"Nobody dares to seek the truth. However, those who dare try to find it. However, those who are not afraid to say it. Those who say they are not listened to. "
Alfred SAUVY
The debate on the right to health caused by the strike of senior members
of the health SYNACASSI, the illegality of the strike and penalties,
including threats of lawsuits, lead me to submit this contribution.
In fact most of the articles and contributions have addressed the issue
only in terms of the rights of people with a strong recommendation to
the union to defend their rights without endangering that of others.
The question is who will take care of the right of physicians and other senior executives.
What newspaper will defend the right doctors, without it is a lobbying
with all that implies in terms of financial, ethical, political, etc ...
That is why I decided to address the issue in terms homework
populations to physicians and therefore senior health.
Many stakeholders in the crisis have tried to explain our duties, as if we do not. Reminder
medical studies last on average seven years for graduation which
confers the title of general practitioner after it takes on average
three years of additional studies to obtain the title of specialist. Various other courses we sometimes allow us to assign the title of consultant. And yet, the fact remains that some of us become experts on certain issues. The title of general practitioner to expert must be a long way, so it is not that we should explain our homework. I would therefore like to provide information to feed the debate if not for the close to dedicate ourselves to the essentials.
LEGAL BASES OF POPULATIONS OF DUTIES TO THE DOCTORS .
1 / The right to health.
Many national laws (constitution, code of public health) and
international treaties have been cited to recall this fundamental right
of peoples. To be able to enjoy so many rights it there's necessarily much homework. Away from us a debate on the sterile legalism, it should be borne in mind that you can always request without giving anything. The right to health imposes a de facto duty to those who are directly involved.
2 / The Hippocratic Oath
A newspaper published the Hippocratic oath, as a reminder that a commitment we made to our parents and teachers. I
mention in passing that while retaining its essence, this oath has
evolved into writing and it takes into account scientific limitations
(cloning, the genetic test or DNA test) the emergence of new diseases
large exposures stigma (HIV / AIDS); socio-political standards of our
time (which impose democracy as a system of reference and to invite
obstacles to abuses such as xenophobia and genocide, for example). Through this oath doctors have imposed many obligations and this as I said, taking into account our time. I chose the oath in the following passage, "I would demand a salary above my work .. ".
Implicitly anyone, regardless who is asking the physician must work to pay him a salary.
Why would you swear he referring to a salary since the dawn of time? In some countries the laborer is worthy salary. To believe all the writings and called the name of the Hippocratic Oath, physicians should Ivorian renounced their incomes. The proposed life of a doctor Ivorian is not he also designed around minimum expectations?. It
is therefore the duty of the people to improve their vision of the
world and hence their vision of the medical profession in our country. It is therefore legitimate to all, requiring a minimum necessary for each of us to realize his life.
3 / confraternity among doctors
This is a legal provision of the Public Health Code and the Code of
Conduct which outlines Failure to disciplinary action and even
civilians. It is not acceptable to encourage physicians to their disengaged colleagues.
4 / The need to ensure a minimum service during strikes .
4-1 / HOSPITAL IS NOT THE DOCTORS.
He belonged to the owners to say where, how, with whom, with which he organizes the minimum service. In this regard, the government has not proposed. I
recall, no advertising, the PISAM; Avicennes; POLYCLINIC THE TWO TRAYS,
THE HOTEL POLYCLINIC GOD THE GRACES THE POLYCLINICS; THE CLINICAL
CENTER GRAND, THE CLINIC CENTRAL STATION ABOBO and many others, but
especially HOSPITAL MILITARY were open and could be the scene of the
management of major emergencies at the expense of leaving the state to
pay then they are guilty.
It is the people who pay for their elected guarantee the minimum, not to
lose sight of that disaster, the state must exist for the good of all. Do not assume its responsibility and always blame others is evidence of bad faith must cease to thrive in our skies.
4-2 / YEAR MINIMUM IS NOT MEDICAL CONCEIVABLE.
To the substantive issue of the minimum service during strikes, drawing " PRINCIPLES OF EUROPEAN MEDICAL ETHICS ", CIOMS, 1995 three types of comments are open to us.
1 / The CIOMS in the text containing "the most important principles
intended to inspire the professional conduct of doctors whatever their
mode of exercise in their relationships with patients, community and
each other," recalls its Article 1 , the vocation of the doctor. The reminder of this article must put an end to those who want lessons we learn what a doctor "doctor's
vocation is to defend the physical and mental health of humans and
relieve their suffering in accordance with the life and dignity of the
human person regardless of age, race, religion, nationality, social
status and political ideology, or any other reason, in times of peace as
in time of war. "Thus enacted ask doctors to work under minimum is inconceivable.
2 / The International Conference Orders, finally enacted in Article 36 of 37 , so at the end of recommendations, in case of a strike, " when
a physician decides to participate in an organized collective refusal
of care, it is not relieved of its ethical obligations vis-à-vis
patients who must ensure emergency care and those necessary for patients
in treatment . "
The doctor has an obligation vis-à-vis his patients and not the service
or the authorities against whom he began an action just type
association. To equate the two not to initiate constructive
dialogue with physicians, is an encouragement to the violation of
medical ethics which places man at the center of its concerns. Indeed, how can we respect people who do not respect us. They are convinced that we will not end until our demands because it would jeopardize social cohesion.
