Years ago a scribe-friend wrote an article about doctors who continue to whine and whimper about their paychecks in Ghana. The article, “Ghanaian medical doctors, the ungrateful-bastards” (on Grandmother Africa), was meant to put into some perspective the salaries of Ghanaian doctors compared to doctors in the United States. The idea was that if Ghana’s doctors could be brought to appreciate the immense sacrifices that taxpayers make to train them, they would come to appreciate more their meager salaries in such a deplorable health system as Ghana’s.
However, in recent months since that article was published in 2013, some Ghanaian doctors have chanced upon it. Obviously, the facts presented there did not complement the doctors who insist on whining and griping about their salaries every chance they got. More to the issues, the tone perhaps, of the article didn’t sit well with some of the doctors who continue to insist that moaning and sniveling about their salaries is the correct way to approach fixing a broken healthcare system in Ghana.
Ghana’s healthcare system is nothing to write home about. We knew that. It is beyond broken. There’s no aspect of it that one can rise to appreciate. Is it the Korle Bu Teaching Hospital? It is better called the Korle Bu Morgue. Is it the Komfo Anokye Teaching Hospital? It is better referred to as the Komfo Abandonment Clinic. What’s worse? The regional hospitals are worse. The village clinics are in worse condition today than the village healing shrines were several hundred years ago.
I make the last statement with undeniable resolve. Ghana’s healthcare system is worse than any traditional healthcare system built and implemented by ethnic groups way before the first colonial African doctors were trained outside of Ghana and repatriated back to Ghana to terrorize the rest of us. For instance, just one hundred years ago any healing shrine in Ntoaboma, Volta Region, would be burned to the ground if it recorded the same death rates as Korle Bu Teaching Hospital. If any shrine or cult killed as many mothers in childbirth anywhere in traditional Africa as Korle Bu does daily (without shame), the place would be called Asamando (the Empire of the Dead). No one would ever pass it by. The grounds would be banned and left for the angry ghost to clean up!
More examples: The herbalists in any shrine in all of Asante would have been arrested and arraigned before the Asantehene if they recorded in one year alone the kind of death rates that the Komfo Anokye Hospital records daily! If 37 Military Hospital was a healing shrine in Dahomey, the Gbeto women would have been correct to call it a grave yard. Healthcare in Ghana is worse than just hundred years ago! The Ghanaian doctor today, who is educated and trained with tax payer money, is worse than his ancestor the herbalist just one hundred years ago.
Why are our healing intuitions in the twenty-first century so bad? Why do mothers die in childbirth now, when one maternal death would have dumbfounded a whole village just one hundred years ago? The answer can be found on the lips of some doctors. One, they claim it’s the deplorable conditions of the hospitals in which they work. Which is true. The conditions in hospitals are not worth picturing. Two, other doctors claim it’s the meager salaries of doctors. Some doctors claim that the salary is not enough motivation for the kind of work they ought to do to save their childbearing mothers, sisters and aunts from the yawning jaws of death.
To this end, understanding the conditions of the hospitals that Ghana’s doctors complain about is not difficult to see. A cursory visit to Korle Bu Teaching Hospital reveals a reality that if Komfo Anokye were still around, he would have undoubtedly summoned a whole nation to quickly address. Else he could not sleep. The lack of seriousness of the government of Ghana, from year to year, from election to election, in addressing such a pertinent issue in healthcare, is stupefying. With these persisting conditions come the usual pantomime of the need for more advanced technology in treating diseases. The government, some experts would emphasize, must invest in better technology. There’s very little merit to this argument however. For example, we know that good sanitation alone has contributed to eradicating more than 80 percent of diseases in the last century alone than any single technological advancement in healthcare or outside of it can claim. The point of more and more technology is mute. Cuba is a laudable example of the medical ingenuity of doctors and healthcare professionals without fancy energy–consuming, planet-killing equipment.
(Ghana’s president has vowed to use America’s drones to solve Ghana’s healthcare crisis at an exorbitant cost to the Ghanaian. The thinking is more akin to enlisting a mercenary to breastfeed your baby!)
What is baffling, however, is why the self-appointed elites (these same doctors) have been incapable of changing the topography of their workplaces? Why haven’t Ghanaian doctors and their fellow health professionals not been able to change the healthcare system in Ghana for the better? That answer lies in the ensuing issue: Some doctors claim that only with the high salaries would better hospital conditions for patients arrive for all Ghanaians. Other doctors claim that government officials (the other group of Ghana’s self-appointed elites) have failed to invest properly in healthcare. They say that only more money poured into healthcare would fix the clinics, and the hospitals. When the excuses are carefully examined, one realizes that year in, year out, it is the story of one faction of the colonially-ordained elites of Ghana pointing fingers at each other for who is more responsible for the deaths of newborns in broken incubators at Korle Bu Teaching Hospital.
The fact remains, and it is indefatigable: Healthcare in Ghana is worse than it was some hundred years ago. The only thing that has changed is that we have two types of elites in charge of healthcare in Ghana, and these two are not serious about life and death: (1) the colonially ordained government clerks like the president of Ghana and (2) the colonial-mission-educated doctor. Hitherto, we had the chief, the chief priests and the herbalists. These three were much better healthcare professionals than the two groups we now have!
