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Opinions of Sunday, 3 June 2018

Columnist: Alexander Kwakye

The frustrated healthcare professional and quality healthcare

I visited a hospital last week and came across one old lady who should be close to eighty years. As the bell chimed to usher the next person into the consulting room, she dragged her buttocks on the waiting bench, with her head resting on her walking stick. Her attendant, a teenage boy, stood by her holding a carrier bag in which she keeps her medications and other relevant medical documents.

When it was her turn to be attended to, there was a patient in one of the wards who needed an emergent attention so the clinician left the consulting room to the ward. It was a weekend, and there were only two clinicians on duty in a hospital which could serve more than three hundred patients in a day.

You can see the frustration in the clinician’s face as he walked down the lane to the ward. You could sense that he is stressed and tired. It is only fair that he receives remuneration equal to the efforts, energy and commitment he puts in taking care of the sick. But that is not the case; the clinician’s salary and conditions of service cannot be compared to other non-vital jobs.

Until recently, not a year passed without a headline on doctors going on strike or at least threatening to go on strike if the government failed to provide certain conditions. That is not happening now because, I suppose, firstly, that these conditions of service and salary discrepancies have been met.

Another reason could be that, perhaps clinicians have grown weary of the government and have given up the fight for any improved conditions of service; the passion to save human life being their only motivation, which is unlikely, given that there are many medical practitioners who contribute to policy making in the country and could easily lobby for these conditions of service to be implemented.

Besides, medicine is a vital aspect of human life; without it, humans have no chance of survival, so the government has to accommodate conditions spelt by providers of such service.

Recent advancements in medicine have placed much emphasis on disease diagnosis. Indeed proper diagnosis is the surest way of administering proper treatment of any disease. In Ghana, disease diagnosis used to be based largely on clinical history and some cut-and-dry diagnostic tools, performed by on-the-job trained personnel. Today, there have been improvements.

Disease diagnosis employs a lot more sophisticated technologies performed by trained and accredited personnel, including the sonographer, radiologist, the laboratory scientist among several others, collectively referred as ‘Allied Health Professionals’.

The laboratory scientist in particular has been instrumental in modern health care provision, performing assays necessary for diagnosing various diseases such as cancers, and also for monitoring the course of treatment of such diseases as HIV/AIDS, Hepatitis B and others. As there continues to be improvement in health care, laboratory science would prove to be even more inevitable, especially as disease diagnosis shift towards proteomics and genomics.

The demand for highly-skilled, knowledgeable scientists would increase; perhaps this is why the current laboratory scientists are fighting for better conditions which could position them in a prepared state when that time comes.

As it stands, the medical laboratory remains largely unattractive. Laboratories are under-staffed, and where there are laboratory scientists, they receive lesser salaries, comparing to other health professionals with similar qualifications. In addition, reagents, and other materials necessary to perform laboratory procedures are lacking. Facilities are not properly maintained, among several other threadbare conditions have made the laboratory an unpleasant place to work.

The laboratory is a promising area which needs to be developed if, as a nation we want to improve the quality of healthcare. I believe that the leaders of Ghana Association of Medical Laboratory Scientists (GAMLS) assessed these problems keenly, and requested the government ensures the creation of directorate for medical laboratory to manage the laboratories. Also, they have called on the government urge managers of health laboratory facilities to create a revolving revenue accounts so that the issue of inadequate funding drawing laboratory practices back would be resolved. Finally, they have asked that the discrepancies in the wages of laboratory scientists should be solved. I believe that these are legitimate requests which could be easily implemented, at the loss of no one, but rather, the laboratory scientists would work happily, and more importantly, the healthcare system would improve drastically, with improved disease diagnoses.

In two decades or so ago, these proposals would have been considered next to invalid. But things have changed; there have been much enlightenment in the health sector, and the country as a whole. As our culture continues to change, we should be prepared to assimilate new ideas and ways of doing things, and not cling on to obsolete ways.

When the new generation of disease diagnosing, principally, involving the use of genomic tools become of use in Ghana, laboratory scientists should be proficient enough to embrace them. Moreover, the laboratory needs to be properly managed, and adequately funded.

As I was leaving the hospital, the old lady was waiting in front of the laboratory for her test to be done. Inside the laboratory, there was a scientist going up and down searching for reagents to perform various tests for over twenty patients at that time. He is on duty alone, undertaking procedures of tests which could take several minutes to hours for all patients present. He is expected to do this in a timely manner, all alone. He is frustrated and worn-out.

As I got out of the hospital premises, I looked back at the building and sighed; this building is full of frustrations and agitations. These frustrations, I believe did not start recently. When the news of nurses and other professionals’ abuse of patients broke out in the past, the defense was that they did so out of frustration. These struggles would continue as long as the health sector continues to revolutionize. The earlier we solved them as a nation, the better!!