Saturday, January 7, 2012

Incomplete, biased and correct.

I was very sad to read an item on GhanaWeb about multiple deaths at the Komfo Anokye Teaching Hospital (KATH). The article states that these deaths are due to faulty equipment and, consequently, doctors are refusing to carry out surgeries "for fear that the patients’ ailments might worsen at their hands".
I know many of the fine physicians at this institution, and it saddens me that their skills are going to waste for want of reliable technology.

It also saddens me that this is not a new problem. Almost a year ago I wrote a post in which I spoke of inadequate / malfunctioning equipment at this same institution. That post did not mention the institution by name out of respect for the professionals working under such onerous conditions. Moreover, such problems are not limited to this one institution (here, here and here are other examples).

It is a popular argument (and one to which I subscribe) that low-resource regions should be thought of less as recipients of aid and more as customers who do not have much money (e.g. 'Toxic Charity', Dr. Moyo,  GoodIntents, Health Policy & Planning, Changamka, Matt Ridley). This beneficiary-to-customer evolution is a difficult transition to make, not only for donor institutions, but also for recipients. As a grateful aid recipient one does not complain or have demands. As a customer one has the right to expect a certain quality of goods and service.

I wonder if that is part of the problem with equipment maintenance at KATH. For too long their equipment supply has been dependent on charitable donations, and maintaining good relations with donors has been vital to the continued running of the institution. No criticism or complaint would ever be uttered. To effectively operative as a customer, however, one must be willing to complain, criticize and 'take business elsewhere'.

It may not be enough to register "displeasure at the maintenance works of the contractor" nor to have "drawn the attention of Gertec Technologies to the broken down machines". I am not privy to the contract between the Ghana MoH and Gertec Technologies, but I would encourage the Ministry to exert the fullest strength of its legal power as a contracted customer. If this means suing, or changing maintenance agreements to one with a more-responsive provider, then so be it.
If it turns out that the responsibility for these disastrous events rests on members of the hospital administration or MoH, then I have every faith that Ghanaian democracy will find a suitable outcome.

Update 21-26 March 2012:
In protest at the "debilitating conditions", the junior doctors in KATH called an indefinite  strike, and their surgical colleagues joined them. As always with these kind of actions there were tragic consequences. The Minister of Health tried to broker a deal between the doctors and hospital management. The local media watched intently and critically. After one week, the junior doctors called off the strike. Dr Osei-Tutu (Chairman of the Junior Doctors Association) said they were returning to work because hospital management had made efforts to address the concerns. However, he called for the dissolution of KATH's governing board, as the doctors have "completely lost confidence in them".

I hope this signals a turning point in the recent trajectory of the KATH.