PREAMBLE
We are Cameroonian doctors in our country and around
the world, united by love of our country, our profession and our patients. We
decided today to leave the reserve that characterizes our work in writing this
manifesto.
Our goal is to contribute to the improvement of our
health system, to the satisfaction of all.
Our health system is experiencing a dramatic crisis
affecting our lives, our bodies, our souls and our honor. Thousands of men,
women and children die every day in the health facilities of the country,
unable to meet the costs of their care. We are witnessing a recurrence of
screaming malfunctions sign that it is time for a profound reform. Because the
weight of these failures is endorsed by all health care providers with a
stoicism pushed to the limits of endurance, in our souls and consciences, and
at this crucial time in the history of the medical profession in Cameroon
►
We CAN longer remain silent over the deterioration of the quality of care in
care facilities in the public and private sectors in Cameroon.
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We CAN NOT more helplessly to all these preventable deaths at all ages in
different health facilities in the country for financial, infrastructure and
equipment, throughout the course of care.
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We are outraged by the resurgence of denigration against care givers held
responsible for all the ills of the health system in general indifference.
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We REFUSE to bear the responsibility for public health policy as we are not
alone policymakers strategic directions, including aspects of health financing
and accessibility of care.
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We refute allegations that the absence of a universal health insurance system
would be the result of a lack of resources while poorer countries than ours succeeded,
proof that solutions exist.
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We denounce the commercialism and bad practices in our profession and we will
continue to participate in combat in accordance with the code of medical
ethics.
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We REGRET the failure of the technical means available to us forcing us to
often anachronistic practices, sometimes approximate and not in line with
international recommendations based on scientific evidence.
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We REGRET the low involvement of the population in the issues of health, on
such aspects as prevention, community involvement, but also the process of
decision making.
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We REGRET shy regulation of consumption of products harmful to health (alcohol,
tobacco, soft drinks, contaminated food ...) and the products of our
traditional medicine, and the low Suppression of Unlawful sale of counterfeit
drugs in the streets of our cities.
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We REFUSE iniquitous material condition that is ours and the condescension with
which we are treated in our home institutions, governments, our employers and
some of our fellow citizens.
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We INSURGEONS WE AGAINST the low remuneration of our practice and ask the
revaluation thereof for doctors in public and private sectors, as well as
nurses and other staff of health, up to the cost of living, level of studies,
and the risks they face.
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We denounce the unfair redistribution of hospital revenues from our own
benefit, and taken hostage by leaders in our places of attachment.
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We challenge the authoritarian management of some leaders of our hospitals and
cliniquesd'exercice that do not reflect our aspirations for optimal working
conditions for the benefit of our patients.
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We REGRET mediocrity of the doctor's career profile, centralization and
arbitrariness of human resources management, which takes into account neither
the performance nor the competence nor the real needs in hospitals.
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We REFUSE the sidelining of key health stakeholders such as doctors, nurses and
other health personnel in the institutional debates and decision making on
health in general.
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We HEAR bring our collective proposals force from consensus within an umbrella
organization,
CONCERNING:
I. THE RIGHT TO HEALTH
It is essential to ensure that every citizen of our
country, and in the spirit of the Act N ° 96/03 of 04 January 1996 on the
Framework Law of Health in Cameroon, an assumption that in the absence of be
universal immediately, the exemption actually pay for access to care in the
critical emergency situations. The institutionalization of universal health
coverage will be gradual and adapted to the local context.
II. THE HEALTH FINANCING
Health has no price but it has a cost and we are
aware. The increase in the allocation of state budget to the health sector
would be currently around 9%, should reach the minimum of 15% adopted by the
African Union. Increased funding of the health sector is an investment in
national human capital, essential condition to ensure the emergence of
Cameroon. We aim to find innovative ways based on new technologies and the
availability of mobile phones to promote, facilitate and secure the financing
of health. For example, the possibility of charging a bill to a phone number or
payment by third persons away. We advocate the development of a local
pharmaceutical industry capable of manufacturing of essential drugs and
consumables.
