Attracting professionals to deprived areas

By Kofi Akordor
that some professionals, especially doctors, are reluctant to accept posting to some parts of the country, particularly the north, is no longer news. If anything, it is a constant reminder of our failure to manage the affairs of this country to the best advantage of all.
There are several reasons why some people find it difficult to work in certain parts of the country but instead of addressing them, we think the solution lies in sermonising or painting these officers as irresponsible and ungrateful.
It is true that professionals are trained at state expense and, therefore, they are expected to reciprocate the gesture by serving where their services are needed. But that should not take away their right to have a simple but decent environment to operate in.
It is not by accident that doctors and teachers have been at the receiving end of public criticism for abandoning the rural people who shouldered most of the burden of their training. It shows that these are professionals whose services are critical to the needs of the rural areas if there should be any holistic national development agenda.
From all indications, it is apparent this is lacking.
If we take doctors and other health-related workers as an example, we know that conditions in many parts of the country are such that it will take more than nationalism, patriotism or appeals to the conscience of individuals to get people motivated enough to work in those places. That is why the state should have strategised so that every health professional experiences the harsh realities of rural life or the hostile environment of certain parts of the country as he or she progresses in his or her career.
If it becomes mandatory, as a national policy, for every young doctor to practise in areas outside Accra, Kumasi and the urban centres in the south for a period of time before earning promotion or getting the opportunity to specialise or do postgraduate programmes, the problem of staff shortage in deprived areas may be less pronounced.
Unfortunately, there seems to be no such policy existence, and it exists, there is little effort to implement it. That is why doctors can afford to refuse posting to the north and other deprived areas because they know others before them who did the same without sanctions.
Also, they might have learnt useful lessons from those before them who accepted such posting in the past and became victims of their patriotism, dedication and hard work. It is a typical “out of sight, out of mind” syndrome.
In short, there seems to be no serious ground rules governing postings and transfers in the health sector. That is why while some spend their entire professional lives in the big cities, others are asked to go to the regions. Naturally, some doctors see these postings and transfers as punitive, as they block, as often is the case, the chances of advancement and professional elevation.
That should not have been the case. Those who offer or accept to render services to our rural people should have been in the front line of consideration for recognition.
As Dr Elias K. Sory, the Director-General of the Ghana Health Service (GHS), himself acknowledged, the issue was now beyond the GHS alone and, therefore, called for a holistic national approach to tackle it.
He admitted in an interview on the matter that the various incentive packages designed in the past to attract health professionals to the deprived areas had outlived their impact.
Dr Sory went further to say that the problem went beyond monetary considerations, since young doctors also wanted to work in an environment where they could have access to good accommodation, good schools and other facilities for themselves and their families. The medical facilities these personnel are posted to should also be well-equipped to make working there attractive.
That is why he suggested the upgrading of all regional hospitals to teaching hospital level to make it possible for young doctors to work in a conducive environment close to the communities.
I stated earlier that sermonising, instead of addressing the real issues, would not solve the problem. You do not post a highly trained professional to a place where his/her services are seriously needed without thinking of his/her accommodation, where his/her children will attend school or access medical care.
Politicians who are given ministerial appointments, with all their attractions, do not fail to insist on government bungalows. Why should the doctor accept his fate into the wilderness without protest?
In other words, there must be goodwill on the part of all — doctors, the GHS acting on behalf of the government and the communities. The GHS must set the ground rules that must be applicable to all. Once there is no favouritism or anything that comes close to that, there will be no victimisation.
Our health facilities need serious rehabilitation and upgrading in terms of modern facilities and decent accommodation for health professionals. The future of the children of these health professionals should not be ignored. It should be possible to upgrade at least one junior high school in each district capital to a level comparable to some of those in Accra as an attraction for public servants, including health professionals, who are posted to the districts.
It is time we reviewed our national development strategy and disengage ourselves from sinking our national resources into Accra alone which has become more or less a bottomless pit swallowing everything thrown into it. We should begin to focus more on the district and regional capitals as a way of attracting and retaining professional manpower there.
There are many people who would not want to spend even a day in Accra if they could get access to certain basic facilities for themselves and their families in some corner somewhere.
As we have seen, the appeals and threats have not been able to solve the rural-urban drift. They have not staffed our medical facilities with the much-needed professionals. You may condemn or even insult those who refuse posting to the rural areas, but once those with political power are not showing the required goodwill or are not ready to forfeit a little bit of their comfort, we will be hard-pressed expecting sacrifice from others.
The best option is pragmatism and a deliberate effort to make every part of this country human-friendly.
fokofi@yahoo.co.uk
kofiakordor.blogspot.com