Regional Profile – United Arab Emirates
Good health for all

Healthcare in the United Arab Emirates has come a long way in the past 30 years and has accelerated dramatically in the past five. What’s more, this heady pace of development looks set to continue for some time to come. Middle East Health provides an overview.

National citizens and expatriate residents of the United Arab Emirates (UAE) are fortunate to reside in the UAE when it comes to healthcare. They are generally well looked after in modern facilities many of which house some of the latest medical technology.

Provision of healthcare has until recently been free of charge for all residents, whether nationals or expats, although this is currently in the process of change. In an effort to relieve the heavy financial burden of providing free healthcare to all expatriates, certain emirates have passed legislation making mandatory the provision of health insurance by companies for their employees to enable them to use private medical care.

By and large healthcare in the UAE is of a high standard in both government and most private healthcare facilities.

As far as public healthcare is concerned, the UAE prides itself on the provision of primary healthcare and has a wide spread of primary health centres throughout the seven emirates. Through this network all citizens have easy access to primary healthcare. The centres provide basic medical and dental care as well as other services, such as maternal and child health including antenatal care, vaccination and nutrition education.

Background

Situated on the Arabian Peninsula, the UAE, established in 1971, comprises seven emirates – Abu Dhabi, Dubai, Sharjah, Ajman, Umm Al Quwain, Ras Al Khaima and Fujairah. Abu Dhabi is the largest emirate and is home to the UAE capital, Abu Dhabi city. The UAE has a Federal National Council, which consists of forty members, drawn from each of the seven emirates.

Each emirate has its own local government, consisting of municipalities and departments. Each retains significant political and financial autonomy.

Oil is the major source of income for the UAE. The country’s proven oil reserves make up about one-tenth of the world’s total.

Building on its oil wealth, the UAE, and Dubai in particular, has embarked on a programme of rapid urban development. The result of this is a fast-growing population, particularly with the influx of expatriate workers. In 2005 the population was estimated at 4.5 million, with an annual growth rate of 4.8% (World Development Indicators database, April 2006).

The Emirates enjoys one of the highest standards of living in the world with a Gross National Income per capita of US$23,770 (World Bank, 2004).

Healthcare

Healthcare plays a significant role in national development and the Ministry of Health (MoH) oversees strategic planning and implementation in this sphere. Its main goals are “the provision of quality comprehensive, primary and specialised care, to all residents and the implementation of various public health policies and programmes to further these aims”.

According to the MoH, the leading causes of mortality in the country are cardiovascular diseases, cancer, traffic accidents and congenital abnormalities, which together constitute about 56% of all deaths in recent years. The high incidence of diabetes and obesity with its related complications is of increasing concern and the MoH and local government health services have initiated a number of public health campaigns to raise awareness of these conditions with the aim of improving early detection for diabetes and preventative measures for obesity. Genetic blood abnormalities, such as thalassaemia, have a particularly high prevalence in the UAE, the cause of which is the high incidence of intermarriage, or consanguinity. Research is ongoing in this field at the Al Wasl Hospital’s Genetic Research and Thalassaemia Centre in Dubai.

Healthcare facilities

Following is a brief outline of some of the key healthcare facilities (public and private) in Abu Dhabi and Dubai, the two key emirates in the United Arab Emirates.

ABU DHABI

The two wealthiest emirates, Abu Dhabi and Dubai have their own health organisations directing healthcare services at local government level - the General Authority for Health Services (GAHS) for Abu Dhabi and Dubai’s Department of Health and Medical Services (DoHMS).

GAHS was established in 2001 to achieve several goals in the Emirate of Abu Dhabi, including the:  

- Establishment of health care standards in the Emirate
- Management of government hospitals and primary health centres
- Promotion of public awareness of healthcare issues in the community
- Evaluation and directing of contracts awarded to hospital management companies
- Provision of training to national staff
- Planning for future healthcare needs in Abu Dhabi

As well as overseeing numerous primary health centres throughout the Emirate GAHS also manages number of hospitals, including:
- Al Ain Hospital
- Tawam Hospital
- Al Mafraq Hospital
- Al Rahba Hospital
- Sheikh Khalifa Medical City
- Madinat Zayed Hospital
- Marfa Hospital

Sheikh Khalifa Medical City
The Sheikh Khalifa Medical City (SKMC) is located in Abu Dhabi, the capital city of the United Arab Emirates.

