6th August, 2011. I remember the day so clearly; it is a day none of my colleagues will ever forget. We all sat in resplendent clothing, listening – or rather not listening – to one speech after the other, overwhelmed by the presence of a day that 6 years before, seemed an impossibility, the arduos nature of the training making it even more so.<\/p>\n
We had finally earned the right to have \u201cDR\u201d before our names, a dream almost every Ghanaian mother dreams for her child, but only 1 out of 10, 000 will realize.<\/p>\n
As we rose to take the hippocratic oath, we knew we had arrived. We had arrived at the beginning of the rest of our lives, where our actions or inactions may make the difference between life and death, where we had no reason not to do our best. We had also arrived at the end of any personal life, because our lives would from then revolve around our work as doctors.<\/p>\n
We nontheless took the oath because we saw it, and still see it, as a calling.
\nBut the prestige that came with the title and the morale with which we entered the profession were dealt a hefty blow when we started working as medical practitioners, as house officers; we had to fight to be accomodated- something that was then guaranteed to the house offcer-, we had to fight to be paid our allowances, we had to fight to get our first salary.<\/p>\n
4 years down the line, nothing has changed; today it\u2019s the turn of 91 house officers. They have not received their first pay after 11 months in the profession, and it had to take drama in the media and picketing at the Controller and Accountant General\u2019s Department for THEIR own hard earned money to be paid. How unfortunate!
\nDespite the fact that he is at the frontline of healthcare in Ghana, the first point of call at every facility where he works, the house officer has to struggle to make ends meet; all he can tell his 2,000 friends on Facebook or the 500 followers on Twitter is \u201cthe kitchen is hot\u201d or \u201cthe hustle is real\u201d.<\/p>\n
Meanwhile, his commercial-driver uncle, who makes over 100 cedis in sales per day- and therefore technically earns more than he does-, will call incessantly to ask for money to pay his daughter\u2019s school fees. The poor house officer will also not miss being called to be a co-chaiperson at a Church harvest and will be expected to present the fattest envelope at the next funeral or christening.<\/p>\n
All because of the \u201cDR\u201d<\/strong><\/p>\n With all of these unofficial socal contracts to satisfy- forget him commuting to work, forget him living in rented quarters, forget him feeding and clothing himself and family- it is an act of social injustice and an infringement on human rights to go 11 months without being paid, and yet be expected to save life and limb, everyday.<\/p>\n With such demands on his shoulders, would he be wrong to demand his due, especially considering that he has no avenue to make any income outside his salary? He is not supposed to do locums (short contracts in another facility, usually a private hospital, for a quick pay), since it is an offence under the law ; even the work schedule would not allow him to; he is on duty every day of the week, every month of the year- except for 36 working days when he is on leave- and a good number of these duties extend beyond 8 hrs, some up to 48hrs.<\/p>\n But the problem goes beyond a tardiness in the delivery of the doctor\u2019s monthly salary and his aggitations concerning it; the real problem is the progressive unattractiveness of medical practice in Ghana. Too often have I heard a colleague say \u201cIn my next life, I will not be a doctor, or at least, not in Ghana\u201d. This is a sad statement to come from one in whose care life has been entrusted. But can you chide him for saying this, when he has to fight with government to be paid his due, or even define his due? Can you berate him for saying this, when specialization in the field of his choice is made more and more difficult by the day due to stringent rules, stifling bureucracy and unacceptable charges? Can you make him the object of obloquy for saying this, when his desire to serve his nation is shot down with incomprehensible decrees and directives?<\/p>\n There are about 3,000 practicing medical doctors in Ghana, with a doctor to patient ratio of 1 to 10,000, while there are probably about 1000 Ghanaian doctors in the USA alone, helping them to maintain a doctor to patient ratio of 1 to 400. I guesstimate that there are more Ghanaian doctors practicing outside Ghana than there are within. This pattern of brain drain will continue if the status quo prevails.<\/p>\n The state needs to put its money where its mouth is. We seek middle income status, and one of the parameters for such an acolade is a doctor to patient ratio much lower than what we have. It has been suggested by many authorities- renouned surgeon Professor Frimpong- Boateng amongst that lot- that Ghana needs about 45,000 doctors to meet its healthcare needs. This is 15 times the number we currently have. It is therefore utterly discombobulating to see people in power make the lives of the few doctors available so miserable. There are still districts in Ghana where there is no doctor, and with the current trend of pushing doctors away, the prospects for remission is very bleak. Unfortunately, it is the poor village farmer that suffers.<\/p>\n There has to be increased spending in the health sector. More health facilities need to be set up and along with that, more medical and para-medical personnel need to be trained and retained in the country to man these facilities.<\/p>\n Serving in deprived communities should come with mouth-watering incentives, to reverse the trend of everyone wanting to stay in the cities. Rational salaries and entitlements should also be given to health workers, and it should not take 11 months to receive your first salary. It is unacceptable for our finance minister to tell us that it normally takes 18 to 24 months for new public sector recruits to obtain financial clearance- which expires after only 3 months by the way. Where on earth does this make sense? I hope the proposed \u201cHRMR interface\u201d the minister mentioned in parliament recently will cut the wait to 1 month; anything else is a waste of the taxpayer\u2019s money.<\/p>\n If these things are done, there will be no need to bond doctors to practice in Ghana. We will all willingly do so. –<\/p>\n By: K.T. Nimako (MB ChB)<\/p>\n Dr. Kojo Nimako is a private medical practitioner with an interest in public health and Citi FM\u2019s Chief Medical Correspondent. He is also the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.<\/p>\n E-mail: kojotwumnimako@gmail.com 6th August, 2011. I remember the day so clearly; it is a day none of my colleagues will ever forget. We all sat in resplendent clothing, listening – or rather not listening – to one speech after the other, overwhelmed by the presence of a day that 6 years before, seemed an impossibility, the arduos […]<\/p>\n","protected":false},"author":14,"featured_media":69253,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[2],"tags":[8,15,38],"yoast_head":"\n
\nPost-graduate training, through the Ghana College of Physicians and Surgeons, should be expanded and the state should continue to fully fund it. No attempt should be made to shift the cost to the enrolled doctor.<\/p>\n
\nOur healthcare system is ailing, yet the personnel needed to revive it are disgruntled and demoralized. All medics love their profession and most have the desire to help their motherland, but a good number of us go out to seek pastures, not necesseraly greener ones, away from this savannah, because, honestly, this kitchen is too hot.<\/p>\n
\nTwitter: @KTNimako<\/p>\n","protected":false},"excerpt":{"rendered":"