III. THE RIGHT TO QUALITY SERVICES FOR PATIENTS
It is essential to ensure in health facilities at all
levels of the pyramid, a minimum package of essential care guaranteed under all
circumstances. It is necessary that:
- Create a platform for coordination and
inter-hospital emergency management to avoid wanderings sources of fatal
destinies.
- Work to develop the concept of quality care,
according to recognized indicators.
- To ensure the comfort and safety of patients in care
facilities.
- Establish a unique identifier and standardized
computer medical records to allow monitoring of each patient within a hospital
and between hospitals.
- Establish and systematize a system of appointments
payable in advance by specific periods, to reduce the waiting time, and size of
the services.
- Adopt a regulatory minimum consultations (30 - 60
minutes depending on specialty), including time for medical documentation.
IV. MEDICAL EDUCATION
In order to improve the practice of medicine, ethics
and performance of careers, we recommend establishing:
- A development at all levels, medical training
programs on ethics, ethics, crisis communication and inter professional
communication with patients,
- Strengthening the teaching staff of training
institutions, improving substantially the number and income (salary and bonuses
Research)
- A mandatory continuing professional development
system after the initial training. As well as a national credit system for ''
recertification '' periodically under the supervision of the National Order of
Doctors of Cameroon (ON ™).
- To do this, it is necessary to provide professional,
skills development means regulated such as continuing medical education online,
Postgraduate Courses (UPE) and research activities in hospitals and
institutions of the MOH at district, regional and national, and participation
in national and international conferences.
V. HUMAN RESOURCES IN HEALTH
We recommend:
- Consistent distribution, fair and harmonious human
resources in health based on medical density. A strict rotation, periodic and
systematic in positions,
- The right to medical specialists to perform private
consultations in public facilities under certain conditions not causing any
deterioration of public service.
- The maintenance of the competitive civil servants
doctors and hospitals by creating a scholarship from the centralized job
through which positions will be formally advertised.
- The professional activity under contracts of varying
duration, renewable on the basis of an assessment of the performance to the
satisfaction of both parties,
- Creating incentives with appropriate equalization
promoting equitable distribution of health professionals across the country.
- The creation of an independent office of the Human
Resources Department but under supervision of the Ministry of Public Health,
which would be dedicated to the management of the training of medical and
health personnel.
- The acceleration of the decentralization of the
management of career records process for applying automatic procedures for
advancement and progression.
VI. OCCUPATIONAL HEALTH COMMUNICATION AND INFORMATION
RETURNS
It is vital that the promotion of a culture of
communication between caregivers and patients is in place and regulated.
It is essential to develop and systematize
communication tools and exchange of business information within and between
health facilities throughout the territory of Cameroon.
New technologies can and should be used for the
implementation of an independent and anonymous mechanism of citizen watch to
assess real-time customer satisfaction / patients in our clinics.
VII. PROFESSIONAL STATUS
We want to doctors and paramedical staff of public
health facilities:
1. Simplifying and reducing the cost of integration
procedures in the Civil Service.
2. Reducing the time taken of costs, following the
integration
3. The guarantee of an advance of systematic balance
during integration periods, especially before deployment.
4. The guarantee of decent housing and secure in
landlocked assigning positions, high arduous or dangerous,
5. The harmonization of various statutes of the State
of active agents in health (HIPC Officials vs vs vs 25,000 Contract vs Decision
makers, etc. ...)
6. The postponement of the retirement age from 55 to
60 years to overcome the deficit in experienced staff as well as in hospital
practice in education.
We wish for all:
1. The promotion of telemedicine and the creation of
communication tools between professionals,
2. Encouragement and support for research and
innovation in all areas of health,
3. The incentives (organizational, material and
financial) to mobilize all the medical expertise of the Cameroonian Diaspora
for the care and teaching.