The healthcare facilities that comprise SKMC are situated on an island about five miles wide and nine miles long. SKMC operates under the management and direction of the General Authority for Health Services for the Emirate of Abu Dhabi. The Medical City has several ‘Centers of Excellence’ and aspires to practice contemporary medicine comparable to the best hospitals and medical centres in the world. SKMC provides comprehensive healthcare services in all of the disciplines relevant to the needs and priorities of the community.

SKMC is comprised of the following facilities:

Acute Care:
- Sheikh Khalifa Surgical Pavilion (Previously known as the Sheikh Khalifa Medical Center)
- Sheikh Khalifa Medical Pavilion (Previously known as Al Jazeira Pavilion)
- Central Pavilion (Previously known as the Central Hospital)

Behavioural Science Facilities:
- Behavioral Sciences Pavilion (Previously known as the Psychiatric Hospital)

Primary Health Care (PHC):
- Ettihad PHC Center
- Rowda PHC Center
- Mushrif PHC Center
- Manhal PHC Center
- Bateen PHC Center
- Khaleej PHC Center
- Medina PHC Center
- Zafaranh PHC Center Falah PHC Center (under renovation)
- Salam PHC Center (under renovation)
- Zafra PHC Center (under renovation)

Additional facilities under the Sheikh Khalifa Medical City include:
- Al Nahyan Maternal and Child Health Center
- Abu Dhabi Dental Center
- Abu Dhabi Blood Bank
- Preventive Medicine Department
- Abu Dhabi Institute of Nursing
- Abu Dhabi Rehabilitation Center

Surgical Pavilion

The Sheikh Khalifa Surgical Pavilion is a 220-bed modern tertiary care hospital located in Abu Dhabi city. It was opened in February 2000 to provide a broad range of surgical healthcare services in all disciplines and includes multidisciplinary Outpatient Specialty Clinics and a separate administration building. It is situated in a medical complex that includes other hospitals and healthcare facilities that are under SKMC management.

Medical Pavilion

Sheikh Khalifa Medical Pavilion is a 300-bed modern hospital providing comprehensive healthcare services to all residents of Abu Dhabi.

The Medical and Surgical Pavilions are ‘Centers of Excellence’ in the United Arab Emirates.

Behavioural Sciences Pavilion

The Behavioural Sciences Pavilion was built following the instructions of the President His Highness Sheikh Zayed Bin Sultan Al Nahyan in 1985 following the “Heroin Epidemic” in the area and followed by the establishment of federal law no. 6 for control of narcotic substances and the like, 1986.

The Behavioural Sciences Pavilion is an advanced psychiatric hospital.
- It is located within Sheikh Khalifa Medical City and has access to Sheikh Khalifa Medical Pavilion, Sheikh Khalifa Surgical Pavilion and Abu Dhabi Central Pavilion. Psychiatric patients can use all the ancillary services within the medical city.

- The Behavioural Sciences Pavilion functions as a national resource centre for clinical work, teaching and research, with special emphasis on the integration of mental health services with other health services and multidisciplinary practice and teaching. The hospital has formal academic links with the Department of Psychiatry of the School of Medicine and Health Services in Al Ain.

Latest expansions

Since its opening in early 2000, Sheikh Khalifa Surgical Pavilion (SKSP) has faced many challenges and enjoyed many achievements. The Surgical

Pavilion completed the renovation and expansion of the New Intensive Care Unit and the creation of a Medical Step Down Unit developed for patients requiring an intermediate level of care between ICU and general medicine. SKSP also established satellite pharmacies in the Outpatient Clinic, the ICU and the Emergency Department addressing the needs of its patients. SKSP started a successful Home Care Programme and opened the first Pre-Op clinic in the UAE, providing care and education to patients undergoing surgery at SKSP.

In July 2004, the addition of the new MRI Suite, Endovascular Suite and bone mineral densitometry systems gave SKSP diagnostic and interventional capabilities that significantly enhanced the services offered to patients.

