Evolution of ENT services in Oman

Mazin Al-Khabori*

Department of Ear, Nose & Throat, Al Nahdha Hospital, Muscat, Sultanate of Oman.

Received: 15 Jan 2008

Accepted: 20 Feb 2008

*Address correspondence and reprints request to: Dr. Mazin Al-Khabori, Department of Ear, Nose & Throat, Al Nahdha Hospital, Muscat, Sultanate of Oman. Email: nadiamaz@omantel.net.om

The specialty of Ear, Nose and Throat (ENT) started in 1974 within the general service provision framework of the Renaissance of 1970 with the ascension of His Majesty Sultan Qaboos. This included urgently needed health services to the Omani population. Prior to that the health services were limited to a few privately run charitable clinics.

The first ENT clinic started at Al-Rahma hospital in Muttrah. It was started by Dr K. Kishore (FRCS) who was recruited to start ENT services in Oman along with others from different specialties. In the beginning, the clinics, theater and beds were shared amongst the various specialties. The amenities were makeshift and rudimentary and the doctors tried their best to create the same atmosphere in which they were trained (mostly UK).

Later on, when Al-Nahdha hospital was expanded from an eye clinic and Khoula hospital became part of the Ministry of Health, the specialties of ENT, Ophthalmology, Dentistry, Dermatology, Medicine and Pediatrics moved to Al-Nahdha hospital and, Surgery, Plastic surgery, Orthopedics and Obstetrics and Gynecology moved to Khoula hospital. In 1977 when Sultan Qaboos hospital opened in Salalah, Dr AbdulBari (FRCS) was recruited and became the head of ENT there.

From then on whenever a turnkey hospital project opened a small ENT unit with surgical facilities was included; thus in Nizwa, Sohar, Sur, Ibri, Buraimi and Rustaq, single specialist ENT departments were established which carried out basic surgical operations. Even at Al-Nahdha only two ENT surgeons; Dr Kishore and Dr Rajan practiced for a while. Audiology was done in the filing room to keep the ambient noise minimal before dedicated sound proof rooms were built. No hearing aids were available locally or regionally and those who could afford went to the UK for it.

Gradually the ENT services expanded and improved to the highest level that was comparable to the best in the region. Now, the regional hospitals are staffed by Senior Specialists with a full compliment of medical and paramedical staff, taking care of routine problems. Al-Nahdha hospital remains the tertiary referral center where cochlear implant surgery, advanced endoscopic sinus surgeries and Head and Neck surgeries are carried out. Now, besides Ministry of Health, ENT services are available in Sultan Qaboos University Hospital, Armed Forces Hospital, and a rapidly expanding private sector. The future plan is to make all the regional hospitals self contained centers of excellence.

The disease pattern has changed dramatically. During the 1970’s and early 1980’s patients with advanced stages of diseases would come to the hospitals resulting in high morbidity even with optimum treatment. The excellent progress in child care, socio-economic improvement and expanded immunization program has resulted in changes in the disease pattern similar to that of the modern world.1-3

The ENT services have started community outreach programs such as "Ear Care program" since the early 1990s. This included School entry Hearing Screening for children, Universal Newborn Hearing Screening, Noise Induced Hearing Loss initiative in the industry, and primary health ear care services to mention a few. Oman is actively involved with the WHO for the prevention of Deafness program and in many fields it leads the region.

The ENT services were ready to teach when the College of Medicine and Health Sciences, Sultan Qaboos University, took its first medical students. The ENT services are also actively participating in training doctors to become ENT surgeons through Oman Medical Specialty Board program.

All this has occurred in the last 38 years, from no services to becoming one of the advanced centers in the region. These achievements are a credit to an active society with sound leadership.

References

1. World Health Report 2000, page 154, annex table 1.

2. Evans DB, Tandon A, Murray CJL, Lauer JA. Comparative efficiency of national health systems: cross national econometric analysis. BMJ 2001 ;306- table 2.