We are all Woyomes

Hello Ghanaians. I am sure that if Alfred Agbesi Woyome was paid 1 Cedi for every single mention of his name by Ghanaians, he could have, legally and morally, made more than whatever sum of money that he was purported to have been paid.

Over the past couple of weeks, Ghanaians from every corner of Ghana, and indeed the diaspora, have discussed at length, the circumstances and issues, surrounding the payments alleged to have been made to the esteemed gentleman. But to me, it’s a simple case of double standards at work nationally. Most of us discuss the log in Woyome’s eye, but ignore the specks in their very own eyes, pardon the twist if you may. To my simple mind, Alfred Agbesi Woyome hasn’t done any worse than what the average Ghanaian routinely does.

That is to benefit from the taxpayers largesse without necessarily working for it or deserving it.

Everybody in Ghana is asking exactly what quantum of work Alfred Agbesi Woyome put in, to warrant such a huge sum of money being shelled out to him. The irony of it is that, some of those asking that very question publicly, are people who routinely benefit from the taxpayer without necessarily putting in the concomitant amount of work.

Allow me to explain. Since the days of Kwame Nkrumah, the average Ghanaian mindset has slowly but surely been conditioned to expect something for nothing. The Ghanaian Government paid for people to go to school, the Ghanaian Government paid for people to go to University, the Ghanaian government paid for those graduates to pursue Graduate and post graduate programs abroad. The Ghanaian government guaranteed them jobs. The Ghanaian government paid for trips abroad, the Ghanaian government gave them houses, the Ghanaian government gave them cars, fuelled them and paid for drivers to chauffeur them around. The list goes on and on but basically an entire generation of Ghanaian middle to upper class functionaries have grown up, with their mindsets conditioned to expect certain perks from the government, as a basic human right. To those who might counter with the argument that such people work and as such deserve such perks, I put it categorically to them that the perks are simply disproportionate for the amount of work that those people put in or the value that such people create. I dare say that for such people, the amount of money taken from our GDP to support them far outweighs their contribution to Ghana’s GDP. Britain, with a GDP 65 times that of Ghana, does not give it’s Ministers Land Cruisers to ride in, neither does the UK taxpayer give their Ministers the option the purchase the government houses that they live in.

At the very top of the government pyramid, the same mentality prevails. A Presidential commission, legally constituted and populated by Presidential appointees, determines an overly generous package of retirement benefits for our ex Presidents. From houses, offices, flights, hotel accommodation abroad, staff and even vehicles, everything is paid for by the government of Ghana. I hereby ask the question again? Whatever work they put into their roles, is it commensurate with the benefits that they are slated to receive post retirement? Take a look at the United States and the United Kingdom. Even with their vastly larger resources, they are not as generous as we are when they are allocating state resources for the luxurious upkeep of their former Heads of States.

Further down the social ladder, those in the public sector, have the same Woyomic mentality. These government employees are paid every month to deliver on their jobs and render a service. They clamour to clamber upon the Single Spine bandwagon but still deem it their inalienable right to demand money from the public for the very services they are paid to render. To my simple mind, this is basically money they are not entitled to, have not worked for but are demanding and receiving.

So the next time you hear or see someone castigating Alfred Agbesi Woyome remember where he works and the perks he enjoys by virtue of where he works. And make your mind up accordingly.

That is assuming that you yourself are not a Woyome.

Institutionalizing Compassion and Professionalism into Health Care

The old man who inspired this article ( head bowed )

Two days ago, I attended a funeral of a friend’s father. After several hours at the funeral, it was time to leave, so our grateful friend, a Ghanaian Doctor based in the United States, accompanied us out of the funeral grounds. At the car park, as the seven of us indulged in some pre departure small talk, we heard a loud thud. We turned towards the source of the thud and saw an old man, clad in funeral attire, lying prone in the dust beside a bench he had obviously fallen off.

Within one tenths of a second, my brain had processed the entire scene and come to the conclusion that the man must have been drunk. I turned away from the scene to continue the conversation. But not the Doctor. He took one look at the scene and walked over to the man lying in the dust. Shamed into action, I followed him. As I got to the scene, the Doctor was struggling to lift the old man into an upright position. I joined him and we seated the gentleman back on the bench. The Doctor started asking questions . . .”Are you alright?”, “ Do you have a headache?”, “Has this happened to you before”, “Are you on medication?”. For a split second, I thought I was participating in a real life episode of Grey’s Anatomy. The old man initially dazed did not answer but when he did, a gust of “fuse” burst out of his mouth and into our nostrils. As if to confirm what our noses had already told us, he declared that he was only drunk and that there was nothing to worry about. With that we wiped the dust off his face and clothes and with obvious reluctance the Doctor walked away, followed by myself.