Most recently, the addition of the SKSP Renal Center enhanced SKSP’s ability to provide complete renal patient care services. The centre consists of 14 dialysis bays equipped with advanced technology. In 2006, the Cardiac Sciences Department was inaugurated at SKMC. It is an ultra-modern, state-of-the- art, all-inclusive centre of excellence providing cardiac services and specialties including non-invasive cardiology, cardiac catheterisation, and cardiac surgery.

The department consists of five divisions including Adult Cardiac Surgery, Adult and Paediatric Cardiology, Cardiac Anaesthesiology, and Paediatric Cardiac Surgery. Moreover, a new state-of-the-art Mammography Suite, and a new Haematology and Oncology Clinic and Infusion Center were opened.

The Emergency Department has also been expanded with the addition of the Paediatric ER services. Sheikh Khalifa Medical City employs more than 4,500 multinational staff.

Emergency Medicine

The Emergency Department of Sheikh Khalifa Surgical Pavilion is the public emergency care facility serving residents of Abu Dhabi city. The Emergency Department has 48 treatment areas. The facility includes a three-bed resuscitation area, an 11-bed paediatric care area, a sevenbed Fast Track area, and more than 15 monitored acute treatment beds. Orthopaedic, isolation and ENT/Opthalmology areas exist within the ER.

Diabetes centre

The Abu Dhabi-based Imperial College London Diabetes Centre (ICLDC) is a private, out-patient clinic specialising in the detection, prevention and treatment of diabetes.

It was launched in August 2006 to tackle the high prevalence of diabetes in the UAE. The centre of excellence also has a dedicated research division, the main aim of which is to understand why diabetes has such a high prevalence in the UAE.

The ICLDC is a ‘one-stop shop’ for diabetes diagnosis. The centre operates in a paperless environment. At admission the patient is issued a smartcard, which is used when documenting all procedures at the centre until discharge.

The ICLDC offers the following multidisciplinary services:
- Pre-Diabetes Treatment – ICLDC provides expertise in reversal of insulin resistance and prevention of Type 2 diabetes

- Paediatric and Gestational Diabetes Treatment – The centre has on-site special clinics for chil dren and pregnant women with diabetes

- Cardiology – ICLDC has a non-inva sive Investigation Suite – and the latest echocar diography technology to detect the earliest signs of heart complications from diabetes

- Ophthalmology – There is an on-site retinal photography unit – and retinal laser machines for diabetes complications

- Urology – The centre has clinics to manage urological complications of diabetes

- Clinical Dietetics and Nutrition – Dieticians are available to provide the latest evidence-based regimes – There is a demonstration kitchen to teach people healthy cooking methods

- Podiatry – The ICLDC has an onsite specialist to manage foot problems related to diabetes

- Pharmacy – There is a pharmacy to dispense medication at the time of prescription

The ICLDC runs a multidisciplinary test package, which includes: height and weight verification, visual acuity test, blood pressure verification, retinal camera photography, lifestyle education, bicarbonate checks, creatine kinase testing, blood test, liver function test, thyroid function test, urea and electrolytes test, and urinary and urinary microalbumin test.

DUBAI

The UAE is witnessing rapid expansion in all spheres, not least in healthcare. No where is this more apparent than in Dubai with numerous hospitals, planned, under construction or recently completed. The Dubai Healthcare City is a prime example.

At the local government level healthcare is taken care of by the Department of Health and Medical Services in Dubai (DoHMS).

DoHMS

The Department of Health and Medical Services in Dubai is the Umbrella of four Government hospitals (Rashid Hospital, Dubai Hospital, Al Wasl Hospital and Al Maktoum Hospital), 19 health clinics and 6 specialised Centers (Dubai Gynaecology & Fertility Center, Genetic & Thalassemia Center, Blood Donation Center, Dubai Cord Blood and Research Center, Cardiology & Cardiothoracic Surgery Centre, Dental Center and Community Center for the elderly) in Dubai. The Department employs more than 600 doctors.

Rashid Hospital

Rashid Hospital is one of Dubai’s premier medical facilities for emergency, trauma, critical care and ambulatory care, providing high-quality services to all patients within the community, as well as striving to provide leadership in the education and training of healthcare professionals.

Rashid Hospital receives many complicated case referrals from other hospitals in the rgion, and co-ordinates closely with the Dubai Police & Civil Defense for the training of emergency medical staff at the airports.

