Personal interest versus the general interest: The sad situation in Ghana

Wednesday, May 5, 2021.

Years ago, I had an interesting ‘disagreement’ with a colleague, an Obstetrician Gynaecologist who decided to skip a clinic in our hospital and send his mother who was unwell to see a Physician Specialist in another hospital. I thought another person could send his mother to the hospital, and that he had to be the ‘last resort’. My point was that in a country like ours with a shortage of doctors especially specialists, we have to try as much as possible to be available for duty. I asked him: “What will you do if you get to the hospital and the specialist you are going to see has also brought his mother who has a gynaecological problem to see you in your hospital? Both of you will miss the specialist services you are looking for, and might not only have made unnecessary trips but denied others of good services.”

I knew my stance could be provocative to many, but as I always say: Time will tell. Then one day a young doctor who was to start a duty at 8am could not be found when the duty started with patients waiting to be seen. When she was reached, her response was that she had been called at dawn that a very close relative was sick, and she had to dash home and take him to (another) hospital. She could not make arrangements for someone to cover the emergencies in her own hospital as she was away!

This was very surprising to me, and meant that the young doctor had not understood our ‘philosophy’. My first question (to her) was: “What would have been your reaction if you had gone to the hospital with your relative only to be told that that the doctor who would attend to him had rushed to take a sick relative to another hospital?”

Over the years, I have watched in sadness as the country has grown worse with a culture that puts self interest against the general interest of the society. Most people work hard to create a system that takes care of only themselves and sometimes close friends and relations. For example, those in authority who can get ambulances to serve the general public including themselves will first buy big cars (V8s) for themselves. When they need to get to places quickly, they put on their lights and are led by dispatch riders with sirens. The ordinary citizen stays in the heavy traffic. These people in authority therefore have no urgency to solve the problems of the society including the heavy traffic.

I know many medical doctors who work or have worked in hospitals where they are the only doctors. They face the ‘wrath’ of their families when they have to attend to patients on weekends regularly and cannot attend funerals and other social activities. Interestingly the same family members who ‘chastise’ these medical doctors get angry when they get to another hospital and are told that the only medical doctor there is off that weekend attending a social activity of his or her family.

Do health workers always have to leave their posts to send their relatives to the hospital? Sometimes even in the same hospital health workers leave their units and accompany relatives to other departments when a structured system will not require this. As usual, in our part of the world, ‘who you know’ comes first. Meritocracy is secondary. So if you are known as a health worker, being physically present makes it easier for your relative to be seen (at the expense of others).

When we have power, we have the option to create structures that take care of everyone or to widen the disparity between the ‘haves’ and the ‘have nots’ by putting self interest first against the general interest of the society. What we must not forget is that one day, we may end up on the other side with the general public and face the dysfunctional structures we could have corrected if we had not only sought our personal interest.

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