16 December 2016

Africa's avoidable deaths

A couple of weeks ago, Kervin Kofi Moses, a 15-year old student of Ghana's Achimota School, died at the 37 Military Hospital after falling ill at school. His distraught mother called for the school to be closed down because school authorities were negligent in his death. This story hit me hard, maybe, because I have a son of the same age.

In truth though, the needless death of this boy was not an isolated incident. In 2012, I was involved in the care of a post-partum patient at Interbertin hospital in Cape Coast who died. Amongst other things, we could not get labs on weekends while the patient was on a ventilator!
A few months before then, I walked into a Healthcare post at Moree in the Central region of Ghana and found a two and a half-year old boy who had mental status changes and was on a blanket quietly waiting to die because his mother could not afford transport to send him to a hospital in Cape Coast.


Some years before then, in Tamale, the Dean of a Medical School had an Asthma attack and died because the regional hospital had no oxygen!

All across Africa, every morning and evening, stories are recounted of people dying in hospital after a short illness. For me, the one that takes the cake is that of the man admitted with a lung infection in "stable condition" who was dead in his hospital bed the next morning with no contact from staff throughout the night.

These are, of course, the stories of those who get to our hospitals.

There are, tragically, the many more who die of cholera and malaria and Tuberculosis and motor vehicle accidents and and childbirth and other illnesses without making it to our hospitals.

It would seem that these avoidable deaths do not just burden the poor.

In April 2012, Malawi President Bingu wa Mutharika died in Malawi. For days, it was not clear whether he had been flown to South Africa BEFORE or AFTER death.

A few months later, Ghana's President John ATTA-MILLS collapsed and died after a check-up after which he jogged on the tarmac of the Kotoka Internacional airport to underline his fitness. When he collapsed, there was confusion and his government was forced to prevent a coroner's inquest that may have caused embarrassment.

When General Abacha took ill in June of 1998, his military aide wasted previous time asking the gasping and unresponsive Abacha for permission to touch him before belatedly summoning his personal physician instead of an ambulance. Of course, he died.

When Ghana's senior statesman, P.V. Obeng had an Asthma attack beside a major road, he was transported to a hospital in a taxi, not an ambulance. Of course, he died.

Now, before proceeding to solution, let me get rid of some myths.

First, the deaths in hospitals are not all due to lack of equipment. Sometimes, they are due to poor leadership and lack of accountability. President Kufuor left Kumasi with the most modern Emergency facility in all of West Africa but a few years after, one after the other, 9 of 11 ventilators were allowed to break down without any effort to repair them while hospital executives stood by idly. 

Not one hospital executive was fired. A few years ago, when over a hundred and fifty Ghanaians perished in fire and floodwaters, not a single official resigned or got fired.

Second, when one has a medical emergency money's usefulness is limited. When Sekou Toure became ill with what was a heart attack, he was flown to the Cleveland clinic for surgery. It was too late.

What should we do?

First, we must build preventive and emergency Healthcare systems.Too many of our loved ones die from cholera, accidents and dirty environments.

Second, we must maintain the facilities we manage to build. 

Third, we must have systems that execute. Hospitals are not just buildings and equipment. They are, even more than these, committed, well-trained accountable people who deliver timely, compassionate care.

Fourth, our leaders must respect and patronize the very systems they build for the rest of us. It is demoralizing for the President of Nigeria to spend billions of Naira to travel abroad for treatment of a ear infection when Nigeria has 250 Ear, Nose and Throat specialists and a National Ear centre. Dr. Enabulele of the Commonwealth Medical Association was right to describe this as "a national shame".

Fifth, we must have rational systems. A health insurance system that will pay for breast cancer treatment but not for mammograms or for Diabetic care but not for Hemoglobin A1c is not rational.

Sixth,we must put the sick ahead of the dead in our society. Too often, we seem more eager to give the dead proper burials than to give the living proper care.
To achieve all these, wherever we are, let us demand the best of our governments, devoid of politics. It is an affront to our dignity that even the progress we have made against diseases like AIDS and Ebola have been due to the generosity of others.

Death and diseases have no partisan colours and we must fight them together.

Let's raise the value of life in Africa together.

Columnist: Arthur Kennedy

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