Regional profile – Bahrain
Ensuring everyone’s right to healthcare

Bahrain has a comprehensive network of clinics and hospitals across the island kingdom ensuring that nationals and expats have access to healthcare. Middle East Health reports.

All residents in the country must enjoy the right to access comprehensive healthcare.” This is the stated policy of the Kingdom of Bahrain Ministry of Health (MoH).

The MoH says this implies “a determination to provide integrated preventive and curative health services through a network of primary, secondary and tertiary healthcare facilities. The technical and financial responsibility for providing this care lies mainly with the Ministry of Health with co-ordination of other ministries, the private sector and the community.”

The Kingdom of Bahrain consists of a group of 33 islands, situated in the Arabian Gulf, off the east coast of Saudi Arabia. Its name is derived from two Arabic words "thnain Bahr" meaning "two seas" and refers to the phenomenon of sweet water springs under the sea which mingle with the salty water.

This phenomenon is believed to be responsible for the unusual luster of Bahrain's natural pearls, the country's major economy before the advent of oil. The land had a remarkable number of natural springs, which irrigated the fertile north and western belts for centuries. There are numerous other tiny islands, but they are mainly uninhabited. The island kingdom has a fascinating history dating back thousands of years.

According to Bahrain Tourism recent finds show evidence that “Bahrain was indeed the site of the lost civilisation of Dilmun dating from the third millennium BC, often referred to as the fabled Garden of Eden and described as ‘paradise’ in the ancient Epic of Gilgamesh”. Bahrain's population of around 690,000 is centred in the capital city of Manama and is a mix of Arab people and a significant percentage of expatriates from around the world.

Heading up the Ministry of Health is a woman, Her Excellency Dr Nada Abbas Haffadah. Bahrain’s primary healthcare network includes 19 health centres and two clinics which act as the entry points for citizens to high quality healthcare services on the island.

The secondary and tertiary care is provided by the Salmaniya Medical Complex, a government-run complex consisting of five maternity hospitals, a psychiatric hospital and a geriatric hospital. The total number of beds available in these hospitals is approximately 1,354 (Health Statistics, 1999). Other health facilities include the College of Health Sciences which was established in 1976. The college provides educational programmes for nursing and allied health professionals.

The private Medical University of Bahrain, which is linked to the Royal College of Surgeons in Ireland, opened last year and accepted its first intake of students from the region. The MoH does allow Limited Private Practice (LPP) at the Salmaniya Medical Complex. Multispecialty medical clinics provide private services for nationals and expatriates in areas such as oncology, cardiology, rheumatology, orthopaedics, dermatology, obs-gyn, ENT and gastroenterology.

The Government has implemented an electronic services initiative using latest information technology – called HealthIT. The Health Information Directorate responsible for the initiative says: “The HealthIT programme plays a major role in enabling the business and management of healthcare initiatives to be achieved. The foundation of re-engineering and modernisation is the implementation of an evidencebased management that requires a total restructuring and redevelopment of its information and automation strategies and systems.”

Core areas where the system is intended for use include: Patient Management, Electronic Patient Records, Patient Appointment System; Orders and Results Communication, Pharmacy System, Radiology Management, Laboratory Management, Primary Healthcare, Accident & Emergency, Theatre, Nutrition, Critical Care.

Private hospitals

Private hospitals in Bahrian include the American Mission Hospital, the oldest hospital in the region, the International Hospital of Bahrain, Ibn Nafees Hospital, Bahrain Specialist Hospital, Al Noor Specialist Hospital and a number of clinics, dentals surgeries and plastic surgeries.

American Mission Hospital

Middle East Health spoke to Dr Paul Armerding, chief medical officer and chief executive officer at the American Mission Hospital.

MEH: You mentioned AMH was one of the oldest hospitals in the region. Can you tell me a bit about the history of the hospital?

PA: American Mission Hospital (AMH) originated as the Mason Memorial Hospital, built and occupied in 1902 and formally dedicated on 26 January 1903. As such, it was the first modern hospital in the Arabian Gulf region.

Not only did the people of Bahrain seek out the services of Mason Memorial Hospital, but others also came from Qatar, Al-Hasa, Nejd, and southern Iran.

This, in turn, led to a pattern of visits to neighbouring countries throughout the first half of the 20th century. The missionaries travelled by boat from Manama to Qatif, Darin and Uqair on the Saudi Coast.

From Uqair, it was a daylong trip on donkey back to the oasis of Hofuf. After a rest in Hofuf, it was five to seven days by camel to Riyadh, the most frequent inland destination. On occasion, trips were extended as far north as Hail and as far west as Taif in Saudi Arabia.

Over the years the work in Bahrain expanded and doctors and nurses were recruited from the West and India. Many Bahrainis joined the hospital staff and were trained in medical disciplines.

By the late 1950’s, the Mason Memorial Hospital had completed its useful life. Funds were raised locally and The American Mission Hospital (AMF) was built and opened by the late Amir, Shaikh Isa Bin Salman Al-Khalifa in 1962. In 2000 a second hospital, the Saar Medical and Dental Center was opened on the west coast to serve the many expats living there.

MEH: Can you tell me a bit about AMH’s current role in Bahrain and the Gulf?

PA: Our current role is essentially confined to Bahrain. We focus on primary care (general practice including urgent care, internal medicine, pediatrics, obstetrics & gynecology, dermatology and general dentistry) and also offer limited secondary care (general surgery, orthopedics, ENT, ophthalmology, anaesthesiology, dental implants and orthodontics).

We expend a great deal of energy educating the community about common health problems like diabetes, high blood pressure, overweight and obesity, blood lipid disorders, and chronic respiratory diseases.

We offer package plans at reduced prices in order to give patients affordable, comprehensive care for these problems at best-practice standards.

We also provide occupational medical services for several employee groups.

MEH: What is the situation with health insurance in the kingdom – are both nationals and expats covered by the state?

PA: For many years, healthcare was offered free to both citizens and expatriate residents of Bahrain by the Ministry of Health (MoH).

In recent years, expatriates have had to pay for elective MoH medical services, but at rates that are heavily subsidised. Legislation is under development that will make it mandatory for employers to provide medical insurance for expatriate workers and their authorised dependants. In the meantime, the private health insurance market is growing and maturing.

Approximately 20% of persons using our facilities are either insured or covered directly by their employers.

MEH: Do many residents (expats and nationals) still travel abroad to seek treatment? For what sort of ailments?

PA: I cannot give you numbers here. It is well known that many people do continue to seek care abroad and for a variety of reasons. When I see the results that some experience, I cannot understand why they went elsewhere when very competent practitioners are available in Bahrain. There seems to be a perception that I call “the 50 kilometre principle” – if the doctor is within 50 kilometres of me, I probably know him or his family, and he’s just some ordinary dude and I’ll never let him operate on me; if he’s more that 50 kilometres away, I don’t know him and that creates the necessary mystique for me to trust him with my body.|

MEH: What are the main challenges in healthcare in Bahrain? What is being done to correct the situation?

PA: The crying need in Bahrain is for lifestyle changes that will combat the growing problems of diabetes, high blood pressure, obesity and heart disease.

People eat too much, their diets are too rich, and they don’t get sufficient exercise. There is a lot of ignorance about these matters and preventative care.

To address this problem we conduct health screening and education programmes approximately two or three times each month at social centres, clubs, schools, offices, work camps and factories. We publish an educational, bilingual magazine three times each year.

                                                                        Copyright © 2005 All Rights Reserved.