Q&A: Cathy Waters, CEO Indira Gandhi Memorial Hospital

Cathy Waters is the new Chief Executive of Indira Gandhi Memorial Hospital (IGMH), the main hospital in the Maldives. She is one of three foreign medical experts brought out by the UK-based Friends of Maldives NGO and the Maldives High Commission to improve the country’s standard of medical treatment, alongside Medical Director Dr Rob Primhak and Nursing Director Liz Ambler.

JJ Robinson: How did your role at IGMH come about?

Cathy Waters: I’ve been on holiday to the Maldives many times, but it’s been a very different experience living and working here, compared to the sanitised version [of the country] you get at the resorts.

I knew nothing about Friends of Maldives – instead a friend of mine sent me an advert in the Health Services Journal, and said “This is the job for you.” I thought it was interesting, was interviewed in December and found myself out here very quickly, in February.

My background is 28 years working in the UK’s National Health Service (NHS), starting as a clinical nurse and working my way up. For the last 15 years I’ve been working in management, and the last eight as Chief Executive of a primary care trust, which commissions health care services.

I’ve had lot of exposure training and working in hospitals, as well as the broader healthcare system. I left the NHS three years ago and worked in a small management consultancy in the UK, which involved going into companies that were facing problems, and working with them to solve those and bring about change.

My last big contract involved working with big local authority in London than needed a transformational change. In reality it meant making significant savings – we had to make 80 people redundant.

JJR: What was your understanding and knowledge of what the position involved before you arrived?

CW: I understood that IGMH is one of five entities that comes under the umbrella of the Male’ Heath services Corporation (MHSC), IGMH being the largest entity, at about 90 percent.

I knew they needed to make significant changes to patient care, and the overall environment for patients. I knew IGMH needed change, which was part of attraction for me as it was somewhere I could utilise all the skills I had to bring about that change.

I also knew it was a hospital that people care passionately about. There’s a real sense that it belongs to the community and that we should be providing high quality services.

One of the things I noticed early on was that staff morale was very low, and people were unsure about what was happening with the organisation and had all sorts of concerns about the future. One of the things I did when I started was observe what going on and try to be very visible as a chief executive, spending time with the doctors and in the labour ward.

A new executive nurse director Liz Ambler is already here, and a Medical Director Dr Rob Primhak will be joining in July, so together we want to be able to demonstrate importance of management staff and clinical teams working closely together. We need to break down some of those barriers and reduce the divide between management and clinical services.

JJR: You arrived three months ago on the tail end of the collapse of the Apollo deal, a 15 year agreement signed in January 2010 with India’s Apollo Hospital Group to manage IGMH. What actually happened?

CW: I did read about Apollo. My understanding was that they wanted to bring about significant change but they wanted significant resources to do that, and that wasn’t an option. One of the things I’m very clear about is that we need to bring about significant change, but within the existing budget. That might involve reviewing everything we do as an organisation.

Unless we can find resources elsewhere we have to work within the budget we’ve got. That’s quite a challenge, because previously there may not have been the same budgetary controls [there are now]. We have to be careful how we utilise our very precious resources.

JJR: What parallels have there been so far with your earlier experience?

CW: Working in an organisation where there are significant financial challenges, and working in an organisation where patient needs are very clearly evident. The population is very vocal about what they want and need – some of that is about manging expectations.

One of the things I know we need address is that people can’t access doctors as quickly as they want. We need to increase outpatient appointments. At the same time there is no system of triage, or prioritisation of the emergency room, which we are now developing.

JJR: It’s true that many people claim the quickest way to get an appointment is to have the mobile number of a friendly doctor.

CW: We have a Maldivian ER consultant in training who is coming back to develop a triage system and ensure those patients who need to be urgently seen are seen straight away, or that those with minor ailments are seen by someone else, or not as quickly.

From what I understand there isn’t a word in Dhivehi that translates into ‘urgent’. We have quite a lot of work to do to make sure patients get to the right place at the right time.

One thing common to people working in the NHS and IGMH is that staff are passionate about what they do. We have to channel that in a positive way. We need to engage staff in decisions rather than it being a top-down management style.

