When Kwagne Elian came down with a high fever, the young woman in Cameroon did what many of us would do in the United States: She went to a private health clinic in her neighborhood.
But unlike the clinic at the local CVS here in the U.S., the one Elian goes to is illegal. And it's the target of a crackdown by the government.
Cameroon is tackling a health care crisis. The country's 22 million people face high rates of HIV, malaria and tuberculosis. And the country has one of the highest infant mortality rates in the world.
But public health care is too expensive, or simply not available, for many families. So they've have turned to unauthorized clinics for care.
One such clinic is the Family Health Medical Center in Cameroon's largest city of Douala.
Elian says she goes to this facility because the doctor is understanding, and the treatment is affordable. "They put patients before money, and take good care of them," she says.
When you step inside the clinic, it feels like walking into someone's home. To the left there's a room outfitted with an old mattress on a wooden frame and, right above it, a mosquito net. A pregnant woman in distress gave birth to a premature baby there earlier in the day.
The clinic often receives patients from nearby government hospitals when people run out of money for treatment there, says Sylvestre Mebam, who operates the Family Health Medical Center.
Mebam says he also sends people to public facilities when a patient's situation is beyond his ability, such as the woman who'd gone into labor prematurely. Her baby died at the state hospital hours after birth.
Mebam says he treats about 10 to 15 people each day. And there are hundreds of clinics similar to his around the country.
But the government sees these private, unauthorized facilities as a threat to public health. And it has kicked off a campaign to shut them down: The clinics that meet standards in regards to their staff, equipment and hygiene will be asked to legally register, the Ministry of Public Health says. The ones that do not successfully register will be closed.
"Most of these clinics do not have the qualified personnel," says Dr. Henry Luma, medical director of the General Hospital in Douala, one of the best-equipped facilities in the country. "And there is no way that they have a system to control the quality of the care they are providing," he says. "There is every right why those clinics should be closed."
STEVE INSKEEP, HOST:
The government of Cameroon say it's standing for law and order and for properly regulated medicine. That's why the government is cracking down on illegal medical clinics. The problem is the illegal clinics have been addressing very real problems. The Central African country has high rates of HIV, malaria and tuberculosis, not to mention one of the highest infant mortality rates in the world. And the legal medical system isn't keeping up. Andres Caballero reports from Cameroon's largest city, Douala.
ANDRES CABALLERO, BYLINE: Near a dirt road in Douala's Omnisport neighborhood, a decaying wall displays the faded name of an illegal clinic targeted by the government for closure. Entering the Family Health Medical Center feels like going into a house. To the left there's a room outfitted with an old mattress on a wooden frame and right above it a mosquito net. A pregnant woman in distress gave birth to a premature baby there earlier today. Sylvestre Mebam runs the clinic.
SYLVESTRE MEBAM: (Speaking French)
CABALLERO: He says he often receives patients from nearby government hospitals when they run out of money for treatment there. But he also sends them to government facilities when the situation is beyond his ability, including the woman and her premature baby. The baby died at the state hospital hours after birth. Kwagne Elian came in with a fever. She's in her mid-twenties and has malaria.
KWAGNE ELIAN: (Speaking French)
CABALLERO: She says she comes here instead of going to a state clinic because the doctor is understanding and treatment affordable: they put patients before money and take good care of them. But the government sees the clinics as a threat to public health and has kicked off a campaign to shut them down.
DR. HENRY LUMA: Most of these clinics do not have the qualified personnel.
CABALLERO: Dr. Henry Luma is the Medical Director of the Douala General Hospital, one of the best-equipped facilities in the country.
LUMA: And there is no way that they have a system to control the quality of the care they are providing. There is every right why those clinics should be closed.
CABALLERO: According to government figures, 60 percent of all deaths at Douala health facilities happen in private clinics mostly operating illegally. However, many government facilities are overcrowded, understaffed and underfunded. Laquintinie is one of the busiest general public hospitals in Douala. The humidity fills the long hallway, where nearly 100 patients - many of them mothers with children - line up along the discolored walls and wait to be seen.
Fabo Abel is here because of heart problems. He's been waiting for five hours.
FABO ABEL: (Speaking French)
CABALLERO: He says there are too many patients for very few doctors, but that people come here because it's better equipped. And the doctor to patient ratio is even wider in rural areas. Dr. Gottlieb Lobe Monekosso is the former Cameroonian Minister of Public Health. He was also the Africa Region Director for the World Health Organization. He says there's a need to employ more qualified doctors.
DR. GOTTLIEB LOBE MONEKOSSO: We have many African countries where the better doctors and nurses are migrating to the United States, to Europe and elsewhere.
CABALLERO: According to Cameroon's Ministry of Public Health, the average government-recruited physician earns about $450 a year.
MONEKOSSO: If you want the professionals to care for people, somebody must care also for the professionals.
CABALLERO: According to the Ministry of Public Health's regional office, the clinics that meet staff, equipment and hygiene standards will be asked to legally register; the ones that do not will be closed. For NPR News, I'm Andres Caballero. Transcript provided by NPR, Copyright NPR.