Letter: Medical Doctors messing up Districts

Filed under: Special Comments,Wealth Watch |
Kalomo hospitalGreetings to all!!!
Thank you editor for the work you are doing…
I wish to put across views on the scarcity of the Medical Doctors in this country. I will put into perspective my own understanding of the staffing challenges in the country.
Zambia has in the recent past experienced a shortage of key personnel in the health sector. My focus is on Medical Doctors, a field I hail from. This shortage can be largely attributed to many reasons and or factors. Some of these factors range from the famous brain drain to the few existing training institutions expected to produce these personnel to fill up the gap. However, through my traversing of the country of official duties, I noticed one reason that a lot of people at Ministry of Health have deliberately ignored. This is the filling up of Medical Doctors trained to manage patients at all levels of care in Health Management Offices in each district in the country.
As of 2013, Zambia had a total of about 103 districts. This was the increase seen from the 72 that were in place before the Patriotic Front government came into office. Each of these districts has a District Medical Office, tasked to manage the health system as a functionary of the Ministry of Health. At the apex of the management system in these set ups, there is a Medical Doctor, trained at either Ridgeway Campus or abroad managing the affairs of the district. Given the scenario I gave earlier on the districts, currently, we have about 103 Medical Doctors in managerial positions. As a trained Medical Doctor, I wish to bring to the attention of the nation that we do not have any management course in the syllabus during our 7 years course we attend. The same goes for provincial health management which is gripped by the lack of competent personnel. Imagine having about 150 medical doctors seeing patients daily in the health institutions in this country. These would go a long way and suffice on the missing personnel in hospitals.
Therefore, I seek to ask the following questions to my colleagues in these offices: How are they managers without the competence in management? How are they managing the health systems when the only training we acquire is patient care management? Are they comfortable not serving Zambians they swore to save after their training? How do they manage real trained managers like economists, business and public administrators without them using their egos? How are the real managers looking at them and their folly lack of competencies in management? How do they feel when there is a mention of deaths due to staff shortages, when they spend their time fully in the offices signing paperwork which they have not training for?
My personal view is that the management of the health system in this country is not up to the required standards. Poor management and incompetence has gripped the health system for many years hence our failure to make positive strides towards health service delivery. Medical doctors in these positions use favoritism, oppressive and the divide and rule approach towards management. As a country we need to attach the management science in dealing with complex systems in health. If right competences that understand health systems, management science and application of governance tenets are put in place, we can thrive as a country and produce the best health services.
May I conclude by making the following submissions: Allow competent and qualified managers to deal with the day to day running of health management institutions. Send all Medical Doctors to the hospitals to do what they are qualified to do. Remunerate all the health managing staff equally so that they perform to the required standards and see the much needed results of health service delivery. Treat all personnel as equal based on qualifications. Allow these health management offices in districts and provinces to be managed by qualified administrators; Business and Public Administrators.
May God Bless Zambia.
Ron Kunda (MBCHB)
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Start: 2019-07-01 End: 2019-07-31