Inadequate hygiene in Hungarian hospitals

Today I’m venturing into the world of healthcare, specifically hygiene or rather the lack of it in some Hungarian hospitals. A discussion of the high rate of infections contracted in hospitals began when the movement “1001 physicians without gratuity” called attention to the problem. According to the statement of these doctors, the problem has been known for years. But not only is nothing being done to try to eradicate the problem, the number of reported cases has also been kept secret. The doctors complained about the quality of the sterilization machines, a lack of diapers, not enough disinfectant, etc. The group demanded the release of data about the number of cases of hospital infections and the death rate from such infections. That was at the end of February. Since then a fair number of articles have appeared on the subject that further highlighted the terrible conditions that exist in Hungarian hospitals.

Nothing, however, elicited a greater outcry than a news story published a couple of days ago by Index, which claimed that the department of dermatology, venereal diseases, and skin-related cancers at the hospital of the Budapest Medical School ran out of “rubber gloves” and therefore the unprotected staff must use “nylon gloves,” which are not as effective. The “rubber gloves” must be saved for operations.

Well, this is where my definitional problems began. I have heard of “rubber gloves” (gumikesztyű), the kind we use when washing dishes, but I had never heard of “nylon gloves” being used in hospitals. I suspect that Index’s reporting was not precise. The gloves we see in doctors’ offices and hospitals are “nitrile non-sterile single use” gloves. I assume that this is what Index called “nylon gloves.” These same gloves also come in a sterile form, which is more expensive, but the non-sterile gloves (which retail for $7.99/100) “pose no higher risk of infection for non-surgical procedures when compared to sterile gloves.” In fact, I read that even doctors and nurses dealing with HIV patients are well protected wearing these gloves.

Latex gloves used to be common in operating rooms because they fit more snugly (though they also puncture more easily). But a fair number of people are allergic to them, so many hospitals have opted for alternatives, admittedly more expensive.

If we’re dealing here with the distinction between latex and nitrile gloves, the hospital’s director was correct in explaining to the journalist that these two kinds of gloves have nothing to do with one another. That is, a shortage of one wouldn’t affect the other. No operation had to be postponed because of a possible shortage of nitrile gloves in the wards. However, the likelihood that the department did run out of ordinary nitrile gloves is very high. Tímea Szabó (PM member of parliament), who is currently working in a hospital as a volunteer to experience first hand conditions in Hungarian hospitals, has been reporting shortages of all sorts of the most basic necessities.

disinfection

Quite apart from this particular case, the fact is that hygiene doesn’t seem to be a high priority in Hungarian hospitals. One reason is the shortage of money, which unfortunately cannot be eliminated by “loving care” as Zoltán Balog, the minister of charge of healthcare, suggested. And because of this shortage hospitals try to save on items they consider non-essential. Here is one example of what is considered to be a “luxury” in Hungarian hospitals. The World Health Organization suggests the use of at least 20 liters of hand sanitizer for every 1,000 patient days. In Hungary hospitals use only 6 liters. They try to save money on disinfectant as well. Moreover, according to one man who worked as a sterilization machine operator, hospitals often sterilize equipment that should be discarded after each use. According to the whistleblower who no longer works in a hospital, he was instructed to resterilize equipment used in laparoscopic surgery as many as fifteen or twenty times. The interesting thing is that it is more expensive to resterilize equipment than to purchase new equipment. In fact, it can be twice as expensive. But since sterilization is done “in house,” the management can put in a request for new equipment but use the money for something else. As he said, “the money simply disappears.”

Meanwhile, the Állami Népegészségügyi és Tisztiorvosi Szolgálat (National Public Health and Medical Officer Service / ÁNTSZ) steadfastly refuses to release details about hospital infections and the resultant number of deaths even as it claims that its reporting is among the most comprehensive in the European Union. The website of the Országos Epidemiológiai Központ (National Epidemiological Center / OEK) does provide countrywide numbers, broken down by year, although its website is so user unfriendly that I didn’t even try to find them. It seems that Társaság a Szabadságjogokért (TASZ), the Hungarian equivalent of the American Civil Liberties Union, did look at their data but found them totally useless. What the doctors demanded and TASZ now demands as well is not aggregated numbers but a breakdown by individual hospitals. ÁNTSZ refuses to release this information. As one of the department heads of ÁNTSZ explained, if they published the data they would create panic. People would avoid hospitals where the number of infections and the resultant death rate is high and would go to hospitals where the danger of infection is low. But this could have grave consequences. Some patients might end up in hospitals that are not equipped to handle their problems. TASZ is not satisfied with this answer, and the organization will sue ÁNTSZ for the data. TASZ usually wins its cases against government authorities.