VIII.LA REMUNERATION OF HEALTH PROFESSIONALS
We want the revaluation of bonuses and allowances of
health workers in the public and private sectors based on the cost of living,
skills, training requirements, and constraints and risks.
We want to physicians, nurses, paramedics and the
private sector
1. The revaluation of the salary scale of the tertiary
sector in favor of health professionals
2. Harmonization, and the strict application of the
above mentioned revaluation by collective agreements in all private care
facilities.
We want to physicians, nurses and other paramedical
staff, the public sector increased:
- Housing allowances up to the current base salary
- Premiums on call
- Technical Premiums
We also wish to medical officers:
- Harmonization regulated the allocation and
calculation of the amount of assessments based on the effective yield in public
hospitals to equal category,
- The consistent improvement of the level of experts
from the reclassification
- The introduction of regulated private consultations
at the hospital out of hours service and in agreement with the management for
two half-days per week for specialist physicians, and half a day for general
practitioners,
- The introduction of bonuses and special allowances,
including:
* Lump Risk premium
* Lump Transport compensation
* Flat rate for night work, Sundays and holiday
* Flat rate shoes and work clothes
* Flat rate for dangerous, unhealthy or obnoxious
* Residence allowance or premium remoteness, incentive
target on the scene of landlocked and dangerous assignment, according to an
equalization based on the distance.
IX. ADMINISTRATION AND MANAGEMENT OF HOSPITALS
We wish :
1. The establishment of colleges 'internal' to health
facilities to ensure the appointment of directors from qualified candidates
from a recognized specific training,
2. The management of health districts by public health
specialists,
3. The promotion of good medical practice and nurses
in the emergency services,
4. Management of ethics by a dedicated committee
within the hospital structures,
5. The re-certification of health professionals by
Independent Body as part of continuing medical education accredited by the
National Order of Doctors of Cameroon (ON ™).
6. The appointment hospital officials by a peer
college.
7. The management of hospitals by doctors trained in
management. The administration can be delegated to a business school graduates
in the sector "Administration hospitals" (ENAM in this case).
Concretely we propose:
- Promote a medicine based on the evidence generated
by clinical research whose promotion must be made and which specific budgets
should be allocated annually,
- Assign a share of hospital revenues improved
techniques and knowledge for better performance,
- Ensure a multidisciplinary medical and collegial
constituting whatever level health teams comprising at least 2 people per
health center (ideally four persons including one for each major group of
disorders).
- Condition the deployment of young doctors in
peripheral health facilities, implementation of an impregnation period under
supervision / mentoring 6 - 12 months in regional hospitals.
X. SAFETY AT WORK FOR DOCTORS AND PERSONAL CARE
We recommend :
1. Installation and regulated control of the
functionality of infrastructure and furniture work in public and private health
facilities,
2. The installation and monitoring decent amenities on
the workplace: running water, electricity, toilets, changing rooms,
3. The implementation of preventive measures and the
full support of all accidents involving biological hazards in hospitals:
hydro-alcoholic solution of local production for
disinfecting hands, available for all, actual vaccinations, compulsory and free
for all existing workers in public institutions against health; hepatitis B,
polio, tetanus, diphtheria, tuberculosis and pneumococcal and meningococcal in
areas at risk. This also applies to interns and students.
4. Upgrading of the technical platform of health
facilities, according to their level in the health pyramid.
5. The introduction of health policy at work for
regular monitoring of practitioners to assess and define the impact of
occupational conditions on the physical and mental health.
RESOLUTIONS
Deeply attached:
the principle of equal quality medicine for all, and
social security solidarity nationally, the relationship of trust caregivers /
carers and carers / cared necessary for quality of care, the need to treat all
patients in our conscience, in decent conditions;
WE:
praise the current government initiative to reform our
hospital system, and appreciate the openness to physician groups, declare as
doctors Cameroon, our resolve to work with the sovereign bodies to contribute
to the improvement of the system Cameroonian health.
THE April 22, 2016
NB/ BaretaNews translated the french document through google translate. We still await the English version.
