May 30th

Fresh Air Matters... with Capt. Yaw

What do hospitals and airports have in common?  Arrivals and departures is a good start!  Having sat for nearly seven hours waiting to be seen in an ‘appointment-based’ clinic at a large hospital last week, I started to make a list of comparisons.

I was sitting with Lydia, the disabled student pilot who dreams of flying into rural communities to take health education to the hard to reach areas.  Lydia has a contracture of her right arm.  It is apparently caused by an insect bite or sting when she was a small child, which did not receive the correct treatment –for no other reason than simple lack of appropriate health education.  Consequently, a treatment that should have been a few pesewas is now running into many thousands of Ghana cedis, and the young person will never have the same arm control as would have resulted from appropriate treatment all of those years ago.  This is not a unique case, but it is a case very dear to me, as I am this magnificent young lady’s flying instructor.

In order to make an appointment for the anaesthesia clinic, one is obliged to attend in person, for they do not allow telephone bookings. This means, in our case as non-city dwellers, a six hour round trip to book the appointment, a few weeks ago.  Already, this sounds incredible, but it was confirmed by the head of the department.  Imagine that amount of time being required to book an appointment to discuss a flight or to file a flight plan! 

Once the appointment is booked, you are asked to attend the clinic at seven in the morning.  Of course, we later find out that the first appointment is at nine, so the ‘two hour check-in procedure’ comparison with an airport is a good one.  However, things digress rapidly.  In an airport, which handles far more people than a clinic, you are treated as a ‘customer’.  Aviation realises that it is a “buyers’ market”.  Not so in the hospital environment.  Much as you are PAYING for the ‘service’, it is treated as a “sellers’ market”.  Lack of communication; poor or no explanations; no ‘announcements’; no signs; no apologies - not to mention the lack of a smile or greeting.  In hospitals it seems that queue jumping is rife, and other activities that may get you reprimanded or disciplined in an airport environment are ‘common practice’ – not just in Ghana, but around the world.  Aviation really has much to teach!

Visit the airport, and you will find that the ‘dust-and-cobweb’ count is low.  Look at the layers of dust and cobwebs in some hospitals.  The payment point at one hospital, a place where ALL must pass, has cobwebs and dust records that are definitely older than recent history.  If an airport were in the same state it would be considered a ‘disgrace’ and action would be taken immediately.  If our aircraft workshops had this level of dirt we would be shut-down!  However, in the location where ‘cleanliness prevents early closeness to God’, it is amazing how little attention to detail seems to be in place.  It is the small things that count towards the overall effect.  Do not tell me ‘it is a staffing issue’, for opposite the worst offending locations of dust and grime collections sit members of staff, doing nothing productive.  I am sure that provision of a little duster and some ‘pride-in-the-workplace’ motivation and the places could sparkle, reducing infections, improving morale and overall effectiveness of the institutions.

Airports workers are expected to wear a certain dress code – including type of shoes.  Knowing that your feet are important to your ability to work, I decided, whist whiling away hour four, to study the footwear of the passing ‘staff-traffic’.  Shock! Horror! I saw that appropriate footwear is a rare sight in this hospital!  Doctors and nurses, like airport workers, are expected to be able to respond to an emergency, and that includes running.  Admittedly, the ‘charlie-wotties’ were missing, but there were some sandals that were not far off – and one pair of heels that could offer a serious injury if you fell of off them!  Nurses seem to have a simple rule ‘white or white-ish’ – if possible.  If I worked in a place with lots of potential infection, I would insist on wearing a closed, easily cleaned shoe, but that is not the case in some hospitals.  Imagine stepping on an infected item that finds it way to the floor with open toes.  At airports the footwear rules are strict (not fully adhered to, but pretty good).   There is clearly some room for simple guidelines – to be enforced – to provide protection for the staff and increase the overall effectiveness of the operation – and that goes for all places of work.  Do note, that appropriate footwear does nothing for the client, it protects the staff, so if the staff fail to understand the basics of wearing appropriate footwear for their own safety, perhaps there is a bigger question of understanding for the overall safety of the institution.

Back to the seven hours of ‘not-heaven’ (on top of the six-hour round trip on the road).  I got verbal and animated.  Nobody would join me.  Why? Because, as it was whispered around the room ‘if you make noise they will not see you’.  Well, change is a necessary part of development and if it needs said, I am ever-ready to say it! 

What I did not expect was the statement from the ‘desk holder’ telling me that ‘this is Africa, it is simply the way it is.’  How insulting to Africans and all Afro-centrics.  Lack of cleanliness, organisation and methodology has nothing to do with the location on the planet!  It is a choice, and we can choose to accept it or change it.  If you see it all as a “sellers’ market” you are less inclined to seek to improve your service.  In relation to this matter, the airport has the edge!  The airport has a monopoly, and yet it strives to exhibit high standards.   Why?  I see pride in those working in the aviation industry, and a desire to improve each and every day.  Such an attitude is needed to turn around the health sectors.  I know some fantastic workers in the health sector who are trying hard to push their boundaries, but most seem to be afraid of being accused of meddling or being called ‘trouble makers’.

I don’t mind being accused of being a ‘trouble maker’ if it is all about being an ‘agent of positive change’.   I know that in my sector of aviation we have demonstrated an ability to achieve the highest standards – from top to bottom - so why not in other areas? Perhaps some do not consider the effort ‘worth it’.  I have been writing this column for two years, and sometimes wonder if the effort is worth it… then I get a little comment that encourages me. 

If you think that there is a sector we should compare to aviation, drop me a line… it may encourage me to stir a few more pots! 

 Capt. Yaw is Chief Flying Instructor and Chief Engineer at WAASPS, and lead Pilot with Medicine on the Move, Humanitarian Aviation Logistics (http://www.waasps.com/   http://www.medicineonthemove.org/ e-mail capt.yaw@waasps.com)