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General News of Monday, 18 February 2008

Source: Moses Kofi Yahaya

Tamale Hospital, a blot on our national conscience

Tamale General Hospital, once an iconic symbol and a source of unbridled pride and joy, is now a crumbling edifice, beset by problems that have accelerated its downward spiral into mediocrity. Battered by years of neglect, the hospital is on its last legs, tethering on imminent collapse, the consequences of which, dare I say, will be catastrophic and a blot on our national conscience.

Except for some minor spruce up in 2003, it is worth mentioning that the hospital hasn't had any significant rehabilitation/renovation since it opened its doors to the public in 1974. Walk inside and you will be floored by conditions that can simply be described as horrifying.

Problems at the hospital run the gamut; I visited the hospital in the summer of 2003 and was dismayed by what I saw. However, to support my argument that things are in worse shape than what has been portrayed, I have woven together information I gathered from highly placed sources at the hospital with first hand stories from people with sick relatives at the hospital, and from Ghanaians resident overseas who visited the hospital and came away with harrowing tales of the prevailing macabre conditions.

Consider: structurally, part of the hospital is sinking, And the block housing the maternity, gynecology, children and antenatal wards are in a deplorable state, and they are in dire need of major repairs to their walls, roofs and windows, as well as fresh coatings of paint. The main tower block has deteriorated to the extent that the top two floors have been closed and patients moved to the a former chest ward.

Water does not run through the taps --- a sad commentary on the decrepit and antiquated water supply system in Tamale. Worse still, the hospital lacks a water tanker to haul in water. So, imagine the scenario that unfolds every day for patients on admission and their relatives.

For patients, there is the unpleasant fact of dirty, clogged toilets, and for relatives, there is the unenviable task of trudging to the hospital with bucket loads of water just so their loved ones can bathe and wash their soiled clothes. Laundry machines are luxuries, if you know what I mean.

Electricity supply in Tamale is intermittent, a perennial problem in the metropolis, and long before The Concerned Citizens Association of Tamale, a civil organization, donated a generator to the hospital, it - the hospital - had to make do without the benefit of a generator. Consequently, when power went out, the entire hospital was thrown into darkness and surgeons, midway through surgeries, were left helpless.

As if these problems were not enough to make the sick and infirm worry endlessly, the laboratory is falling apart, and the pharmacy is rife with shortages of vital life saving medicines.

Emergency ambulance service is non-existent, dental chairs, X-ray machines and eye equipments are conspicuously missing. Due largely to its inability to provide adequate accommodation, the hospital has consistently failed to attract top flight talent and specialists, and for it be designated a Teaching Hospital was infuriatingly bad policy.

Since the label was slapped on the hospital without the accompanying upgrading of teaching and clinical facilities, the medical school at the University of Development Studies has suffered immeasurably. It has been denied accreditation and students who have worked long and hard, are being compelled to do their clinical training at the Komfo Anokye and Korle-Bu Teaching Hospitals.

It was not supposed to be this way; the hospital was a component part of the late Dr. Kwame Nkrumah's accelerated health development plan for the nation, and was originally conceived with the aim of catering to the West African sub region by producing doctors, nurses, pharmacists and other skilled specialists. His overthrow by the military in 1966 temporarily shelved plans for the hospital but these were revived by the late General Ignatius Kutu Acheampong.

When it was finally completed in 1974 and opened amidst much fanfare and huge expectations, the hospital was sadly four times smaller than what was originally envisioned. Nonetheless, for almost 20 years, it met the health care needs of Tamale residents and also served as a referral point for the district hospitals in the region.

The precipitous decline of the hospital and its current struggles to survive point unmistakably to the apathy of authorities in Accra. Mention the hospital and its problem, and that is enough to drive officialdom into apoplexy. It bristles and then comes up with a list of arcane reasons to explain its ineptitude.

What is more, the slow-paced effort so far demonstrated by the central government confirms what many in the north already know, and that is, their region is always an afterthought, something politicians won't publicly acknowledge, but deep in the recesses of their minds they know very well that they are barely doing enough to close the never ending gap between the north and the south.

The UNDP representative in Ghana, Daouda Troure, even pointed to this divide in a speech launching Ghana's National Human Development Report for 2007. He observed that though recent progress in the country had led to the creation of wealth, its equitable distribution still remained a challenge (Ghanaweb. Feb. 13). I rest my case.

Troure went on to praise the government for allocating budgetary resources to promote development in the northern regions and its introduction of LEAP, the Livelihood Empowerment Against Poverty program. One just hopes that these are not band aids or stop-gap measures designed to win the hearts and souls of northerners in an election year.

