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Medical Drones to Supply Blood and blood products / Essential Medical drugs
My Take
I will try to fashion my discussion around the 3-Delays concept of causes of maternal mortality ( Why pregnant women die!), it can be applied to all other group of patients / causes of mortalities.
So paraphrasing, Why do people Die in Ghana
- Delay in decision making* to seek early healthcare
- Delay in getting to healthcare facilities* early
- Delay in instituting emergency care at healthcare facilities!
For the 1st delay public health education is key and I think public health education is ongoing at all levels of our healthcare delivery! Interestly Research has also shown that the delay in seeking healthcare is partly due to bad experiences of people at some hospitals especially the referral centres due to Congestion and bad attitude of some health workers. So there is the need to decongest these referal facilities and customer care service training for health workers.
For the 2nd delay we need good roads and transport system! The need for ambulances can’t be over emphasised!, but ambulances can only be well utilised when we have very good road network ( access roads) in the rural areas!and also to the referal centres
The 3rd delay, that is the delay in instituting emergency care at facility levels, mainly due to non availability of space (bed) and lack of essential drugs for resuscitation. Many of these patients die sitting on wheel chairs and benches at Teaching hospital due lack of bed space and even sometimes essential drugs!
The part I think the Drone thing if properly handled would address include!
- That our roads are deplorable and until properly constructed the ambulance system would always breakdown as we witnessed with the national ambulance service and the St. John ambulance service. The St. John Ambulances are actually Land cruisers but could not survive these deplorable roads. So lets explore the essential service delivery via air while working on our roads, cos people continue to fall ill day in day out! I think an MP was recently flown to 37 military hospital! Early initiation of emergency care saved him. If it were me in an ambulance, even i will still die in traffic!. This will enable us start early resuscitation. In some rural areas the roads are so bad that even a 40 mile road requires 4 – 5 hours journey by the strongest means. Compare this to even 30 – 45 minutes GXM.
This again will also reduced the many needless referals to main Regional hospitals and teaching hospitalson account of no blood or essential drugs (eg. IV Labetalol, hydralazine, ASVs and even tab cytotec) from district hospitals, polyclinics and healthcentres. This will go a long way to decongest our regional and teaching hospitals and only cases that really need tertiary care would be referred there and that will also solve the NO BED SYNDROME.
Some Mathematics
The Cost of the drone delivery system is about 12.5 million dollars! = 62.5 million Ghana cedis!
Just thinking aloud, how much can 62.5 million cedis do in terms of road construction? I think this money can’t solve our deplorable road network!
Yes I agree we can buy some ambulances with this money but it will not solves the other numerous problems enumerated. These ambulances would not stand the test of time like mentioned earlier on with the national ambulance service and the St. John ambulance service!
Human resource at the various facilities, I agree we need more skilled hands but we are far better off today with human resource than time past. Taking the northern region for example, each hospital has between 2 – 3 medical officers, even some Polyclinics and healthcentres have Medical officer(s). Some district hospitals even have more and even specialists. Likewise the other health professionals. Time past many of these facilities had no medical officers. This is not to say we are ok with these numbers, we need more skilled hands as the population grows!
Talking about the issue of Screening, Grouping and cross matching of blood to ensure that it is safe for transfusion.
What should be noted is that the blood that is to be transfused is the one that needs proper screening not the one receiving it! Proper screening for diseases that need to be done on these blood could be done at the centres to be set up! We have a universal donor group which everyone can receive regardless of your blood group, that is the O neg group. In the very difficult situation that a patient blood group is not known and the centre calling for the blood can’t do GXM, the O neg one could be sent for transfusion, It must be properly screened. I agree we have blood transfusion reactions and even in the big centers it does happen.The facilities which can not manage a particular medical condition which needs initial resuscitation would still refer after starting the blood transfusion or that essential drug to a higher centre for continum of care. It’s the Early start of appropriate resuscitation that saves life, not the Big structures!
The Last Big Issue
Why are we not talking of the other component of THIS DRONE THING so much? That is the supply of Essential drugs? Is it because we agree it will saves lives! Because all the argument is on the blood component! FROM IMANI, HARUNA INSTITUTE JUST TO MENTION A FEW!
Lets take our political lenses away and examine it critically!
For me I see few grey areas in this whole brouhaha! These are:
- The area of lack of stakeholders consultation, but hey, it was said to have come through the health committee!, Who constitute that committee I dont know. This is were I think GMA and other health professional bodies lost it. Fight to have representatives on the committee if you don’t have them on the committee and the law permits it – because this committee have brought up controversial bills / policies and this one will surely not be the last one!
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Monitoring: Who is to monitor this system to ensure value for money?! Is it going to be the politician or Technical people? If this system perform poorly will Ghana get her money that the tax payer laboured to raise? GMA and the other professional groups should be asking these questions and professing solutions because we lost in stopping the deal. They shoukd not be quiet again and only appear late with ANTHENOZOOSPERMIC / AZOOSPERMIC press release. IN FACT THE PRESS RELEASE ONLY CONFIRMS THAT WE WERE JUST PLAYING WITH THE HEALTH OF GHANAIANS! IT APPEARS THERE ARE SOME MISSING PAGES OTHERWISE HOW DID WE GET TO OUR CONCLUSION. IT EVEN CAME OUT AFTER WE DEAL HAS BEEN APPROVED! Please Let’s make our ASSOCIATION relevant rather than collection of dues from Members! “Ti bali ni na yaga in my Dagaare vernacular!
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Lack of education of the health professionals on it before its implementation! That is where I agree that piloting it before full implementation could have help but again free SHS policy is probably giving these politicians the hope that it’s possible!
CONCLUSION
We can still benefit fully if our monitoring and evaluation of this systems is given to technocrats and feedback system frequent. We should not throw hands in despair!
Well like the Free SHS Policy, lets embrace and help it to achieve it’s aim so that the tax payer will benefit from it.
This is citizen Wadeyir Jonathan Abesig,
Resident OBGYN, West Gonja Hospital
