Dr. Ngo Kana’s death: the doctors scapegoats …
Faced with this death that is chronicling in Cameroon, the investigation of responsibilities appears to be exclusively directed towards (some) doctors involved in the care of Dr. Ngo Kana.
Medcamer is a strong advocate of high quality medical practice and ethics, but is concerned about the partial approach of such an approach which considers doctors the only guilty of incidents that happen every day In our hospitals and affect a multitude of anonymous fellow citizens.
Medcamer supports the administrative and disciplinary procedures as well as any arbitration procedure initiated by the National Order of Physicians of Cameroon and the competent authorities against the doctors whose responsibility is clearly committed in the final report of the expertises in progress. However, we hope that these arbitrations will be carried out in compliance with the presumption of innocence.
On the other hand, this event should be an opportunity to analyze the other parameters that contribute to the frequent occurrence of such tragedies in the medical and hospital environment of Cameroon. All models of error analysis agree that a series of successive failures are required for the occurrence of an accident. Thus, although the health system is organized around doctors, they are only one part of the health system, and only a very small number of decisions depend on it.
In assessing this situation, we would like to see, in addition to the necessary assessment of medical responsibilities, the following:
- Why the emergency procedure is not automatic in a 4th reference hospital. The doctor could thus devote himself to caring for the sick. It does not have to decide who can benefit from this procedure, and does not have to collect money, as the president of the ONMC reminded us?
- How a contract of insurance can be denounced without the insured being notified and their solutions proposed. How can a contract valid a few days ago be disowned even in the face of a life-threatening emergency?
- How can a hospital that wants to be of 4th reference (HGOPED) can obtain an authorization of opening whereas the minimum technical plateau is not available (shocking, intensive care, ambulances …) clearly putting in danger the life of the patients Who would venture there?
- When was the last evaluation by the ministry and / or ONMC of the clinic that is now in the viewfinder? It is, however, the responsibility of the state to ensure the maintenance of public and private health structures.
- What are the means of communication available to doctors and hospital structures to communicate with each other (telephone, fax, email …) and ensure the transfer of patients in the required safety conditions (ambulance equipped, dedicated staff … )?
The answer to these various questions will highlight all the failures, some of which are more significant in the tragic evolutions of patients who submit to the good care of doctors in Cameroon:
Administrators of hospital structures (whether physicians or not)
Effectiveness of the ministerial oversight bodies and the professional orders,
Initial and continuing training of health personnel,
etc.
The physician is only a pawn in this complex chessboard and his sole responsibility would not explain the profound failings of our health system and the many dramas that stem from it. The death of our late sister is in fact only a tiny summit of the immense chain of icebergs. This is an opportunity to openly present a genuinely inclusive systemic diagnosis and to discuss the points of deep reform.
MEDCAMER, the 01.03.2016