3 / The CIOMS ends its recommendations by Article 37 relates to the fees . The
incompatibility between the medical practice and the perception of
income is not proven, it there's place to address all the different
regulations that appear on this question. No legal or ethics shoed dam just compensation cost of services rendered by the entire medical Ivorian.
RECOGNIZE THE MEDICAL, ITS ACTS PATRIOTIC
Currently many players have decorations and official congratulations for patriotic acts. What about medical?
1 / From October 2000 through September 2002 and November 2004 and
ending with the advent of toxic waste, medical Ivorian body as a whole
has never been lacking. Reminiscent of their contribution,
which is unacceptable is undemanding to victims of medico-legal document
proving that they were victims among the documents required to obtain
compensation. Every man knows warns that without
this document, nor still less tomorrow, no serious courts will not
respond to a complaint of a victim (how will he prove that he was
sick?). This serious omission is part of a logic that
physicians who do not perceive worked thirty thousand francs CFA (the
cost of the certificate) per patient intoxicated. Made in some felt that three billion francs nothing as medical would be excessive.
2 / In our daily practice, delivering effective treatment at lower costs
is a patriotic act which must be recognized and proclaimed. I did some understanding that are this obvious logical view. To
understand, we must bear in mind that no doctor has an interest in
seeing stigmatized for treatment failure and therefore has an interest
in using the most effective treatments and obviously the most expensive.
THE MEDICAL CORPS AS A DRIVER OF DEVELOPMENT
1/ACTEUR OUR CENTRAL MEDICAL PROJECT.
" Everything was ready in October 2002 , "according to those responsible for implementing the project of AMU. If
this were true, it implies that the medical Ivorian was ready to
participate in the realization of this dream that all Ivorian would like
to see succeed. It would have been an opportunity for
physicians and other colleagues to fulfill their duties towards all the
Ivorian population.
2/3 OBJECTIVES OF 8 (37.5%) MDG (THE MILLENNIUM DEVELOPMENT FOR) MUST BE MADE BY THE MEDICAL COPrS. ( see page 24 of the fraternity morning Wednesday, September 19, 2007 )
Ultimately, the only reason for me to make a contribution is the " Joint Statement of the members of the steering group for the achievement of the Millennium Development Goals in Africa ", the newspaper quoted has been widely reported . For
the small number of African and especially Ivorians who have knowledge
of this project, what answer do we bring to this statement?
1 / From the direct and indirect role of the medical profession in the MDGs .
The part of the medical work is excessive, since in Anglophone Africa most doctors in the United States, Britain and Australia. In
Francophone Africa, where the language barrier made of doctors are
still in their country, the place should be theirs is not appreciated. Overall,
though, on the continent, there's a shortage or misuse (abuse including
salary) of medical it is feared that even justified it will review the
objectives themselves. Made in the objectives are
consistent in themselves, South Africa is recognized as one of the few
emerging countries in Africa recruits physicians (especially Arabic and
French), which demonstrates the correctness of the MDGs. Made of our position we know the strategies used by other developed countries to recruit doctors from us. The internal and external conditions favorable to hypothetical departures doctors make the achievement of Africa. In
addition to the direct role they must play in three goals, they are
expected to contribute qualitatively to the implementation of the other
five.
2 / Côte d'Ivoire is it you involved?
If
our country has entered the MDGs in its development policy, people who
have represented our country would benefit us explain what they expect
from us (the medical profession as a whole). Because all the press articles we walked in the latter time leaves us hungry. Being
unable to understand how the world works (globalization,
globalization), to focus on issues such as the organization of basic
minimum services for the populations to castigate a whole body of work
is appalling. How to maintain the medical Coast Ivory? How to find ways to enable them to train to be at the same level as the other doctors? (Yes,
doctors must maintain their level of knowledge) and how to help them
achieve their life goals without requiring that they are to engage in
activities contrary to their ethical conduct and even leave their
country?
To conclude my remarks, I would like to emphasize that in community life, each of us will be frustrated sooner or later. It
is therefore necessary to avoid offering food workers, whose strong
sense of ethics, lead, now that things seem to go in order to ask those
who have it right. I thank those who sanctioned, now they have a reason to start over just because they know the penalty.
Dr.
kouakou thank you for the support and especially to give tools to
understanding each other and to better understand the delicate situation
of health actors. two points must be stressed beyond the support of all.
1)
one of our biggest problem in Ivory Coast, is that the defense of
mental or physical safety of our patients we care little, otherwise how
can we accept work with existing tools of public service. failure
of free came here, we should say stop, you are at the stage of
prescribing operating tables in addition to the box surgery without
knowing exactly what the patient because no diagnostic tools. there is nothing to work on was not to continue to pretend. we continue to see and be blind towards ways of working.
2)
for more than 50 years managing health or at least the Ministry of
Health is in the hands of those directly involved, health professionals
(excluding made for the period of Mr. Poto Lanzéni that the rest was not
very bad though secular health) and is always at the same point of
claim (wages), I think that the strategy so far may be wrong in
principle we change that equips not win. here is the strategy must change. For this no need for a showdown with the government or the people. remember the strike of 2009, without responsibility, without minimum service. at the time the population was attacked doctors and cars, the caduceus authentic. promises
are always at the same point, so to change strategy, work will resume
on the basis of minimum acquired and negotiations will be as scheduled
by the promises. pr. The reanimation Soro Abidjan Ivory Coast
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