Project for Acha-Tugi Healthcare System (PATH SYSTEM) NGO represents a paradigm shift in the way we craft access to basic health care services for the Mbengwi District (Meta region) of Cameroon. It is a collaborative integrated healthcare delivery system sustained by microfinance system. The system is made of Acha-Tugi hospital, Health Centers in the Meta region, and Mobile Outreach Clinics for servicing regions with no formal medical care settings. The system's mission is to provide accessible basic health care through treatment, prevention, screening and outreach education. It is also a structure setup to collect, share, transfer, and store patient medical history for ongoing medical care in a team or cooperative environment.
The challenges of poor roads, poor communications' technology, dilapidated buildings, inadequate management strategies, inadequate accountability, limited assessment strategies, lack of equipment and medications, and limited trained medical staff create a complex structure for implementing effective patient care services. To develop a solution we must think ‘out of the box’, stretching knowledge boundaries from traditional medical care settings so that each solution developed for each challenge or around each challenge results in saved lives.
PATH SYSTEM's patient management strategic model is FACAS:
- Free Health Care and Education of the poor: For indigenes to accept and respect medical help, you have got to provide free health care tho those who cannot afford to pay for the cost of care. Those who can work will be provided micro-loans for investments. Profits from such investments will be used to purchase quasi healthcare insurance, repay loans and purchase of basic necessities.
- Access to Primary Health Care: The principle is that, HIV/AIDS cannot be treated, or prevented in isolation. Therefore, the total care of the patient must be taken into consideration.
- Community Partners: All leaders of the community should be included. It means the church, local government, village leaders and TRADITIOANL HEALERS. This is a new concept that we think allows us to build a sustainable health care delivery system for oMeta region.
- Addressing Basic Social and Economic needs: Microfinance is used to sustained healthcare... because poverty and healthcare are linked.
- Serving the poor through the public sector: We have to build a relationship with local government. NGOs cannot succeed without building a partnership with the local Government.
PATH SYSTEM BASIC MISSION
- PATH SYSTEM Legacy: Historical accounts of Presbyterian General Hospital Acha-Tugi precept that “no one is big enough to be independent of others” is what made the hospital a regional respected facility in Cameroon and in West Africa in the mid sixties. The interest of the patient is the only, and only the interest to be considered. To succeed, we need a cooperative healthcare delivery system for the region based on sound patient management strategy
- PATH SYSTEM Vision and Values: PATH system is a step up in size, scope, and complexity of today’s healthcare challenges, but, by and large, our value system is patient-first medical team philosophy.
- PATH SYSTEM Patients are our Partners: PATH’s style not only means partnering with health centers, hospitals and outreach clinics but it also means partnering with patients. Our success will be determined by the trust and confidence of our partners.
- PATH SYSTEM Unbinding Self-Interest: Medical staff and leaders have no economic reason to “hold ” onto patients rather than refer them to colleagues (centers and hospitals) that have knowledge and the expertise to treat them. It is purely a humanitarian effort to implement the new paradigm
- PATH SYSTEM Team players: Providing clinical healthcare services is very demanding work. Setting up a patient management structure is very demanding work that requires sacrifice and long term dedication. It is stressful, physically and emotionally. PATH System is structured to overcome medical obstacles using support from the church, local government, other organizations, individuals (within and outside Cameroon) and ivillagers. Not only will PATH System’s core strategy of integrated, multispecialty medicine require teamwork but the complexity of the illnesses also compels a team approach.
- PATH SYSTEM Life Commitment: PATH System aims at building a solid team of people who are committed to high-quality care and service; convey a positive attitude; are enthusiastic, resourceful, and honest; have a strong work ethic, unconnected to extrinsic rewards, demonstrate understanding of cultural diversity, and aspire to collaborative work. Training and education of staff becomes a corner stone to the successful implementation of the project.
