By Allieu Sahid Tunkara
The fact that Sierra Leone can boast of only one virologist, one pathologist, one psychiatric expert, the list goes on, confirms that the health sector is faced with shortage of enough specialist medical doctors that could respond to the health needs of the growing population.
The matron at the Connaught Hospital told Politico that the terms and conditions of service for medical doctors are not good enough to retain them. The matron’s penetrating statement is bolstered by the beggarly salaries medical doctors in the country are paid. Prior to the pronouncement of the Free Healthcare Initiative on 27th April, 2010, a medical doctor was given the sum Le 500,000 the equivalent US$ 110 (one hundred and ten U dollars) as his take home package. In addition to the miserable salary, accommodation for medical personnel is also poor. This situation, according to Matron Isatu Kamara, is largely responsible for the massive brain drain the health sector is currently experiencing.
A great percentage of Sierra Leonean medical doctors are serving in overseas countries in Africa, the US and Europe where they can have better emolument to take care of themselves and their families. The country has been grappling with the shortage of medical personnel from time immemorial. The situation has been worsened when 12 of the country’s specialist doctors succumbed to the Ebola virus. According to the Vice Chancellor of the University of Sierra Leone, Professor Ekundayo Thompson, most of these medical doctors are lecturers at the College of Medicine and Allied Health Sciences which is one of the constituent colleges of the University of Sierra Leone. He said he was working with the government to see how foreign medical doctors could be flown into the country to fill the vacuum in the short term. ’’It cost the government several million of Leones to train a medical doctor,’’ Professor Thompson said at the launch of a joint Ebola vaccine study between the College of Medicine and Allied and the United States’ Centers for Diseases Control.
When the All People’s Congress-led government took over the leadership of the country, it made strong promises that it would strengthen the health sector through capacity building and the provision of good salaries to the medical personnel for quality service delivery. In the government’s Agenda for Change policy, the health sector is mentioned as one of the five pillars that government would pay attention to. The implementation of this policy saw an increase in salaries of health workers as doctors are now paid Le2, 500, 000 equivalent US$600 and nurses are paid the sum of Le 1, 000, 000 equivalent to US$200, backed up with the construction of several hospitals and health centres to boost the health sector.
Considering the inflationary trend in the country, the salaries for these medical officers is just a drop in the ocean. To supplement these salaries, very senior doctors and officials of the Ministry of Health and Sanitation have been caught up in some corruption scandals. Some of them have been going through trials in the law courts.
Corruption in the health sector became evident when the former Ministers of Health and Sanitation, Dr Sheku Tejan Koroma and Haja Afsatu Kabba were arrested and convicted. This situation has lowered the morale of the medical doctors and most of them have left the shores of Sierra Leone serving in other nations.
Today, the effects of the migration of these doctors are visible in the country. An example is the inability of most Sierra Leoneans with serious health problems to access local treatment as the required specialist doctors are not available in the country. We have witnessed several situations in which Sierra Leoneans have been flown to Ghana and other countries to secure quality medical treatment. Even civil servants and other government workers are taken to several countries for medical treatment especially those with cardiac and other complicated health problems. For instance, few years back, a certain police officer called Ibrahim Keita was flown to Ghana for medical treatment following an injury he sustained on his scrotum when he was head-butted by a cow. Such situation makes it impossible for the poor to access medical service outside the country considering the cost involved.
This way brain drain has left behind a broken health system as many people have died of many curable diseases. This claim is lent credence to by a research conducted by Dr. Katie Hampson, a research fellow at the Scottish university of Glasgow in the institute of Bio-Diversity, Animal Health and Comparative Medicine, who found that 500 people died of rabies every year in Sierra Leone. These deaths could have been preventable if there had been a heavy presence of qualified medical doctors, the research found.
All these deaths have an impact on the human resource base of the country. It is not a surprise, few years back, that the international community rated Sierra Leone as the country with the highest infant and maternal mortality rate on the African continent second only to Angola.
This situation badly affected Sierra Leone`s standing in the United Nations Human Development Index as the country was ranked bottom.
Jonathan Abass Kamara, communications officer of the Ministry of Health and Sanitation, said because of all these problems in the health sector, Sierra Leone was not likely to meet the health related Millennium Development Goals (MDGs).
The MDGs are governance indicators which nations pledged to achieve by 2015. One of its integral components is the building of an improved health system, for which Sierra Leone has evidently failed woefully.
Even with the conditions that existed before the outbreak of the Ebola Virus Disease it apparent that Sierra Leone was only struggling to catch up with other African nations. The Ebola virus has just come around and damaged everything and exposed the dysfunctional state of the country’s health system.
The fact that the virus rapid took a foothold in the early stage of its eruption is largely attributed to the presence of only one virologist in the country, Dr Sheik Umar Khan, attached to the Lassa fever unit in Kenema Government hospital, east of Sierra Leone. He eventually succumbed to the virus and died few months following the outbreak.
The absence of qualified medical doctors in the country has deprived the government of sound health advice and policies in the ministry. This was clearly evident by the response pattern of government to the Ebola outbreak in the initial stage. It is also possible that government will respond the same way for any future outbreak if actions are not taken immediately to change the situation.
In its attempt to bring Sierra Leonean technocrats into the country who are operating in the diaspora in various fields including medicine, the government has established a unit known as ‘Office of the Diaspora’ in the Public Sector Unit, placed directly under the supervision of the Office of the President. This office has recorded some achievements, but much difference has not been brought to the health sector.
The Sierra Leone government therefore needs to flex its muscles in order to put up a vibrant health system that can stand the test of time as this is the first West African country to have a medical doctor in the person of J.B. Horton.
Again, Professor Peter Piot, the Belgian scientist who discovered the Ebola virus has not ruled out future outbreaks.
(C) Politico 14/07/15
