U.S-based Ghanaian Medical Doctors, Nurses, Allied Health Practitioners to Volunteer Services in Ghana During Vacation

By R. Y. Adu-Asare
AfricaNewscast.com correspondent
(First published on) Friday, April 20, 2001, Washington, DC


There was a resounding and spontaneous "yes", in unison, as a small group of Ghanaian medical doctors, two nurses and some allied health practitioners responded to the question: "Now, is the question of volunteerism acceptable to all?" The questioner was Dr. R. W. Anane, Ghana's new Minister of Health.

Hon. Dr. Anane who serves also as a Member of Parliament, MP, (NPP-Kumasi), in a little drama, posed the question about volunteerism at the climax of an informal discussion he had with a few Ghanaians resident in the United States, at the Ghana embassy in Washington, D.C., Friday, April 20. The focus of the discussion was about how to resuscitate Ghana's healthcare delivery sector.

Dr. Anane detailed the life-threatening state of Ghana's healthcare delivery service, including heart-breaking statistics. He appealed solemnly to the handful of Ghanaian medical doctors at the forum to go home and at the minimum, "share your knowledge with your colleagues; share the new things you have learnt abroad with those at home."

Rather than lamenting over "brain-drain" from Ghana, Dr. Anane is convinced the country should take advantage of "brain-in", whereby outward bound talent returns more refined to contribute at a different level. In this instance, Ghana must stand to gain from its medical doctors practicing abroad who received basic training in the country and are likely to have had specialist training elsewhere.

Dr. Anane in the United States for a World Bank-sponsored conference on the global fight against malaria, quipped that any and all contributions by Ghanaian doctors abroad will be considered as payback for the cost of training them in Ghana.

Dr. Anane announced two initiatives to help the retention of Ghana trained medical personnel in the country. Before the end of 2001, Ghana would have started a post-basic training program for nurses and allied health personnel. Also, plans are well advanced in setting up post-graduate medical training in Ghana. "But who is going to teach them?" Dr. Anane asked.

Responding to his own question as to who is going to teach the post-graduate medical students, Dr. Anane told the Ghanaian medical personnel present at the forum, "My hope is in you." He emphasized, "I have a lot of confidence in you."

According to the new Minister of Health, "If we train more then more can be retained," referring to the tendency for Ghana trained medical personnel leaving the country to sell their services abroad to higher bidders.

Another initiative toward enhancing healthcare delivery in Ghana, according to Dr. Anane, is that "Government has decided to introduce a risk-sharing insurance scheme" based on traditional social safety net approach of each being a brother's keeper. He explained that Ghanaians are familiar with the principles of pooling community resources for funerals, for example, and the same could be applied to a health insurance scheme.

Dr. Anane admitted that Ghana has a poor health care delivery that is linked up with the weak state of the national economy that has gone through some restructuring in the past few years. As a result, Ghana was compelled, in 1985, to introduce a "cost recovery" policy in healthcare provision through a system of "cash and carry."

Because of the cash and carry policy, poverty has become a leading problem of healthcare delivery in Ghana since people wait until the last minute to access health service. He pointed out that "sometimes delayed treatment for patients becomes difficult and too late for doctors."

Despite the poverty-related problems associated with the current healthcare delivery service in Ghana, the New Patriotic Party, NPP, government has determined that the cash and carry policy is needed, hence the necessity for new ideas and external assistance, Dr. Anane explained.

Dr. Anane indicated that the NPP government, with affinity towards free enterprise economic system, has no aversion to any form of health insurance at any level, whether community, district, regional or national based. He stated that "Government will give a lead in the insurance scheme as a means of showing people wealth creation in healthcare financing.

Dr. Anane explained that "The idea of health insurance in Ghana is not a fait accompli," hence he is calling on Ghanaian doctors in the United States for suggestions.

According to Dr. Anane, currently, there are only 1,900 doctors left in Ghana to take care of a population of over 18 million. "There are only two anesthesiologists in Ghana, despite the fact that new hospitals with 'high tech' equipment have been opened." He lamented that there is no single pediatrician in the northern part of the country.