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| USING MICROFINANCE TO CREATE AND SUSTAIN MEDICAL CARE |
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| PATH SYSTEM SHIPPING SUPPLIES TO META |
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Meta tribe of Cameroon is at cross-roads of poverty and diseases. Effective government solutions barely exist. Corrupt legal systems deter investment trust. Poverty, diseases, hunger and land disputes threaten the lives of thousands of indigenes. HIV/AIDS infection rate is the highest in Cameroon. Low standard of living and economic stagnation dwindles the hopes of many villagers. This outlook presents a sad picture of hope, pulling some humanitarian organizations who want to help to the region. Unfortunately solutions for Meta people to overcome these problems cannot be designed for the people of Meta without the participation of those impacted. Western approach to problems impacting Third World countries have followed one conventional thinking model of “We know best what they need and the idea of one size fits all cultures”. We want to partner with humanitarian organizations to assist Meta people but not based on conventional obsolete thinking models. PATH System needs resources for medical care provisions and poverty reduction programs.
HIV/AIDS infection statistics of the region presents a glimpse outlook for the people of Meta region. UNAIDS and other nongovernmental organizations agree to the problems facing the Meta region and other neighboring tribes, but continue to recycle solutions based on conventional thinking. Unfortunately there has been no way to break the filibuster of conventional solutions to provide long term sustainable help that will lead to empowerment and creation of potent teams.
HIV/AIDS STATISTICS OF CAMEROON
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Year
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Prevalence estimate (%)
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Source
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2000
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10.8
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Ministry of Public Health, 2000/2001
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2001
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7
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ONUSIDA
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2002
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7.3
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Ministry of Public Health, 20003
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2003
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6.9
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UNAIDS/WHO, 2004
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Prevalence (%) of HIV/AIDS according to age (2004)
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Age (Years)
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Women
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Men
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Total
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15-19
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2.2
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0.6
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1.4
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20-24
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7.9
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2.5
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5.5
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25-29
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10.3
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5.1
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7.8
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30-34
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9.4
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8.3
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8.9
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35-39
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7.8
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8.6
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8.2
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40-44
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6
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5.6
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5.8
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45-49
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5.5
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3.8
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4.7
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Total ( 15-49)
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6.8
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4.1
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5.5
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Prevalence (%) of HIV/AIDS NWP of Cameroon which includes Meta (2004)
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Province
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Women
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Men
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Total
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Adamaoua
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9.8
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4.1
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6.9
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Centre
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6.8
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2.1
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4.7
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East
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9.4
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7.6
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8.6
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Far-North
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2.2
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1.7
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2
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Littoral
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6.4
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4.7
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5.6
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North
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1.7
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1.7
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1.7
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North West (includes Meta Tribe)
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11.9
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5.2
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8.7
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West
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4.3
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5.2
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4.7
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South
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8.4
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4.5
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6.5
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South West
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11
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5.1
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8
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Total (15-49 years)
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6.8
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4.1
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5.5
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Data Source: Department of Public Health, Cameroon
The complexity of the problems facing Meta people and the commonality of problems require a strategy, a hybrid of several theories for example, Kuklin believes that,” … logic alone cannot support a moral consensus, instead a common intuition regarding underlining values is necessary, and one should address the sources of this commonality” (Kuklin 1994:19). The initial step is to build a coalition of villagers with common interest for example farming. Communities facing same problems for example lack of healthcare need similar solutions. For the solutions to be effective and sustained over time, members of the community have to be active participants. This concept is based on backward mapping policymaking such as the Feminist Legal Movement and creation of Civil Rights in the United States of America.
What is wrong with the solutions put in place by Cameroon governments and non-governmental organizations, and why are they not working for the people of Meta tribe? Leo Sandon in ‘It’s time to face demons’ notes that, “he is inclined to think that we are all Ghosts…. It is not only what we have inherited from our fathers and mothers that exists again in us, but all sorts of old dead ideas, all kinds of lifeless old beliefs … we can never get rid of them” (Sandon). Cultural change requires change of mindset. Poverty and disease are bedfellows. Until we recognize the linkage, solutions cannot be sustained. This argument is supported by Desmond Cohen of United Nations Development Programme (UNDP) who noted poverty reduction as a way of improving and sustaining health care in Africa. He notes that, “Poor nutrition leads to poor health which is an important cause of low labor productivity and thus the persistence of low incomes for the poor. Poor and damp housing is a major factor in causing illnesses such as tuberculosis, which is itself exacerbated by the HIV epidemic (where there is now a dual epidemic underway in Africa). …, children will continue to experience poor health status over their lifetimes with all kinds of social and economic consequences for them and their families” (Cohen, 1997-1998).
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