This means helping them to be part of the decision making process, which can be difficult to get your head around. The key groups are patients and staff – happy patients mean staff are pleased they are doing a good job, equally, happy staff are more likely to perform well.

Sometimes it’s very simple stuff – such as saying ‘Thank you, well done.’ I don’t think that’s happened here very often. It doesn’t take a lot to say thank you.

The work that went into planning for mass causalities for the Friday of the recent protests was great. It was a really great example of working as a team and getting everything ready for an influx of casualties.

I recognised the hard work that had gone in so I made sure I came in on the Friday and was part of what was going on, so staff felt supported, and afterwards I wrote a thank you memo. Simple stuff like that makes people feel valued for what they are doing.

IGMH was gifted to the Maldives by the Indian government

JJR: What have been some of the key cultural challenges?

CW: There is a very, very different work ethic to the UK. Some of the things I’ve found very different and very frustrating are about how people manage their time, and motivating people to work. That’s a huge issue.

Getting people to plan ahead and put processes together is challenging. One exciting project is expanding the intensive care unit – I said we need a proper process and justification of the expansion, a proper plan about how we are going to do this. For me there’s a discipline to this, but it’s not always the way things have been done.

Also different and very distinct to IGMH is the lack of use of email – staff still attempt to use memos. I’m trying to encourage the use of email, and encourage people to think ahead and write agendas for meetings.

JJR: On other side of the cultural question, what has been the reaction among staff to a foreigner coming in as a top-level manager?

CW: Inevitably there’s been a degree of suspicion at someone new coming in, at someone from the UK coming in and imposing their views. For me what has been important is how we work with people and lead. I firmly believe that how you lead is important – working with staff, rather than telling them what to do. You do need boundaries and parameters, but people need a sense of direction, and permission to do things themselves.

The other issue is that my contract is for a year with the possibility of extending to two years. Whatever I do, I will feel I’ve failed if I haven’t managed to find someone in IGMH to transfer leadership skills to, and leave a positive legacy. The worst thing would be for me to do would be to go back to the UK and for things to tumble down. That would be an absolute failure on my part.

JJR: How did these obstacles come across? Were there initial difficulties?

CW: People have been very accommodating and very welcoming. I’ve convinced people that they don’t need to stand up when I walk into the room, which was very traditional, and I don’t expect people to call me “ma’am”. People generally been very welcoming. There’s been a few challenges with language barriers, although this has proved less of a problem than I thought it would be. I have very good support in meetings- I might do an overhead presentation, and it is translated into Dhivehi. Unfortunately I’m failing miserably at learn Dhivehi words. Generally people have been helpful and make sure I’m involved in what’s going on.

JJR: What are some of the unique characteristics of the Maldivian hospital-going public?

CW: They are very demanding, and very quick to blame the doctors if things go wrong. Inevitably in a hospital things go wrong, by the very nature of the work we do. And because IGMH is the country’s main hospital, we inevitably get the more complicated and high-risk cases. People are quick to be cutting.

Equally the general public should demand good care, and rightly get that care.

We need to work to enhance communication. One of the things I’ve noticed that is quite different from UK is that different departments still work in silos. We’re trying to break down these silos and get people to work across the organisation.

JJR: There has previously been conflict and misunderstandings between Maldivian doctors and foreign doctors working at the hospital, amid the cultural challenges of having a high turnover of foreign medical staff. Is this something you have observed?

CW: It fascinating that the hospitial talks about ‘Maldivian doctors’ and ‘foreign doctors’ as though they are completely different. Part of the problem I think for the Maldivian doctors who are very dedicated and are here for the duration is that they don’t get some of the benefits expatriate doctors get, such as support with their accommodation. Inevitably that brings some degree of conflict.

Expat doctors are also here for a short time, and I’m making a huge generalisation, but the commitment of some of them may not be as high as that of the Maldivian doctors. Some of that is the sort of contract we have for expatriate doctors, and that needs to be reviewed. Some of the expatriate doctors see IGMH as a staging post to get broader experience and go off to somewhere else, which must be quite annoying for the Maldivian doctors.

We’re trying to move to a position where as much of the workforce as possible is Maldivian, but inevitably that takes time.

JJR: What about the training of local staff, such as nurses?

