Tuesday, June 16, 2009

Why do doctors in Ghana complain so much?

I’m out of tune with what’s making news in Ghana. I neither watch tv, nor listen to the radio. I don’t even read the newspapers. But even I who am so out of tune know that there’s been some deal with doctors going on strike to get the government to pay attention to their demands for better conditions of service, including salary increment. But hey, I’m your average Ghanaian. I heard the news, I didn’t think there was anything I could do about it, and it didn’t affect me directly (there are no doctors in my family...maybe I should marry one) so I went on with my life. Until a few weeks ago when I went to Korle-Bu for my annual breast exam and pap test.

When I got to the maternity department, I met a classmate of mine who is now a doctor. She asked me to guess how long she’d been working. I guessed 12 hrs. That’s as long as I could imagine working at a stretch. I was wrong. She’d been working for the past 36 hours. When I saw my doctor, he and I got into conversation about their working conditions. It was clear that this is an issue that is close to his heart. The picture that he painted for me was in sharp contrast to what I’d been hearing on the news. See, the Korle-Bu Teaching Hospital is often heralded as the premiere healthcare facility in Ghana, and news reports mention such facilities as the MRI and CT scanners as evidence of the hospital’s progress. In the past year, it’s been reported that the hospital has successfully performed its first kidney transplant.

According to the doctor, what the media fails to mention is that the CT scanner has not worked for close to a year, and the MRI scanner breaks down regularly. Also, the elevator in the maternity ward is so old that it breaks down almost every week. He added that even though MTN has remodelled the theatre of the hospitals maternity department as part of the company’s corporate social responsibility, the telecommunications company did not provide the medical equipment and the hospital has also not provided equipment so the theatre remains closed. Newspapers have also been known to publish sensational headlines that say doctors are earning 3000 GHC supported by stories that mention that doctors are provided free housing, can import cars without paying import duty and receive benefits such as subsidized lunch and car servicing yet in some cases doctors do not enjoy these benefits and even where they do, the benefits are not as good as they’re reported to be. Even some basic materials such as long gloves used for surgery are not available and doctors regularly risk their own health when performing surgery on HIV patients and their upper arms are covered in blood- an act of sacrifice.

Despite these sacrifices, when Ghanaian doctors threaten to go on strike, media coverage seems to favour the perception that doctors are well respected, well-remunerated people who have little to complain about but who are just crying for more. Once I listened to one interview in which the person being interviewed suggested that doctors complain too much. Adding that as a developing nation, most workers are dissatisfied with their salaries but they do not complain so doctors should also quit complaining. One of my friends even makes the argument that before people go to medical school, they are fully aware of the working conditions and so if they go ahead to choose that career path, then they have little justification to complain later. He goes further to mention that if with the benefit of hindsight, a doctor can still say that he’d choose the medical profession if he were in a position to choose a career all over again, then it goes to show that that doctor derives some unquantifiable pleasure from his/her profession and that they’re not in it for the numeration. If this is so, my friend says, and then doctors should not complain about remuneration since that is not the reason they do what they do.

Maybe my friend is right. Maybe he’s wrong. But I what I would like to highlight is that doctors are right to complain when they get less than their due. Even though on paper, specialists are supposed to earn about 3000 GHC as is reported by the newspapers, the truth is that they are earning only about a third of that, whilst newly minted doctors are earning less than 700 GHC. On paper, doctor’s salaries are to be reviewed every two years but in practice, they have not been reviewed for the past 3 years. In theory doctors should not perform surgeries when there are no long gloves, but in practice, they do so every day. On paper, doctors have air conditioning in their consulting rooms. In actuality, the air-conditioners do not work. In theory, the government services doctor’s cars. In actuality, they receive a small allowance which will not even cover the cost of one oil change. They are not really asking to be paid more. They are merely asking to be paid the amount stated in their employment contract, and for this, I think they are justified.


