Killing doctors in Ghana

“Doctors are arrogant. They are pampered rich kids who get the opportunity to help people but end up going on several strikes leading to the death of the innocent Ghanaian”. I used to think like this in those days and I am sure most people have the same perception still.

As bad as they are perceived to be, we like most of them and that is what brought me joy when my daughter got into medical school some 7 years ago. I will skip her school days stories and go straight to the main reason I want people to get to know what goes on inside of the medical profession.

She started her horsemanship in one of the big hospitals in Ghana. As a father, I was happy for her for becoming economically independent and I loved the way my contemporaries called me ‘doctor papa’ but little did I know that practicing medicine in Ghana is worse than anywhere else in the world.

My daughter, Esi shares a lot of things with me but my doctor was being ‘killed’ barely 6 months into the profession. Her passion for the work, compassion towards patients had all disappeared and her constant prayer for a strike action worried me, so as a father, I sat her down one day to discuss what was the problem and what she told me, made me scared for the future of our health care system.

I verified this from some of her friends in other hospitals and what they told me was worse to the point that I could not sleep for days. I have finally decided to tell the whole world about it now that Esi is no longer a house officer.

To understand what Esi was going through, let us see the hierarchy in the profession-consultants sits on the top, these are usually the professors who are called upon in extremely difficult situations and hardly go to the wards to see patients, except to teach medical students and diagnose rare cases.

Next are specialists who aspire to be consultants in the future, followed by senior residents who hope to be specialists after some years, followed by junior residents, then medical officers, and finally, house officers. Esi therefore as an entrant to a profession with a long road ahead, is supervised by all these people especially senior residents.

However, barely 6 months into the profession, she was still taking upkeep money from me and what I thought was a relief was indeed not the case. She went to work every day including Sundays with no rest, she often went home tired and had to go back to work the early morning the next day; worse of all, she was sometimes called in the middle of the night, like 2 am to go see patients that residents ideally should see.

This schedule had taken a toll on her relationship and I wonder if she will ever get a chance to maintain a healthy relationship and find a husband.

Accommodation

About 2 years ago when she was posted to the hospital, it was a mixed feeling for me; I was sad because my only daughter that helped her mother at our supermarket was leaving home and was at the same time excited because she had been staying at home for close to 7 months after school unemployed.

Most people have the perception that doctors have a ready job after school and that the job market is always in their favour but the reality is in fact the opposite. It was sad to see her wallow in self-pity when her mates who had to do only 4 years in the university driving their cars, getting married, and moving on in life. So much for someone who decided to help save lives.

Government had provided accommodation for new house officers on the hospital premises and which is intended to accommodate ALL of them so that they will not be far from fetched when the need arises but for some corrupt reason, the accommodation was not enough.

They balloted for the rooms and from what I hear, it was not all of the rooms. Some of the rooms at preferred blocks where reserved for those who can bribe those in charge.

For some fees ranging from 1000 up to 5000 Ghana cedis, those who chose ‘no room’ and those who preferred certain blocks paid these bribes and were accommodated. Esi was unfortunate to have chosen no room and since I did not have any bribe money for such, I rented a hostel for her.

Anytime, she was called in the middle of the night, she had to dangerously take Uber to and from, and all these were from my pockets one way or the other.

Salary

So why was I still paying for my daughter's transportation to work when she had become the doctor that she always wanted to be? Perhaps it was not the doctor that she thought she will end up becoming. The house officers are not paid for the first 180 days of working.

Some hospitals give these overused and underappreciated new doctors, patriotic enough to die for their patients,10 Cedis a day for meals to sustain them until their salaries are paid.

Esi told me that some big men in the government, intentionally delay the salaries of these innocent energetic young bright minds their well deserved, woefully inadequate salaries so that they can invest them over the 6 months period. Ei what a country it is if this is true!

I asked a friend of mine at the CAGD and he told me the delay was due to paperwork and biometric verification...and I wonder, if it takes that long to process these, why was it not done during the period that Esi was home waiting to commence her medical career?