CW: We have a good relationship with the Faculty of Health, and more Maldivian nurses are coming back into the system. Liz [Ambler] is very keen on in-service training to make sure we are training effectively, and Dr Rob [Primhak]’s background is in education so I’m sure he’ll be keen to ensure high standards of education and training when he starts in July. It’s an area we’re developing.

JJR: How have you found living in Male’?

CW: We’ve settled in well. My husband is semi-retired; he used to be a director of Mental Health Services. He’s made a decision not to work at the moment – he’s a diver and he’s doing his diver master training and really enjoying it.

One of my worries at the hospital is that we haven’t got the facilities to care for patients at the acute stages of mental health problems, and we haven’t necessarily got the right staff.

JJR: What do you think of the relationship the hospital has with the community, and what did the outcry over the widely reported ‘baby decapitation’ incident tell you about that relationship (the head of a deceased newborn had to be surgically removed during labour after its shoulders became stuck during delivery, endangering the mother).

CW: I had only been here a few weeks when that happened. Without going into the details, what surprised me was how quickly quite confidential details about the patient and the case were spreading like wildfire across Male’.

Understandably there was a lot of anger and concern, and fear generated. One of the key learning points for IGMH was how we need to handle that more effectively with the media – we didn’t handle that very well at all. It’s in the hands of lawyers now – it was a tragic and very unfortunate case, and a very emotive situation. From the hospital’s perspective we did all the necessary investigations that we needed to do.

JJR: Does it come back to this recurring mistrust of doctors?

CW: That’s one of the things I’ve picked up on – there is this mistrust. We still have to rebuild that, because we have some fantastic doctors and clinical staff in IGMH, and inevitably when we have high profile cases like that it creates more damage for the medical profession, which bore the brunt of that incident. We need to be more proactive about how we talk about some of the great things that happen in the hospital.

I’m not sure Male’ is ready for it, but I’d like to start a patient involvement group – a number of people from the community who work with us to improve what we do in the hospital. We do that a lot in the UK, but I’m not sure people here would be interested in doing that yet. It does help people understand the challenges we face as an organisation on a daily basis.

The President has appointed an envoy to work with the hospital. He has already brought through some significant changes in terms of the environment. It’s looking much better when people come in, and the outpatient area is now air-conditioned.

We need to focus on what we need to do to implement quality of care and improving access – there are hundreds of things need to do, but have to manage expectations.

One of the things we want to introduce is catering – at the moment patients’ relatives have to bring food in for them. That’s so different to the UK – nutrition is so important to a patient’s recovery. We want to try and introduce a catering service before the end of the year, so patients get a better service.

JJR: What are the hospital’s key strengths and weaknesses at the moment, aside from the shortage of mental health support you mentioned earlier?

CW: One area we do need to improve on is diagnostic capacity, and tools for helping diagnose. We are going to get a mammogram machine, which will have the facility to do biopsies, and we are going to get an MRI scanner which will improve diagnostics.

One of the key problems we have is access to equipment and medical consumables. We’ve put new processes and deals in place which will hopefully improve that, but I didn’t realise until I lived here that absolutely everything has to be imported. We are reliant on things coming in a timely way, and I don’t think that just affects us.

We also have a hospital kindly donated by the Indian government, but inevitably the building itself is in need of renovation. It was fit for purpose then but with the influx of people living in Male’ the need for services is huge. We have 500-600 patients a day, sometimes more, and the building is almost too small now. We have to look at how we take care of it and develop a more modern facility.

One of our big concerns in relation to the operating theatre is lack of anaesthetists. We have to pay a premium for them to come, as there’s international shortage. That’s a real problem for delivering key services.

Those are some of the key areas. We have a good team paediatricians, and a very busy but effective neonatal intensive care unit with 20 cots.

JJR: Is it difficult to attract people to come and live and work in the Maldives?

CW: I think it’s becoming more difficult now because of the dollar situation, and the cost of accommodation in Male’. The MHSC provides accommodation to doctors as part of their package, but nevertheless food prices and living expenses are going up.

A big problem is paying people in rufiya – the expats who come and work in the Maldives want to send part of their salary home but banks are struggling to enable them to send dollars. That seems to be a very major problem at the moment.

