FEATURED: The Bushy Roads In The City Of Accra: Who Is Sleeping On The Job?...

15.10.2008 Health

Dirty Rags in the Healing Art?``


If you went to an outpost with some complaints relating to health, chances would be that you might “be seen” not by a doctor, but some health care personnel, who cannot examine you, but may listen to you, and then prescribe “ some medication.” The road is cut shorter, when the outpost the would-be patient attends belongs to some Pharmaceutical set-up, which avails the medication. In such circumstances, you get some concoction dispensed, and the recommendation may be, “You take it for one week, and if you are not okay, come to see us again.” In the best of circumstances, the patient may be “cured” of some self-limiting illness, or conversely get worse, and the sufferer makes the wise decision (hopefully), of going to see somebody else, who may handle the situation better. The worse case scenario may be that, the victim dies, of some “missed diagnosis”. That happens an awful lot. In the example of the 23-year-old-man, who with “some acute illness”, died in hospital, (some clinic), within twelve hours, before some doctor would talk to the family, the illness could have been anything, or among a myriad of illnesses, (? affecting the central nervous system), or the gastro-intestinal tract, or you name it, whereby your guess is just as good as anybody else's. The young man in that scenario wasn't examined by a doctor. He probably died of something potentially curable. The reasons are many, but none is an excuse.

We as a nation, (perhaps, Doctors and the Establishment), are oversensitive, when we talk about Health Care. Each feels standing accused. But, that is missing the point. We, as a nation, have missed any chance of addressing the issue. We have a very efficient system however, of sending some civil servants, (mostly senior, and their families, but for sure, people in politics), to hospitals overseas. South Africa seems to enjoy unprecedented preference. It is common knowledge, that if we would like to be like Malaysia , (as it seems we are aspiring to be), then it is simply this: Malaysia 's population is 22 million souls, and that is the case in Ghana too.

They have 22-thousand Doctors, permanently working in their country. But, we have only 10%, (two thousand only), of that number of Doctors, working in our country. Sophisticated surgeries, like open-heart surgeries, Craniotomies, (opening up of the skull, to work inside the brain), are done in Malaysia , just like in England , Japan , or Australia , a lot on daily basis. That is not the case with us. When you cross over from Malaysia to Singapore , which is in a matter of minutes, depending on your starting point, the situation gets even better. The first Prime Minister of Singapore, and now Senior Citizen, Mr. Lee Kuan Yew, did get done, multiple by-pass heart surgery right there in Singapore, fifteen years ago, successfully, by Singaporean Doctors. All citizens of our Republic should raise their hands, and say “yeah”, if any of our elite citizens, would “dare want” any surgery of significance in our Republic. If we dare compare some statistics of interest, the following is the picture: Egypt , the home-country of our former 1st lady in the 1st Republic, has 76 Million citizens. There are 300 Brain Surgeons practicing in that country, and they are all busy. By comparison, we are 22 million, and we should have 100 Brain Surgeons, (and if we acted like in Egypt , all hundred would be very busy). But, if I can't count well, accept it that we have just ten Neurosurgeons. Craniotomies and open-heart surgeries are done routinely in Egypt too. Let us stay for a while, with brain surgery, (called Neurosurgery, because, it's among the most sophisticated). If you were a citizen of Egypt , or Lebanon , or South Africa , and you complained one day in the morning, of severe headache, you would need investigations that should show your doctor, what the heck may be wrong with you. You may have a condition in the brain, for which some operation may be required, to save life. The best machines that would show clearly, what the trouble in the head might be. are called (CAT-Scan), or Computerized Axial Tomography, and (MRI), or Magnetic Resonance Imaging. Egypt has 50 CAT-Scanners, and 18 MRI machines. We have access to only five CAT-Scanners, and one MRI Apparatus in the entire country. The few machines are in Kumasi and Accra only. Our Philosophy that, machines are susceptible to breakdowns is highlighted by everybody, and even some Chief Executives, in charge of important institutions. As a result, a health care utility machine, breaking down as many months as six out of the year, will be “jokingly” tolerated. The citizenry has acquiesced the situation, in a way that, even if pathetic, is bluffing as well. They don't have a choice, and that is all the educated, as well as the non-enlightened have to say, seemingly satisfactorily.

These machines, of course, are anything except cheap. A Mercedes Benz or Lexus is equally not cheap. So, where do we draw, or cross the line? Europeans fly to Mauritius , to get a hernia fixed, when they may have to wait, (especially in Britain ) for years. South Africa , in our example, from the beginning, has in more than enough institutions, facilities that make sophisticated investigations, and managements, possible. The pioneer work in Cardiac Surgery was accomplished in South Africa , in the mid-sixties, (by the late Christian Barnard). South Africa has become the Mecca of health care delivery, for West Africa, especially, and Ghana leads.

Looking at it from the pecuniary angle, a couple of situations are different, if you take the Republic of Ghana , vis-a-vis countries like South Africa , Mauritius , S. Korea, or Malaysia in comparison. The political system in Ghana at the moment, (since 2001), could claim the credit of having eased the “tight-fisted banking system”, which, even after the collapse of the communist bastion, the Soviet Union, missed embracing a free, and market oriented economy.

The banks lived on so-called “premium bonds”, whereby Governments took money from them, and did whatever they wanted with it, and paid the banks back, as high an interest rate as 40%. The banks loved it, of course. There was the true story of a Doctor, who at one time, approached a Ghanaian Bank of international connections, and he sought a loan to build a clinic, to provide services, not hitherto available in the country. How does a bank grant you a loan, when the Government is waiting, with a guarantee of 40%, and the individual might go bankrupt? Productivity in Africa has stayed low, (2% of World Trade, but we are 10% of world population). Health Care Delivery must fall within the private sector of the economy, (like in Egypt , Lebanon , or South Africa ). Trials had been undertaken in Great Britain , where following the most devastating World War II, a welfare state was thought the best for the populace on that island, which housed some 60 Million men and women. A British citizen residing in Canada , or Australia could buy an air-ticket, and fly to England to have dental treatment, under the National Health insurance System, and come out cheaper, than getting the treatment in Canada , or Australia . Time showed that this wasn't sustainable ad infinitum, and it took a bold Iron Lady, in the seat of Prime Minister, to have the inefficient system dislodged, or replaced. Problems still exist.

The experts seem to have their hands full with the NHIS that we are dabbling, (grappling with). A very productive economy is what everybody hopes might bail us out. A lot of medical investigations, (Laboratory) must be done outside, (in South Africa at best), because, we don't have the facilities anywhere in the country. Multitudes of laboratories in the country all do just the routine. When the big medical institutions acquire the “big facilities”, then the reasons why they don't work are: NO REAGENTS, NO TEST-TUBES, MACHINE IS DOWN! These remain the pervasive reasons, or excuses, for which neither the Chief Executive, nor the laboratory Chief seems capable of solving, or desiring to have solved?! It is a proud man/woman, who walks into an office, and tells co-workers, that, she/he paid 600 US Dollars, (many a time, the employer pays), to have blood tests done in South Africa . When you go deeply into it, you may get to know, the South Africans would have had a big laugh, but stayed happy, realizing, a whole nation cannot do what one calls, “Assay of Pituitary Hormons.”, (a special gland attached to the brain, potentially causing trouble). Anything quoted in Dollars, (medical Care), is grandiose in our country. We all need to embark upon a campaign, which gives Health Care more attention than hitherto. We won't do well in the long-run, with a down-trodden Health Care Delivery.