During her time, the biometric registration was a whole new corrupt process because what was meant to be a free collection of data, these data collectors demanded 60 Ghana cedis from each registrant before enrolling them. As starved as these doctors are, surviving on 10 cedis a day and waiting for so long for their salaries, most of them paid and those who stood their grounds against the corruption saw further delay in their salaries, some of them, close to a year before their salaries were paid, and that is after they agreed to pay and larger sum as a bribe to those working on it.

This is shocking!

I began to understand why some good children end up becoming bad doctors. The system corrupts them and demoralizes them from the beginning of their career and that explains a lot about the ailing health care system. A friend of mine also said his son who is a community health nurse had not being paid for over 8 months and he is still taking care of him all these months the son completed school.

Oh, Mother Ghana!

I have lost the last hope I had for the future generation if this is what is being meted out to them. Is it a punishment for them to choose health care as a career in Ghana?

Workplace Demoralization

With no payment of salaries and no time to rest, one may think the passion for the work as a doctor would be enough to keep a young man or woman going but that joy is cut short by workplace bureaucracy, politics, and ego of some superiors that never gets satisfied by anyone who has not achieved more that they have.

I had no privy to this inside information until Esi called me late at night on one Saturday crying uncontrollably. On probing further, she told me that they lost a patient at work the day before and what is circulating in her unit of work was that she was to blame for the death.

I probed further to find out any mistake she might have made, as new as she is if she was indeed the cause.

The story goes that an octogenarian woman who was presumed to have recovered from her surgery went to the washroom without the assistance of anyone as usual and on her way back, she could not breathe, signaling for help and before she could be put back to her bed, she died on the arms of the nurses.

When she finished her story, I was more puzzled and asked if she was with the nurses and she said, she had stepped out briefly for dinner, less than half an hour.

Esi had not eaten since her breakfast in the morning and had been on her feet running errands for one doctor to the next. She finally had some time to get some meal from around when the incident happened and the report said there was no doctor on the ward, so she got blamed for it.

In their profession, the house officer is the one who takes the fall for the mess when none can be found.

I was so angry listening to my daughter cry her heart out just a few months after starting work. I wondered if it was right to make the new doctors lose self-confidence in their abilities if they are being mentored to take over the role of their bosses.

It is said that when on ward rounds, house officers are intentionally asked difficult questions just to prove they don’t know much and to humiliate them among others in order to keep them at their lowly place of clinical inexperience.

They are not deemed competent enough to be involved in some basic life-saving procedures such as putting a tube in someone’s lung to drain blood or water when they cannot breathe. These were what was taught house officers not so long ago, according to Esi but such knowledge is now rationed and deemed a privilege for those who are lucky to meet a benign resident willing to pass on the knowledge.

Workplace bullying of house officers is not limited to their fellow doctors but nurses and other staff also take advantage of the innocent, compliant, and committed nature of some of these house officers, to make them feel less than who they are with any chance they get.

I have listened to specific instances over and over again, one that I remember most is where one nurse in reference to Esi, said to her hearing, in front of a patient that ‘true doctors are not around at the moment, only house officers’ when the patient wanted a refill of prescription which Esi could easily issue.

In her conversations, I think she does not feel welcome into the profession and I am worried about the kind of woman that she has grown up to become. But I think some bad people in the profession are making the work unattractive to house officers. To me, though she is extremely good at her work, she has lost compassion. She told me once that a patient had run out of funds for his medication and no relative was coming to visit him again.

I inquired what happens to such abandoned patients. Her response startled me – “Of course they usually die, dad!” I was surprised that she could say something so grave that easily and move on to another topic for discussion as if it was not death we just spoke about.

In all, my daughter's life as a house officer has given me a chance to understand why most doctors do what they do. Though this is not justifiable, the desire to help people is nipped in the bud during the horsemanship period and replaced with ‘just doing my job-what I can’ even before they climb up the ladder of seniority.

Perhaps, if there were not so much corruption in the system that forces them to go to work tired, hungry, unappreciated, humiliated, and having to find their own accommodation and make a living despite being unpaid, the doctors we grow and the ones who will eventually take care of us will not be so much of killers, will not be planning to leave the country (Esi already has one foot overseas out of this corrupt and wicked healthcare system) and maybe not grow up to sell babies despite their conscience and oath they have sworn just to make ends meet...though not justifiable in any sense.