HIBAPRESS – Abdellatif Barka
The development of nations is not measured only by the number of roads or skyscrapers, but by the number of lives that are saved every day in their hospitals. And if health is truly a constitutional right as stipulated in Article 31 of the Moroccan constitution, then daily practice in many health facilities says the opposite.
In Morocco, talking about the health sector has turned into a seasonal refrain that is renewed with every crisis or protest, only to disappear afterwards in the archives of speeches and plans. The reality, however, is more complex than can be summarized in spending figures or coverage rates. It is a reality that the citizen experiences moment by moment, in the emergency room, in the waiting room, or on the road to a closed dispensary.
– Multiple symptoms of a single crisis
The Moroccan health system suffers from a set of accumulated defects, in which structural and managerial reasons overlap. The first of these is the registration of a huge deficit in health cadres, especially in rural and remote areas. The second is the weakness of equipment and medical equipment, even in regional hospitals that are supposed to play a pivotal role. The spatial disparity in access to health services is striking, with the registration of administrative bureaucracy that weighs heavily on both the citizen and the doctor, with an increase in spending in non-vital sectors, in exchange for a realistic freezing of the health budget.
Official figures say that Morocco does not exceed 0.7 doctors per thousand citizens, while the World Health Organization sets the minimum at 1.7. Also, the percentage of health spending is still below 6% of the gross domestic product, which is much less than the rates adopted in countries with a similar level of development.
– The doctor at the heart of the storm
Talking about the health crisis is not complete without addressing the situation of doctors and nurses. These, who are entrusted with the task of daily rescue, work in dire conditions that do not provide the conditions of professional dignity, nor even the minimum of incentives. Trade union representations of doctors in the public sector in the regional hospital of Agadir reveal that "sometimes we are forced to transfer the patient only because the device is not available, or because the only nurse took a vacation. This is not medical practice, but a type of crisis management."
There is also the problem of medical training in Morocco, which still produces scientifically capable graduates, but the repulsive professional environment and the lack of horizons push many of them to migrate or silently withdraw from the public sector.
– Treatment by discrimination: from Rabat to the Rif
In the administrative capital, Rabat, university hospitals and major clinics are available, and the choice is varied for the citizen, even if it is expensive, but in the heights of the Atlas or the depths of the southeast, the citizen finds only a long road and a semi-abandoned dispensary. This spatial disparity not only strikes at the principle of "health justice," but also deepens social disparities, and opens the door to medical smuggling, and reliance on alternative methods, some of which are unsafe.
– Is there a prescription for reform?
The state has launched ambitious reform projects, the most prominent of which is the generalization of comprehensive health coverage and the reform of the social protection system with the digitalization of services, a gradual increase in the sector's budget, but previous experiences show that will alone is not enough.
The real reform requires restructuring the system with a comprehensive vision, not patching with incentives for the human element, because it is the pillar of the system and not just a number in the budget, with the adoption of a fair distribution of resources based on the real deficit, not the logic of political balances, and an attempt to establish a strict governance that links responsibility to accountability, and prevents the escape from administrative shortcomings, in addition to democratizing health information, and facilitating the citizen's access to the service without obstacles.
When will the sector be treated from its illness?
Talking about the health sector is not a luxury of reform, but a matter of survival and dignity. One cannot talk about development, stability, or even social justice in a country that does not guarantee its citizens decent treatment.
The time has come to break with the patchwork logic, and to look at health not as a sectoral file, but as a mirror that reflects the extent of the state's respect for its citizens.
In Morocco today, we do not only need new hospitals, but a new trust between the citizen and the system, a trust that will not be achieved except when the patient feels that he is being treated because he deserves it, not because he is lucky.
