Re: Beyond Mistrust - Tweaking the Doctor-Employer Relationship

Dear Doc,

Many thanks for this. I am following the intrigues of salary negotiations between Ghana's governments and the medical fraternity. You are right- In Ghana and most African countries “health workers do not have any document that spells out the terms and conditions of their service”.

We at www.AfricanLiberty.org and IMANI (www.imanighana.com) have long
argued, that access to health care cannot be a sanctioned human right when the basic infrastructures and reasonably well-paid doctors and nurses are non-existent.

Add absence of good drinking water and good food and the real poverty profiling of diseases stare activists for free access to healthcare and health products in the face. I will publish this in www.AfricanLiberty.org and if I make the time, I could summarise it for African media.

Franklin Cudjoe
Executive Director,www.imanighana.com
Editor, www.AfricanLiberty.org
Earhart Dotoral Fellow, Buckingham University

Re: Beyond mistrust

Thank you for sharing your article on beyond mistrust. It is worth developing further - when you have time.

I do not know if you have received any feedback. I read it rapidly initially and then decided it needed a more careful and thoughtful read which I have tried to do.

You are very right about the mistrust and the difficulties it creates. I think your article also in a way brings up how complex the issue has become with all the layers. It is almost like a garment that has been patched and re-patched - until you wish you could just throw it away and have a fresh start.

Would it be possible to build a little more on the way forward part of this? I do not want to believe there is no permanent way out of this problem - and yet I have an uneasy feeling that it may just be a matter of time before something else erupts again. In Ghana we tend to go to sleep as soon as a temporary solution is found to a problem - some guaze and plaster over the wound - and we forget it is not yet healed and still exist - forgetting that without a more permanent solution it will resurface .....

It would be useful if just as you have tried to clearly document the process since 2006 from the GMA perspective, it was possible to get better insights into the other stakeholder perspectives i.e. government and other professionals in the sector. I suspect getting to a place where we can carefully listen to and try to understand each other without ancient mistrust and enmity intervening is part of the start of a solution. It would also be useful to go back in time because I think this problem really goes back to ADHA and beyond (the patched garment again.)

Sometime ago, I tried to understand what was happening - because the regional administrations were to an extent in the dark about the details and the whys of the negotiations and the repeated stalemates, checkmates and false starts, etc. At the same time the constant unrest was very destabilizing all round. I thought it would be useful to at least understand without the interest group coloring, that tended to accompany the reporting. However, depending on who you talked to, you got such a variety of perspectives it was a pure headache - and one really got nowhere nearer to understanding or being sure you were finally near truth.

But the mistrust between stakeholders - making it almost impossible to objectively understand; and the use sometimes of inferior tactics was very clear.

Anyway .... thanks for sharing the article.

Irene Akua Agyepong MBChB DRPH

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