The Bambao hospital, nestled in a tropical forest on Anjouan Island in the Comoros, was meant to bring state-of-the-art medical care to the poor Indian Ocean nation.
Just two years later, the hospital is deep in debt and shunned by people who find it too costly.
“A poisoned chalice,” “a colossus with feet of clay” and “a sinking ship” are among the cliches that chief pediatrician Ahmed Rakibou used to describe the facility funded and built under a Chinese aid scheme.
“If they had consulted us while building it, this could have been a jewel,” the doctor said. “Today it’s all going straight to hell.”
The hospital is about 30km east of Mutsamudu, the capital of Anjouan, the poorest of the three islands comprising the Comoros.
The aim was to make the hospital a flagship of Comoran healthcare, with 120 beds in a brand-new building, a team of 167 staff and modern equipment.
Former Chinese ambassador to the Comoros Xiao Ming (肖明) hailed a “new page in the annals of cooperation” at the opening ceremony, saying that “public health has always had a priority place in Sino-Comoran cooperation.”
However, a project that cost 4 billion Comoran francs (US$9.19 billion) today looks more like a ghost ship, with a handful of patients wandering its corridors in stifling heat. For lack of funds, about 100 staff jobs have not been filled.
In the emergency ward, a doctor silently examines a child’s injured arm. The lethargic mood is broken only by the arrival of an ambulance carrying the victim of a motorcycle accident.
“Our activity is very varied,” nurse Ali Mosthadoi said cautiously before going further. “In fact, we don’t have many patients.”
Deputy director Sidi Chaanbane was more forthcoming.
Since the hospital was opened by Comoran President Azali Assoumani in 2017, it has faced mounting difficulties, he said.
“At the start, the road from Mutsamudu was in a very bad state and patients had trouble getting here,” Chaanbane said. “It’s been repaired since, but our real problem is that we sorely lack equipment and staff.”
In addition to staff salaries, the Comoran state provides just 5 million francs a month, but the hospital needs three times as much to pay its bills.
Day-to-day management is a nightmare. The scanner broke down soon after it was first used. Repairs were not covered by the Chinese cooperation agreement, so the hospital took out a loan to get the machine working again.
The main problem is the cost of treatment, which is not free in the former French colony.
Much of the funding comes from the French Development Agency in its aid budget. France still rules over the fourth major island in the archipelago, Mayotte.
The three Comoros islands lack the standard of living on Mayotte and are far from able to make up the remaining health budget.
The hospital charges 125,000 francs for a caesarian birth, Rakibou said.
“What Comoran can pay that?” he asked. “No — this hospital is not made for the population.”
Kanissa Adbou, 27, brought her eight-year-old daughter who stepped on a nail to the hospital.
“The treatment is expensive. If I could afford it, I would go to Mayotte, because there hospital is free,” she said.
Those who believed that providing a modern hospital on Anjouan would dissuade Comorans from trying their luck on Mayotte have been disappointed, although the trip is illegal.
“People here prefer to pay 1,000 euros [US$1,131] to go to Mayotte by kwassa kwassa [human traffickers’ dugouts] than to come to us,” a nurse said. “They trust only white doctors.”
The failure to put the equipment at Bambao to regular good use enrages Ahmed Abdallah, secretary-general of the Hombo public hospital in Mutsamudu.
“The money spent there would have been enough to repair our buildings, replace our equipment and build roads so that sick people could come from nearby villages,” he said. “We don’t have even a single ambulance, yet the government has I don’t know how many four-wheel drives.”
However, Rakibou refuses to give up. He hopes that the winner of Sunday’s presidential election and the international community will come up with increased funding.
“It wouldn’t take much to change our lives,” he said.
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