The stories of infections and death continue to multiply in the Hungarian media. A few days ago Index reported another serious infection, this time in a hospital in Pécs. The infection, called “methicillion-resistant Staphycoccus aureus” (MRSA), is caused by a type of staph bacteria that has become resistant to many of the antibiotics commonly used to treat staph infections. This sounds bad enough in English, but I’ll bet that Hungarians were petrified to read that “meat-eating bacteria are at work in a Pécs hospital.”

Infections picked up in hospitals are a problem worldwide, but according to some Hungarian doctors who came forth lately, the Hungarian situation is worse than that in most developed countries. One doctor I heard being interviewed claimed that the number of deaths as a result of these infections is twice as high in Hungary as in the U.K. According to one of the sources I consulted, the disparity is even worse. The British figure is 6.4% per 100,000 while in Hungary it is 14.7%.

It is ironic that in the country of Ignác Semmelweis, the pioneer of antiseptic procedures, hospitals are not using enough disinfectant, doctors and nurses don’t wash their hands often enough, toilets don’t function, and hygiene is altogether neglected. Devotion and hard work on the part of the staff is simply not enough, although admittedly it would start to address the problem. How often members of the staff wash their hands is not a question of money.

Hungarian healthcare needs more funding and an entirely different attitude on the part of hospital managers and staff. One of the early tasks of the post-Orbán administration should be to break the stranglehold on Hungarian healthcare by hospital administrators, trade union leaders, the Hungarian Medical Association, and those doctors in high position who are the beneficiaries of this corrupt system. Otherwise healthcare in Hungary will never improve.

April 9, 2016
Sort by:   newest | oldest | most voted
dos929
Guest
There are not enough words to describe the conditions of the Hungarian hospitals. It is not only that most of the hospital buildings are dated back to 100 years or more, but their state of repair both inside and outside is such that in a developed country they would have been demolished decades ago. The absence of minimal basic needs for the patients are the norm. This extends to all areas and includes that in many cases medication has to be provided by the patients, the beddings wouldn’t stand up to scrutiny in a 3rd world country, and even in the #1 major hospital of the country the lifts do not always work, as the maintenance company locked up 2 out of 3 because they were not paid…. The list is endless! As yet there are wasting millions of $’s for building stadions one after another just because of Orban’s “mania” soccer… Hungary’s infrastructures are falling apart, and not only the health care, but the roads, the education system, the transport infrastructure, etc… etc… The country is getting behind its neigbours in so many areas that it no longer can be compared to its western countries, but only to the… Read more »
Observer
Guest

Yes, there’s a looting of the public domain on a historical scale.

No, not all hospitals are in the described state of repair and operation. Budapest has some nicely renovated ones (admittedly without toilet paper, soap, etc but with WiFi.

Guest
Dos929: ”There are not enough words to describe the conditions of the Hungarian hospitals.” And there are not words strong enough to describe its cause. So far three different commenters on this post have suggested that the health care systems is running out of money because the bottomless pockets of the Fidesz gang must be filled first. I feel that neither of them succeeded in finding strong enough words. dos929: ”The systematic stealing of the nation’s wealth by the regime” Observer: ”looting of the public domain on a historical scale.” ambalint: ”obsessive thievery and institutionalized looting (raised to a high art since 2010)” I am also at a loss to find words strong enough. I have thought of ”unprecedented thievery” in order to emphasize the unique scale of the crime but, alas, when I googled ”unprecedented thievery” I learned that the expression has wide circulation in descriptions of what is going on in different countries. The expression can be traced back to tsar Peter the Great who called the first governor of Siberia, Prince Matvei Petrovich Gagarin, back to Moscow and had him hanged for ”unprecedented thievery.” Gagarin’s body was on display on the Kremlin wall until the ropes holding… Read more »
Guest

Yes, the situation is terrible!

