Why Do African Leaders Neglect the Health Sector Only to Die in Hospitals Overseas?
By Hans Ngala
The year is 2016, a woman has just arrived at the doorsteps of one of Douala’s largest hospitals after an exhausting drive in the town’s chaotic traffic. Her name is Monique Koumateke. She’s pregnant with twins, but the nurses at the Laquantinie Hospital demand upfront payment before Koumateke can be taken into the delivery room. She falls on the steps of the hospital from the labor contractions, as the nurses and doctors who took the Hippocratic Oath to save lives, disavow that oath by refusing her entry into the hospital. In a moment of desperation and agony, Koumateke’s sister-in-law took a pair of razor blades and cut open Koumateke’s stomach at the entrance to the hospital, where staff had refused her entry. The then health minister, Andre Mama Fouda, later claimed that Koumateke was already dead before she arrived at the hospital, even though her family refuted these claims and sued the hospital. Videos of Koumateke covered in blood and the children being removed from her womb, shocked not just Cameroonians but the whole world.
Miles away from all this, President Paul Biya of Cameroon travels to Switzerland, where he gets world-class, top-of-the-shelf medical treatment – shielded from the chaos and rot he oversees back home in Cameroon. Biya has never set foot in any Cameroonian hospital, and when he takes one of his countless trips to Europe, tongues are sent wagging in Cameroon, with many suspecting that he is seeking treatment for some undisclosed health issue. Territorial Administration Minister, Paul Atanga Nji, went as far as threatening Cameroonians who discussed Biya’s health, claiming it was a “national security” issue. The fact that Biya never visits any hospitals or clinics in Cameroon and that his health is treated as though he has something to hide is all the more reason Cameroonians don’t trust those around him, like Atanga Nji.
During the COVID-19 pandemic, millions of CFA meant for the procurement of personal protective equipment (PPE) to curb the virus vanished into private pockets. Nearly five years later, there has never been any accountability, and this state-led rot in Cameroon’s health sector seems to have been blessed by the regime itself, which proved itself incompetent (or unwilling) to address the matter concretely with arrests and or firings and presenting Cameroonians with a balance sheet of how the funds were recovered or disbursed. Had it not been for the grace of God, who knows how many Cameroonians would have died from COVID-19?
This neglect of health systems stands in stark contrast to the fleet of cars which Paul Biya buys for himself and his ministers, cars estimated in hundreds of millions, while most public Cameroonian hospitals either lack crucial equipment like oxygen cylinders or incubators for babies. Just in January this year, we reported on the death of pre-term triplets who died at the Logbaba District Hospital because the hospital didn’t have a single incubator and the babies died while being transported in cardboxes to the Laquantinie Hospital.
While Cameroon’s hospitals fall apart, the obsession of the authorities is often with frivolous activities like football. Billions are spent on football players, managerial issues at FECAFOOT, and to pay foreign coaches for the national team, and billions more are spent on building football stadia that are often left in disrepair once the matches are over, and Cameroonians have to contend with more life-and-death issues at their neglected and rotting hospitals.
What Can Be Done?
The neglect of the health sector by African politicians has led to the mass exodus of a large chunk of the few medical experts African countries train. It is no surprise that there are more Nigerian doctors in the US and the UK than in Nigeria. There are more Cameroonian doctors in France, the US, and Canada than in Cameroon itself. Driven away by everything from overwork and underpay to lack or shortage of basic medical equipment and drugs, these doctors find themselves working in countries where the pay is better but where some of their training in tropical medicine may never ever be needed – a huge loss for Africa. African governments need to address this. Salaries for doctors and other medical specialists need to be increased and the health sector (especially in Cameroon) should not be politicized. Appointments should be done independently by subject-expert panels and organizations to ensure efficiency and expertise which will deliver on medical roles in Cameroonian hospitals and health institutions.
Secondly, Cameroon’s public health insurance is very weak at the moment. It needs to be strengthened, digitalized and centralized to ensure that patients can contribute to it digitally and can access healthcare in any hospital in any part of the country.
Third, the health ministries and other health stakeholders need to embark on a rigorous campaign of preventive (rather than curative) medicine. People need more education on not just infectious diseases but non-communicable ones too. This reduces the burden of public health demands, reducing the billions of CFA that go to treating diseases rather than preventing them.
Fourth, the government should equip every district hospital with just the basic supplies: a functioning ambulance, ICU units, oxygen plants, biogas-run generators to reduce reliance on gasoline-powered ones, especially in rural areas where fuel is hard to reach.
Fifth, Cameroon’s government will need to increase how much it allocates to health. Cameroon is a signatory to the Abuja Declaration, where governments agreed to spend at least 15 percent of their state budgets on healthcare. Cameroon currently spends just a meager 6 percent on health.
Sixth, an independent anti-corruption task force for the health sector needs to be created to investigate corruption within Cameroon’s health sector, and those found guilty are punished per the provisions of the law. This task force can also be tasked with conducting audits on public health spending, how much health workers earn, listening to health workers’ complaints, and addressing them accordingly to avoid issues like strikes by health workers, etc.
Unless this is done, one day, Cameroon’s leaders may find that the planes to Switzerland are grounded, and the doctors and hospitals they ignored in Cameroon are the only ones available. Perhaps then they will realize that a nation’s greatness is not measured in football stadiums or presidential convoys, but in whether its poorest citizen can walk into a hospital and receive care that preserves life and dignity