Trauma centre

Ajacent to Rashid Hospital is the new state-of-the-art 140- bed Accident and Emergency Trauma Centre. The advanced centre makes use of the latest technology and the newest principles in trauma centre architectural design. It is the largest and most advanced freestanding trauma centre in the region.

With a detailed disaster management plan in place, the trauma centre is built to cope with large-scale disasters and emergencies.

Dubai Hospital

Rapid development in Dubai since the mid 1970s, and its consequent population growth resulted in DoHMS decision in 1977 to build a specialised hospital. By March 1983 the Dubai Hospital began admitting patients. The hospital comprises numerous specialised departments and clinics, such as the cardiology centre.

Al Wasl Hospital

Al Wasl Hospital is a renowned secondary and tertiary healthcare facility specialised in obstetrics, gynaecology, paediatrics and paediatric surgery. Its mission is to offer high quality diagnostic, curative and preventive healthcare services. Often viewed as the mother and child hospital, Al Wasl Hospital is DoHMS newest medical facility. It is equipped to serve as a teaching hospital and as a referral hospital, offering state-of-the-art medical care at its Special Baby Care Unit, Thalassemia Center, and the Paediatric Surgery Unit.

Primary health care

The provision of primary health care is a principle part of DoHMS, whose aim it is to ensure primary healthcare is available to all in the emirate.

Primary health care (PHC) is provided by 19 health centres and peripheral clinics throughout the Emirate of Dubai, offering a ratio of one health centre or clinic for every 30,000 individuals. The geographical distribution of these centres takes into consideration their ease of accessibility to patients. The health centres are well equipped and staffed with qualified health workers trained to serve in this field.

Welcare World

Dubai-based Welcare World Health Systems (Welcare World), a member of The Varkey Group, owns and manages several healthcare facilities in Dubai and abroad, the most significant being the multi-specialty Welcare Hospital, Emirates Diagnostic Clinic, the recently opened Welcare Ambulatory Care Centre, the new Welcare Eye Centre – all in Dubai.

Welcare World is also developing two hospitals, which will be part of the DHCC – City Hospital and Creek Hospital. Welcare World has recently embarked on an expansion programme and has created strategic alliances with a number of internationally reputed healthcare institutions.

American Hospital Dubai

American Hospital Dubai is a 143-bed, acute care, general medical/surgical private hospital with a 60 physician multi-specialty group practice, designed to provide superior quality, healthcare to the people of Dubai, the UAE and the surrounding Gulf States.

The hospital has been operating in Dubai for 10 years, and over the past few years has accelerated the ongoing move into highly skilled tertiary care, with the notable additions of two new regional centres of excellence – the Heart Center and the Cancer Care Centre – which join the two existing regional centres of excellence at the American Hospital – the Total Joint Replacement Centre, and the Diabetes Centre.

Having recognised the increasing importance of organising specialised disciplines around the needs of the patient the hospital has also created the Breast Clinic, which brings together a formidable, multi-disciplinary team of physicians and other medical staff.

The American Hospital Dubai has expanded to meet the demand for more personalised services, comfort and convenience, while broadening the services and deepening the level of expertise and care offered. In response to the strong increase in local and regional demand for its services, the hospital constructed a new state of the art outpatient clinic building; this additional space will also allow the expansion of existing physician services in Obstetrics and Gynaecology, Paediatrics, Primary Care, Surgery, and Oncology.

New physician services will be introduced through units dedicated to Dermatology, Plastic Surgery, Allergy, Retina Surgery, and Head and Neck Surgery. In addition to the new facilities and services, the hospital continues its ongoing physician recruitment plan, which will extend the number of American Board Certified or equivalent practicing physicians at the Hospital from 60 to 110 over the next two years.

Last year the American Hospital Dubai received reaccreditation from Joint Commission International (JCI) for the third time.

American Hospital Dubai became the first hospital in the Middle East to be awarded JCI accreditation in May 2000 and successfully underwent a further survey by the JCI in 2003 to maintain its accredited status. The American Hospital Dubai is the only private hospital in the UAE with JCI accreditation.

The American Hospital Dubai Medical Laboratory is also accredited by the College of American Pathologists (CAP), making it the first private laboratory in the Middle East to be accredited by (CAP).