The big thing is making sure there is the right commitment from expatriates to stay and make a positive difference. There’s got to be some way of making the working conditions right for the Maldivian doctors as well. They are the life of the organisation, and we are dependent on making sure they don’t move elsewhere.

We are in the process of expanding inpatient facilities, and renovating the old staff quarters into more private facilities. We will have 56 beds finished in late summer, and we have also signed an agreement with the 11 storey building next to IGMH to provide 72 beds. This time next year we will have a significant increase in the number of beds, but that brings its own problems, such as where we are going to get staff. We’re trying to make sure there is joined-up thinking going on.

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40 thoughts on “Q&A: Cathy Waters, CEO Indira Gandhi Memorial Hospital”

  1. Past experience with Dhiraagu shows an experienced with good foreign management, a company can build local managers who could eventually run the place.

    One hope that this model could be used in IGMH..

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  2. Enjoyed the interview
    Wish Mrs.Cathy Waters all the best in her work.

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  3. Wonderful interview, i hope and wish Cathy Waters will solve our major problem in the country. but we must also give all the support and time

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  4. Dear Cathy Waters,

    Wish you well,I really do hope you and you team succeed in your mission.

    May Allah Bless you.

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  5. I started off thinking why cant they get a Maldivian for the post. But as I read through I can see she has keenness to improve. I hope people will treat her kindly and she will also view us Maldivians in a good way.

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  6. Unusually frank interview. Enjoyed reading it.

    The CEO's absolutely right when she says there's mistrust of doctors.

    I've seen too many mis-diagnoses and treatments that ended up making problems worse to trust them.

    One of my biggest worries about getting really sick is that I might have to consult a local doctor - the very idea is terrifying.

    I sincerely hope the new management is able to change this perception.

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  7. Mrs Cathy, Welcome to Maldives and I simply adored your plans. I wish you all the best in your work and hope your experience and skills are of utmost benefit for the people of Maldives. Please try alo to make the cost of healthcare low to our people. Our people cannot bare the present high prices of IGMH consultations and other fees. The people are still very poor and with the price rise of daily commodities,its even making us more difficult to obtain health care. Another discipline where you can work on along with communication element is implementing 'Safe doctor and Nurses' programs in IGMH,just like the way it is in NHS. As you said a health staff are bound to make errors because of the type of works they do, but IGMH does not have continuous training, conferences, audit programs etc which enhances the staff quality of work and skill levels. so please try and work on this. Good Luck.

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  8. yaamyn the fear monger strikes again.
    constantly creating fear against religion and now doing the same against local doctors. give it a rest, will ya?

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  9. Ziyan said: "Please try alo to make the cost of healthcare low to our people.
    Alhumdulillahi!!!!

    Ameen Brother I second that!

    Thankyou for stating that!

    Yes, please Cathy, please reallyu care for the poor Maldivians and the really exploited ex-pats. Many of the very poor Maldivians really care for themselves, they may seem selfish seems many do cheap drugs and neglect their own health, but, they are internally hopeless, please care for them and they may be inspired to begin caring for themselves!

    In fact, MDP rich, DRP rich, Z DRP rich, Yameen and Nazim party, Gasim, Hassan Saeed's followers, Dr. Waheed's people, PLEASE! IF you worked together, you would be able to pool enough resources to prepare a system of free health care to the very poor, and cheaper health care to the lower-middle classes! make it a reality. Prove to the Maldivian people, that you can overcome your personal rivalries and get together and genuinely CARE, that your caring for your ppl is greater than your selfishness!

    It is not unachievable!

    This is my deepest, sincerest prayer for Maldives, really, it would be the most beautiful thing I ever beheld!

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  10. sorry made too many typo's in my above comment, please release it again I will re-present it

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  11. Ziyan said: “Please try alo to make the cost of healthcare low to our people.

    Alhumdulillahi!!!!

    Ameen Brother I second that!

    Thankyou for stating that!

    Yes, please Cathy, please really care for the poor Maldivians and the really exploited ex-pats. Many of the very poor Maldivians really DO NOT care for themselves, they may seem selfish seems many do cheap drugs and neglect their own health, but, they FEEL, internally hopeless, absolutely CRUSHED! please care for them and they may be inspired to begin caring for themselves!

