Letters

Costs incurred by one severely ill Jehovah's Witness could run one unit in Africa for one year

EDITORMinerva reports that a Jehovah's Witness survived emergency surgery for a leaking abdominal aneurysm despite having a postoperative haemoglobin concentration of only 30 g/l; he spent 14 weeks in hospital.¹ Those of us who work in rural Africa can only wonder how much it cost in the face of claims of rationing and cost cutting in the NHS. Such a stay must easily have cost a six figure sum.

Here in Uganda for £250 000 a year we can treat 25 000 outpatients and 7000 inpatients, conduct over 1000 deliveries, and perform 1500 operations. We run a community health programme for 500 000 people. The costs incurred by this one patient might run our unit for a whole year. Will the time come when a religious group will be charged the costs of keeping its members alive? Ethically one may feel that one should do everything, whatever the cost; at the end of the financial year, however, elective surgery that could be life improving has to be cancelled.

The choice is easy here in Uganda. When a child who has severe anaemia from malaria with hookworm infestation and undernutrition comes in the choice is simple: he or she has a transfusion or dies.

Nicholas Wooding, Medical superintendent. 
Kiwoko Hospital, PO Box 149, Luweero, Uganda

1. Minerva. BMJ 1998; 317: 690[Free Full Text]. (5 September.)