Growing up back in the village the hospital as I knew it was my grandma’s fingers! Ginger was the universal medicine for all childhood diseases. Hot water served as the universal antibiotic for wounds of all kinds. It was only when things got out of hand that you were referred to a traditional ‘licensed’ healer. Today, things have changed and we refer to these changes as progress, growth, development and what have you.
There is endless advocacy aimed at sensitising the people especially from the rural areas to patronising the modern hospitals against the traditional homes. With the traditional system, healers used their observational skills and experience of the disease patterns to predict cause of ailments and relied on the suitable herbal preparation to provide cure. Even today, some people even in the cities still rely on the traditional systems despite its associated dangers. They do so because they believe it is the same observational skills used at home that are employed at the hospitals and will only visit the hospital on emergency cases.
Then the million-dollar question goes: What makes the modern hospital system a better alternative compared with the traditional system?
Could it be due to the number of years used in training the hospital staff? Or
Could it be because of the nice buildings of the hospitals?
We can ask several questions in trying to answer the above question but the only logical answer pops up when the Science is mentioned.
Yes! Science is the only reason why the hospital comes off as safe and less subjective in handling cases. What then is the science of medicine?
Let’s read this short story together before we try answering the above question.
One wealthy man in eastern Africa had 5 children and as he got older there was growing tension about how his wealth would be shared among his children. All his children wanted to inherit his only business. His last born was a cripple and was often left out on almost any important activity in the house.
After several weeks of thinking the man decided to test his children. The wisest of them was to inherit the business. He called his children, provided them with equal sized pots filled with water. He was going to travel and he will check their pots whenever he returns and if your pot was still full then you would inherit the business. They were not informed when their father would return and you could only have access to the pot once a day.
The children were so excited and thought the test was very simple. As soon as their father left they kept checking the pot of water. Every day the water reduced by half the original quantity and they all thought it was the others who were sabotaging them. They would refill it anytime they found out the water reduced. however, this refilling of the pot was rather too difficult for the cripple. After a few days of refilling he decided to find out the reason the water kept reducing because it was now obvious it wasn’t sabotage from his colleagues.
As the others kept refilling he decided to let the pot dry up so he could see the bottom. After a few days the pot was dried up and he realised there were four holes from which the water soaked out slowly. As he was involved in this, his elder brothers were pleased to see he wasn’t making any efforts to keep his pot full.He covered the holes and filled the pot again. He checked the pot for a couple of days and found that it was not reducing again. His brothers kept refilling and refilling.
Long story short, he won the test and was given the business as his share of the inheritance. His brothers could not understand why he never made as much effort as they did and yet won the test. The wise man sat them down and made the cripple to explain how he was able to discover the real problem. Even though he made fewer efforts he targeted the real problem.
Applying this story to the concept of this article it becomes obvious that the science of modern healthcare is diagnoses. Treating ailments without knowing the real problem is like trying to fill a pot that is leaking. The difference between the hospital and home treatment is the MEDICAL LABORATORY. Without proper diagnoses based on science the hospital is only but a beautiful traditional healing centre. Everyday there are advancements trying to reduced the level of subjectivity in medical practice and the laboratory is at the centre of it all.
No physician is allowed to treat malaria unless there is scientific evidence that confirms his suspicions. It is the role of the medical laboratory staff to provide this evidence. Even though the medical laboratory is not the only unit responsible for diagnoses, research shows that an estimated 70% of all objective decisions regarding the patient diagnoses are based on laboratory test results.
Unfortunately for the medical laboratory scientist, aside the phlebotomist, he does not come in contact with the patient. He only interacts mostly with the stool (faeces), blood, urine and other body fluids and sometimes tissues from the patients. Due to this, the public knows very little about the role of the laboratory scientist in the healthcare system. Often, the people you would expect should know better ends up showing even more ignorance. An instance was when the health minister attended an Allied Health induction and was addressing nurses instead of lab personnel.
Usually in this country, anytime a hospital is being built the laboratory has no place until they finish and remember that there is a need for a laboratory. They then use either a store room or any unused space as the laboratory.
Why is that?
Our healthcare policies in this country do not accord the required priority to the diagnostic sector of healthcare delivery. While some parts of the world are moving towards customised healthcare delivery based on the individual needs in Ghana we still give antibiotics without microbiology culture reports.
“It’s far more important to know what person the disease has than what disease the person has.”
Do we have the capacity as a country to develop the diagnostic sector? Yes! Ghana is the only country in Africa and among the very few in the world with Doctor of medical laboratory science professionals and prior to that Ghana has always been ranked higher in terms of the human resource in the medical laboratory science sector.
So what is wrong?
The policy makers seem to be ignorant about the healthcare system and the role of the medical laboratory, hence the policies they implement do not consider much about the field.
It is hard to imagine that even at this point in time the medical laboratory profession in Ghana has no directorate of its own. The laboratories are therefore forced to operate under the medical directorate with combined financial accounts which only leads to poorer management and consequently poorer service delivery. It is therefore not surprising to find Teaching Hospitals in Ghana unable to perform basic tests such as iron studies for patients suspected of iron deficiency anaemia.
As we wait for the next post let’s ponder: where is our healthcare sector headed as a country?
In the next of this series you will see why we can’t develop the healthcare system of this country until the ‘right’ stake holders are duly engaged in developing our healthcare policies.