Earlier this year, I lost my grandfather-in-law to a short illness. He had lived a long fruitful life and my memories of him where those of smiles and laughter. When I first met him, everyone called him Baba, so I found it easy to follow suit. His last days were tough…very tough. However, I found myself privileged to having met him.
This story is however not about my grandfather-in-law but about medicine. When I say medicine, I also do not mean bitter pills forced down one’s throat with syrup coating to mask the taste but the noble profession.
There is an ongoing debate on Gambian social media triggered by an accident and the eventual death of the victim. It has rekindled a debate that has for long existed not only in The Gambia but around the world. “How healthy is health care?
” A friend of mine narrated a sad and hair-raising story about a woman who lost her life due to the negligence of a nurse and the lack of doctors at an accident and emergency ward of a medical establishment. The next day, a doctor friend of mine refuted the allegations and brought their own side of the story. Whoever is right in this scenario doesn’t negate the fact that healthcare in The Gambia raises questions that need answering.
When our dear Baba started showing signs of ill health, arrangements were made for him to be taken to a medical establishment I had sworn I would never visit again. It was here that one of our most experienced medical doctors misdiagnosed my wife. What she suspected to be early signs of pregnancy was diagnosed as an infection. She was prescribed a couple of antibiotics that would be almost impossible to pronounce and was set to get on with taking them. Luckily for her, mother’s instinct took over and she decided to look for a second opinion.
This was not my only bad experience. Prior to that, a niece of mine was rushed to this same establishment as she showed early signs of malaria. In her condition, she threw up on the floor and instead of assisting in cleaning up the floor, the cleaners of this highly priced private clinic decided it was their duty to discipline the family by handing the mother a mop to clean the floor. I almost lost it that evening…come to think of it I think I actually did. I didn’t get it. I couldn’t get it.
On the day Baba was taken to the clinic however, I saw the other side of our healthcare system. Three doctors rushed in to check on him as he was wheeled into the clinic. Every detail was looked into…every procedure followed. A family that should have been frustrated and perplexed were calm and collected because the men and women of this noble profession allowed the ethics and positive practices of medicine to take hold.
That day I could tell that the old man was saying goodbye to his family but there was such pride in watching young doctors do all they could to keep him with us. Days later the inevitable would take course and he would take his last breath. One of the doctors reached out to the family to offer his condolences and to apologise for not being able to keep him with us.
In Complications: A Surgeon’s Notes on an Imperfect Science, Atul Gawande writes “We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.”
I have said in a previous essay that the most difficult things to be in countries like The Gambia are a medical practitioner, an engineer and a genius. The first will be held responsible for things out of his or her control. Patients do not want to know that the procurement department is on cost-cutting measures and therefore gloves are being recycled. We do not care about the fact that someone forgot to put fuel in the power generator. It is not our concern that the cleaners haven’t touched the floor for days. It is certainly not our business that the clinic or hospital have neglected standard doctor to patient ratios and that these people are being overworked and in some cases overlooked.
When we walk into a medical establishment, we go in with the hope that our problems will be solved and our ailments will be cured. Excuses will not cut it. It is a tough responsibility to take but it is one that every medical practitioner should be prepared to shoulder. It must be clear that the key word in healthcare is care. We will also not understand why someone would spend years going to the school of nursing and showing that this is something they would want to do for the rest of their lives yet show with such passion that they hate dealing with patients.
Now I am in no way defending our men and women in white (or green….or blue). My worst experiences have been in our clinics and hospitals. A nurse almost spat in my face once. Later she would recognise my face and ask me who I was. It turned out we were Facebook friends. Lucky me!
In my short lifetime, I have gone under the knife a couple of times. On those occasions surgical procedures were conducted on me by Dr Jones (the older one…the male one). A generation later, he has conducted a similar procedure on my son. There was such professionalism in the way he conducted himself around me and my family. Our little boy would smile anytime he was around. At one point he almost inspired me to quit my job and go to medical school! On the other hand however, I have witnessed and experienced such arrogant (and sometimes ignorant) responses and reactions from people in the medical profession that being on their side can be a tough pill to swallow. I however find comfort in the words of Atul Gawande…that constant reminder that fallible individuals wear the coat.
So as a people where do we draw the line between reasons and excuses. When do we accept things as the doing of the Almighty and when do we hold practitioners accountable for negligence…because negligence does occur frequently. We have all heard the story of the nurse that refused to attend to the former president’s mother because she was watching Maria de Los Angeles. Okay…truth be told, that telenovela was the bomb!! Orquidea Cordoba Escalante never forgets a favour! I mean how many telenovela have you seen that has a man with one hand being mayor! Every girl and their mama (excuse the slang) was in knee length boots. That was perhaps the sexiest era in our history! Okay I feel I am getting excited reminiscing on the past.
For a country that believes so much in Dogali Ya’Allah, someone must take responsibility for fixing these deficiencies. In the 21st century deaths should be explainable. How long will we continue to say, “Bilai teh febaarut sah deh. Xaleh bu ndaw. Dara jotu kor. Wakhtoma jot rek. Ndeysaan”. Our good doctors and nurses must acknowledge the fact that the sack of potatoes is not all good. I have enough friends in the profession to understand that it is a tough responsibility and one which has more cons than pros. Medical establishments around the world continue to battle on the balance between creating a sustainable business and providing affordable healthcare.
However, our humanity must never be absent. If Nawec engineers, technicians and managers make a mistake we probably lose power for a while. If our medical practitioners makes mistakes, people die. There must be a special setup to look into cases of negligence and poor medical practices if good practitioners will be rewarded and bad ones punished. Things yi fokk nyu demm…