On the other hand one shouldn’t forget to get in a word (or more …) for the people working in the health system – most of which are trying and giving their best.
We had good experiences with several doctors and hospitals – sometimes in the system and sometimes paying ourselves.

So the real problem is just as Jean describes.
Not enough money arrives in the system because it’s taken away by the top people …
Or as we say in German:
The fish starts to rot and stink from the head …

Bouncingball
Guest

I live in Eger and the situation in the hospitals has been poor since i moved here 14 or so years ago. However, the situation in the city’s hospital has got much worse over the last couple of years – no soap, no toilet paper, lack of basic hygeine ( e.g cleaning staff using cloths to wipe floors and then bedside locker tops), nurses smoking in the corridors, tye food, no money to repair essential machines, etc etc. I watched my wife’s grandmother dying in Eger’s hospital and the lack of compassion and basic care displayed by the medical staff broke my heart.
Eger now has a spanking new wing ( paid for with structural EU funds)but without the staff and money to run it efficiently I dread to think how it will function.

Kingfisher
Guest

It doesn’t seem much better in Budapest. We went to the Heim Pál Gyermekkórház a year or so ago, in an emergency. It was about 10pm on a Saturday night. The receptionist desk was quite badly lit because lots of lightbulbs in the ceiling had stopped working. There were lots of parents waiting with ill kids.

After about an hour, the poor woman at the reception desk told everyone that they had to leave, because there were no more doctors to work the next shift. The parents were furious. The receptionist switched off the remaining lights and left the desk.

cormoran
Guest
Sadly people never in the world have voted according to their health care or education policy preferences. These issues are decidedly middle-class issues and until people get into a hospital (and everybody thinks this will never happen to them) they just don’t care. Also most Hungarians just don’t care about education. In other words, Orban just doesn’t give a shit about public services because voting does not depend on them. Voting is based on ‘animal instincts’. Hating the enemy, being proud to be Hungarian and so on. Plus doctors and teachers are conservative who can’t vote for Jobbik (it’s too working class and tasteless for the elite professions) and who obviously can’t bear the thought of voting for the communists. Which means that the public services will continue to deteriorate ad infinitum. The middle class will of course purchase these services privately (as they do now) and the lower classes don’t vote according to rational policy choices (and blame the lack of services on whatever they do, but not on Fidesz). They are absolutely OK to bring their toilet paper or eat offal for breakfast. They are used to that and are happy to endure as long as they can… Read more »
tappanch
Guest

The government has not given a plausible explanation to the thousands of extra deaths in the first quarter of 2015. The journalists have accepted the vague allusions by the authorities, made months later, to an alleged influenza epidemic.

Deaths in Hungary, in the first quarter of

2011: 35109
2012: 35797
2013: 33944
2014: 32988

2015: 38678

tappanch
Guest

Death rate :

1941: 1.32%
1950: 1.14%

1955: 1.00%
1960: 1.02%

1965: 1.07%
1970: 1.16%
1975: 1.24%
1980: 1.36%
1985: 1.40%
1990: 1.40%
1995: 1.41%

2000: 1.33%
2005: 1.35%
2010: 1.30%

2015: 1.34%

The number of deaths was below 110,000 a year only in the period of
1949-1967. (excluding 1953, but including 1956)

Absolute minimum was in 1961: 96,410.
Absolute maximum in the post-ww2 era occurred in 1993: 150,244

2010: 130,456
2015: 131,600

tappanch
Guest

Local maxima in the number of births:

1954: 223,347
1975: 194,240
2006: 99,871

Absolute minimum: 88,689 in 2013.
The number of births in 2015 was 91,700.

Guest

@tappanch
Today 2:05 am

All of these stats are very interesting indeed, but it would also be good if you could add a few words explaining in what way would these stats be actually relevant to the topic at hand, because if not relevant, then it might be best to head up such posts with an indication that they would be OT.

tappanch
Guest

I have a suspicion that there was a hushed-up epidemic in the hospitals in the first quarter of 2015.

