by Assan Sallah
The long-standing strike by doctors under the Ministry of Health and Social Welfare has become a major concern. The two week-long stand-off has put the country's health sector to a difficult state, with possibility of patients dying as a result.
Since it began two weeks ago, a lot of negotiations and efforts have all proved futile. Despite the Health minister’s apology to the doctors, they have continued to demand her resignation before they could resume work.
I am aware that the Secretary General and head of the Civil Service, Habibou S. Drammeh did invite the angry doctors to a meeting and advised them to go back to work, as well as reminding them that the Civil Service General Orders (G.O) do not permit them to embark on a strike. He said he is not threatening them but government will take further action to resolve the case.
As a concerned citizen who has been following the situation, which is apparently still deadlocked, I wish to share my opinion on what I think is the solution to the impasse.
First of all I would like to urge government authorities to launch an independent investigation into the Health minister's corruption allegations against the young doctors. This I believe will help put a definitive end to the ongoing strike, potentially mitigate corruption in the health sector, restore public confidence in the doctors and save lives of the patients admitted in the various hospitals countrywide.
However, the team of the independent investigators must not include any staff of the Health Ministry and it must as well not include any doctor serving in the public sector. They must be independent in order to establish the truth. The team could comprise of professional medical practitioners and the police.
While investigating this case, it is important to follow certain procedures and make certain considerations, such as the hierarchy in the Health ministry in order to get the desired result.
It is important to note that hospitals make request for supply of drugs (medicine) through the director of Pharmaceutical Services. The Department of Pharmaceutical Services has the right to supply drugs based on its availability at the Central Medical Store (CMS). The director is the boss of the Central Medical Stores.
According to the protocol of diagnoses in all hospitals, a doctor can only prescribe medicine to the patient but does not have access to drugs or to the Hospital Pharmacy. And for the admitted patients, it is the responsibility of the hospital pharmacist and the nurse on duty to administer drugs to them as prescribed by the doctor. This means that in a 'normal' setting, doctors have no access to drugs.
Pharmaceutical service delivery to hospitals
Anytime hopsitals make request for supply of drugs, it is the responsibility of the CMS to monitor how it is used. If the director of Pharmaceutical Services realises that the drug consumption at the Edward Francis Small Teaching Hospital (for eg.) does not balance with the supply, then he should cross check records of the supplies from the CMS and also the consumption in the said hospital (EFSTH). The results of his findings will enable him to write a report to the Minister or to whoever is concerned under the Ministry to inform them of the irregularities detected.
Regarding the allegations made by the Health minister, the Department of Pharmaceutical Services in collaboration with the Department of Health Services should have conducted an investigation first incase of any missing drugs. These two departments would have got clear evidence of any corrupt practice and would have passed this information and evidences to the Health Minister offically.
So long as this is not done, Mrs Saffie Lowe-Ceesay should not have made such allegation of corrupt practices against doctors. Although there is a possibility that drugs are being stolen, I think the right procedure has not been followed to establish this fact. Even if the right procedure was followed, the minister should have come out with concrete evidence to back her statement and pinpoint the accused doctors.
I am of the opion that the Health minister has made the allegations at the wrong place and wrong time. Her action has made things very complicated now and it will be more difficult to investigate this case.
Method of investigation
In my opinion, investigating this case requires putting into consideration some essential points. The investigation should begin from:
*The ordering of drugs by the Pharmaceutical Services from abroad,
*The storage at the Central Medical Stores in Kotu
*The delivery of supply to the hospitals
*The hospital pharmacies and,
*Consumption by the patients.
If all these areas are investigated thoroughly, then the investigators will definitely know where the problem lies.
Equally, this team should also investigate the Health Minister; ask her how and where she got the information as contained in her allegations. Then they can follow the channel and question whoever informs the minister. The list goes on and on….., etc.
Caution to the doctors on strike
As doctors, you should all remember the oath you have taken to safeguard the health of the patients in all conditions. So, a mere allegation must not warrant you to be on strike for two weeks, leaving patients in limbo. What happens to the oath you swore to?
Finally, I wish to commend the Gambia Police Force under the leadership of IGP Landing Kinteh for the great initiative he took to save lives in Gambian hospitals in this difficult moment. The IGP has deployed all the police medical doctors to offer help to the patients. Your role is to save life and properties and indeed you are saving lives. Thank you.
I wish to advise the government to consider appointing the right people in the right positions. Putting the right people in the right places is paramount in any national development. Key sectors such as health, interior, foreign affairs, justice, agriculture, education and defence, need professionals and specialists to man them for effective service delivery.
It is said that, He who feels it knows it, and the local parlance (wollof proverb) says, 'Sama katti mbota, mo ham bii chiy sohk', meaning, the frog rearer knows which one has an injury on the leg. Wasalam!
God bless The Gambia.