UNCURABLE DISEASE: Ghana’s hierarchy of healthcare horrors

Esther A. Armah

Health-care and our hospitals. Two issues on Ghana’s mind this week. Our Vice-President Dr. Bauwmia was flown to London to seek emergency medical treatment. That news ignited a flurry of headlines, social media engagement and a series of discussions and disturbing revelations about the state of our health systems.

There are questions, numbers, ironies and issues to this.

The numbers: news of the VP’s flight prompted Citi FM to run a series of discussions detailing incomplete hospitals, abandoned hospitals, and completed hospitals minus patients or doctors. In districts, regions and right here in Accra, the list of unused and unusable but completed and/or abandoned hospitals is long.Citi FM online reported that ‘a number of health projects undertaken by successive governments costing the taxpayer several millions of dollars, have been abandoned.

The major ones are the $217 million University of Ghana Medical Centre, the Bank of  Ghana Hospital, the solar-powered medical Centre at the Volo Digital Village in the Volta Region, as well as the GHc320,000 CHPS compound at Teshie.With the University of Ghana Medical Centre, although the first phase has been completed, there is a tussle between the University of Ghana and the Health Ministry, regarding who should manage the facility. The government claims it needs an additional $6 million to make it operational.’’

The numbers sound like the GDP of multiple African nations.

There are other numbers to think about. There is an extraordinarily high patient to doctor ratio; and yet doctors languish at home post their long education, as the Ghana Health Service fails to place them, and they refuse postings at deprived areas. At the Ghana Medical Association’s 59th annual General Conference in November 2017, the GMA president lamented the GHS failure to place doctors across the 10 regions.The Ghana Health Service struggles with consistent accusations regarding mismanagement and slowness. Such Ministries – and their Ministers and Deputies – are quick to defend themselves, play the blame game or accuse others – but ultimately they offer few concrete responses and little to no progress.

The questions: Hospitals are built. They stand. And yet they are unoccupied and unused. In each of these incidences, it would be fair to conclude that hospitals are built due to demand. Who called for the hospitals to be built? What specific need was identified to justify building it? Who sanctioned the contract? Who carried out the work? How much money were they paid? How did the politics of these contracts work? The failure by successive governments, the incompetencies of successive Ministries of Health and the lack of political will to do the work to transform this particular sector – and the millions who would benefit from such transformation – is the real incurable disease.

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I issue a call to investigate. I would like to see Our Newly Appointed Special Prosecutor, Mr Martin Amidu, formally investigate the contracts that led to the building of these unused and abandoned hospitals. The public has a right to know who paid, who profited from the building of such hospitals.

The ironies: The VP has flown to the land of the British, our former colonizers, to get treatment. In that nation, there is a National Health Service (NHS). It guarantees you treatment if you are sick. It is not without myriad issues – rampant racism being one of the major ones. It does not suffer the particular issues we have heard reported across Ghana radio and in the news this week.There are numbers that connect Ghana and London’s NHS too. It grew and became staffed because of primarily Black nurses and medical professionals from Ghana, Jamaica and Nigeria. In 2005, a report by Save the Children reported the medical brain drain from sub-Saharan Africa was ending up in the NHS and propping up that system. Between 1999 and 2004 the number of doctors registered in the UK and trained in Ghana doubled from 143 to 293.There were 40 new registrations of Ghanaian nurses in 1998/99, but by 2003/04 an estimated cumulative total of 1,021 had registered. It was estimated that the UK has saved 65 million pounds in training costs by recruiting nurses and doctors trained in Ghana alone, with services delivered by these workers valued at 39 million pounds per year. More numbers that look like the GDPs of African nations. To be fair, post the release of these disturbing numbers, measures were put in place to ban active recruitment. That was, however, long after the fact.

The hierarchy of horrors is Ghana offers politicians elected by the people escape from its own medical nightmares; but the people have no escape. Numbers paint partial pictures. Stories paint complete pictures. Mr Bauwmia was flown to London due to a medical emergency. I am thinking of the daily millions of health emergencies for Ghanaians. Millions of ordinary people who have neither the luxury nor are part of a hierarchy that will usher them out of the horrifying halls of a Korle Bu or 37 and whisk them away on a plane to the land of their former colonizers to get health care.

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I think of Adolf Lawson. He is a father.  In July 2017, he buried his daughter due to our inadequate health service. He was a card carrying blood donor, as was his 21 year old daughter. She needed a blood transfusion. He was told by a technician it would cost GhC340. He did not have that much cash. He begged this man. He pleaded with him. To no avail. Mr. Lawson ran from hospital to hospital seeking blood he could afford. He finally found it for GhC120. By the time he returned to the hospital where his daughter was waiting for the blood – she was dead. His child died for a lack of GhC340. But hospitals to the tune of millions of dollars stand completed and abandoned. This horror reveals a health system that mirrors that of the US – no money, no treatment. Had the system reflected that of our former colonizer; and the current location of the VP’s medical treatment, this father’s child would have been treated. I think about Mr. Adolf Lawson going to his child’s grave. She was 21.

Our system turned his child into a corpse. There are no cemeteries of incompetence where the loved ones of those ranked at the top of our hierarchy will be buried – that is for the ordinary citizenry to weep and wonder and wail at their children’s tombstones raging at such avoidable despair.

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And then there are the connecting issues: our recent Presidential Media Encounter did not offer one question on health. It is one of the 5 areas targeted as priority by this current government. As evaluation of that exchange made headlines, and there was critique about the poverty of too many in our profession’s performance regarding question quality; I think of fathers like Adolf Lawson. He deserved better from our profession. He and millions of others deserved that we demand answers and raise the issue on his – and millions of other Ghanaians – behalf. Our failure to do so is inexcusable, given some of the irrelevant questions asked of the President.

When we connect the dots and do the maths, the picture is bleak.

This is a litany of loss and a legacy of brokenness. It should also be recognized and reimagined as lives that could have been saved.

We wish our VP a full and speedy recovery.

Health is about our nation’s citizens and their loved ones at vulnerable moments in our lives.

There is no hierarchy in vulnerability. There should be no hierarchy within our humanity.  We must end healthcare’s hierarchy of horrors.

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