakin. Sai kawai
kujera daya yarda, baka san haka ba?"
akwai
wasu ne, kamar karancin ma'aikata da yawan cin zarafi daga likitoci
kuma kadan albashi.
A
namiji ma'aikacin jinya rubuta mini kwanan nan exclaiming cewa ko da ya 19 shekaru
gwaninta ya yanke shawarar barin aikin jinya. Ya bayyana wasu dalilai nasa
daya daga cikin sharhina na baya-bayan nan inda na ba da labarin yadda marasa lafiya suke a yanzu
" zargi" ga kowane kuskuren likita. Ya ci gaba da cewa a farkon lokacin da ya ke
kawai ya fara a matsayin ma'aikaciyar jinya abu daya "Na fi so fiye da komai
iya ɗaukar lokaci don taimaka wa majiyyaci fahimtar abin da ke faruwa a ciki
kalmomin da za su iya fahimta - ta hanyar da za ta iya yin ma'ana a gare su.
Godiya ga karuwar mayar da hankali kan kiwon lafiya a matsayin kasuwanci da kuma halin yanzu
mayar da hankali kan "ribar layin ƙasa (ko da a cikin yanayin jama'a ko na sirri
asibitocin "marasa riba" an yanke shawara a cikin shekaru goma da suka gabata don yanke
dawo da yawa a gefen gado."
He
ya ci gaba da cewa “A karshe na yanke shawarar cewa ba zan iya ci gaba ba
aiki a cikin yanayin da ya haifar da kasancewata a kullun
hawaye. Na ji haushi sosai da rashin ƙarfi bayan ci gaba da kin amincewa da kowane ɗayana
shawarwarin da aka ba gwamnati kan hanyoyin inganta tsarin. Yaya
sau da yawa ana tsawatar da ni cewa ban fahimci "tattalin arziki" na ba
halin da ake ciki.'
Cunkoso akan ER ya shafi likitoci, ƙwararru, mazauna - kowa da kowa. Kuma
hadurran da ke faruwa akai-akai kuma a asibitoci da yawa. Har zuwa a
shekara ko makamancin haka, dakunan ER sun fuskanci wannan logjam mai cike da jijiyoyi na 'yan kwanaki ko
makonni a cikin hunturu lokacin da mura da ƙwayoyin cuta masu sanyi suka zama masu mutuwa
ciwon huhu, jarirai suna fadawa ga ƙwayoyin cuta na numfashi da na hanji, damuwa
yana cika sassan masu hankali da ƙanƙara mai santsi yana sa likitocin kasusuwa su shagala. Yanzu muna
ganin mini-surges a cikin bazara, bazara da kaka.
"A
Kira zuwa Aiki: Ji mai biyan kuɗi guda ɗaya a Majalisa Mayu 1,2001 zai fara, ina fata,
kwalla na mirgina. Ƙungiyar Black Caucus na Congressional and Congressional Progressive
Kungiyar Caucus ta dauki nauyin wannan sauraron. Kungiyar ta samar da farar takarda mai shafuka 27 wato
sauki don saukewa. Kawai aiko mani da gaggawar rubutu zan yi bayani, don ku kawai
bayanin URL zuwa shafin shine
www.kaisernetwork.org/health_cast
A
ƙungiyar kusan dozin biyu fitattun likitocin ƙasa-ciki har da Dr. Marcia
Angell, tsohon editan jaridar New England Journal of medicine, da kuma rundunar
wasu kuma sun shaida a gaban Majalisa cewa cikakken sake fasalin Amurka ne kawai
tsarin rashin lafiya zai magance matsalar kula da lafiya a kasar.
We
sun tsunduma cikin gagarumin gazawar gwaji (idan da gaske ne mara laifi kamar
haka). Magana game da fa'idodin gasa da kula da kiwon lafiya da ke haifar da riba
ba za su iya ƙara ɓoye gaskiyar ba: Tsarin lafiyarmu a cikin ruɗe. Ina tsammanin mu
sun fara wani kyakkyawan motsi na ciyayi a nan - bari mu ci gaba. ina jin a
Tad kyakkyawan fata tun 1999 lokacin da na fara rubutu akan wannan batu don Zmag.org.