Daniela Gondová (38) lives in one of the concrete blocks of flats deep in the Bratislava district of Petržalka. A former secondary school teacher of French, she has spent the last five years at home since the birth of her daughter, Tatianka, who suffered severe health complications during her delivery. While most children can walk unassisted at 13 to 15 months of age, Tatianka likely never will. Her brain activity is limited and she has only recently begun communicating with her mum by forming barely discernable sounds such as 'ma-ma'.
Gondová has suffered every mother's worst nightmare. After a normal pregnancy, Tatianka was expected to be a healthy baby girl. But on Thursday March 16, 1995, something went wrong. Now Gondová is left with the frustrating belief that her permanently brain-damaged daughter would today be leading a normal life if only her gynaecologist had been present during what turned out to be a complicated delivery.
"The nurses told me that they'd called him, but he never came to the hospital - it was just me and the nurses," said Gondová on June 6. "The doctor told me the following day that he hadn't come before because he was at a police station helping his friend whose car was stolen. He never apologised."
Maroš Suchánek, Gondová's gynaecologist, told The Slovak Spectator that although he had not been present during the birth, he should not be blamed for the child's ensuing defects. Other doctors were on duty at the time, he said, who should have assisted. "I understand that she feels badly about her child, it's a very emotional issue for her - but such things happen in life," Suchánek said. "If she thought it was my fault she could have filed a complaint at the hospital or with the Health Ministry."
Suchánek added that Gondová was not the first patient he had had problems with. Another woman, whom he referred to as a "stupid goose", had also recently complained about his services: an investigation by a hospital committee ruled that the woman's complaints were unfounded.
Gondová's case underlines a major concern for both Slovaks and foreigners dependent on Slovakia's strapped health care system for adequate treatment: What can patients do if they feel they have been mistreated or misdiagnosed by a doctor?
Rut Geržová of the Slovak Health Ministry's press department said that unsatisfied patients can address their complaints either to the director of the hospital, or at the ministry's department of control. "But it takes quite a long time since we have to check all available details of every case and hear both parties involved," she said.
Ladislav Petričko, head of the Slovak Chamber of Doctors (SLK), said that official complaints had in the past helped the chamber expell bad doctors. "I remember one case of a general practicioner who was constantly refusing to go see his Roma patients when they called him in an emergency," he said. "They complained about him and eventually he was kicked out of the SLK and his license was stripped from him. As far as I know he is now unemployed."
But Gondová, for her part, said that taking time to file a complaint after the birth had not been a priority because of the heartbreak over accepting her daughter's condition. "I didn't have the energy," she said.
Although many patients may have neither the energy nor the time to submit official complaints, deteriorating conditions in Slovak hospitals are cause for widespread concern. Most feel that underfunding is at the root of the problem.
Patients often grumble, for instance, that they have to buy the attention of doctors with gifts or cash. According to a 1999 survey by the corruption watch-dog Transparency International Slovakia, 75% of Slovaks believe that it is necessary to bribe doctors in return for adequate medical care.
Doctors, meanwhile, complain that their role in society is both financially and morally under-appreciated and argue that the Health Ministry does too little to alleviate the situation. Citing crippling debts, decreased availability of drugs and medical supplies, poor funding and low wages, members of the Liek organisation (a group of medical professionals, health insurers, private pharmacies, and other healthcare-related sectors) have appealed to the government to ease their plight.
"The state managed to scrape up 10 billion crowns for the revitalisation of the banking sector - they should manage to find four billion crowns somewhere for the healthcare sector," said Ernista Tothová of the Slovak Chamber of Pharmacologists.
Figures support the complaints levied by medical experts. According to the Slovak Statistics Office, the health sector had the lowest average wages in 1999 beside the educational and agricultural sectors. While health employees made 9,100 Slovak crowns per month ($200), the average wage in Slovakia was 10,728 crowns.
In an attempt to address the most pressing problems facing the sector, the SLK has prepared an amendment to the medical law which would give more power to local specialised administrative units in hopes of creating better management of finances.
"The indebtedness of hospitals has been growing steadily over the past five years. While in 1996 the debt was 3.11 billion Slovak crowns ($68 million) in 2000 it is expected to be around 15 billion crowns ($328 million)," said Petričko. He explained that provisions such as basic sanitary supplies were often lacking in hospitals and that wages had not improved since 1997. However, he added, no doctor should use the poor conditions as an excuse for taking bribes or refusing to serve patients.
Gondová, meanwhile, says that she is all too familiar with poor conditions. "My husband left me after Tatianka was born and I had to be there for my girl. Doctors in Slovakia told me I should send her to a sanatorium but I didn't want to give up so easily. Instead, I started a public collection and had her treated in France. Now we go there twice a year for special 30 days cures. That's my priority in life now."
Anyone wishing to contribute donations to help cover the costs of Tatianka's health care can do so by giving to the following bank account fund:
Tatra banka 2665455009/1100
Constant symbol: 0558
Variable symbol: 198
(Note: June 30 is the last day that the Interior Ministry-approved fund can accept donations.)