Legal, technology dilemma facing doctors in Tanzania

Medical practitioners in the country also lacked professional indemnity when performing their duties

What you need to know:

If laws and regulations to guide the profession are not urgently put in place, practitioners may be thrown into unending legal crises

Dar es Salaam. Cases of breach of medical ethics by practitioners in hospitals are now blamed on the advancing healthcare technology and the mushrooming of private health facilities across the country.

Experts warned yesterday that if specific laws and regulations to guide the profession are not urgently put in place, healthcare professionals -- and patients alike -- may be thrown into unending legal crises in the coming days.

Retired director general of the Commission for Science and Technology (Costech), Prof Yadon Kohi, told health stakeholders in Dar es Salaam that the ‘commercialization’ of healthcare services in Tanzania has also created loopholes for medical malpractice, yet the country has not put adequate measures to regulate the business.

Presenting a paper at the Tanzania Health Summit, which ended yesterday, Prof Kohi said since the start of the 21st century, medical demands have changed greatly and therefore the medical ethics and medical-legal regulations needed to adapt to the changes.

The don, who is also a board member of the Medical Council of Tanganyika (MCT) said that doctors in the country also lacked professional indemnity when performing their duties, warning that the situation exposed them to a number of legal and financial risks.

“We have heard of cases in the country, where a doctor was charged with medical negligence and the complainant demanded millions of shillings from the hospital. But the laws are not yet specific in cases where a doctor is forced to pay,” noted Prof Kohi.

One such land-mark case occurred this year in Tabora Region, where a woman was left unable to have children after a defective Caesarean section procedure. She won the case against a local hospital. It had emerged that the surgeon left a piece of cloth inside her.

Mwamini Adam and her husband filed a lawsuit at the High Court in Tabora Region against Urambo District Council’s hospital four years ago, demanding Sh500 million for physical and emotional distress.

Adam, 37, accused Jacob Kamanda, a gynecologist and obstetrician at the district hospital, of professional negligence and misconduct after he left a piece of cloth in her abdomen after performing the Caesarean section procedure.

Prof Kohi believes that the doctors need professional insurance because their job was full of risks yet the laws were not adequately protecting them.

He said that the doctor-patient relationship was also changing due to increasing technology, with medical professionals increasingly working under pressure due to patients who can diagnose themselves on the internet.

“Nowadays, people have access to a wealth of knowledge on the internet and this can be a source of conflict between doctors and the patients,” he observed.

But according to the CEO of the Association of Private Health Facilities of Tanzania (Aphta), Dr Samuel Ogillo, advancing medical technology is slowly creating room for some professionals to abuse human rights and escape legal action.

“Tanzania has not yet invested highly in medical technology,” he noted and added, that when private investors come into the country with their new technology, the government readily accepts them but unfortunately, the current  laws cannot regulate the type of services they offer. “Such investors can walk out scot-free when their clients complain in court, simply because there are no laws regulating what they do,” said Dr Ogillo.

He appealed to the government to urgently address the matter by enacting laws—just as it did with the cyber security area—so that the Medical Council of Tanganyika and the Tanzania Medical Association can deal with cases of medical malpractices more efficiently and objectively.

“The country’s medical council and the association of medical professionals must also see the need to push the agenda on the new laws forward,” added Dr Ogillo.

In response to Dr Ogillo’s call, the director of the Dodoma Christian Medical Centre, Prof Charles Majinge, informed a team of researchers and health professionals at the just ended Tanzania Health Summit that the government would soon establish the law.

“I’m informed that the laws relating to healthcare delivery were being revised this year and would begin the process of deliberations and enactment in the coming parliament,” said Prof Majinge, who is also a board member of the Private Health Facilities Registration.

According to him, the mushrooming of private health facilities, coupled with the increasing commercialization of healthcare delivery in the country, is also leaving room for unqualified people to penetrate into the healthcare industry and hence providing hazardous care to patients.

“There is an urgent need for a quality control mechanism and its enforcement so that the doctor and owners of the facilities can be well regulated,” added Prof Majinge.

For some years, there have been reports of a number of unscrupulous persons being arrested in hospitals for allegedly pretending to patients that they were medical professionals working at the facilities.

Some high profile cases have even occurred at the country’s major referral hospitals—The Kilimanjaro Christian Medical Centre and the Muhimbili National Hospital.

Prof Majinge was of the opinion that such people took advantage of the shortage of medical staff in the country, such that there was even little room for supervision from the administrators of the health workers at their work places.