LUANDA (AlertNet) - A deadly fire in a satellite town of the Angolan capital has shown the woefully inadequate state of hospitals in a country still struggling to get back on its feet two years after the end of a brutal civil war.

The accident in late February happened when a truck carrying barrels of petrol caught fire in the town of Viana, killing 15 people immediately and injuring more than 80.

The wounded were admitted to nearby Neves Bendinha Hospital, where staff did their best to treat them for third-degree burns in under-equipped facilities.

As patients lay screaming in corridors and overcrowded wards, many on plastic mattresses on the floor, and as the stench of burnt flesh filled the building, hospital director Dr. Valdemiro Diogo said resources were desperately over-stretched.

“We weren’t prepared to deal with this avalanche of patients,” he told AlertNet. “We’re trying to treat them as best we can with the means we have. We’ve made an appeal. Some hospitals have already responded with medical staff and equipment but we need more help.”

It was fortunate that the accident had happened close to this hospital, the only one in Angola that specializes in the treatment of burns, Diogo said.

But the sight of flustered, over-burdened staff and a group of women hurriedly preparing bandages by hand demonstrated the difficulties faced by even the country’s best facilities in the face of crisis.

The death toll from the accident stood at 39 as of February 26 and was expected to keep rising.

“Everyone knows that burn wounds are always serious and particularly here where patients can easily catch infections,” said Teresa Cohen, a doctor and lawmaker with the ruling MPLA. “Of course the death toll is likely to rise.”

She added: “This is a big problem for us. We are trying to improve our health services but everyone must understand this isn’t an easy situation -- we’ve had only two years of peace.”

SYSTEM IN TATTERS

Angola’s health system was left in tatters by the 27-year civil conflict that ended in April 2002. Even after two years of peace, medical institutions struggle to provide adequate treatment even for common illnesses.

Malaria is considered the single largest cause of child death, and Angola boasts the world’s third-highest child mortality rate with one in every four children likely to die before reaching the age of five.

This appalling statistic belies the potential wealth of a country rich in oil and diamonds.

The government recently admitted that Angola was facing a huge shortage of doctors -- with a ratio of just one to every 13,000 people.

“A lot of those are working in the private sector so can’t be taken into account for public services. To aggravate this situation, the vast majority are in Luanda,” World Health Organisation country representative Pier Paulo Balladelli said.

“The government is aware of the problem and has agreed to a vast package of measures providing health workers with incentives to work in the provinces. But most are still pending as a lot of financial resources are needed.”

Those incentives have been too slow in coming,” doctors said. Salaries for doctors at state hospitals start at around $600 a month -- not enough to live on in one of the continent’s most expensive countries.

At Divina Providencia hospital in the working-class district of Golf, a suburb of Luanda, one pediatrician is doing her best to treat children against the odds.

The 36-year-old doctor, who has a young child herself, pointed to an old ventilator in the intensive care unit.

“Look – this is the kind of equipment we have to work with,” she said.

“But it’s not just the conditions that make working in this kind of hospital difficult, it’s also how little we get paid. We continue doing this work because we love it.”

For Dr. Joao Bastos, the head of Angola’s medical association, the problem with the health system boils down to a lack of resources, appalling working conditions and pitiful pay.

“Doctors need to be given better equipment, better salaries and better social conditions. The government is doing its best but I think its best isn’t good enough. It has to do better,” he said.

“Doctors can expect a top-end salary of around $1,500. For those who are working outside the country, what’s the incentive for them to come back?” In its 2004 budget, the government allocated about five percent of funds to the public health sector.

For one health worker, that isn’t simply enough.

“It’s still well below average when you compare it to other SADC (Southern Africa Development Community) countries, where the average is more than seven percent,” he said.

“Without enough resources allocated to the sector, you simply can’t materialise plans and projects,” he said.