ARTHUR KOBINA KENNEDY, MD

In the last few weeks, some of our major hospitals have been in the news quite a bit in connection with preventable deaths and other problems.

The Police Hospital, Korle-Bu Teaching Hospital and most especially Komfo Anokye Teaching Hospital have all been in the news.

The Police hospital had to deny that the death of a patient was due to negligence following public complaints by the family of a deceased person. Korle-Bu has closed a unit due to the outbreak of Methicillin Resistant Staphylococcal infections. This follows reports last year about the age and state repair of CT Scanners at the hospital.

Komfo Anokye Teaching Hospital’s problems were perhaps the most serious of them all. According to a report filed by Nhyira FM’s Ohemeng Tawiah and later confirmed by the hospital “Doctors at the KATH are refusing to admit patients in critical conditions due to broken down life-support equipment at the Intensive Care Unit.” The report continued that “six people have died within the last 4 days as a result of the malfunctioning equipment.” Mr. Tawiah revealed that “nine out of eleven ventilators at the ICU have broken down forcing patients to queue for treatment.”

In response to this report, the hospital got into spin mode. “The Public Relations Officer of the Hospital, Kwame Frimpong, told Nhyira news that the Intensive Care Unit has been encountering some challenges. The PRO continued “It must be stressed that KATH is not directly responsible for the repairs of the equipment at the ICU centre. The maintenance of the equipment is in the hands of a private company that has been contracted by the ministry of health.” It was later revealed that the contract for repairs was awarded to GERTEC Technologies in 2010 by the ministry of health. During a visit by the then Minister of Health, Mr. Joseph Yieleh Chireh, there was a round-table meeting between the contractors, the hospital and the minister to iron out issues. The contractors revealed that they wanted to get supplies from Egypt and that this became impossible due to the mass protests that toppled Mubarak and brought Marshall Tentawi to power! That excuse is bull.

Afterwards, everybody shook hands and promised to do better. Nobody—as far as is known was fired or reprimanded. The contractors did not lose their contract. Those who died or lost loved ones were not heard of or from again. Elsewhere, they would all be heading to court and certain success against the hospital and the ministry of health.

To be fair to the institutions mentioned, they were just the flavour of the month. Of course, accusations do not equal guilt—either of the institutions or the affected staff.

A few years ago, after the death of Admiral Dzang, former President Rawlings complained that negligence by hospital staff may have contributed to his death. After Honourable Inusah Fuseini lost his spouse during childbirth, similar sentiments were expressed by none other than the President, His Excellency John Evans Atta Mills.

Just as nothing came of the KATH deaths, nothing was heard about any of these either.

We probably will never hear anything about the inquiry regarding the death at Police Hospital.

Now, this should bother all of us.

To return to the KATH case, it is difficult to understand how nine of eleven ventilators can break down. They certainly did not all break down the same day. It must have taken a long, long time for these to break down. As they broke down one after the other, what did the hospital administration do? What did the ministry do? When did the ministry first learn that something was wrong and what did they do? As for GERTEC, they may be a fine company but it can be asserted confidently that what happened at KATH would never have happened in Germany or Britain or the United States. If it did, there would be accountability for both key individuals and the Ministry. This should not be one of those “fama Nyame” moments.

One important lesson to take away from this is that preventable deaths are not always due to gaps in the performance of doctors. They can be due to poor performance by administrators or sometimes other health professionals, like nurses and laboratory staff.

While the consequences of omissions by administrators and or civil servants and/or politicians may be—err gargantuan, nurses and other staff are just as important to the well-being of patients. The nurse who fails to attend to a woman in labour in a timely manner may cause death or serious disability. The laboratory person unavailable to perform a crucial test on a week-end may be the difference between life and death for a patient. Even the technician responsible for reliable supply of oxygen, may, by his negligence, cause death or harm.

Before moving on to discuss solutions though, let me be clear that an overwhelming majority of those who go to our hospitals do get good care.

Indeed, on any day, a sick person is far better off going to one of our hospitals than buying herbs in public, going to a “dunsini” or a prayer camp. While indeed some herbs and herbalists are good—far too many of our people use herbs and end up in our hospitals with kidney and liver problems that are avoidable. As for prayers, while we should all pray, particularly when we are not well, we should use prayer to supplement good well-proven care by qualified professionals instead of in place of it.

In response to the concerns that I have raised here, many in the health profession will respond that we are understaffed, underpaid, undertrained and under-equipped. And these responses are right—for the most part.

I agree with these responses mostly because I am a physician and see first-hand the problems. Like most of my colleagues, I have made mistakes and will continue to make them. Our goal is to reduce avoidable errors and death through better systems and accountability.

However, we should not accept it when nine out of eleven ventilators can break down without anyone being held to account despite deaths.
We should not accept it when a child can die because those who are supposed to ensure regular supply of oxygen are negligent.

We should not accept it when a new mother can bleed to death because her nurses were asleep.

We should not accept it when a patient with Asthma dies because the doctor was not available.

And we should not accept it when a patient feeling unwell is persuaded to buy an unsafe product by the roadside that kills them.

As we proudly move forward to claim our status as a middle-income country, we must have institutions that match our new status.

Our nurses, who contend rightly that they are understaffed, should not be permitted to be in class without authorization when they are scheduled to be on the wards.

Our young doctors must not be permitted to jump the queue and enter graduate programs when their classmates are in rural districts, working and playing by the rules.

Staffs that are scheduled to work on week-ends must not be permitted to unilaterally take the week-end off.

And we must find incentives for those who work well and better.

Let us monitor and regulate our alternative medicine practitioners better so that we can take off the market unsafe products. When we permit products to be advertised on radio and TV as well as in our public places many of our people assume them to be safe.

To do all these, we need accountability. We must be accountable for our jobs—to our supervisors and to our institutions.

Even beyond these, we must be accountable to our consciences and to humanity.
Our institutions have a very crucial role in this. I am astonished that Parliament did not hold hearings on the KATH deaths.

What has the Ghana Health Service done about all these complaints?
What has the National Health Insurance Scheme put in place to improve care at our hospitals?

How are herbalists being regulated?

If ever there was a matter fit for a public inquiry, this would be it. It should be an inquiry that should be more focused on preventing deaths rather than punishing people.

Our leaders assume that they can get good care abroad when they need it. Sometimes, however, the sick will live or die depending on the standard of care in the local area. That is why Nkrumah had to be treated at Tamale after Kolungugu.

Each and every one of us was made in the image of God.

Today let us focus on all the deaths that can be prevented.

They are our fathers, mothers, children and spouses who will not be there to celebrate births, weddings and graduations anymore.

We failed them—all of us.

Let us resolve to do better—for all our people—together.—Myjoyonline.com

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