Aishja*, one of the few patients we find at Burrel Hospital, has been hospitalized for 5 days in a room filled with damp and mold.
"Here you get sicker because of the conditions. The doctors do their best, but it's a shame that he's left in this state," the relative who accompanies him tells us, pointing out the conditions of the hospital room. Ironically, on the damp-barren wall, there are some tips posted on how to protect ourselves from infections, but the hospital itself does not offer decent conditions for patients.
"Can a hospital be like this in 2025?" she asks, without waiting for an answer.
The room in which Aishja is hospitalized is one of the few that remains open in this hospital, which serves about 30 thousand residents of the municipality of Mat and Klos, but also some patients who come from Bulqiza.
Consisting of a complex of four buildings, the "Xhavit Mara" hospital in the city of Burrel has been completely depreciated after being left without investment for decades. Currently, only the emergency building was reconstructed in 2017, while the pediatrics building has been closed for years.
As a result of the lack of investment, patients at this hospital are facing difficulties. The main building of the hospital, which houses patients who need surgical interventions, is completely dilapidated, while the third floor of this building is closed due to humidity coming from the building's plumbing system.
Three years ago, the Ministry of Infrastructure and Energy intervened in the roof system of this building as part of energy efficiency in cooperation with the Municipality of Mat, an intervention that cost 600 million lek.
The reduction in hospitalization rooms has led to patients of all pathologies being "sheltered" in the maternity building, even the dilapidated one.
Eduart Brahilika, a lawyer by profession, often goes to the hospital for his clients, mainly in cases of accidents. He considers the situation in which health care is provided to patients unacceptable.
"I had an accident and went to OPJ to have the procedures done and honestly, you don't find such conditions even in Cambodia. It's a shame because it was one of the model hospitals," says Brahilika, who ran in the November 9 by-elections for mayor of Mati, under the Democratic Party logo.
Despite the difficult situation, in a written response, Mati's hospital says that "The partial depreciation of the building has not limited the service to patients."
But Erion Dasho, a public health expert who has been working in Germany for years, thinks otherwise. According to him, the degraded infrastructure creates problems in the provision of healthcare.
"If the patient is treated in difficult infrastructure conditions, or as in this case, where there is humidity, the possibility of the sick being exposed to infections or other disease-causing factors increases," Dasho explains.
"The degraded infrastructure does not allow doctors and nurses to practice their profession properly, while it creates additional consequences for patients and distrust in the healthcare system," he adds further.
The rehabilitation of the Mati municipal hospital has been included in the 2026 draft budget. It is expected to cost 4.1 million euros, an investment that foresees interventions in the internal structure, electrical, hydrosanitary systems, ventilation, elevator, heating and improvement of the hospital hotel. However, the investment is expected to last three years and in the first year, 820 million lek is expected to be paid.
"Our vision is to transform into a modern institution that provides quality, safe and accessible services to all residents of the area," it is stated in the response of the Mati hospital management.
All patients are "admitted" to the maternity ward
Envisaged as an emergency solution, in fact the hospitalization of patients with all other pathologies in the maternity building has been going on for more than 3 years. The small two-story building, also depreciated, houses the gynecology service in half, while the other half houses the sick, including pediatrics.
Limited facilities have often meant that patients are unable to be treated in dignified conditions.
"The problem is the toilets, because there are men and women in one place. It's embarrassing, when you're not in the hospital and not there anymore because you're sick and your body isn't in order," one of the hospitalized patients tells us.
Due to the lack of infrastructural conditions and difficulties, patients from the town of Burrel or surrounding villages have found another solution.
"I'm hospitalized, but I don't stay here. I stay for a couple of hours in the morning, the doctor gives me all the medications or tests, I go home, then I come back in the afternoon when I have my medication schedule again and in the evening I go home and sleep. I don't stay here, there are no conditions at all," another patient we meet in the hospital corridor tells us.
Erion Dasho sees placing all patients in the building as an emergency solution, but not a long-term one.
"There are some mandatory separations, the seriously ill, or those likely to develop infections must be kept in strict isolation conditions, which must be respected in the planning of services," Dasho explains.
Despite the patients' complaints, the hospital management explains that their separation was done based on medical specialties to ensure the necessary treatment.
"The maternity building is a functional, well-maintained building with safe conditions for patients," they say the written answer.
