Finding a cure while dealing with reality – Healthcare in Ghana

“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 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 doesn’t mean a total absence of malaria parasites from the human host.

Thanks to this misconception that a cure means eradication, we have treated our health whether as individuals or society in compartments. Taking action when symptoms appear and going 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. Exposing what on the surface comes across as a total waste of the taxpayer’s money.

However, like anything that relates to health, 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. As citizens, I don’t believe these arguments are of many benefits to us. As it is said, when two beasts fight it is the innocent grass that bears the brunt.

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 won’t 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 as a country, we have 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 from the former government on how they intended to address this challenge, that is if one exists. With that, the onus would fall on the current government to explain to us why they have failed to go on with its implementation.

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 won’t fault you. However, I have a few concerns.

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. Either of deliberate maleficence or willfully causing 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, however, you do not have any such evidence then it would be advisable to sit with your predecessor government to find solutions to the current impasse. Alternatively, the option of engaging private medical consortia to operationalise and manage some of these facilities for a period can be explored. Such schemes exist in many well-established health systems and are feasible, achieving significant efficiency whilst improving quality of care provision too. But they only thrive if performance benchmarks are set with clear deliverables are tracked and measured.

These structures have become an infectious blot on our health landscape and must be managed. I do not expect an eradication but at least steps must be taken to reduce the number that is idling to a minimum to obtain an effective cure. 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 operationalising all these health facilities before the next general election. If they don’t it is on that front that to health agenda battle of 2020 would be fought.

For me what matters most is the learns we all obtain thereof. As citizens, we should understand that politicians meddling in health with little technocratic input has consequences. Requesting from a power-thirsty politician anything that will ensure electoral success may not necessarily be a bad thing. But when in answering your request 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.

By Kwame Sarpong Asiedu