This Is What Doctors’ Offices Look Like Around the World

This story is part of a month-long campaign highlighting global health inequities. To learn more about how Project HOPE is promoting global health equity and how you can help, click here.

An overcrowded waiting room. An unsanitary bed. A tent in a crowded market.

The physical space where people receive medical care can say a lot about health inequities. And the spaces can range wildly around the world.

If you happen to be born in Japan, you would enjoy universal health coverage and would be free to choose one of the 8,000 state-of-the-art hospitals available at little cost. But if, instead, you were born in Lesotho — where the average life expectancy is 34 years shorter — you might have to travel long distances over rocky terrain or be evacuated to South Africa in a life-or-death emergency.

It’s a problem in the U.S., too: quality of health services can vary wildly across states, especially among the urban-rural divide, and particularly in minority or indigenous communities like Navajo Nation.

Health is a fundamental human right. But building a more equitable world is not possible without investing in local health care workers — and the spaces where they work. Here’s what those spaces can look like in different contexts around the world.

Colombia

Colombia is host to more than 1.7 million Venezuelans — a population shift that has significantly strained health care facilities near the border. Waiting rooms like the one at Erasmo Meoz University Hospital, above, have been filled to capacity, the hallways lined with patients waiting hours to be seen.

Thousands of Venezuelans give birth in Colombia every year, leading to dangerously fast turnarounds in hospitals near the border: women who give birth in the morning can be discharged in the afternoon, while those who deliver in the afternoon may receive just one night in the hospital.

Malawi

Where do you get your HIV test if you’re a traveling vendor in a local market in Malawi? For Peter, you get it in a tent.

Malawi has made incredible health gains over the past several years, yet it remains a country of great challenges. Even as AIDS-related deaths have been cut in half over the last decade, 1 million people in Malawi still live with HIV — many of whom do not receive medical care due to access or income.

That’s why Project HOPE helped provide rapid HIV tests here: so that vendors like Peter could get tested where they are, instantly. It’s a solution that works for the local community, and for Peter. In less than 10 minutes, he’ll learn he’s tested negative.

The Bahamas

Health care standards in the Bahamas have increased thanks to recent investments in health care infrastructure, but in a nation of more than 700 islands, access to that care can change in an instant.

That’s what happened when Hurricane Dorian struck the Bahamas in 2019, devastating Abaco and Grand Bahama Islands and rendering multiple clinics nonoperational. Coopers Town Community Clinic, above, serves about 4,000 people on Great Abaco Island, the epicenter of the storm. In the critical moments following the storm, Dorian destroyed critical supplies, ruined lab tests, and left thousands of people without electricity, gas, or a way to communicate.

Sierra Leone

There are fewer than 250 doctors in all of Sierra Leone, a nation of 7.6 million people — one of the worst doctor-to-patient ratios in the world. Life expectancy is just 57 years, and the maternal mortality rate is the worst on earth. In a country that is largely rural, health care access is extremely limited, making motherhood a life-or-death scenario.

Project HOPE is investing in Sierra Leone’s health care by helping establish Special Baby Care Units, as well as training health care workers in essential interventions like Kangaroo Mother Care, a simple intervention in which the baby is protectively wrapped skin-on-skin to the mother’s chest for warmth, creating a kangaroo-like pouch that simulates the womb. In places where resources are limited, it’s a life-changing practice for babies who need it most.

Indonesia

For women in rural Indonesia, the health network connecting villages to formal care is too expensive or too far away. Small village clinics, called posyandus, report up to public health centers, called puskesmas — clean, well-equipped facilities that are staffed to handle deliveries. Puskesmas are key to reducing high mortality rates, but many women forgo them to deliver at home using dangerous traditional practices.

Project HOPE saw a way to help bridge the gap: supporting the puskesmas with new equipment like infant warmers and blood pressure equipment, as well as training midwives to walk alongside women throughout pregnancy and delivery. Volunteers meet with new mothers every month during pregnancy, encourage them to deliver in the puskesmas, hold monthly wellness clinics in villages, and check in frequently to make sure new mothers are breastfeeding and immunizing their newborns.

In the last five years, this work has made the difference between life and death for tens of thousands of mothers and newborns.

Mozambique

In the wake of a once-in-a-lifetime storm, health care often happens wherever you can get it.

That’s what life was like in Mozambique following Cyclone Idai, one of the worst tropical storms to ever hit Africa, which rocked Mozambique with winds over 120 miles per hour. With tens of thousands of people displaced and widespread outbreaks of cholera and malaria, more than 1.8 million people were left in urgent need.

Project HOPE deployed medical volunteers into the immediate aftermath of the storm, which included helicopter flights to some of the country’s hardest-hit rural areas. Immediate health care was provided wherever it was possible, outside the clean, quiet context of a doctor’s office, whether beneath the shade of a tree or in a crowded village square.

Dominican Republic

Though most women in the Dominican Republic give birth at a hospital, there are still many obstacles in the way of a safe delivery. A shortage of equipment, poor infrastructure, and a lack of training lead to high numbers of preventable neonatal deaths.

Project HOPE is working to give mothers and babies in the Dominican Republic a safer start at life, partnering with the government to renovate health care facilities and give mothers a brighter and cleaner place to give birth. We brought in new equipment like delivery beds, vital signs monitors, incubators, and ventilators, then spent a year training nursing staffs on how to use and maintain it, ensuring the impact would last.

The result? Inside the Doña Reneé Klang Maternity Hospital in Santiago — where the neonatal mortality rate was 40% higher than the rest of the country — the rate dropped 81% in just one year.