  1. Esi,I have a brother who is a doctor and will confirm to your findings. We blame them when they decide to practice outside the country but those who decided to stay are not treated well. Where is the incentive to keep the rest. they are not payed but expected to sacrifice for patients. how can you work when you are hungry? i always complain that my brother has a weird life. he sleeps little and has bad eating practices. No one cares so far as he is there to save someone else's life. people talk about the government keeping them in school for 7 yrs so they have to give back to society. nobody remembers that their parents who also tax payers provide for their books, food and other things for the same 7 yrs. the total amount is more than someone's school fees. Ethel Tettey

  2. What is the problem here? The people in government who are in a position to review these matters do not themselves use the government hospitals - I am quite sure they send their families to private clinics and/or overseas for expensive treatment. It's a real shame; there are many well-qualified doctors doing fantastic work in the US and UK and Middle East, and who can blame them given the working conditions you describe?

  3. Thank you, Esi, for raising this important issue.
    The whole question of how much of a salary is enough for doctors in Ghana, in my opinion, is pretty difficult.
    Here in South Africa, doctors in the public service are agitating for a 50% increase in their remuneration. The government realising that this could eat a huge chunk out of the fiscus is playing hide and seek.
    The government in Ghana must be very careful to pay salaries that are equitable but also sustainable to those in her employ.
    There is a great deal of tough talks required.
    I am afraid it wont be easy to reach a win-win settlement.

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  5. I recently became really good friends with a Ghanaian doctor and I must say it broke my heart to see [and hear] first hand some of the conditions that they work in. They work ridiculous hours with little to no resources. As you mentioned, they sometimes dont have simple necessities such as gloves to perform routine examinations. And for the times they work on call overnight, there is no cafeteria available to provide them with food. Mind you, to be on call in Ghana is completely different from being on call in the US. In the US a physician in training is governed by specific rules where they MUST LEAVE THE HOSPITAL premises after their shift is over or the hospital will face serious consequences such as probation and in extreme cases, loose its accreditation if a complaint is ever brought forward. In Ghana however, a doctor who has been on call for an umpteen amount of time (usually 12+ hours) can be called back to work even before they get to leave the hospital because there is no one else to take care of the patient? which makes little sense to me. As for the pay,that went completely over my head. While I dont expect a physician-in- training to be making any kind of "lavish" salary, they do not deserve to pe underpaid either. (I am yet to meet a rich intern/resident, lol) They just need to be paid fairly and ON TIME for their service and dedication to their nation. The government owes them this!

    BTW: This only applies to doctors at public hospitals, Korle Bu to be specific. Doctors in private settings have a much better story to tell.

  6. You've raised a very stimulating topic worth a debate. I think Ghanaian doctors are just whinners!! They make a mistake of comparing their renumerations to those in the west...can any of those doctors tell me they spent ~$40,000/yr on their education??can they tell us how much student loans they have to pay off?? and if you look at the cost of living in Ghana, these whinning professional are doing very well and shouldn't get greedy so fast!
    The one complain i'll support is the lack of facilities to work with. I can understand their frustration when so much is expected of you and yet you dont have the adequate resources to help you acheive that. I think they should fight more for and improvement in the health care system. Getting open operating rooms, working MRI, CT scanners etc., save more lives and they'll be a lot happier than selfishly fighting for more money in their pockets..

  7. Well, look at at the remuneration a doctor in the west gets - no doctor in ghana earns at least $100, 000 do they? And could you point which doctor in the West has a patient burden as @ Anthony Ellis - great as the ones our doctors have? or work in such crap conditions as the ones we have? the doctors are not greedy - they demand what they deserve and should be given it! WHo won't fight for money in their pocket when they work and don't pay their wages. Doctors are people with responsibilities too. They need to pay their bills and cope with inflation just like everyone else! Obviously you are not a doctor, nor do you know anyone who is not a doctor. Let's see you work 36 hours and not be paid (or not be paid right), then we will talk. As for the education - who says every other person in Legon or any public uni doesn't get subsidized? Please! Doctors are not the only people who get subsidized education -AND they do have to buy their own books and equipment (which costs more than some people's tuition)...So again - PLEASE!

  8. Anthony Ellis, I think you got it all wrong. I also think you should spend a day with a Ghanaian doctor. See what they go through to give you a better understanding of what is being discussed here.

