Feature Article of Thursday, 28 September 2006

Columnist: Jeffrey, Peter

Health Care Delivery in Ghana

The Role of our Diaspora health professionals:

With a population of 25 million and still classified as a poor third world country, Ghana can proud of her 4 medical schools and the professionals who have kept the schools running despite the difficulties in the country.

During the 1980s sub-Saharan Africa under went harsh economic difficulties which resulted in massive brain drain of the region’s professionals. Ghana lost almost all her health professionals during the crisis. Laboratory technicians, nurses and midwives, pharmacists, dentists and doctors left the country in droves, almost collapsing Ghana’s health care delivery.

A United Nations report on international migration report stated that by the end of 2005 Ghana lost over 50% of her highly skilled labour. Of this 50%, 90% were health professionals. Ghana was the only country to lose most of her professionals during the 1980s “lost decade”.

The report of Ghana’s predicament was reported around the world, from Taipei Times with the headline banner “Ghana bleeding from brain drain” (Monday 31st October 2005) to Los Angelos times. Health care and education were the areas that suffered most.

The 1983 expulsion of Ghanaians from neighbouring countries brought home to the authorities the desperate situation that the country faced. At the height of the expulsions, young pregnant mothers, some as young as 18years old, children born in Diaspora and old folks, some as old as 84years old were driven from their homes with nothing. Most came with varying health problems. HIV/AIDS pandemic which was prevalent at the period in question was the common disease among the young female members of the returnees, thus putting more pressure on health care delivery in our motherland. The pale shadow of helpless sick compatriots at the quay side of Tema harbour, holding their few belongings in plastic bags and with few doctors and nurses to attend to them drove many to tears including Flt Lt Rawlings, then chairman of PNDC. Ghana was on her knees and almost bankrupt.

As the economic situation in our motherland became precarious the PNDC government headed by Flt Lt Rawlings was persuaded by the young technocrats in the finance ministry headed by Dr Kwesi Botchwey to adopt the Structural policies of the Bretton Woods Institutions in its entirety. User fees were introduced in health care and education. As results many of our compatriots died needlessly of illnesses that can be treated or contained because many could not afford the fees.

With the shortage of medical personnel HIV/AIDS became a major health problem in Ghana, especially in the Ashanti and Eastern Regions. In Agomeya in the Krobo traditional area, over half of the young women were infected with HIV/AIDS. The pandemic threatened to reverse decades of achievements in all aspects of human development in Ghana. Meanwhile Ghanaian nurses, pharmacists, dentists, doctors and researchers were being hailed in most western countries as the best medical professionals to emerge from sub-Saharan Africa. Majority were trained at University of Ghana Medical School and Kwame Nkrumah University of Science and Technology Medical School. A study by World Bank economists stated that over half of doctors practising in Inner cities of London, New York, Chicago, Washington DC, Toronto, Paris, Marseilles and Hamburg were from sub-Saharan Africa. Young graduates and professionals seeking to establish themselves and build secure futures disregard calls to patriotism to return home. The havoc wreaked by the exodus was devastating to Ghana. Agyeman Badu Akosa, Director General of the health service at the time, stated, “We are not just losing many doctors but the best ones”. Akosa further said, “I have 9 hospitals that have no doctor at all, and 20 hospitals with only one doctor looking after a whole district of 80,000 to 120,000 people. The country lost 8 of every 10 doctors it has educated. The “drain” is not limited to health but education as well. As the crisis worsen University of Ghana lost almost all its lecturers.

A study conducted by this writer and colleagues in the early 1990s found that most of the African doctors migrated not because of financial rewards, but rather due to lack of resources and lack of opportunity to gain further knowledge in their chosen field of studies. Most of the respondents left the motherland in their prime (25-35 year group). The brain drain at the period in Ghana was attributed in the 1980s to poor economic management, bad policies, high income inequalities and corruption. Some attributed the crisis to the debt crisis and in effect the spread of HIV/AIDS.

In the 1990s Ghana was hailed as an “African success story” and an “Economic Miracle”. As part of the reforms the economy was liberalised, thus enabling the skilled labour that Ghana lost the opportunity to remit money into the country without being penalised.

As the Ghanaian economy began to get better the skilled migrants, whose remittances perhaps help to fuel the energetic economic activities in the motherland began to play more active role in every aspect of the country.

