Last week, the story emerged of how a ‘hit-and-run’ road accident victim was refused emergency care by the Ridge, Police and Korle Bu hospitals for close to three hours before he died.

Somehow, the tragic story struggled to hog the limelight of the media space, perhaps because the issue of cocoa producer prices, with all its political connotations and shouting matches, seemed to occupy pride of place and would not budge from the major headlines.

Of course, there were some howls and screams of indignation over this incident and the state of our health care, with Mr Bernard Avle of Channel One TV notably leading the charge in the media, but otherwise, it seemed to be just another sordid chapter in the weary saga of the state of our health care.
Pulling ‘protocol’ strings

As I digested the sad story of the young man’s death and imagined what he must have gone through, it struck me that if he, or his family, knew someone who knew someone reasonably high up in any of these three hospitals, the necessary strings would have been pulled with alacrity and somehow there would have been a mad scrambling for a bed for him and he would have lived.

I have seen it happen on more than a few occasions.

Among the many angles to this story, it is undeniable that over the years, the quality of services from our public institutions has deteriorated.

What we have euphemistically termed as ‘protocol’ is simply a mechanism for seeking to bypass weakened and corrupted systems.

It is not even just about paying bribes to get things done, but falling on contacts to smoothen and expedite things.

It has become quite standard in alumni, church-based and other WhatsApp groups for people to enquire almost on a daily basis whether anybody knows anyone working in a particular public institution.

Invariably, it is to secure help with various services – getting a transfer, clearing goods at the port, getting a school place, securing a public sector job, facilitating a simple process in a government ministry or an agency, or getting extra attention for a relative on admission, among many others.

To this extent, it has become almost compulsory and plainly sensible to develop and sustain a network of contacts in the right places.

I know a parent who once swore he was willing to pay whatever it took to get his son into one of the top senior high schools in this country because he wanted the child to have the right classmates in the places that mattered in order to make his life smoother, even though the child’s grades were less than deserving of the school.

Once upon a time, the only people one needed on speed dial were one’s lawyer, pastor and personal doctor.

Today, in addition to these, knowing a police officer or someone who knows one – even a junior one – is useful in the event one needs help to get a relative out of a sticky situation with the law when arrested, such as the otherwise routine process of getting police enquiry bail.
Weakening public institutions

The inclination by those with the means to find private solutions to public problems manifests itself in other interesting ways.

Unstable power? Buy a generator. Taps not running? Dig a borehole in your backyard. Derelict public hospitals?

Sign up with a swanky private hospital.

Poor public schools? Get your child into any of the posh local private schools, or better still, ship them abroad. Bad roads?

Get a four-wheel drive vehicle to absorb the shocks, or better still, fly if possible.

High crime, noise pollution and urban decay? Gated communities.

The list goes on and on.

This phenomenon is a direct result of a weakening of our public institutions that are responsible for these services.

Those who do not have the right contacts or, in some cases, the financial muscle to navigate the almost impenetrable webs that these public institutions have become are left to their fate, helplessly watching from the sidelines, as must have been the case with the unfortunate accident victim last week.

It has become a question of the jungle rule of survival of the fittest, or ‘each for himself, God, for us all.’

Of course, in a dysfunctional public sector, it is very rational to fall back on some ‘wings’ to fly around faster and get things done if one has the right network and/or resources.

It is, therefore, unreasonable to lay blame at the door of those who get so frustrated by the system that it is almost sinful not to seek some help to expedite matters.
Interconnected society

No society can prosper on the wings of jungle rules.

Whether weak or strong, we are all interconnected one way or the other, thank God.

When a shop building collapses because the frustrated owner had to cut corners to obtain building permits due to the hopelessly inefficient bureaucracy involved, it may trap, injure or even kill the shopper who has found all the private solutions to his road, water, electricity and healthcare challenges.

When the rich, powerful man driving far out of town suffers a heart attack at the wheel, the only available hospital nearby at that crucial, material time may be the poorly resourced public district hospital, because there will be no time to ferry him to his posh private hospital many miles away or airlift him abroad.

A gated community with private security protects against burglaries and noise pollution, but beyond the gates, one is as vulnerable to crime and noise pollution just as everyone else.

Everything leads back to something.

I have always maintained the view that the educated, professional, financially secure, and well-placed classes in society (what some call the middle classes) are best positioned to agitate for and drive change in society.

Because of the immense power they wield on account of their stature, and they cannot be fobbed off easily, they can make politicians sit up and do the needful.

When they stay away from the fray and use their immense clout to find their own private solutions to public problems through their contacts and their resources, and then smugly pull up the drawbridge, it only lulls them into a false sense of security, because in essence, they really are as vulnerable as everyone else in many other ways.

What we cannot afford is to keep going the way we are, because ultimately the system will grind to a halt and consume us all when only a few can get things sorted out, and everyone else will have to look on helplessly.

Extreme deprivation can lead to revolt.

As the 18th-century French philosopher Jean-Jacques Rousseau is said to have declared, ‘when the poor have nothing left to eat, they will eat the rich.’

Our public institutions desperately need reform, and we cannot leave it all to the political class.

Rodney Nkrumah-Boateng.
E-mail: rodboat@yahoo.com