    In fact, MDP rich, DRP rich, Z DRP rich, Yameen and Nazim party, Gasim, Hassan Saeed’s followers, Dr. Waheed’s people, PLEASE! IF you worked together, you would be able to pool enough resources to prepare a system of free health care to the very poor, and cheaper health care to the lower-middle classes! make it a reality. Prove to the Maldivian people, that you can overcome your personal rivalries and get together and genuinely CARE, that your caring for your ppl is greater than your selfishness!

    It is not unachievable!

    This is my deepest, sincerest prayer for Maldives, really, it would be the most beautiful thing I ever beheld!

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  12. For an unknown reason, Yamyn's stalkers see 'religion' in every of his thoughts. No one knows why, but it is highly amusing.

    Still, it's worth mentioning a religion that endorses genocide, oppression, tyranny and bullying is to be feared - and crushed to dust on the wind.

    -

    Back on topic: Well, I wish Cathy Waters good luck in transforming IGMH into a hospital. =3

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  13. I hope all the maldivians got the message : Be polite and exercise some good manners, don't barge into a hospital screaming and shouting for services..Follow the rules and behave like a civilized human being...Even those people working at the hospital, staff,doctors and nurses are all human beings doing their best to provide services despite all the shortcomings and limitations that they have..So be human and practice some patience...Shouting and yelling is not going to help anyone.... People like Cathy Waters who come to our poor little country to help us progress sacrificing their comfortable life to serve in a poor nation like ours and if we behave like animals it's not going to reward anyone...

    Don't come to the hospital for some minor ailments screaming around to get instant care...have some common sense,read about diseases and learn to manage simple ailments at home..don't just come running to hospital for vomiting two times or fever for one day with no other problems..Learn to treat a fever at home with plenty of fluids and panadol tablets and if fever does not subside get doctors advice after three days...Don't take unnecessary medicines,dont go to ten doctors in five days..read on the internet,care at home and if you are really sick then go to hospital..

    Don't over crowd at the hospital,don't take the entire family for a walk at the hospital..it's not a park,It's a place filled with all sorts of sick people,you and your small children will catch unwanted infections...Be sensible in getting a doctors help,just don't waste your time and money for unwanted visits to doctors..think and be rational and behave like sensible human beings and learn to control your outbursts,your bad temper won't help anyone..

    Finally,thank you,Ms Cathy Waters,you are doing great despite of all the short comings and challenges...We are grateful for your expert services..Kind regards and best wishes for your stay in our troubled little island

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  14. One very important issue I noted in this interview was the cost of accomodation in Male for IGMH staff. This is something that the government can directly intervene in.

    In other countries such as the UK, key workers are given priority for housing and we need to get that here in Male. Even by legislation, we need to create affordable accomodation for key workers in the community such as health professionals and teachers.

    Instead of paying accomodation charges just for expats, there should be a uniform policy that applies to everyone and that can be done by forcing landlords to reduce rent to realistic levels.

    Afterall, most Maldivians are "expats" themselves in Male! Remember that not long ago, under the leadership of Zedey, islanders had to get a "visa" and a Male sponsor to even land in Male!

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  15. I am sorry to say this but shes what shes doing is not going to help anything....The only way to improve healthcare is for government to pump HUGE somes of money into the health sector...To produce more Doctors trained from US and europe.

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  16. Enjoyed reading this and it seems that there's light at the end of the tunnel. All this comes down to Leadership skills. Well done cathy. This is the first time I have ever seen all positive comments on a post (at least for now it is)

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  17. She can't be paid all that much. It's nice that there are people who lend their skills like this.

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  18. work ethic and mentality major challenges, good luck Cathy w.

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  19. cathy i really pray that end of ure contract u would not go all koo koo n gaa gaa,with all whts on ure plate. best of luck.we are already in love with u...keep in my as maldivians we are very good at presenting u with all the impossibilities..lead us!

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  20. One of the most important things that people like Cathy can teach Maldivians is proper work ethic and standards of workmanship. As she has already noted, there is a distinct lack of these in the Maldivian workforce.

    If you look at successful countries around the world, one character that marks them out is work ethics. Look at Singapore, Japan, Germany etc. Those countries built their vast economies out of nothing or out of the rubble of destruction from wars.

