When Central Bank issued a directive to scrap push-pull fees to boost a local cashless ecosystem, telecom operators and banks were disgruntled that a portion of their revenue would disappear, but they duly obliged and the public was happy. When RURA issued MTN an enforcement notice, giving the operator a deadline to fix their network issues that customers have been complaining about, the company came out to assure its customers that it would be doing all it could to address their grievances. Central Bank and RURA are examples of regulators doing their job in the interest of the public. These tough regulators are also known to slap hefty fines on businesses that are non-compliant. It is high time the regulators of the health sector get tougher on medical malpractice and poor service. And one way to do this is by hurting the bottom line of the medical establishments. It goes without saying that healthcare is one of the most profitable ventures in Rwanda and the world over. However, to maximise return on investment, a substantial amount of money must go into infrastructure, equipment, and personnel. One of Rwanda’s flagship medical establishments, the King Faisal Hospital, has invested close to USD 20 million to upgrade its facilities and services as it aims to tap into regional patients. Private facilities are doing the same as well. As investment goes into the major needs, there are areas that can be simultaneously fixed and may not be as costly especially in the quality of care and service. Someone will have to explain to me how in our country, Rwanda, where we can book a driver’s test, do a title transfer, or apply for a passport online, our clinics, both public and private have failed to install working appointment systems. I can already see some clinics and hospitals going up in arms to declare that they do have appointment systems, but here is the challenge, should I come in for an appointment at 10 a.m., and find people waiting, will I be ushered in? It is unlikely, almost every health establishment uses a first-come, first-served system. It’s unbelievable. This is not a 100% technology problem, there is a human element to it too. For an appointment system to work, both the patient and the doctor need to respect it. There is not much that can be done if, at opening time, the doctors are always running late. I cannot count the number of times I have arrived at the opening time only to sit for 2 hours in a reception area waiting for the doctor to arrive. To summarize, here are your options, especially if you need to see a specialist. Either go to the clinic/hospital first thing in the morning and be first in line or come in time for your appointment but expect to wait. Surely, we can do better than this. We are living in a fast-moving world where everything is going digital, and time really is money. It should be unacceptable to be expected to wait for 20 minutes, let alone 2 hours. Why should a mother wait in a crowded waiting room with a sick baby when, with a simple investment, on the institution’s part, she could arrive just in time to see the doctor? Why should a patient travel all the way from Nyamasheke to Kigali for specialist care, only to be told that the doctor has reached the maximum number of patients to be seen that day? Ultimately, why should patients be exposed to Covid-19 in waiting rooms cause hospital and clinic administrators cannot be bothered to step into the 21st century and upgrade from the archaic first-come-first-served appointment system? And with the advancement in technology, there are so many tools that hospitals and clinics can deploy to provide better quality care. We have three months left to the end of the year, and 2020-2021 has been difficult for public institutions, but private clinics and hospitals, have no excuse. Make a commitment to value your customers. If things like processes cannot be implemented, you create an environment that breeds more complex issues like misdiagnosis or botched operations. There have been a couple of situations this year where the Ministry of Health has suspended the operations of prominent health facilities in Kigali for grave mistakes – rightly so. However, the trick with closing such facilities is that the culprits can move to another facility and continue with their malpractice and with a shortage of health practitioners, it is the patients who bear the brunt as closure of facilities only makes the doctor/nurse-to-patient ratio worse. I write this very aware that I do not have enforcement power, so I will close by making an appeal; Dear Regulator of health care institutions, RISA, and the Ministry of ICT, could you please use your directive power to carry all along with you on this journey to digitize Rwanda. And, for non-compliance, impose hefty fines that leave dents on profit margins and hurt their businesses. When targets are missed due to negligence and malpractice, heads will roll, and we will begin to see real, transformational long-term change.
