Feature Article of Thursday, 24 May 2012
Columnist: Bonna. Okyere
WHY ARE MANY DYING AFTER DISCHARGE FROM HOSPITALS IN GHANA?
Ministry of health should look into the frequent deaths of many able Ghanaians who return from the hospitals or clinics after receiving drips (aka wáter) only to die at home. It could be either the patients were not properly diagnosed or the drip had expired or contained the wrong ingredients.
Drip is a life-saving medicine but if one does not use it rightly it could be a killer as well. There are 3 kinds of drips that can be administered:
1. Normal saline: without sugar. Good for diabetics.
2. Dextrose: contains sugar or glucose. Not good for diabetics.
3. Ringer’s lactate: contains potasium. Crucial for a patient whose potassium levels are low.
Before the right drip can be administered there has to be a proper diagnosis. Better diagnosis are the results of lab testing. Lab tests could be as simple as X-Ray, EKG, BP check, Bloodwork or the use of advanced technology such as CT Scan etc.
Recently I have heard several news of many patients who having received a drip, and discharged from the hospital die a day or two later at home. This is becoming too common a cause of death these days in Ghana and the Government (i.e., Ministry of Health) cannot turn deaf and blind over this. I am calling for IMMEDIATE and Urgent investigation.
This morning I received a phone call from Ghana only to hear that my cousin is dead. I asked the cause of death and I was not very amused, though shocked to hear it was the same cause of incident. I have heard over and over again from friends who have just lost their loved ones by the same trend- discharged after receivung a drip-. WHY IS DRIP (aka wáter) KILLING SO MANY IN GHANA?
The cause of death
My cousin, for the purposes of our discussion let me call her X.
“X” was very fine. Three days ago she had vomiting and diarrhea. She was taken to a nearby hospital. They gave her a drip and discharged her. This morning she felt weaker so they decided to take her back to the doctor/hospital. On the way to the hospital she died. This is shocking news because her sickness was not all that serious for a young lady to die.
I have a question to the authorities but before I do so let me applaud and thank all our healthcare providers who are doing everything right within their scope of expertise to save lives in spite of the limited resources at hand. Thank you and God bless you.
QUESTION TO MINISTRY OF HEALTH TO CONSIDER:
In almost all the cases when the drip was given the patients were sent home either on the same day or the following day.
Why are the hospitals rushing to discharge sick patients?
At least they can keep them 3 to 5 days at observation and make sure they are stable before they discharge them.
In two of the cases of death that I probed the patients were diabetic. I learned no further test was administered before the drip was given. In another case the patient had upset bowels but he was only given a drip. No further test was taken. Meanwhile the facility had access to some machines that could have been employed to do furthe investigation. Not even EKG was administered.
Why are patients not being thoroughly examined or diagnosed before medication? Why are the hospitals not using the machines promptly on emergency cases or following up with basic tests ?
If and when the hospital has the machine it was only prudent that they get a technician standby all the time. Funny enough, due to lack of supervisión and responsibility these techs or nurses would tell you they are on break while the patient moan and suffer.
For the past month I have had more than four friends and families whose relatives have passed away in Ghana. Upon inquiring about the cause of death I must report that 75 percent of them died at home after being discharged and their discharged summary hardly show any lab work. Many of these cases had only received a drip at the hospital/facility. Why are all those deaths related to drips? Are the drips contaminated? Were these patients properly diagnosed? Were these patients in need of drip? If so what kind of drip?
It is important for us to know that there is not only one kind of drip that needs to be administered to all patients. To put it in simple terms, the composition of the drip is crucial. If you give a diabetic drip that contains glucose, you are only speeding his or her death. Unfortunately many of the healthcare providers may not know this simple misdiagnosis or care less. The nurses keep giving the same drip to each and every patient. Dextrose could be a miracle saver where the patient was only simply dehydrated but not when hiso her sugar levels were already high. Almost anyone who is dehydrated automatically receives a drip in Ghana, withou any discrimination; be they dibetic or not. This must stop. Gone are the days when the eating habit of the Ghanaian was so good that diabetes or HP was not a big issue.
CONTINUOUS MEDICAL EDUCATION IS CRUCIAL
The old information that these healthcare providers and hospital staff are keeping to could be dangerous and murderous. What they learned in the text books 10 years ago may no longer be valid today. However, many still stick to the old text books and archaic notes and offer diagnosis base on old knowledge.
IT IS IMPERATIVE THAT A POLICY BE MADE HERE AND NOW TO COMPELL HEALTH PROVIDERS TO HAVE SOME FORM OF CONTINUOUS EDUCATION (CME) AND RECERTIFICATION AFTER EVERY 5 TO 10 YEARS.
1. A healthcare provider or doctor must make surew that he or she updates his or her profesional knowledge by some number of required credits each year before he or she could be promoted.
2. Goverment must assist the Ministry of Health to institute a programme to offer refresher courses or continuous education to the healthcare providers and hospital staff to stop the “inocent murdering” of Ghanaians.
3. In these days of technology and easy access to computers there should be no excuse why the Ministry of Health cannot implement and enforce this rule religiously. Adapt online courses or encourage Exchange programmes.
Continuous medical education is the key to improving healthcare in Ghana and everywhere. The truth of the matter is, this is the only way to avoid little mistakes and sabe lives.
Many of the deaths in Ghana are caused by common and petty mistakes on the part of the healthcare providers, especially the nurses as the doctors are few, very bossy and or hardly at post. Since there is no accountability they keep making silly mistakes.
Therefore it is equally important that Parliament begins to delibérate on the need for making doctors and hospitals liable for negligence. Families should be able to sue the Provider (doctor or hospital) if they have cause to believe that the healthcare provider was negligent.
Lack of accountability is making some of these doctors and hospital staff rude, flippant and unethical. The fact that doctors are scarce in Ghana does not mean they should not practice good medicine. Their first responsibility must be to save lives not to speed death. When patients are taken care of it is the people who will fight for doctors and nurses well-being.