Guest

To use a couple of clichés, you reap what you sow, and if you sow the wind, you reap the whirlwind.

Nowhere is it written that things had to turn out this way for Hungary. Twenty-five criminally wasted years after the regime change.

Twenty-five years of dog whistle politics, incessant dog fights, obsessive thievery and institutionalized looting (raised to a high art since 2010), together with continuous compulsive lying to the public and appealing to its basest instincts.

Instead of sensible economic and social policies applied consistently and in the interests of social cohesion and solidarity whilst maintaining at all times the highest standards of public integrity, transparency and disclosure.

What a monumental screw-up!

Guest
London Calling! “Keep on running!” This is, for me Eva, an amazingly timely post. Three weeks ago my partner and I were enjoying an Easter break between my partner’s studies and two weeks later were preparing to get back to London. I hadn’t been feeling well for quite a while and knew I would have to see my doctor on return to London for what I thought was a secondary infection after a lingering cold. On the day of departure, feeling rough, my partner suggested we leave 12 hours earlier than planned. In the back of my mind I was fearful of having Hungarian healthcare intervene in my health. I have always been aware of the terrible hospital conditions that exist in Gyor through my partner’s mother’s dialysis treatment – truly awful. Her blood goes in warm but the hospitals are so cold that it is returned cold and this cold goes to the fundament of her body. It takes days to feel warm only for the next cycle to fall due. I have seen the wooden planks to hold frail patients in their beds and experienced the dreadful toilets. I too have mentioned how Semmelweiss must be turning in… Read more »
Guest

Charlie, that was a very moving story – luckily for you and your partner (and us too …) with a happy end!
Hope you get well soon.

And now another example of the Hungarian health system:
A friend of ours who’s a hairdresser has had problems for a long time so her doc recommended an ultra sound exam of her intestines, liver etc …
She got an appointment for the end of May …

Now luckily for her, she works in a house where several docs have their private practices (every time we visit her we see some shiny German, Swiss and Austrian cars parking …) and one of them arranged an appointment for early next week.
That means of course that some other poor person will have to wait even longer …

Andrew Endrey
Guest

Hope you make a full and speedy recovery, Charlie.

Stay well,

Andrew

PALIKA
Guest

Charlie, you had a very lucky escape both by leaving Hungary early and by not reaching Dover before you were treated. Can you imagine what the provincial NHS in Dover would have dished up in the middle of the night in A&E? Do not even think about it, it might make you Ill again. I wish you continued good health.

Member

What a story! I am glad that you are doing better! I wish you a speedy, and full recovery. Keep is posted even if it is OT!! All the best!

spectator
Guest

Oh, man!
“Thankfully I’m alive, because I missed the hospital in Hungary..!”
Obviously one not only needs to take toilet paper, soap and cutlery in case of hospitalisation , but a doctor too!
Good to have you back!

petofi
Guest

Actually, the doctors are pretty damn good…that is, if you get one who’ll treat you before giving knowing looks and sly winks
about…well, you know what.

spectator
Guest

Of course, allowing you have/find one who taking a good care of you.
In case there isn’t any ready and willing, bring along one 🙂

petofi
Guest

Charlie,

no wonder I didn’t hear from you!

Great escape. The Hungaricoes would’ve done you in for sure.
Be well, pal.

Guest

Eva, I think these numbers are a bit misleading:

“The British figure is 6.4% per 100,000 while in Hungary it is 14.7%.”
The percentage signs are wrong, it should be
“The British figure is 6.4 per 100,000 while in Hungary it is 14.7.”