  9. @all, am i the reading wrong? seems folks are taking on Esi wrongly!

    i don't think what Esi is saying is that doctors complain too much. in fact she does make an explicit (i love this word huh! me!) statement to the effect that and i quote:

    "They are merely asking to be paid the amount stated in their employment contract, and for this, I think they are justified." ref. the very last sentence!

    ok for now, my own comment follows shortly! we go for a quick commercials' break now! stay tuned!

    buy champion condoms! champion, wu ye mecho!

  10. ok folks, my points:

    1. doctors like everyone else deserve 'living wages'. period. there's no reason why the cleaner who makes sure the doctors theatre is clean (as a paid job) can hardly afford to send their children to secondary school while the doctor is comfortable in doing so.

    2. the doctor in Ghana's case is not too unique. all manner of professionals face near-death situations in carrying out their job everyday!

    3. the doctor does not save life more than the farmer who ensures that there's good food to ensure life. the doctor does not save life more than the street corner sweeper who ensures that cholera is kept to the minimum! if you disagree then tell me how you measure it.

    4. the doctor has right to complain even if he/she is too comfortable. so also everyone else must complain. at the end of the day, let the powers that be look at the general economic conditions and make sure every worker got good pay to take care of at least 4 kids in secondary school.

    5. there's nothing unpatriotic about a doctor running away to serve New Yorkers. let the doctor run if he she wants to. aid him/her even by getting them running shoes to do the dash out of the 'blocks'. we must all be free to chase our dreams once we are withing 'good' law. not bad law!

    5. all the comparison with Yakee, or US for me is neither here nor in my bed room! the US system just didn't jump and started making doctors filthily rich. there are all kinds of complexities that make up the 'greener pastures' there.

    5. this whole idea about seeing the doctor as special i don't get! no body is! some one must be a doctor. simple as that! it does not mean we should carry you in a palanquin in all stupidity just because you became a doctor!

    so i say, let the doctor scream, let him jump, let him cry even! at the end of the day, teachers, sweepers, drivers, secretaries, administrators, police, firemen, and doctors too must have good pay!

    it's a total system!

  11. @Novisi

    I take your point that the doctor is a human like everyone else. True. But I'm sorry 7 years (MINIMUM, no mentioning strikes and the like) dedicated to a profession which is not just any profession but a NECESSITY for the nation warrants according pay.

    The cleaner DOES not by mere fact of being cleaner DESERVE the same pay. Period. Pay should reflect living wages, AGREED but it should also reflect the level of work, education and dedication you put in to get there. Firstly, to PROPERLY renumerate/reward/compensate/etc... the professional for the work they put in to get there and the skill they have (a skill I might add that is costly to produce). Secondly, their pay should reflect the risks and hazards of the job they have undertaken. Thirdly, the pay should act as an incentive to get the right number of new recruits at the right level (intelligence-wise).

    To imply that a doctor and a cleaner should be paid the same is both offensive and frankly ludicrous!

    And finally, in answer to Esi's point the doctor's have every right to complain and I encourage them to do so. Give them what their contracts state...then we can discuss the rest

  12. I believe the conditions under which Ghanaian doctors are deplorable. They work very long hours like every other doctor in the US or Britain but are underpaid. The go for 36 and 42 hour calls but i wonder if in Ghana,if even the best of hospitals have on call rooms in which doctors can take rests and breaks.............They don't have even basic stuff like gloves and how do we expect them to be happy about these conditions.......I believe the government should focus more on making their working conditions acceptable......I mean we are not asking the government to provide them with remuneration as huge as those in the US or other developed countries but something decent because they do have families and bills like everybody else...
    Do you know how long it takes a typical houseman to receive their first salary? & or more months after they have started housemanship........How does the government expect them to pay their electric bills and stuff.........or do they think providing that small flat for them is enough incentive..........Let the government get realistic and start sitting up and paying doctors what is in their contracts...

  13. kudos to you Esi, for painting a very good picture as to the situation Ghanaian doctors face.The media often has it very very wrong, and that is what most Ghanaians are led to believe. It is very refreshing to know that people like anonymous and Nsoromma at least know what's really going on.I totally agree with Novisi: people should be free to follow their dreams! afterall, at the university, all other regular students receive government subsidy and many of them leave the country too.

  14. I hope the the govt is paying close attention to the doctors' & nurses needs now. They have to start somewhere. Next on their list should be teachers.