    It's not just Maldivian who are lacking in work ethics. Most southern Europeans have a different attidue to work compared to their nothern counterparts. Perhaps that explains why most of southern Europe is being bailed out by their northern neighbours!

    My fellow Addu/Suvadheeb people in the past were fortunate enough to have experienced proper work ethics thanks to the British presence here for over 20 years. Our fathers and grandfathers learned a lot from that experience. Sadly those standards and skills have long disappeared.

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  21. Thank you Cathy. Thanks to Government for making this right decition at the required right time!!

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  22. i find that I can obtain services from IGMH much faster than before. I sometimes wonder where the long queue has now disappeared. I remember waiting for hours to see a doctor at OPD. whoever has done this has done a great job.

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  23. indeed good news for us. However I strongly feel that the nurses in the hospital over rule doctors and they seem to dictate doctors. This is mainly in the Prenatal and Antenatal and Gynecology department.

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  24. Ibrahim Mohamed: The nurses working in the antenatal, and gynaecological departments are Midwives. Them being a completely different profession are part of a team that doctors themselves beling to.

    Most of these midwives had been there for years and years and are very qualified and experienced, i don't see why they can't be mentors to newly joining Medical Officers? THere is no one on top of another....this is exactly the attitude that needa to change. Midwife run clinicas and birth suites is not something new to the rest fo the world.

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  25. Mr.Ibrahim , I kindly request you to analyse & evaluate the situation before jumping on a conclusion.
    It should be pointed out that the role of a nurse is not always as a subordinate to doctors.

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  26. "me"

    I find it quite amusing that you cannot read my name without thinking 'religion'.

    That kind of adoration is usually reserved for prophets. 😉

    As for my 'fear mongering' (which I believe, is the term you use for anything that disagrees with your viewpoint), I used to live in India for quite some time and I've met literally scores of Maldivians who've actually gotten worse after consulting inept doctors and getting misdiagnosed.

    I've seen people pay out of their pocket to go abroad for minor surgeries, despite being covered by insurance.

    So. Fear mongering, it must be.

    Aliased,

    I know!

    That is excluding the hundreds of others who prefer to travel abroad for even seemingly minor ailments.

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  27. It was a nice way of answering the media, but still I feel, one thing which requires attention is, MHSC have to promote public awareness about the facilities and capabilities of doctors(Maldivians & Foreigners)working in the corporation.For small things still patients have dilemma going abroad!Stop them before its too late.

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  28. and i find it sad that u cant think of anything without blaming religion for it.
    and FYI its not adoration, but abhorrence!
    I used the term fear mongering as it should be used.
    and for someone who worked in the health sector, I’ve met literally scores of Maldivians who’ve gone to india for a better treatment and got cheated into doing unnecessary investigations, surgeries, etc..
    i have even met a patient who had a kidney missing after a hernia surgery in India.

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  29. its already too late. but lets try to improve things, hand in hand. I'm sure we will succeed.

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  30. My message to CATHY WATERS is, take an extra dose of "patience" and "tolrence", and roll up your sleeves (as seen in the photograph)and get ready for a roller coaster. You were right! You only visited the the "Sunny Side" of Maldives , so this time we welcome your team to the "Dark Side" of Maldives. We have seen many people like you come and gone to different institutions to implement transformational programs without much success. Even though I'm little pessimistic, I wish you good luck with your job and hope and pray you'll make a difference to the health sector of our nation.

    This country is in great havoc.Our system is built on a very wrong foundation which needs to be changed before anything changes. Being a participant of a professional transformational program held in a reputable institution some years back, I can tell you the reason why it failed. The very high professionals couldn't convince any thing positive to the minds of the participants because of the mistrust they have for there bosses and seniors. The reason is, our culture, which determines the "attitude" of the people, is built on a very corrupt system where there is lot of mistrust between the bottom and top. Unless you change the "attitude" of the big bosses, nothing at the bottom works. Can't see any such changes happening at the moment, instead we are witnessing confusion and corruption at all levels in the country.

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  31. @Dr Pradeep Gadugesh

    "For small things still patients have dilemma going abroad!"