Qamil Dika, a lecturer at the Faculty of Medicine, says that "patients should be guaranteed the same quality of health service in every public institution."
"In this regard, the institutions themselves must be more dynamic in addressing infrastructure issues, while the Ministry of Health must create the legal basis that enables faster follow-up and decentralization of the solution to these issues," he explains.
In 2024, there were 65 hospitals in our country, of which 41 were public hospitals and 24 were private hospitals. According to INSTAT, 299.318 patients were admitted to public hospital service institutions, which had 8.911 beds available. Of this number, 178,864 patients were admitted to University Hospitals, 117,888 patients were admitted to Regional Hospitals, and 27,248 patients were admitted to Municipal Hospitals.
Hospital bed utilization, which is considered a very important indicator of hospital efficiency, shows that during 2024 they were used only half of the year. On average, a bed was used for 176,7 days, or 48,4% of the calendar days of the year. 2024., from about 75% which is the average of EU countries. University hospitals had a higher average bed utilization of 81.68%, while in regional hospitals the average bed utilization was 35.87%, but the Health Insurance Fund does not report data on what this coefficient is in municipal hospitals.
Hospitals without specialist doctors
Bajrami is a patient who has undergone coronary angiography twice and the visit to the cardiologist should have been routine, but at the Burrel hospital the cardiologist has been absent time and again for very long periods. Due to the massive dropout and the decline in the population, there are no private clinics in this city that offer this service, except for a private clinic in the city of Klos where the cardiologist comes once a week.
"Either I go to Klos, or I go straight to Tirana. At Burrel Hospital, the heart doctor has been absent for a long time, and now he comes once a week. What can I do if my heart is beating the day the doctor is not there?" he tells us.
The hospital itself admits that it has been without a gynecologist and a cardiologist, two very important specialists, for a period of one year.
"During the period of temporary absence of two specialists (due to maternity leave), the hospital has collaborated with the Dibra Regional Hospital through patronage with a cardiologist, while cases that were presented to the Obstetrics and Gynecology service were transferred with nursing staff and ambulances to Tirana," representatives of the Mati Hospital explain.
The hospital offers municipal-level services in pulmonology, cardiology, nephrology, endocrinology, dermatology, emergency, obstetrics and gynecology, surgery, pediatrics, anesthesia, resuscitation, clinical biochemical laboratory, radiology and polyclinic, but for years this hospital has been facing a shortage of specialist doctors.
But Eduart Brahilika says that it is not a temporary absence but has been for years, "Every emergency presented at this hospital is sent to Tirana because there are no specialist doctors, no equipment to perform the examination."
"The head doctor is missing, the heart doctor is missing, the resuscitator is missing. In this hospital, surgical interventions on the nose have been performed, just like in the QSUT, today only minor injuries are treated. Most of the doctors are over 70 years old and have retired, but they are still kept at work with provisional contracts and a significant part of the services are covered only once a week", he explains.
Currently, the hospital has a reduction in surgical interventions as the resuscitation doctor is on maternity leave, performing an average of 10-12 surgical interventions per month, down from 30 that were previously performed.
Despite these difficulties, hospital leaders are optimistic and say that the services designated to be provided by the hospital are covered by specialized doctors.
"Within the framework of the policies of the Ministry of Health, Health and Social Affairs, Mat Hospital has been covered from time to time with doctors with bonuses, with doctors with patronage, or according to legal provisions, doctors with secondary income have been contracted, to meet needs according to morbidity and patient flow."
For Erion Dashon, the problem lies in the abandonment of the healthcare system by doctors themselves, so he suggests a "balance between provision and the needs of the population",
"The flight of doctors and the depopulation of areas are two factors linked to each other, where the deterioration of one encourages the deterioration of the other. Therefore, today we have hospitals without doctors and cities without people. If we want them to have access to health services, a master plan and the identification and fulfillment of the needs of the population are necessary."
For experts, the solution is not difficult. It must be achieved through special support policies for doctors, so that they do not leave.
"As long as our hospitals are not attractive to doctors with professional skills, through dedicated payments and individual contracts, the problem of specialist doctors in small districts such as Burreli, Puka, Devolli, Delvina, Gramshi, etc. will be a problem that will be ever more present," concludes Qamil Dika.
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