Past and present administrations have been remarkably "generous" towards northerners in times of elections. So, it follows that in the 1990's when it was in control of the national purse, the NDC administration widened and redid all the roads in Tamale, but inexplicably neglected to redo the hospital.

Its successor, the NPP, desperate to reverse its political fortunes in a place that has come to be regarded as its electoral Waterloo, got the Chinese to build a spectacularly beautifully sports stadium just in time for the recent African Cup of Nations, but it has been excruciatingly slow in finding funds to restore the hospital to its former status. Talk of misplaced priorities and the above are glaring and inescapable instances.

Many have blamed northern politicians for not being proactive on the hospital's misfortunes. But this is completely misleading. Contrary to widely held opinions, northern policy makers have been very vocal. Let's be clear eyed here; the political fortunes of the northern regions have risen over the years and with it the clout of northern legislators. Though they suffer from ideological sclerosis, politicians of northern extraction have always managed to forge a united front on issues of common interest to their constituents.

In passionate speeches before Parliament in 2006, representatives Haruna Iddrisu and Edward Salia both of NDC, and John Ndebugre of PNC appealed to the Parliamentary Committee on Health to double its efforts in finding solutions to the hospital's problems.

Without doubt, northern lawmakers have been at the high table - source of power - long enough to force action on the hospital. Whether the central government pays heed to their emotional pleas is the fundamental question. And northern politicians are not the only group frustrated by the lack of concrete action. In an email response to questions posed by a northern association (Timyutaba) in New Jersey, a top hospital official had this to say about the central government's ambivalence.

"The situation is quite serious and huge to describe. We still therefore look to anybody or group of persons who can come to our aid while we wait for the government. The problem has now reached a point that current management finds it difficult to solve the problem from our own resources."

Not unexpected, the sorry state of the hospital has generated outcries and rage. Indeed, the anger and frustration culminated in a spirited demonstration by the city's youth last year. They asked the government to fulfill its promise to upgrade the hospital.

But the government's response was tepid and less substantive; the usual promise to renovate the old hospital and construct a new one was parroted by officials. Promises are just that, promises and nothing else. While politicians wring their hands and can't seem to come up with practical solutions, it must be stressed that the need for a modern and well-equipped hospital becomes urgent in light of Tamale's rapidly exploding population.

With increased migration from rural areas----confirming a recently released report by the London School of Economics and the Deutsche Bank's Alfred Herrhausen Society, which asserts that during the next three decades, more than 80 percent of the world's urban growth will take place on just two continents; Africa and Asia---the population of Tamale has swelled, leading to an exponential growth in the demand for quality and adequate health care However, with a dilapidated public hospital and few private clinics, the health care system would be overwhelmed and not be able to meet the needs of Tamale residents with the urgency and timeliness they deserve.

In its glory days in the first decade of its existence in the 1970's and early 1980's, the hospital was a spectacle to behold. Sitting on several acres of land in the northeastern corner of the city, it boasted meticulously clean patient wards, well-equipped surgery rooms and laboratory, a fully-stocked pharmacy and an adjacent nursing school, all complemented by an eminently qualified staff of specialists, doctors and nurses. Indeed, moral at the hospital was high, and the atmosphere was constantly punctuated by the hearty chatter of workers diligently going about their work.

Oh yes, it was heartening to walk into the hospital with a health complaint. I vividly recollect (in 1975) sitting in the dentist chair at the dental clinic to have a painful tooth pulled out. The attending dentist was coddling and overly patient with each squeamish reaction to the drilling probe into my tooth. "Open your damned mouth," he playfully interjected as the procedure went on.

When the dentist mercifully wrapped things with an injection into my pink red gums, I walked out of the clinic with a healthy set of teeth. Needless to say the treatment was free, and to note with immense pride and certainty, like many Ghanaians who grew up in the 60's and 70's, I have not had extensive dental work in almost two decades, testimony to the incredible efficiency of the then health care system in Ghana.

In the 1980's however, as the national economy showed signs of strain, the hospital began its slow decline. Forced by the IMF to adopt a structural adjustment program that was hugely unpopular in some circles, the government withdrew its subsidies for public hospitals.

The pay as you go system failed to generate enough capital to run the hospital. Consequently, the good doctors who once plied their trade in its wards had either retired or moved into the lucrative private sector. Specialists and nurses set their eyes on much more rewarding jobs overseas. Successive governments simply took their eyes off the hospital and things have never been the same again.

Yet another narrative about the Tamale General Hospital, some may say, tired and needlessly repetitive, they may add. However, given the unexplained reluctance of administrations, past and present, to find lasting solutions to the glaring problems at the hospital - despite all the promises made - it is appropriate to continuously prick their minds with riveting narratives.


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