Manque d’hygiène, structures dégradées, pénurie de matériels…traduisent la gravité de la situation des hôpitaux publics nigériens. Les problèmes de dégradations et de saleté sont régulièrement pointés du doigt. Ce phénomène qui prend de plus en plus de l’ampleur représente un risque potentiel sérieux, que ce soit pour les patients ou pour le personnel médical. Malgré de nombreuses plaintes du côté des patients, le gouvernement nigérien ne fournit que très peu d’efforts pour remédier à cette situation déplorable.
En effet, c’est bien là où la population se rend pour se soigner qu’elle se retrouve aussi dans la plupart des cas avec d’autres nouvelles infections. Par exemple, un Centre de Santé Intégré situé au cœur de Niamey dont nous nous gardons de citer le nom, serait vétuste, d’après le témoignage d’un père ayant conduit son fils malade dans cet établissement. « Insalubrité…moustiques pullulant à tous les endroits…les lieux d’attente sont infestés… du sable et des sachets de nourriture jonchant le sol…à croire que les lieux n’ont pas été balayés depuis des lustres » confie le parent pris sous anonymat. Des fois les patients sont délaissés à leur sort, c’est les cas de Ayata, une jeune étudiante qui raconte sa mauvaise expérience : « pendant que je faisais le ménage, je me suis blessée avec un morceau de verre cassé. Vers l’après-midi je me suis rendue dans le centre mais le médecin me demande de revenir le lendemain ».
Malheureusement même dans ce contexte du nouveau coronavirus qui ne cesse d’exercer de la pression dans le domaine sanitaire. Les règles d’hygiène et les mesures barrières ne sont quasiment pas respectées. « Même la salle de consultation laisse à désirer… en cette période de covid-19 les infirmières de garde n’avaient pas l’air de se soucier du port des bavettes…vu qu’elles n’en portaient pas elles-mêmes. Bien que visibles…les dispositifs de lavages offerts par diverses institutions ont été relégués sous un hangar et semblent n’avoir pas servi depuis longtemps », poursuit le père du malade.
Pour rappel une bonne salubrité, aussi indispensable que de bons soins de santé, est synonyme d’un faible taux d’infections. Une gestion bien organisée et sûre des déchets de tout type est donc indispensable pour garantir la sécurité dans les établissements médicaux.
Les problèmes de salubrité soulevés ne sont pas nouveaux dans les établissements de santé. Malgré de nombreuses plaintes au niveau des patients, le changement ne se fait pas remarquer. Certes l’intention du gouvernement est louable, mais la mise en œuvre va se heurter rapidement à des problèmes de culture, d’organisation, de formation et de moyens. Il est même possible de constater un grand décalage entre le discours des cadres du ministère et la réalité objective du terrain. Aussi certaines problématiques pourraient être indirectement liées aux compressions budgétaires en santé.
Le manque de moyens est une évidence au Niger, sous toutes les latitudes. C’est un fait à prendre en compte mais qui ne doit pas conforter la résistance des professionnels au changement. Face à cette réalité, la réaction naturelle de tout responsable de structure sanitaire est de se référer à ce qui se fait de mieux, à savoir les organisations des pays riches. Il peut donc tendre, dès que possible à reproduire dans son établissement les systèmes existants dans ses pays de référence.
C’est pourquoi il parait souhaitable de rechercher d’autres voies, d’utiliser d’autres méthodes peut être moins sophistiquées, mais mieux adaptées à la réalité et aux moyens des pays en développement.
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