A Glimpse Of Hope In The Midst Of Turbulent Health System (1)

Our once cherished health system has been in the news in recent time for all the wrong reasons, the reasons for being in the media are artificially created, in short they are avoidable. We can decide to behave like ostrich and pretend all is well or begin to fruitlessly defend it but the public barometer negative opinion about the health system is at its historic record high whether perceived or real.

Frequently cited is the shambolic nature in which nurses communicate to patients and how they responds to the needs of their patients, we cannot forget a recent case where a nurse had to go on facebook live at workplace for fun at the expense of her professional integrity, we have been overwhelmed by series of medical negligence- Senchi Health Center Benzathine injection comes to mind, we cannot forget Komfo Anokye saga where alleged stillbirth baby's whereabout could not be found, we have been hit by unpleasant ambulance issues where we are told by the PRO of the National Ambulance Service that a country of 27million have only 30 to 35 functioning ambulances ( https://mobile.ghanaweb.com/GhanaHomePage/NewsArchive/Only-35-ambulances-functional-nationwide-National-Ambulance-Service-586808 ) this troubling situation makes almost all of us "walking corpses" though 161 ambulances were purchased in 2012, 200 ambulances were promised by the Honorable Minister Alex Segbefia, we are still in this dire situation, where did the go wrong?.

The straw that is breaking the camel's back is the extreme partisan politicisation of the only Quaternary hospital we have managed to build in this country with the core mandate to provide a specialized healthcare to the vulnerable masses, train health students, and conduct research; this monumental edifice is being allowed to wear off due to ugly politics with unhealthy and unintelligent justifications that further breaks the heart of well meaning citizenry.

One cannot overlook the culture of financial intrusion in the health sector that has effectively aided in sacrificing professional ethics to the dogs in return for quick money; it is curious to see how some prescribers have turned the consulting room into their personal pharmacy and selling all manner of drugs with money as the primary overriding consideration and not the patients health, very keen is the CELLGIVITY and it's allied drugs which they openly prescribe to all manner of patients suffering from indigestion, constipation, stroke etc without any shame; this is done to the neglect of the "essential medicine list" and the "standard treatment guideline" which the official documents that should guide all health personnel.

Reflecting over these myriad of issues facing the health sector and its root causes would actually reveal to anyone that the causes are complex and even some outside the domain of the health services. The issues starts from Junior High School where the pupils are made to understand that hard work doesn't pay, pupils are charged various sums of money to facilitate their passing of exams during BECE, this has effectively taken away the quest to study, this attitude is gleefully carried to the SHS where teachers and students do their possible best to outsmart the system (WAEC), even academically challenged students are made to pass with flying colors to keep the school among the elite schools in terms of ranking.

As if that is not enough ineffective and subjective interview system has been put in place by the health institutions to just pick largely their favorites, this is popular known as "protocol" which sees recruitment of substandard students, this unhealthy practice is further compounded by immoral and biased tutor-students relationship which has dealt a big blow to the sieving system in the schools which is supposed to see academically weak students been withdrawn, some students are passed by their tutors based on emotional and sentimental considerations rather than meritocracy and academic excellence; the outcome is the half-baked health workers that we have in our facilities.

The inordinate desire of getting rich quickly is not equally excluded from this canker, why would one turn consulting room into a pharmacy shop? Why would all skin infection be referred for Benzathine injection? Why would health workers especially at level A and B use their discretion in charging patients for services rendered which is usually not receited? Some health workers have dangerously resorted to buying and selling drugs they are legally not mandated to administer at their level of care.

In the midst of this heartwrenching issues is small important steps being taken by the current Director General of GHS to correct certain teething issue that had the potential of ditching the morale of the already low motivated staff; The letter from the from Director General dated 10/04/2018 with the reference number GHS/DGS/G2 captioned : "clarification of professional status of direct and post NAC/NAP midwives" has boosted the morale of some sections of midwives and has effectively cured a longtime discriminations among some category of midwives in terms of recognition, conditions of service and uniform.

Second important letter was dated 18/04/2018, referenced GHS/DGS, and captioned : "Reassignment of Enrolled Nurses and General Nurses in CHPS zones" this letter is crucial in invoking the original intention of CHPS zone as discovered in 1994 and implemented in 1999 by Navrongo Health Research Center in the hope of achieving the goals of 1978 Alma Alta declaration and 1986 Ottawa Charter. Unfortunately the CHPS zone has been outsourced to Enrolled Nurses who are made incharges in the presence of their senior colleagues CHNs because allegedly they generate money, virtually turning the process upside down. This is in flagrant disregard to the 15 guidelines and 6 milestone.

The morale of the CHOs would be boosted by this singular act and ensure preventive health care is given the needed priority, whilst I believe in multidisciplinary approach in healthcare, some health workers should not disregarded and secondly right things should be done without unhealthy monetary considerations by the managers of the health services. Finally is the letter dated 9/04/2018, captioned : "Support for CHPS verification" which has mandated Kintampo, Navrongo, and Dodowa Health Research Centers to verify all functional CHPS compound (with or without wall) in line with the 15 implementation guidelines.

We know how some managers out of greed of amassing MCHNP funds or recognition among their peers do shoddy work by branding everything and anything as functional CHPS zone. The dangers of bloating of CHPS zones would be buried once and for all with this rigorous exercise which commences today 23/04/2018. Surprising all the above letters are dated in April, 2018, these and other interventions not state here are giving a glimpse of hope and an indications that all is not lost.

Shaibu Issifu
Concerned Health Worker
[email protected]