The entire episode did not take more than five minutes but those five minutes highlighted and underlined the glaring difference in Medical Care, Medical ethics and patients rights between Ghana and the United States. Most Ghanaians have stories to tell about the lack of compassion and professionalism, exhibited by Ghanaian Health Professionals towards their clients, i.e patients. Many a Ghanaian has a story to tell of friends, relatives and loved ones who have died avoidable deaths in Ghanaian hospitals. In most of these situations, a slight dose of professionalism and compassion would have saved Ghanaian lives.

Ghana trains many Doctors, some of whom stay in the country to work, others who emigrate to other countries to practice their medicine? I have always wondered why, the same Ghanaian Doctors, excel out there and are more compassionate and in many cases, more professional than the colleagues they left behind in Ghana? My Doctor friend had been trained in Ghana by those, and together with those who currently man our health system. He left for the United States 10 years ago and obviously had entered a system that had institutionalized compassion and care. By working within the American Medical system and doing what the “Romans” did, professionalism and compassion had been imbued in him. It was second nature, almost reflex for him to react the way he did, irrespective of geographical location. The saddest aspect for me was the fact that if he came back to Ghana to work in our health care system, this work ethic would slowly evaporate and he would become as ______________ as the health care professionals here in Ghana. I leave you, the reader to fill the blanks as you see fit.

My hypothesis is that the framework that exists out there, has institutionalized compassion and respect for patients rights in a manner that simply does not exist here in Ghana. We need to replicate this framework here.

What is this framework? Basically United States Congressional law protects and ensures the right to quality medical care and the right to informed consent. These laws essentially provide patients with rights and enjoins Health care providers to guarantee those rights. The first Hospital Patients Bill of rights was drafted in 1973 and must be posted in the corridors of accredited hospitals in the US. It includes 12 basic rights, namely:

1. A patient has the right to considerate and respectful care.

2. A patient has the right to receive complete information from a physician about a patient's diagnosis, treatment plan, and prognosis.

3. A patient has the right to obtain information about the specific nature of a proposed treatment or procedure, a disclosure of the risks involved, and information about medical alternatives.

4. A patient has the right to refuse treatment and to be informed of the medical consequences.

5. A patient has the right to privacy during discussion of one's medical condition and while undergoing medical care.

6. A patient has the right to expect all records related to medical care will be kept confidential.

7. A patient has the right to expect that reasonable efforts will be made to respond to the patient's request for services, and that the patient will not be transferred to another medical facility without advising the patient of the need to be transferred and without ensuring that the new facility will accept transfer of the patient.

8. A patient has the right to obtain information about the relationships amongst care providers in the hospital and related medical and educational institutions. This is designed to protect patients from conflicting interests that might affect quality of care.

9. A patient has the right to obtain information about human experimentation and research that might affect treatment or care, and to refuse to take part in such experimentation and research.

10. A patient has the right to expect reasonable continuity of care. This is meant to assure the patient that, for example, diagnoses will be followed up with continued treatment.

11. A patient has the right to examine and receive an explanation of the hospital bill.

12. A patient has the right to be informed of hospital rules and regulations that apply to patient conduct.

These rights, combined with:

• The Hippocratic Oath

• American Medical Association Principles of Ethics

• American Nurses Association Code

• Federal Emergency Medical Treatment and Active Labor act 1989

• Patient Self Determination Act

• Medical Malpractice Precedents established in courts

have combined to ensure that the highest standard of medical care is given to each and every patient in the United States. Basically US Law and Medical ethics require a Health Professional to provide comprehensive treatment to a patient who is presented at a medical facility and/ or find another medical professional who can. Anything less than that and you could be open to a Negligence or Medical Malpractice lawsuit. I submit that there is nothing like this to inculcate professionalism and compassion into any Health Professional.

If Ghana could replicate to an appreciable extent, the above framework, customized to our peculiar context, we could create the foundation for a total revamp of our health care system. Recognition by health professionals, that patients have rights, can transform the Doctor-Patient relationship from an authoritative and paternalistic one to one where the quality of medical care is enhanced and both sides form a partnership to achieve the goal of universal health care.

To the average Ghanaian Health Professional, all this will be scoffed at and regarded as being too "book long", inapplicable and unnecessary. But this framework, with enforcement, provides benefits to both patients and hospitals. It guarantees the patient quality and appropriate health care and ensures that in the long term, with enforcement, the health profession and professionals deliver on their objectives as well as the Hippocratic Oath.

It is my hope, that somehow,the Executive and Parliament of Ghana will establish a legal framework emanating from our Law of Tort, to create the necessary foundation from which to build a healthy Ghana. We owe it to our friends, relatives and loved ones, who died avoidable deaths.