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Donka: X-Ray of an African Hospital

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Donka Hospital in Conakry, Guinea - the largest public hospital in the country - is similar to many African hospitals. Built in 1959 just before independence, it was designed based on a European model, with little consideration for the realities of Africa. The most important hospital in the country, its plight typifies the crisis affecting the entire African health sector.

Over the years the hospital has accumulated substantial debt that neither the Guinean state nor international agencies will pay. Compelled to develop its financial autonomy, the hospital enforces a pay-as-you-go policy. This financial strategy is rigorously applied, but at a high human cost. In this hospital of last resort, families strive to save a child or parent, but without money, there are no drugs and little chance for survival. Revenues rise, but access to treatment diminishes.

As we follow the floor-to-floor progress of patients, their families, doctors and nurses, portraits alternate to form a living chronicle where tragedy meets hope.

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Main credits

Leclercq, Carin (film producer)
Artois, Patrick d' (film producer)
Quinet, Patrick (film producer)
Michel, Thierry (filmmaker)

Other credits

Director of photography, Luc Frisson; editor, Marine Deleu; original music, Marc Hérouet.

MARC Record See Worldcat record

Keywords

Economics; Hospital; hospitals; Guinean; Hospitals Public; Quality of Health Care; hospital; public; health; aid; care; Western; private; Guinea; West; Africa; reforms; patients; failing; documentary; film; Conakry; video; DVD; "Donka: X-Ray of an African Hospital"; Icarus Films

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[music]

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[music]

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[music]

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[music]

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The casualty department where

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all emergency cases are first brought
in, lies across from the main building.

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It’s opened 24 hours a day.

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[sil.]

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[sil.]

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[sil.]

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Having arrived at 5 o’clock that
afternoon, Mr. Diallo(ph) dies at 11:00

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that same night.

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[sil.]

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Donka hospital situated on the
west coast of Africa in Guinea

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is reminiscent of many such
hospitals on the continent.

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[sil.]

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Located at the entrance to the capital
Conakry, Donka hospital not only serves

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the multitude of patients who live on the
outskirts and in the suburbs of the town,

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but also those from the
interior of the country.

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It’s the main hospital of the
country, a public institution

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run by the state who cover the running costs
and salaries. As a university hospital center,

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it offers all the specialized medical
services of a major institution.

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It has a present capacity of 350 beds.

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[non-English narration]

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Donka hospital is representative of the present financial
crisis, which is hitting the health sector in Africa.

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Access is regulated and patients have to
pay the consultation fees in advance.

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Here at the entrance door.

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[sil.]

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[sil.]

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[sil.]

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[music]

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[sil.]

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The fifth floor, the pediatrics department.

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A sick child suffering from a Purulent
meningitis lies among many other sick children.

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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How does one film human
suffering in African hospitals?

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How can one be a witness to sickness and death
without offering assistance to the most deprived?

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These questions have plagued
us, since we started filming.

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Which should we choose, the brutal
truth of reality or human compassion?

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Without a second thought, we ought to help
the sick either with money or with medicine.

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Even if it means compromising
the truth in the face of which

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we cannot remain unmoved.

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[sil.]

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[sil.]

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[music]

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Prescriptions which have to be collected,
treatments that have to be paid,

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and money which has to be found.
With an average wage of

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1,00,000 Guinean Francs,
the equivalent of $100.

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How can one possibly afford medicines
whose price often represents a fifth

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or even a quarter the monthly income.

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[sil.]

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[non-English narration]

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[sil.]

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[sil.]

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[music]

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[music]

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[sil.]

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Mr. (inaudible) came to the
pediatrics department, two weeks ago.

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His five year old son Abdoulay

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had a fishbone stuck in his throat.

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Once the bone was removed, the
child suffered from inflammation

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which led to a fistula,
a hole in the throat.

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[music]

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[sil.]

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[non-English narration]

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[non-English narration]

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Dr. (inaudible) head of pediatric surgery

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was called a meeting of his medical
staff to examine the case of Abdoulay.

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[sil.]

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[sil.]

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To heal the wound on the child’s neck, Dr.
(inaudible) has decided to operate.

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He intends to insert a feeding tube in the
child’s nose, so he can be artificially fed.

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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Over the years, Donka hospital has
accumulated a considerable deficit,

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which neither the Guinean state
nor international aid can make up

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or do not want to make up. Obliged
to operate as a going concern,

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the hospital charges for its services in
order to cover a part of the running costs.

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This new style financial management

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now a priority for the hospital
entails however, a high social cost.

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While revenue increases, access
to health care diminishes

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for many Guineans, threatening the
very notion of public medicine.

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[sil.]

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[sil.]

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The management’s objective
is to fix tariffs

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and to have an official method of payment for the
patients. It’s a question of ending the system of

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parallel transactions from hand to hand
which escaped the hospital accounting.

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Today, the financial director is seeing
the head nurses on different departments

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with a view to fixing the
scale of salary bonuses.

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[sil.]

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The emergency service the hospitals
nerve center, handles the most diverse

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and the most dramatic cases.

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[sil.]

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Dr. (inaudible), assistant medical officer

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diagnoses the patients before sending the
moment to the various specialized services.

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[music]

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[sil.]

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[sil.]

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Notified of the case, Dr.
Barry(ph), head of reanimation

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comes to personally look at the patient.

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[sil.]

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[music]

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The lifts here have long
ceased to be operational,

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the medical staff have no choice but to use
the stairs in this five floor hospital.

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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[sil.]

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Built in 1959, at the end of the
colonial era, Donka hospital was modeled

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on European hospitals. Today, it’s
undergoing a complete renovation.

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Soon, many of the departments will be totally
upgraded. However, this won’t be the case

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throughout the whole hospital. The works have
called for an international financing of

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more than $27 million coming
mainly from Saudi Arabian funds of

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the Islamic Bank of Development.

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The renovation doesn’t however solve the fundamental
question of accessibility both regarding

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treatment and that link to
the training of doctors.

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First beneficiary of the renovation,

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maternity has just moved into its new
buildings equipped with modern material.

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[sil.]

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[music]

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Mrs. Hizaji, obstetrician and gynecologist is
a dynamic part of the maternity department,

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where she’s also assistant medical officer.

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[sil.]

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[non-English narration]

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[sil.]

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[sil.]

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Today, Dr. (inaudible), head of maternity

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is carrying out a cesarean operation.

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[sil.]

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[sil.]

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A few minutes later, the power is restored.

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[sil.]

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[music]

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[music]

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[music]

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[music]

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[music]

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[sil.]

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[sil.]

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[non-English narration]

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[sil.]