Ghana's Inhumane Healthcare System

Ghana is increasingly seen these days as a progressive country. Many visitors return with glowing, optimistic accounts of a nation that is headed in the right direction. They talk excitedly about highway construction and other public works projects dotting the landscape. They even talk about a building boom, especially in the major urban centers. But in spite of all the great strides it appears to be making on the economic front, Ghana is still stuck in the Neanderthal era when it comes to basic social services. And nothing exemplifies this situation more grimly than the dysfunctional state of the health care system.

The Ghana health care system is in bad shape, and the emergency care is the most egregious example of how bad things are. For most people in Ghana who suddenly find themselves in life-threatening medical situations, access to that crucial, initial medical help is not an option. So you have people dying everyday in circumstances where death could have been avoided.

The whole idea of emergency room care is for doctors and nurses to attend to patients whose conditions call for immediate and urgent attention, unconditionally, the sole objective being to save human lives. That is what emergency care is all about throughout the world except in Ghana where, quite incredibly, emergency room staff will not attend to a patient – who may be barely conscious and in the throes of death – unless he has a referral from either a lower-level medical facility or his personal physician. To illustrate this point, here is the heartbreaking story of a man who was suddenly taken ill in the middle of the night in Ghana recently, the victim of a heart attack as it was learned later – a story that may sound eerily familiar to most Ghanaians. After overcoming daunting transportation challenges – which is a fact of life in Ghana – to get the deathly sick person to the nearest general hospital, the relatives were told by hospital officials to take the patient to another facility instead, to a so-called poly-clinic, without as much as a nurse checking the patient’s blood pressure and body temperature, preliminary procedures that are taken for granted in any self-respecting medical institution.

Obediently and without much choice, the relatives did as ordered only to be confronted with another problem or a set of new problems. Before the hapless, dying patient would be given any attention, the second facility wanted to see both a referral from the patient’s personal physician and an insurance card. Of course, the gravely-ill patient, stricken in the dead of night, couldn’ t reasonably be expected to arrive at the hospital clutching a note from his own doctor, but he had an insurance card.

He was denied help anyway. Soon afterward, as his family tried desperately to transport him to yet another facility, which would have been the third in a row that night, the poor man gave up the ghost while still on the road.

And compounding the sense of frustration of those he leaves behind is the knowledge that no one is going to be held liable for his death; not a single doctor or medical facility will be taken to court on charges of medical malpractice simply because the legal mechanism for such an action doesn’t exist in Ghana. So much for progress! No one can deny that the medical facilities that refused to save the life of the dying man committed murder, something they do regularly with impunity. Nothing in the world could be more inhuman than the spectacle of a hospital refusing even to make an attempt to save a dying person’s life. It is as morally indefensible as it is unprofessional. In many of these cases, administering a simple dose of aspirin could make the difference between life and death.

Yet Ghana’s emergency room doctors and nurses casually turn dying patients away rather than make any such effort, hiding behind bureaucratic excuses in clear violation of the medical code of ethics and common human decency. What makes the shabby and callous treatment of patients in hospitals and clinics in Ghana all the more reprehensible is that it is done mostly on the basis of a person’s social or economic status. The well-heeled, the well-connected, and the politically powerful are always taken care of promptly and with the utmost civility. There is none of the rigmarole that ordinary citizens are routinely subjected to when the rich and powerful show up in emergency rooms.

It is clear that health care and a host of other social welfare issues have been largely neglected by various Ghanaian administrations, including the present one. It is an unacceptable situation, to put it mildly, one that is hard to reconcile with Ghana’s image as a progressive nation, and the next president and his team should make a solemn commitment to rectify it without further delay. The health care system in particular should be thoroughly reorganized so as to emphasize its fundamental role as an agency for saving lives, that is, the lives of all people, not just the lives of a few privileged individuals. And just as important is the need to put in place medical malpractice laws as an incentive for doctors, nurses, and medical establishments in Ghana to treat human life with a little more respect. Fancy new sports complexes and ultra-modern motorways are fine, but it will take live, healthy, and happy citizens to make such investments worthwhile.