Maternal Mortality: The Impact Of ‘No Doctor Syndrome’

I would like to bring to the notice of the Minister of Health and all stakeholders in healthcare delivery in Ghana how the “no doctor syndrome” in the system is contributing to maternal mortality. Recently, a woman started bleeding after delivery (a condition called Postpartum Haemorrhage or PPH) at the Nkawie Government Hospital in the Ashanti Region. This occurred on May 20, 2014 at about 11 p.m. The midwives on duty tried to reach a doctor, but to no avail. Upon realising that her condition was deteriorating, the midwives decided to refer her to Komfo Anokye Teaching Hospital (KATH). Unfortunately, there was no ambulance available. In view of that, they had to call one from Nyinahin before she could be sent to KATH. By the time she got to KATH, her condition had become so critical that she finally died after a few days of battling for her life on a ventilator. Similarly, another woman died because of this same “no doctor syndrome” (Daily Graphic, Tuesday, November 15, 2011). This woman had PPH after delivery at a maternity home in Afienya. She was rushed to Tema General Hospital. On reaching there, she was asked to proceed to another hospital since there was no doctor on duty. The relatives then decided to continue to 37 Military Hospital. On their way, the woman died. In 2005, a woman died from bleeding during her third trimester of pregnancy (a condition called Antepartum Haemorrhage - APH) as a result of system failure (Daily Graphic, Friday, February 9, 2007). This woman went to Sefwi Kofikrom SDA Hospital when the bleeding started. But because there was no doctor at post, she was asked to proceed to the Sefwi Asafo Catholic Hospital another hospital. On reaching the second hospital, she was again asked to proceed further to Sefwi Wiawso Government Hospital because there was no doctor. On her way to the third hospital, she died. I believe there are so many unreported similar cases. It is, therefore, imperative to investigate the reason why no doctor could be reached at the Nkawie Government Hospital on that fateful day. Besides, measures should be put in place at all hospitals to ensure that doctors on call can easily be reached. For instance, a paging system could be used since the existing telecommunication networks cannot be relied on at all times. Again, hospital drivers could run duties so that they could be sent, when necessary, to call doctors on call. The state should, however, have a medium to long-term plan of having adequate doctors to run duties where doctors will stay at the hospitals when on duty, instead of being on call. Currently, most hospitals in Ghana, especially in the districts, have only one or two doctors, making it impossible to run proper duties.