    I am pretty certain that quite a lot of these people are going abroad not just because they don't understand the capabilities of IGMH doctors.

    It's just too damn expensive to come to Male and stay there for treatment! Take someone from our local province of Suvadheeb. It's far cheaper to go abroad. Not only is it cheaper, it's also a much more pleasant experience for the patient and their carers. Male is an expensive, dangerous and vile place!

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  32. O my Allah! Did anyone notice that huge big cross sticking above her chair? I fear she will be marched out of her office and deported for being such an unashamed and blatant missionary. Doesn't she know we don't allow crosses in our hospitals and classrooms?

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  33. pork fellow, stop the sarcasm. No one is interested.
    on a different note, i hope Mrs. Cathy Water, waters IGMH and make it blossom.

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  34. Read through the whole thing....can't imagine how well you have picked up. Dear Cathy, You already seem to knwo thesystem better than people who ahd been here for years and years. This looks very hopeful and convincing. Thank you!

    I have seen very passionate, capable and qualified Maldivians in all sectors lost within the system, not utilized or just supressed because they do not beling to a specific political iedology. Results of poor management.

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  35. As usual for every good things we have so many negative features,when this little thinking mentality for fools will change???

    Before criticize just understand what is the matter that has been focused?
    You people never qualify for such responsibilities because of your cheap mentality and unawareness how to treat others.

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  36. ibrahim Mohamed: I think you haven’t realized the situation that now that Nurses are not doctors assistants..Nurses form an independent profession with its own values. Nurses respect Doctors and all other health professionals who work with them…. I feel that what’s been hurting is your ego, when Nurses with experience knows the situation during crisis better than doctors. Nurses are there 24 hours, but doctors are not............tell me who will know the patient better? The world has changed now don’t try to belittle nurses. If there are no nurses, doctors cannot manage, and similarly vice versa. Nurses make a great team with other health care professionals in IGMH. You cannot see a better relationship with nurses and doctors if you search Asia. Nursing in Maldives shows compassion and caring, and bond that a nurse and a patient should have …………..do you see it yaamyn, after “living in India for some time.
    Be careful of what u think……. nurses are much more stronger than u think now… Ibrahim Mohamed.
    Human makes mistakes and hope they learn from it.

    I haven’t personally met Cathy. However, I feel , with the trust and support that the staff are giving her, shows that she is already accepted in IGMH.

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  37. Dear Cathy Waters

    Urgent means "avas" in dhivehi in terms of changes and imporvements you need to be avas.
    1.No toilet paper in the tissues and they reek of the smell of urine.
    2.ER toilets are not cleaned properly I was there for 24 hrs and saw it cleaned only onece during the whole day and no tissue there.
    3.ER floors and beds are cleaned with bleach making it impossible to breath inside the place.Im sure Dettol is not that expensive.
    4.Whats with the guards always aruguing among themselevs or picking fights with people as there are no proper signage and direction shows in the whole place.
    5.The cafe should be closed now as its un hygienic and service is poor.
    5.Why do patients admitted into IGMH have to run to the phar,macy to buy medication im sure this need to be sorted as well.
    6.STO pharmacy lacks in service it might have 10 counters or so but only one or two will be operational.After years of running they still havent figured out the best que system.
    7.If you are just released from the ER u still have to walk to the road to get a taxi and the whole area is a mess.Why do Guards not allow taxi to come in and pick patients from the lobby?
    8.Why do u allow lorry's and heavy vehicles to pass through the road that leads to ER.
    10.At night for strecher cases there is only one woman helper.
    11.Waiting room for ICU is now closed but the notice on the door asking ppl to stay there still remains.
    12.your triage system needs very fine tuning.
    13.Hospital needs to change the whole administrative hierarchy.
    Just VIP rooms wont quite do the job.Thanks these are few things i Picked up from visits there and I Know that the Hospital management is pathetic doesn't care and just keeps pocketing the salary.You probably are powerless and will leave soon rather than stick around on an under budgeted facility that struggles to pay wages.The government needs to prioritize improving the health sector as it will probably be politically more important than buying MP's.The lack of engagement in Local dailies by The CEO suggest she still doesn't understand the country as very few "raiyithumeehaas" read MINIVANNEWS.

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