Health Care Reform, African Style

By: Katherine Marshall

July 6, 2009

"Obama Fever Grips Accra" reads the banner headline of Ghana's Daily Graphic. President Obama arrives here July 10 for his first African visit as president. U.S. Air Force planes crisscross the airport and the streets are loaded with Obama memorabilia.

Obama's visit signals that Africa truly is important to the United States, and that despite many competing agendas, it is a priority for this president. He will be feted, will visit the historic slave castles, and hear that Ghana is on the move, though it faces many threats, especially from the global financial crisis.

I'm sorry that Obama cannot visit, as I did Friday, the Alpha Medical Center in Madina, on the outskirts of Accra.

Run by the Pentecostal Church of Ghana, it serves a neighborhood of some 400,000 people with a small and dedicated staff. They deliver babies, some 250 a month, treat people for a host of diseases, especially malaria, distribute ARV drugs for HIV/AIDS, and do some surgery. People sit for hours in the outdoor waiting area with sick babies and children, but there is an aura of kindness and professionalism about the place. In this largely Muslim neighborhood, a Theovision loudspeaker issues Bible verses on a continuous basis. That's really the only sign that this is a Christian-run facility; under an agreement with the Ghana government hammered out over 10 years, it is integrated into the national health system, adhering to the same standards as any other health facility.

And like most heath facilities in Ghana, Alpha Center suffers from "resource constraints." A sign on the patient sign-in window announces that only emergency surgery is being performed; "we assure our clients that services will be restored as soon as things improve." The back story is that the government-run insurance system has not paid the bills. Nurses lament that pregnant mothers without insurance cannot get the minimum supplies they need (though their babies are delivered). Building and improvement plans on the makeshift complex of aging buildings are on hold. The dispensary is thinly stocked.

A visit to Alpha would remind Obama that many human problems are the same across the world and that health care is basic to happiness and welfare here as well as in the United States. It would also highlight the vast gulf between the care that rich and poor receive, both within countries and between them; Alpha is exponentially inferior to a clinic in a poor American neighborhood. And the people who live near the Alpha Center are among the lucky ones; in rural areas modern health care is often a long trip away and those "resource constraints" bite even harder. The visit would serve as a reminder of how tightly, in many faith traditions, religious beliefs are bound to health, whether it is running hospitals and clinics or teaching cleanliness. A visit to Alpha might bring home that for all its complexities, health reform, in the United States and in Ghana, is truly part of the most basic call to human dignity and decency.

It's fair to say that a society's care for the health of its poorer citizens is a test of its values and of its ability to deliver on promises. Ghana is leading African countries on health in various ways, including its promising insurance scheme and the hard negotiated agreement that integrates and supports the church-run facilities. But for poor Ghanaians health care is pretty basic and a host of illnesses that we know well how to prevent (malaria, TB, HIV/AIDS) are still so common they scarcely attract any notice.

Obama's Ghana visit will revitalize America's commitment to Ghana's and Africa's development, using the best tools we can muster. It will surely underscore how much can be done to bring better health services to the people. That's a promise that deserves faith, hope, and resources.

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