African health care systems: what went wrong?

In the developed world, access to basic health services and the existence of a functioning health system are taken for granted by most of the population. The situation is different in Sub-Saharan Africa, due to fundamental limitations in funding, staffing, training and other manifestations of essential infrastructure.As recently noted by a columnist, President Malam Bacai Sanha of Guinea Bissau died recently in a Paris hospital. Independent regimes in Africa have meanwhile done nothing in Health systems to write home about. It should not surprise us that there is no hospital good enough for the nation’s president to die in, at home. But, again, when African Heads of State and government die in their countries, they do not die in hospital. No hospital or doctor at home is good enough for them. These are for the ordinary citizens.

Ivory Coast’s Felix Houphouet Boigny was urgently flown from Paris so that he could die at home. Mzee Kenyatta passed on peacefully in his sleep at State House in Mombasa, in 1978.

The rest of them have either died in ignoble exile, or in some foreign hospital in Europe. When that is not the case, they have been killed by their adversaries.

In essence, African leadership after independence has not believed in Africa. It has not provided an environment that can build institutions they can believe in. Even the iconic Mwalimu Nyerere of Tanzania died in London.

In 2008, Zambian leader Levy Mwanawasa died in a Paris hospital after suffering a stroke.

In 2009, Omar Bongo, the president of Gabon, died at a clinic in Barcelona, Spain.

In May 2010 Nigerian President Umaru Musa Yar'Adua died at his presidential villa following a long illness. He had been receiving treatment in Saudi Arabia

In 2011, it was reported that, Robert Mugabe travelled to Singapore, “where he has been receiving medication in recent months”.

When those in leadership must turn to other people’s countries for treatment, who should the citizens look up to? In the main, the African political class has needed the country only so that it can plunder it. Our leaders do not consider it necessary to build anything they can believe in.

The man in charge of health will receive treatment in Paris and die in Brussels. The man in charge of education presides over the local education system but takes his children through the London GCE and the International Baccalaureate system. At the end of each year, he releases the local examination results and reads edicts about education in the year ahead. His own children do not eat from this pot, however.

The big paradox is why Africans allow people who do not eat from the African pot to be in charge of the pot and the contents. The political class no longer cares to disguise its contempt for the lumpen massive population. In Kenya, they no longer pretend to even give you a verbal promissory note.

Kenyan Ministers of Health recent medical tourism is a searing indictment of the countries health sector. From any angle that one looks at it, it is a tale of many woes for Kenya and particularly for the Health Sector. But most important, we thank them for being bold and open about their conditions and wish them quick recovery. I urge them to use their positions to change the current state of health sector.

Roel Van Der Veen’s What Went Wrong With Africa shines light on a few areas that are problematic for African development such as internal conflicts and patronage networks.

One example is how Van Der Veen repeatedly evidences the corruption of African elites, a very real and ongoing problem. He illustrates how powerful networks of political leaders such as Taylor in Liberia, Mobutu in Zaire and Abacha in Nigeria used public money as their own, enriching themselves and their loyal base of cronies while neglecting public institutions such as healthcare and education.

The 1993 World Development report set the stage for healthcare reforms. The main theme was investing in health. But the question remains-Healthcare reform: Why so much talk, so little reform?

• A child born in Niger today is 40 times more likely to die before her fifth birthday than a child born in the United Kingdom.
• A 15-year-old boy in Swaziland has only an 18% chance of celebrating his 60th birthday; if he had been fortunate enough to have been born in Switzerland, he would have a 91% chance.
• A young woman in Uganda is 300 times more likely to die in childbirth than her sister in the United States.
• The impact of poor health on economic growth and political stability in Sub-Saharan Africa has been devastating
• Two African heads of state have predicted that their countries will cease to exist if HIV/AIDS is not brought under control.
• More than 300 million people—nearly half the population—live on less than US$1 a day.

The combined impact of these conditions is that residents of Africa have the world’s shortest life expectancy. Struggling economies are being sabotaged by high mortality rates among the most productive segments of the population. This has created a vicious cycle of disease and poverty, undermining effective efforts to pursue economic development.nt.