Istvan
Guest
Please do not get me wrong in making this point but MRSA is rampant in Hospitals in the USA too, clearly infection control systems are in much better shape here than in Hungary. There is even a MRSA survivors network in the USA, statistically using data from 2005 (the best available) from the US Centers for Disease Control and Prevention (CDC) there were estimated 94,360 MRSA infections (invasive) in the US with approx. 18,650 deaths. Other organizations estimated the true numbers to be over one million infected in the US with MRSA and over 100,00 deaths in the USA. About 85% of all invasive MRSA infections in the US were from healthcare facilities with patients contracting infections after their stay ( two-thirds) and one-third while in the facility. Another 14% of all infections occurred in the community with no exposure to healthcare and this number is continuing to grow. However, our Veterans Administration Hospitals have reduced the rate of infection with strict protocols (see http://opinionator.blogs.nytimes.com/2015/01/30/for-v-a-hospitals-and-patients-a-major-health-victory/?_r=1 ). But then there is the problem of what is called MSRA nasal colonization among health care workers. Possibly around 15.2% of emergency room workers in the US show MRSA infections. This rate was similar… Read more »
webber
Guest

Istvan
Increasingly, I have the feeling you are attempting to relativize problems in Hungary.

Surely you know sheer numbers are irrelevant. Far fewer people die in hospital in Guinea Bissau (pop. 1.7 m.) than in Hungary (pop. under 10 m.) Does that mean the hospital system in Guinea Bissau is better than Hungary’s? Of course not.

Why do you even mention the fact that people getting infections in the US as well? That happens in every country. So what.

Mentioning this is just like nationalists in Hungary if – for instance- you talk about discrimination against Roma in Hungary, they counter: “Amerikában verik a négereket.”

The question is what percentage of people admitted to hospital pick up a secondary infection FROM the hospital, and what percentage die of this?

So what’s up? Why this ridiculous contortion trying to show that things are “bad” elsewhere as well?

Is the situation with cleanliness in hospitals as bad? No. And you know that. Why do you keep doing this?

Guest

Probably a crazy question. But why doesn’t the Nagtar medical establishment pay attention to ‘infectious’ details? Hospitals in my area have been greatly concerned of infections to their patients to the extent they constantly implore their professional medical staff and virtually all hospital workers to be constantky observant of hygiene in their daily work. They are always made aware of how hygiene affects the health and prognosis of patients. Again Magyarorszag looks like it can an award on being the ‘not caring’ nation.

tappanch
Guest

Attention, OLAF !

Research, based on the investigation of 127,776 contracts :
Hungary overcharges the European Union not by 30% but by 140% to 320%.

[I know, Frau Merkel & M Hollande have been too busy with other issues since 2010]

“Stregth of Competition and Corruption Risks. Statistical Analysis of Hungarian Public Procurement – 2009-2015. Data and Descriptive statistics”

http://www.crcb.eu/?p=943

http://www.napi.hu/magyar_gazdasag/meghokkento_tenyek_magyarorszagrol_erre_a_szakertok_sem_szamitottak.612793.html

tappanch
Guest

Average time spent debating a bill in the Hungarian rubber-stamp “Parliament” before voting:

2011: 2 h 12 m (215 bills)
2015: 1 h 15 m (230 bills)

http://hvg.hu/itthon/201615_a_rendeleti_kormanyzas_fele_lefokozott_parlament

Guest

Soon after this started I coined the following:

A new bill/law every day keeps sanity away!

Next year the bills will be valid one day before they are voted on …

Unbelievable, especially when I compare this to the procedure in the German Bundestag:
There are three “Lesungen” (readings, discussions) normally several days/weeks apart before a bill is voted on.

petofi
Guest

“Unbelievable”?

Why so?
There’s a mad gypsy who’s got the country by the balls…

spectator
Guest

Yeah, but the Hungarians notorious speed-readers!
Nowadays — since they performs better — they managed to surpass even the speed of light, hence the time wrap.
And now you know too just how amazing it really is 🙂

spectator
Guest

Time warp— on my way to dyslexia 🙁

tappanch
Guest

Orban is in friendly terms with the less-than-vassal oligarchs too, provided they support a soccer club.

Leisztinger: Diósgyőr

comment image

http://444.hu/2016/04/10/a-futball-osszehozza-az-embereket-orban-3-leisztinger

Nyerges (Simicska): Szolnok

comment image

http://444.hu/2016/04/09/orban-koszoni-szepen-nyerges-zsoltnak

HirTV (again) & RTL Klub (again) & ATV have been less critical of the Fidesz regime recently, in my opinion. In other words, there is not a single opposition television outlet in the entire country.

petofi
Guest

It costs money to be in opposition: in Hungary, it costs you your business, too.

wpDiscuz