Ghanaian Nurses and midwives’ in the UK formed an association to help deliver health equipments to the homeland. Ghanaian pharmacists followed suit. Even Ghanaian Ex-Police Officers Association did their bit to help their compatriots still in the service. They were supported by the Metropolitan Police Commissioner in London in their presentation of equipments to the Ghana Police Service.

On 9th September 2006 the Ghanaian doctors and dentists in the UK came together to pledge to offer their services free to the motherland. Their departure from the homeland almost brought our country to a halt. Thus after acquiring the necessary skills, the very issue that made them to leave the motherland in the first place, are now willing to share their knowledge with their young compatriots home. Some like Professor Amonoo-Kuofie went back to help set up medical school. Professor Kuofie is the dean of University of Cape Coast Medical School. The UK organisers in conjunction with their counterparts in the United States are planning to fully equipped the 4 medical schools in Ghana, namely University of Ghana Medical School, Kwame Nkrumah University of Science and Technology Medical School, University for Development Studies School of Medical Sciences and University of Cape Coast Medical School.

The only University in this writer’s home region, University of Mines and Technology, Tarkwa has no medical school, yet Effia Nkwanta General Hospital is the only general hospital in the Western Region looking after a population of over a million people.

At their inaugural dinner, Dr Anthony Annan, president of GDDA supported by his team of executives including Mr William Kedjanyi, Dr Hopeson Alifoe, Dr Stephen Addai, Dr Abigail Akita-Addo and Dr Emma Quartey pledge to support health care delivery in Ghana. The response from Ghanaians in Diaspora to this pledge was overwhelming.

This writer was marvelled by the organisational skills of our medical professionals, the doctors, dentists, nurses and midwives. This writer who grew up in a medical household knows how important the profession is to a family and to a greater degree a nation. In this regard this writer want to directly appeal to Dr Anthony Annan and his members to show the same level of patriotism in Ghana towards health care delivery as they did in their inaugural meeting. At the meeting our doctors and dentists from every corner of Europe came together as one “BIG FAMILY” to pledge their loyalty to mother Ghana and to one another.

It is true that most left the motherland when the country was on her knees, but the fact that they are contributing towards better health care delivery in Ghana is what must be applauded. As Agyeman Badu Akosa stated in the 1980s “we are not just losing many doctors, but the best ones”. In 2006 the best doctors that Ghana lost (this has been documented by many academics, including this writer) have come together to repay the debt they owe mother Ghana. In every village and district their contributions towards health care delivery would be felt for years to come. No nation can develop without their medical professionals.

On 9th September 2006 the doctors and dentists exhibited their enthusiasm and determination to help and support health care delivery in their land of birth – Ghana. The World Bank has recognised their willingness to put something back into the country that trained them. Our doctors, dentists, pharmacists, nurses and midwives and laboratory technicians world wide are priceless, their dedication to service and duty is what stands them out. Ghana is proud of them, but their services are needed in Ghana as well. In this regard this writer want to directly appealed to Anthony Annan, Stephen Addai, Emma Quartey, William Kedjanyi and Hopeson Alifoe and the members of the GDDA to form a closer collaboration with the Registered Ghanaian Nurses and Midwives Association of UK to increase accessibility and help improve quality health care “free” at the point of delivery in Ghana, especially in the northern half of the country, where most communities lack basic medical care. As your colleague, teacher and friend Professor Amonoo-Kuofie stated, there is only one doctor to 160,000 in the motherland. The test is to train and retain those coming through medical schools. The onus is on the government to pay our medical professionals decent wages plus generous incentives to encourage them to stay in Ghana. In Tumu, the hometown of Ghana’s late President, Dr Liman, there is no doctor. The only one caring for the whole district left town a few months ago. People have to walk for hundreds of miles to Tamale metropolis to see a doctor.

To Dr Anthony Annan and your members, Ghana needs your skills towards health care delivery in the motherland. As Ghana prepares to celebrate her 50th anniversary health delivery in the country as envisage by Dr Kwame Nkrumah is still not up to standard, yet we have two of the finest medical schools in the world and our professionals are deemed as some of the finest. This is fact recognised the world over. Ghana needs you.

God Bless our medical professionals, God Bless our Homeland Ghana.

Peter Jeffrey MSc, BSc(hons)Lond.

Views expressed by the author(s) do not necessarily reflect those of GhanaHomePage.