Dr. Anane said, "part of the slot in medical doctor shortage has been picked up by foreigners." At this point, Dr. Anane asked pointedly, "Do we always have to rely on foreigners?"

In making the case for the need for more hands in healthcare delivery in Ghana, Dr. Anane said, "The problem is not always with doctors." He pointed out that "Today one nurse has to take care of 37 beds," a ratio that is far above the World Health Organization, WHO, recommendation. In this instance, Dr. Anane asked the Ghanaians at the forum, "What can you do; what can you also offer?

To emphasize the point about the need for Ghanaian healthcare practitioners abroad to go home to help, he said, "I appeal to the core that links you to your home to come home and help your nation, even on vacation time." He noted that "The Jews returned to build Israel and Ghanaians must return to build 'Israel' in Africa."

"I believe by coming to you directly, you'd come back home and help," Dr. Anane implored the few Ghanaians present at the forum, some of whom had come from out of state.

When the Ghanaian medical practitioners at the Ghana embassy forum indicated willingness to volunteer their services in Ghana, Dr. Anane asked the embassy staff to take information from them for the preparation of a directory. At that juncture, Dr. S. K. Allotey, a Washington, DC-based medical doctor in private practice, informed the minister that "Ghana Health Foundation", already has the required directory. It was announced also that "Ghanaian Nurses Association", based in Washington, has a registry of its members.

Dr. Anane requested the Ghana Health Foundation and the Ghana Nurses Association to expand their directories to cover the whole United States.

Some of the doctors and nurses present at the forum, told the new minister of their frustrating experiences when they had tried to render services in Ghana during visits. In response, Dr. Anane pledged his "personal intervention to remove barriers to volunteerism." He indicated his readiness to establish a mechanism within his ministry to co-ordinate the volunteer service in co-operation with the existing organizations.

In response to a question regarding excessive bureaucracy and duties associated with clearing donated medical equipment through Ghana Customs and Excise, Dr. Anane pointed out that there is specific language in Ghana's 2001 budget streamlining the process of donated educational and medical equipment. He indicated that on the basis of the budget provision, the Ghana embassy should be in a position to facilitate the ease of donating educational and medical equipment to Ghana.

Where necessary, the Minister of Health asked that his office be contacted directly for assistance in clearing educational gifts. He indicted that according to 2001 budget statement, there should be no tax on educational gifts under a provision of "educational gift system."

When the question of urban sanitation in Ghana was raised, Dr. Anane explained that the problem needs to be solved through a multi-sectorial approach between his ministry and others such as the Ministries of Housing and Local Government. He said, "The provision of disease prevention services is multi-sectorial; my job is to hone in on the specific."

In connection with inadequate urban sanitation, Dr. Anane pointed out that "Ghana's problem is not only poverty but also management." He announced that "Services at our institutions are going to be on contract, whereby non-performing contractors will be kicked out." According to him, Pres. Kufour and his entire cabinet took a weekend course in management at the Ghana Institute of Management and Public Administration, GIMPA.

There were signs of consensus among the assembled Ghanaians that maybe compensation and benefits for medical doctors and nurses need to be raised. Dr. Anane responded, "We are taking care of that--- we want to avoid the Mustapha Syndrome." The "Mutapha Syndrome" refers to a hard working medical practitioner in Ghana who retired in poverty, according to Dr. Anane's explanation. He cited other instances of medical doctors whole retired in poverty and cautioned that that experience is not worthy of emulation by prospective medical doctors.

"We want to create a new environment where a young doctor will know that at the end of service he would have a two-bedroom house," Dr. Anane indicated.

Kwadwo Nketia, a Ghanaian research economist employed by the United States government agreed with most of the ideas generated by Dr. Anane. He said the idea of multi-sectorial approach to solving urban sanitation problem in Ghana is especially useful because of the benefit of "multiple effect". However, he is of the view that Ghanaian doctors must be given the same compensation and benefits as their foreign counterparts. Nketia is based in the city of San Francisco.

Please submit all comments to: Adu-Asare@erols.com