Friday, October 15, 2010

Horror Hospital

Recently I wrote about some of the problems my wife and I had experienced with the maternity hospital we were in, but things were going to turn out to be worse for other people in what seemed to me like a perfect storm of Korean cultural issues.

The first aspect of Korean culture which differs from my own country lies in the fundamental nature of the birth experience itself. In Korea, women can – within a period of around four weeks - choose when to give birth; they pick a date and then report to the hospital to be induced or – if this is their preferred option, to have a caesarian section to deliver the baby. Now add to this ability to schedule a birth to the Korean thanksgiving holiday of Chuseok, one of those extremely rare times of the year when family might not be out working 12-hours a day, apparently making it a good time to schedule said birth. Next add in the near total contempt some business owners demonstrate for their customers in Korea, nurtured through a pathological pursuit of profit that might even make a financial trader blush. Add a little of the legendary local construction quality on top, and mix all these things together to achieve predictable results.

So this is what happened. A large number of women checked themselves in to have their babies during the Chuseok holiday, and it was probably double what the hospital could cope with. Normally, the recovery area of the maternity hospital, the 'sanhujoriwon' (산후조리원), takes up three floors – over Chuseok, the hospital expanded it to six by commandeering other floors which were not designed for the purpose. Whereas my wife's room was solely for her with en-suite, a desk, a TV and double bed for the husband to sleep in, the Chuseok mothers ended up in shared rooms with four beds and little else. That makes it no better than a bad British experience, and possibly worse because the already seemingly understaffed Korean hospital had not employed extra personnel for the holiday rush. Crucially for the people here though, this was not what they are accustomed to expecting, and it certainly wasn't what they were sold in the brochure.

And it gets worse. I said the hospital hadn't employed any extra staff, but in fact they'd gone the other way. The cleaning staff had the week off. So you have these new mothers, packed into rooms kept at abnormally high temperatures because of the belief here that this is better for their 'shattered' bodies, there's a lot of sweating and a lot of clothes going in the hospital wash baskets. But now nobody is around to clean them, piles of smelly clothes are building up in the corridors, and mothers are running out of clean clothes to wear. You can imagine the situation with bedding, bearing in mind that many of these women have undergone operations or procedures and were still bleeding.

And then there was the woman in the room next to us. Like my wife, she had been lucky enough to have her baby just before Chuseok, so she had a room to herself as she was supposed to. But the bathroom had a drainage problem. It was fitted incorrectly with the drainage grate too high, so after showering water would just collect creating an indoor pool. The room isn't exactly new so presumably it's been like this since it was built two or three years ago. She complained to the Sanhujoriwon Director - he offered her a small tool to push the water uphill into the pipe. She'd just given birth and could hardly walk, but the Samhujoriwon Director apparently thought nothing of her bending over pushing water around the floor. She protested.

Was he embarrassed? Afraid? His response was “If you don't like it, I have plenty of other women who would gladly have your room.” And sadly he was probably right, because when you're packed into a small room with three other women with no facilities whatsoever, you'd certainly see a single room with an inch of standing water in the bathroom as an upgrade. This is not really a good excuse, and it reminds me of the time I found a long black hair baked into my pizza at an expensive restaurant in Busan, and when we complained, the manager looked at us incredulously and said “well, it's only one.” On the face of it, Korea often seems to have a positive customer service culture – but perhaps only because they want to sell you something – once the transactions is done, attitudes can rapidly change – not always, but often enough to make you feel like you're stepping into a minefield every time.

It must have been bad because the husbands got unionised and all went to see the Hospital Director to complain, and by this time you can probably guess how that went. 'If you don't like my hospital, pick another!' I understand that a private Internet forum for mothers in Busan is now buzzing with anger about it, so word of mouth may at least provide a little karmic retribution.

Given the appalling conditions in the lower decks it almost seems churlish to mention another area in which the experience fell below expectations, but I will for completeness. The 'samhujoriwon' experience is about recovery and education, with mothers attending various classes to help them transition from hospital to coping on their own with their babies. There were no classes during Chuseok which meant that of the ten days of activities promised, many women only got seven. It's understandable that this is just bad luck and while I would expect cleaning to continue during the holiday, educational classes are a bit much to ask for. But there certainly won't be any refunds for the women who were short changed in this and other ways during the holidays. By this time, I couldn't say I was surprised.

Can I name and shame the hospital here? Sadly, probably not. The way things seem to work here is that criticising companies in public can easily lead to lawsuits. And in a nutshell, this tells you a lot about reason why the Hospital Director all but laughed in the faces of his patients and their families.

The problems I detail above effected others far more than they effected my wife. We were lucky – if you can call it luck - to have our own room away from some of the horrors. But I asked my wife, in principle rather than with intention, what could we have done to formally complain about the hospital had we suffered like some others had suffered. I was curious. She really wasn't sure, because often it seems people really don't ask those kind of questions here. I had an idea that ultimately, hospitals had to be licensed, and medical companies that ask new mothers to crawl around the bathroom floors of understaffed hospitals in dirty clothes are probably not what the government have in mind when handing out those licenses. So one imagines there must be some mechanism for calling people who run institutions like this to account. But it's not really my problem and it's a given that the Koreans who suffered won't take action either. Nothing will change. Meanwhile the Korean Government will keep talking about their desire to promote medical tourism to Korea within the Asian region, with discounts for properly qualified plumbers, presumably.


Anonymous said...

A lack of accountability and responsability is indeed a huge problem in Korea. It is easy to also see this at the local universities here...

The ridiculous defamation laws are of not much help either, basically protecting the powerful and the corrupt in Korean society.

Hope you and your family are doing well!

Mike said...

I think the protection of the rich and powerful might be guaranteed under the Korean constitution so I guess everyone just has to live with it ;-)

Despite his rather rocky introduction to this world, our baby is doing fine thank you. Personally, I haven't had this little sleep since my university days though so it's certainly exhausting!

Talking to myself said...

Like you, I'm from Britain, living in Korea and married to a Korean woman. I'm glad we've decided not to have a baby right now while we live here.

It is heart breaking to read of the conditions that you write about in that so-called hospital. At least mother and baby are doing well. Good luck with sleeping the next few months.


Mike said...

Hello Gavin - you will of course make the best choice for your wife and yourself, and it's a very personal decision. After everything I've experienced I should clarify where I'm at on this subject though.

My wife did some research on the hospital, it didn't raise any warning flags, but our experience in reality differed radically from our expectations. On balance my wife and I would still choose to have another child in Korea rather than Britain, but what we would correct is the choice of hospital - we really need to do better next time. The problem is that even with research beforehand, some outcomes aren't predictable, and I fear this was one of them. It could go wrong again, and as I have a superpower - I'm an incident-magnet - it probably will.

I think we would certainly try to choose a larger institution with more staff and a cross-section of specialists in case of complications, rather than a small narrowly focused maternity hospital, if that's possible.

You'd certainly get the backup in a British hospital but what your wife probably wouldn't get is the bi-weekly ultrasounds and other tests which really provide a lot of comfort - I believe by comparison the NHS normally offers only two ultrasounds in the entire pregnancy.

On the other hand, the Korean 'cultural issues' surrounding pregnancy stretched my patience and credulity to breaking point and I'd give anything not to have to go through that again. There are some serious issues in this that I haven't directly addressed in what I've written. There's something to be said for giving birth outside Korea and avoiding some of this.

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