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Making systems work and the typical Ghanaian's selfishness

About four years ago, I got one of the greatest fulfilments in my profession. A specialist (obstetrician gynaecologist) in one of the big hospitals in Accra called me to thank me. "What have I done?" I asked. He responded: "You operated on a relative of a very good friend mine." He went ahead to tell me how the friend came to him and wanted him to call me before the surgery so that 'they would get good services.' He told her he had worked in Battor (for 3 months) and knew how we tried to make sure that clients were treated fairly without having to know anyone. The woman 'went through the system.' I happened to perform the surgery. Everything went well.

Ghanaians

One of my greatest frustrations as a medical doctor in Ghana (in my two decades of practice) is that most people don't believe they will get good services if they don't know anyone in a public institution. Even those who know that the system is fair want to get undue advantage over others by calling people they know so that they can jump queues themselves or do this for their friends and relatives. What they do not realise is that by doing this they create and perpetuate a culture where they themselves will suffer when they get to an institution where they do not know anybody. And for some people because of what they do, they believe the system can never be fair.

This puts so much pressure on workers in public institutions, not only in health. If the public institutions are understaffed causing long waiting times, why don't we work together to correct this instead of manipulating the system for only our benefit? Once we get what we want, everybody else can go to hell?

There is another side of this. In some institutions, the workers try hard to make the system difficult, so that they take advantage of it. People take illegal monies to give people unfair advantage. I know a hospital where some of the labourers work so hard to make sure that the lift does not function so that they charge money to carry patients to the wards upstairs. As long as the lifts don't function, they are guaranteed daily 'allowances'. Interestingly, these same people will complain when the same things they do are meted out to them in another institution.

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How do we solve this as a nation? Can't I tell my relatives and friends who use my institution to 'go through the system' and let me know what happens when they are done? Some of my relatives and friends get angry when I tell them this. They want to take advantage of the system because of me, but do not find it acceptable for others to take advantage of the system in other institutions where others have relatives and friends but they don't. What is good for the goose is good for the gander?

We are creating a culture by our actions everyday. What benefits us today may put us in a disadvantaged position tomorrow. If we all realised this, we may see the need to fight for a system that benefits everybody, not only those who have power or know people in the institutions we go to.

By Dr. Kofi Effah

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