Open letter to Ghana’s Minister of Health: Check bureaucratic bottlenecks to health sector brain gain

Dr. Benjamin Kumbuor

On September 24, 2008, a Ghanaian dentist living and working in the UK, Dr. Christopher Elvis Kwaku Vondee, was presented with the coveted Lewisham Primary Care Trust (PCT) Diamond Staff Award For Innovation in Dentistry 2008.

Dr. Chris, as he is affectionately called, is a graduate of the University of Ghana Medical School, and of King’s College in England; he owns and runs his own practice (dentistry) called Perry Vale Dental in England, and he is an approved Vocational Trainee Trainer in Implantology, Oral Surgery and Cosmetic Dentistry, who trains young dentists for the British National Health Service (NHS).

In fact the UK NHS is what it is today because of many factors, including the fact that Ghanaian health professionals, like Dr. Chris, work in that country and also train others. Dr. Chris is also pursuing a Masters Degree (MSc.) in Periontology.

But Dr. Chris is just one of many such successful and highly skilled Ghanaian doctors and dentists in the UK and other parts of the Diaspora who are making the effort to bring their expertise into the country and give Ghanaians world class healthcare at zero cost.

He belongs to the Ghana Doctors and Dentists Association of the UK, and they have been trying to set up a programme where Ghanaian health professionals from the UK and other parts of the world will come home in batches all year round every year, for two weeks each and offer free top quality healthcare, training, and in some cases bring in equipment for free.

One would have thought that every government or regulatory body would have jumped at the opportunity to bring in these much needed health professionals to help our healthcare system, particularly because politicians and bureaucrats always talk about brain-drain in the health sector and run their mouths at Ghanaian health professionals living and working abroad.

They always accuse Ghanaian health professionals abroad of betrayal because they (the health professionals) chose to go seek for greener pastures after being trained with Ghanaian taxpayers’ money.

The World Bank recently said in its 2011 Migration and Remittance Factbook that, 37 per cent of Ghanaian physicians trained in Ghana live and work abroad.

That side of the story has been overplayed and it’s now a dead record. But the other side about the bureaucratic stumbling blocks and systemic bottlenecks that are deliberately placed in the way of the Diasporan health professionals, for very flimsy reasons, have been subtly kept out of the public domain.

To say the least, the Ghana Medical and Dental Council (GMDC) has a bureaucratic arrangement that enjoins Ghanaian health professionals from the Diaspora, wanting to come help their country with their expertise for free, to register with the council at a whopping cost of £300 per head for every professional brought in to come work for free for up to three months; they also pay extra money to renew the registration for each person on subsequent visits.

Besides, those who want to stay and work beyond three months, even if for free, must and write “English” and a “specialist” exam before they are allowed to even start anything.

The thought of coming to write, register and or do exams in your own country before being allowed to work for free is enough to put one off, much more coming to write an English exam, including orals, given that you trained up to university level in your own country and you have been working in “the English speaking country”.

The only explanation given by the Registrar of the GMDC, Mr. Eli Atikpui was that the council did not want to discriminate against Ghanaian doctors coming from non-English-speaking countries, but that sounds flimsy.

It is more like majority of the Ghanaian health professionals abroad live and work in the UK or the USA so the council wants to cash in on that, since there is very little money gain if they focus only on those from non-English-speaking countries.

Not knowing about that bureaucratic requirement, one other Ghanaian dentist in the UK, Dr. Felix Dery Touper made an arrangement with the Tamale Regional Hospital and brought in a team of 20 doctors, dentists, and nurses in 2006, to offer free care, train young doctors and supply some equipment to the hospital. This was something Dr. Touper had been doing since 2003 at no cost to the country, the people and the hospital.

News of that got into the public domain; GMDC followed the news and invited the head of the Tamale Regional Hospital and asked him not to allow Dr. Touper’s team at the hospital anymore because Dr. Touper had not registered with the council.

The poor doctor, wanting to continue helping his people, registered at the cost of GH¢500 but could not make for the period he registered and he had to pay an extra GH¢300 before being allowed to write the exams.

He passed the exams, but was given a temporary registration with the excuse that he needed to have a permanent employer in Ghana so his employer would apply for a full registration for him at a fee.

This is a doctor who says he is not looking for money or an employer in Ghana because he and his team members have employers in the UK paying far more than any employer in Ghana, including government, could ever pay them; they just want to help their country for gratis, pro-bono, free. One wonders which part of ‘free specialist medical care’ the council doesn’t understand.

The GDDA in the UK have had several interactions with the GMDC but the council does not seem to see what disservice they are doing the masses of Ghana by protecting their flimsy bureaucratic arrangement and denying Ghana of the free services of the specialists we don’t have and can’t afford.

The Diasporans have said over and again, their intention is not to stay and work in Ghana, but to do specialist procedures, tackle specific major health challenges, which cost a fortune, plus give free training. They are only asking for either a waiver or subsidies on the registration fee only to come and work for free.

Reports at the GMDC itself shows that more than 80 per cent of the local medical doctors do not accept postings to the rural areas, and the Diasporan health professionals have expressed their willingness to go to those remote areas and help for free.

There is no justification in insisting on some unnecessary registration and exams. I am not the only one who thinks the GMDC’s arrangement is unnecessary; the former Minister of Health, Dr. George Ajah Sipa Yankey held a meeting with the health professionals in UK, at which some council members, including Mr. Atikpui were present. The former Minister directed the council to abolish that unnecessary exams and allow the professionals to run their programme for the benefit of our people.

But like the saying goes, ‘new king, new law’; that directive has been thrown to the dogs since Dr. Sipa Yankey resigned over some unproven allegations of corruption.

The GMDC insists that the decision to keep or abolish that arrangement does not lie in the powers of the minister but solely with the council; they seem to be enjoying the chaos of a health system they are overseeing in Ghana and they do not want any interference from some Ghanaian health professionals from the Diaspora.

These same council members have been using taxpayers’ money to travel abroad and join the Diasporan health professionals every year for conferences, dinners and what-have-you, but they do nothing to make their brilliant idea to save lives in Ghana work.

Some of the health specialists in the UK said they suspect that some of their counterparts who live and work in Ghana government hospitals and also have their private hospitals, are also working against their coming because it will deny them the opportunity of transferring cases needing specialist attention to their private hospitals.

Some of the local health professionals indeed confirm the suspicion saying they hate the fact that the Diasporan specialists only come in and do procedures and leave the patients for the locals to manage.

It beats one’s mind whether these local health professionals rather prefer that people lived and died slowly with their diseases or that the procedures are done thoroughly for free by the Diasporan doctors, and the post procedure cases left for the local doctors to manage.

Between the Ghanaian health professionals in the Diaspora, who are accused of deserting the country to seek greener pastures, and the GMDC, who use taxpayers’ money for conferences abroad, and has mounted a huge bureaucratic stumbling block in the way of brain gain, who should be accused of betrayal?

Whiles the GMDC gets on with protecting their sloppy bureaucratic requirement, and the local doctors preach about post procedure management, lots of Ghanaians needing specialists medical attention are dying in droves, while Ghanaian health specialists who can stem the situation are on board the brain gain ships all over the world waiting for the green light to come help their people and their country for free.

It behooves on the current Minister of Health, Dr. Benjamin Kumbuor, and the Ghana Health Service to reconsider the proposal of Dr. Sipa Yankey, and do what is right by the people of Ghana; what is in the public interest; what will save lives of many Ghanaians, and not what will allow some stuck and backward-looking bureaucrats to continue protecting their killer bureaucratic joke.

By Samuel Dowuona

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