The old traditional health systems of all the ethnic groups could have been improved to match the changing structures of healthcare needs in the twentieth and twenty-first centuries, and they could have been harnessed to answer the call for the integration of disparate traditional systems within a new country. But alas! Healthcare in Ghana is worse now than one hundred years ago because we have a bunch of colonial-mission-school educated whiners in our midst who whine and grumble about conditions and salaries, and who proceed to use this excuse to oversee the mass death of innocent babies, innocent mothers and innocent lives.
I have a niece who on finishing her medical internship was posted to a village in her ancestral neighborhood and she quit in a heartbeat. She did not want to be away from the urban center and neither was she conversant with her native language as she only spoke English and the urban slang which is a mixed bag of national languages and English. Although she was raised in the city I hardly know of any young trained professional raised in the village that wishes to go back to the village and serve their community.
Throughout Africa, a serious case of benign neglect of the rural areas is emerging especially in critical social services such as medical services. My hunch is most young doctors don’t even want to serve in rural areas where they can’t spend their large salaries to mimic the lifestyles that are portrayed for doctors on medical TV dramas like ‘Grey’s anatomy’.
Ostensibly, the Grey’s anatomy drama can only be lived out in the city but not in the village. It is practically for this reason that several countries in both Latin America and Africa Cuban doctors have been called in to stem the tide of brain drain from the villages. This of course is a temporary political solution because politicians don’t think and plan long term and are more inclined to favor importation of personnel and technology because in one way or another it’ll line their pockets.
The colonial-mission-school educated herbalists (doctors) in Ghana are not even aware that they are herbalists! Fancy herbalists that they are, but herbalists they remain. The problem with the chemical imbalance in the brains of our colonial clerks and the colonial-mission-school educated doctors of Ghana is that the condition of chemical imbalance make it difficult for them to see through the weeds. Whatever sits in the skulls of these people tends to force their hands to commit crimes against their fellow country men without knowing they commit crimes. To abandon patients in the village for whom you have been authorized to be responsible for is the height of insanity. More, to breed a culture of constant abandonment of the sick as Ghana’s or Kenya’s authorities have done, is the epitome of gross malevolence. This is not incompetence or indiscipline. This is madness.
Indeed there’s an element of guess work and trial and error that doctors result to especially those without experience. And even the experienced ones who have a taking to designer clothes and fancy lifestyles…these are all herbalists and negligent ones at that.
But what I find even more repulsive is this side hustles they start on the margins of their public duties whereby they treat people in private wings when they are not on regular duty as “consultant” herbalists… and in so doing they give minimum attention to their public duties and direct their attention to those able to pay a premium for their herbal incantations.
These boutiques have made the cost of access to healthcare out of reach especially for the ordinary folk. Healthcare has become an exhorbitant privilege for the elites. Going by the undisputable success of the Cuban model, the place of doctors is in hospitals and medical research centers and not in some mahogany panelled office suites… after all these very herbalists were educated using public resources for that very purpose.
As for the shamefulness of the rising appeal for boutique practices among the colonial herbalists (doctors), I have yet to find the heart—without compromising my laptop with my actual fists—to address what I feel is the bottom of colonial material indulgence among our doctors. You’ve put a finger on a matter close to the hearts of many. An increasing number of patients where I come from have to see their doctors after hours, in far away places (often by Trotro or Okada), in boutique clinics, behind shiny large mahogany desks, and inside heavily air-conditioned rooms. The patient, once inside the boutique must pay for the desk, the air-conditioning, the carpet, the task chair (just imported from China); the patient must pay for the doctor’s shoes, the doctor’s dry cleaning, and so on. By the time the patient is actually ready to pay for the care he was promised way back in the public hospital that he would receive if he came to the private clinic, all the money in his pocket have evaporated up into the ceilings with the warm air and been pushed outside by the air-conditioning pump. The trouble is that the patient never gets his much needed care. The best he gets, if any, is guess work. If our ancestors, the herbalists, guessed as much as these colonial herbalists do now, they would have been labeled quacks. Quacks, however, in the twenty-first century—unbeknownst to our dear people—come in dry-cleaned clothing and shiny English shoes, sitting behind mahogany desks with stethoscopes in hand.
The way colonial education works is that it shrouds the point of view of the sick and their loved ones. My great grandparents, for some reason, knew that hospitals and clinics built by colonial herbalists practiced quackery. They were not always correct by my own estimation. No one is. But their insights are worth examining today. My great grandparents refused to be sent to hospitals in their old age and be killed there. They chose to die at home, away from the dirty hands of the colonially educated herbalists who have little respect for the sick they treat. How is Korle Bu Teaching Hospital (the biggest most advanced hospital we have in Ghana), where barely anyone survives a cardio-thoracic-surgery, any different from the hospitals and clinics my grandparents described in their old age? No difference.
Still, what’s even worse than the deplorable care our fellow countrymen and women receive in hospitals, and what’s even worse than the money-grabbing wealth-extracting side-boutique clinics of the materialist colonial-herbalists of today, is the transformation of large portions of public hospital- and clinic- space for private practice! Our doctors today are not ashamed to take private patients in public buildings (in their assigned offices), after so-called hours. The idea that dying patients would be waiting for a doctor in public hospitals, yet we have doctors taking private patients in their public offices at the same time, is the height of inhumanity in our healthcare system. This practice of transforming taxpayer clinics to private money extracting boutique clinics at noon, is insanity. Personally I would ask for the electric chair for any doctor caught killing fellow men in this way, but I am a nice scribe and so I ask for something to be done immediately to check this insidious practice.
You’ve nailed it…well in!
On point Narmer Amenuti.
This is an Eye-opener.
May it gets to those who could put its directives into proper use.