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Health workers contributing to the decline of the health system in Ghana by being quiet

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“When a man who is honestly mistaken hears the truth, he will either quit being mistaken or cease to be honest.” – Anonymous.
The average Ghanaian is ‘diplomatic’. We ‘respect’ authority, so suffer tremendously to please our leaders who rather should be making our work easier for us. I have been a medical doctor in Ghana for two decades and I have some experiences to share.
A prominent minister of state calls you that he/she wants you to attend to a relative. The ‘diplomatic’ Ghanaian doctor or health worker responds, ‘yes sir.’ When the person gets to the hospital, he/she thinks they are more important than anybody else in the clinic that day because a ‘big man/woman’ had called the doctor earlier. They forget that some 10 other ‘big men/women’ had also called the doctor and their relatives/friends are in the queue also waiting to be seen. After a short time, while the doctor is attending to a patient (sometimes even an emergency), his phone keeps ringing.
These ‘special clients’ in the queue are calling to make the doctor aware that they are keeping long in the queue. The next is a series of calls from the ‘big men/women’ alerting you that their relative/friend has been in the queue for long.
The doctor is confused. He may have his own relative calling him about his aunt’s father in law’s niece who is also in the queue. Then there are also staff who need medical care… I pity the sick person who knows nobody in the hospital.
Please don’t take this as fiction. This happens to me often. And it happens to many doctors and health workers who find it difficult to explain to relatives and ‘big men/women’ about the pressure they are constantly under.
Why does this happen? These may be some of the reasons:
  1. People are generally selfish. They don’t care about others once they get what they want.
  2. People want the best services at the cheapest costs. They can decide to pay more and be seen well and quickly at private facilities, but they prefer to ‘beat the system’ using public facilities that they can manipulate for their personal and selfish interests.
  3. (Public) health institutions do not put in place structures to make things run smoothly. There should be ‘a minimum standard of care’ for everyone which does not depend on whether someone knows anyone in the institution. The processes must be transparent.
  4. If a doctor is asked to see over 50 clients in less than 8 hours (unacceptable but happens in some institutions), then we should all be aware and prepared to be one of the 50 patients, including being the last person to be seen.
  5. Health workers (including doctors) have not been bold enough to explain the above to many relatives and ‘big men/women’ and so continue to suffer in silence.
  6. Many, including health workers, would like to exploit these lapses in our system.
Health workers must understand that by refusing to be bold to bring these up to streamline them, they contribute to the decline of the (public) health sector in Ghana. We can decide to remain silent and let this continue, or be bold to let people do the right things. If we remain silent, we could find ourselves as victims one day. It may not even be in the health sector.
Some of our leaders, relatives and friends may not be aware of these things in our health institutions. Maybe if we made them aware of the challenges in our health institutions (and the need for them to follow due processes), they will push for changes (better equipment, more health personnel etc) to make things better for all of us.
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