Lessons from Alphonso's report

I have read the report of Alphonso; a final year MD student from Yale School of Medicine who did a 4 week clinical rotation at the department Obstetrics and Gynecology, Korle Bu Teaching Hospital on Ghanaweb titled -  

What I learned during my rotation in Ghana - Foreign medical student

(https://www.ghanaweb.com/GhanaHomePage/NewsArchive/What-I-learned-during-my-rotation-in-Ghana-Foreign-medical-student-627687). 

This report has been published widely in both local and international media houses as well as social media. As a Ghanaian health worker, I agree and disagree to parts to her report. I see some of her description of Ghana and her citizens as derogatory and insulting. Even though Ghana is a developing country, these descriptions do not in anyway portray the exact picture of Ghana. They are very unfortunate and are in bad taste. 

"The first thing that I noticed when I stepped off of the plane was intense heat. We landed during a giant dust storm - part of the annual harmattan - with temperatures bordering 100°F. I learned very quickly that sweat would become an inescapable part of my daily life.

But even more striking than the heat and dust was the poverty I saw as soon as I stepped out of the airport. Dozens of people were walking barefoot, wearing tattered rags for clothing. Women balanced heavy tubs of goods on their heads, gently avoiding the goats grazing on the sparse burned grass. Colorful billboards and signs decorated dilapidated and abandoned buildings. Small houses and shops were fashioned out of old shipping containers. As I looked more closely at my taxi driver, I realized that his shoes were mismatched. His watch had only the hour hand, and his shirt was that of a woman. He had clearly put together what he could find. I looked down at my own clothes and I realized that my shoes not only matched, but were also thick and sturdy. My clothes were my own and fit well, and my two bags of luggage were conveniently on wheels. These small details felt like embarrassingly massive luxuries." 

Anyone who has visited and those who live in Ghana will not agree to the description above. Many of these things are totally false. 

This is what she could say about our physicians and our health system.

 "Physicians in Ghana are impossibly outnumbered by patients, so patients often serve as one another’s caregivers. Women in neighboring beds — prescribed bed rest for days or weeks at a time — often became friends and would alert physicians if their neighbor had a problem. Rounds started each morning by asking each patient, “Ete sen?” or “How are you?” in the local Twi language. Either from deference or denial, patients would undoubtedly respond, “Eye” or “I’m fine.” If this was true, rounds would continue, but if not, the neighbor would often respond, “No!” and explain the patient’s complaints for her. “She feels nauseous,” or “She’s been vomiting all night.” Women who were not on bed rest would seek out the doctor and report if a patient on the floor seemed unwell or if a baby was jaundiced. Privacy was a luxury, but no one seemed to mind". 

The descriptions above are overly bias and do not give an accurate description of our nation. Ghana is a beautiful country with a great culture and extra ordinary people. We don't wear tattered rags as clothing. We are very decent people. A simple Google search of Ghana will give you beautiful pictures of Ghana which are far from the description of Alphonso. 

Aside her erroneous description, there are some lessons we can learn from her report.  These lessons when taken into consideration will strengthen our health system and improve quality healthcare delivery in Ghana.

Congestion: Our hospitals need to be decongested. A visit to the Out Patient Department of our major hospitals speaks volumes. Some patients get to the hospital as early as 3:00am because of long queues and usually leave after mid-day. Worse can be said about our wards. There is the need for our authorities to expand the infrastructure in our facilities especially the teaching hospitals. 

Health financing: Health financing should be taken very serious in this country. The National Health Insurance Scheme should be well resourced to take care of its beneficiaries. I have nursed patients who could not afford medications as cheap as $5. Many health workers can testify to the fact that, they use their scanty money to buy medication and even pay for patient's laboratory investigations. Families should be ready to support their members who get sick and are hospitalized. Let us help them whilst they are alive than to spend thousands of dollars to organize their funerals. I will recommend the beautiful song by OJ titled: Onipa hia mmoa (Human needs help). Its a great song.

Shortage of Staff: The doctor-patient and nurse-patient ratio remains high in Ghana. In some of our facilities, we have 3 nurses taking care of 30 patients. A report I read some time ago on myjoyonline stated that there was only one doctor in one of our district hospitals. This situation puts much pressure on our health workers depriving them of the needed peace of mind and motivation to work. Many of our health workers resort to medications in order to get the needed strength to take care of the sick. The sick taking care of the sick-what an irony. The government and private individuals should invest in the training and employment of health workers most especially nurses and doctors.

Poor working conditions: The conditions in which we work are very bad. In some situations, basic items like gloves, methylated spirit, cotton, bed sheets, Thermometer etc. are not available to work with. How will we work to the optimum when the things needed to work with are not there. The common word among health workers in Ghana is improvise. We improvise to the extent that in our training institutions, we are taught how to improvise. There are no proper wheel chairs to carry patients from one place to the other. The hospital beds are bad and the least said about the mattresses the better. We (Ghanaians) should pay attention to our health facilities because no one knows when there will be an emergency and you will be rushed there.

To conclude, let us not throw away the baby and the dirty water. Even though the report contain many irritable comments and description of Ghana, let us pay attention to the problems she has brought to the floor. Lets take care of our health facilities and health workers because they are all we have as a nation. A nation that plays with its health workers and facilities has no future. 

Written by James Mckeown Amoah