Sun, Feb

Finding a Cure Whilst Dealing With Reality

Thoughts From Afar
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I am under no illusion that unless the blame game is dropped, the NPP government will be incapable of operationalizing all these health facilities before the next general election.

“The greatest scientific discovery was the discovery of ignorance. Once humans realised how little they knew about the world, they suddenly had a very good reason to seek new knowledge, which opened up the scientific road to progress.” Yuval Noah Harari

There is a sense of ignorance that has underpinned our approach to healthcare, which is partly reliant on our initial infectious diseases burden. That infectious diseases plagued our population since medical records were kept meant that most of our language around healthcare reflected the absence or otherwise of ill health. In essence, we were made to believe that all ailments could be cured. To us, a cure meant the total elimination of the disease.

Research, however, points to the fact that in reality no disease is ever cured. A cure could be defined as, “relieving (a person or animal) of the symptoms of a disease or condition.” This can occur when the concentration of the causing organism in the body is reduced to a level that renders it incapable of producing symptoms. Using malaria as an example, it could mean reducing the concentration of Plasmodium (malaria parasite) in the blood to a level where it cannot be easily detected, and thus incapable of causing feverishness, headache, chills, and other symptoms that make the patient feel unwell. However, it does not mean a total absence of malaria parasites from the human host. Thanks to this misconception that a cure means total eradication, we have treated our health, whether as individuals or society, in compartments. We only take action when symptoms appear, and we go into hibernation when we feel well.

Last week, the minority in parliament toured several health facilities at various stages of completion that are yet to be operationalised. This tour exposed the waste in taxpayer’s money. However, like health-related, I am of the view that this situation irrespective of what the sunk cost is, cannot be remedied without a clear understanding of what led us here, and what we can do to prevent it from happening again. My understanding of the minority’s view is that nothing is preventing the government from making these operational. In recent times, however, the government has, on the contrary, indicated that though most of the funds for these projects were disbursed, there is still considerable work to be done before these facilities are functional. I do not believe these arguments are of many benefits to us citizens. As it is said, when two beasts fight, it is the innocent grass that bears the brunt.

 The Kumawu Government Hospital is one of several hospital projects that remain uncompleted following the defeat of the defeat of the NDC government in the 2016 General Elections.

The Kumawu Government Hospital is one of several hospital projects that remain uncompleted following the defeat of the defeat of the NDC government in the 2016 General Elections.

Emotionally, it is easy to see many of these structures and agree with the minority that these facilities should be put to use. If you did, I would not fault you. However, I have a few concerns. I have always wondered what drove the siting of these new health facilities and what the blueprint for resourcing was. I do because, much as I agree that Ghana has a health infrastructure deficit, I am also aware that our doctor to health facility ratio is nothing to write home about. At the last count using Ghana Health Service Data, the ratio was 1.5 doctors per each health facility; that is assuming all doctors on the register are in clinical practice. Considering that doctor numbers drive all health human resources, it would be intriguing to see a blueprint, if one exists, from the former government on how they intended to address this challenge. With that, the onus would fall on the current government to explain to us why they have failed with its implementation.

The position of the current government also needs addressing too. To tell us that the monies disbursed do not seem to correlate with work completed must be backed with evidence of either deliberate maleficence or willful cause of financial loss to the state. This should then be followed by prosecutions and efforts to retrieve the said funds. It is not enough to peddle these allegations without backing it with action. If such evidence does not exist, it would then be advisable to sit with the predecessor government to find solutions to the current impasse. Alternatively, the option of engaging private medical consortia to operationalize and manage some of these facilities for a period can be explored. Such schemes exist in many well-established health systems and are feasible. These schemes have achieved significant efficiency whilst improving the quality of care provision too. But they only thrive if performance benchmarks are set with clear deliverables and are tracked and measured.

These structures have become an infectious blot on our health landscape and must be managed. I do not expect eradication but at least steps must be taken to reduce the number that is idling to a minimum to obtain an effective cure to our health infrastructure deficit.

I have lived long enough to see many uncompleted structures across the country that supposedly should have contributed to our health physical infrastructure, but are not. We cannot afford any further additions to these unsightly ghost structures. Under the current circumstances, I am under no illusion that unless the blame game is dropped, the NPP government will be incapable of operationalizing all these health facilities before the next general election. If they do not, it is on that front that the health agenda battle of 2020 would be fought.

For me what matters most is the lesson we can get from this. As citizens, we should understand that when politicians meddle in health affairs and have little to no technocratic input, there are consequences. Making a request from a power-thirsty politician for anything that will ensure electoral success may not necessarily be a bad thing. But when the result is that no net improvement to your quality of life occurs then you should know you have been screwed. In today’s world where healthcare is moving from healing the sick to upgrading the healthy, these aspects of our health infrastructural history must aid our thinking in freeing ourselves from this sordid past, and imagine alternatives to fix our healthcare access gap. In doing so, we should know that as citizens we have a stake too and must not just accept anything we are presented with as a solution to our problem.

I would conclude by reminding readers that the answer to our healthcare access problem does not lie only in brick and mortar. It most certainly lies in our ability to leverage the little resources we have using creative thinking and our willingness to source ideas from other disciplines far removed from health. The notion that health is an area where only practitioners can input intellect and politicians can manipulate is far from reality. That is the ignorant notion we need to cure to progress further in our quest for universal healthcare coverage.

Edited by Winifred Awa

Featured  Image Courtesy of Delph Bedel

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