Monday, December 2, 2013

Medical Education in Cameroon Needs Product Approval and Certification, Not Disruption!

By Asonganyi Tazoacha* 
"Vision-2035” that has since become the mantra of the Cameroon government promises in the area of health, education, science, and technology that “A national product approval and certification system will be established.” Such products, one would hope, include goods, services, and trained manpower. The system should include an oversight on the production process. If well executed, the system would prevent people from settling on the notion that “anything goes.” The system should be based on special codes to reduce complexity and establish behavioral expectations. It should not threaten the autonomy of society and the vibrancy of the private sector. It should be robust enough to avoid being abused or being used for strategic ends of groups or individuals, whoever they may be. To increase their robustness, such codes should be constantly acted on through plural democratic processes that not only put into question the established “norms,” but also help to legitimate, concretize, or improve them.
When government policy is not well thought out and appropriately communicated to society, public opinion is easily dominated by general, speculative ideas. If policy that should be shared through processes of participation and communication becomes subject to the organizational logic of administrative power, this leads to confusion, demobilization, distrust, and poor implementation.
The recent activities of the ministry of Higher Education in relation to medical education in Cameroon were an effort at fighting against an old error which the ministry was a willing accomplice in perpetuating. The ministry gave authorization to persons to start medical training institutions without clear rules of engagement; without enforceable codes of conduct. So when the ministry started playing the catch-up game, it left the impression of the desperation of someone trying to catch a train that was already in motion. It also left the perception of theatrical actions that did not seem to have been well thought out, and so lacked a well laid out plan. In the process, it appeared to the public like the settling of personal or group scores because it ended up with decisions that were not only extremely disruptive, but were also certainly unsustainable.
Citizens usually want well-being not only in body but also in mind; they want both health and happiness. It is because of this that we are clamouring for “development;” for “emergence.” To achieve these, they need to be powered mainly by science, and by the things that science has already delivered to us, and will surely deliver to our children, our grandchildren and beyond. This is why all education systems of the 21st century have the “STEM” component – Science, Technology, Engineering and Mathematics – as their centerpiece. Since Medicine that the ministry of Higher Education seems to be grappling with is a well deserved component, we can say that it is “STEMM.”  But medicine is just part of a broad spectrum, and should not be allowed, as the ministry seems to be trying to do, to distract attention from other important components of STEMM.
It is the place we give the STEMM component in our education system that will permit our universities to become knowledge centres of excellence, and generators of knowledge, entrepreneurship and innovation - elements that will impact the economy and general policy development. It is STEMM that should drive our university system and ensure that the universities, private and public alike, produce highly skilled manpower that is internationally competitive; manpower that is disciplined because it pays attention to details induced by careful and rigorous training received from highly motivated staff. Such skilled, disciplined and highly competitive manpower is obviously not the “semi-skilled workers and second-line managers” our universities are presently spinning out as holders of “professional” diplomas and degrees.
The theatrics engaged by the minister of Higher Education in the medical education sector should not distract attention from the fact that our universities lack infrastructure and a friendly environment to support teaching and research in all domains; that university leadership is appointed, not based on merit but on nepotism, tribalism, and cronyism; that university administration is tele-guided from a central control point in Yaounde that has a penchant for leveling and cutting every institution to size, thus, usually blocking the individual genius and human intelligence that invariably make one country different from the other, one institution different from the other, and one university different from the other.
 If “product approval and certification” means merging the public and private sectors into one unit under the diktats of the government, it will obviously be more destructive than constructive. In the pursuit of the goals of “approval and certification,” the public and private spheres should co-exist and depend on each other, but should operate as different units. The goodness in the private sector is usually the strength of a sure factor – the human factor - which, in the exercise of free choices and actions in an open society, can give birth to competitive institutions that set the bar high on what universities can achieve. Indeed, the goodness of the private sector is in the generation of competition, which has always been the surest means to bring all human capacities to full development. The private sector works on the imperative of efficiency that rejects advancement by personal favour, tribalism, regionalism, corruption or party affiliation that have become the hallmarks of the public sector in Cameroon.
In what looks like a confused effort to streamline medical education in Cameroon, government is being perceived as an actor among other actors rather than as the provider of the framework that makes possible the competitive operation of university institutions in the public and private realms. The government is perceived as attempting to impose itself on private actors, who, in reaction, seek to resist it because government is believed to have lost its proper function by being reduced to an object of social competition, and a prey to real interests. Such a posture denies government the autonomy and responsibility of judgment in the formulation of just and sustainable policies for medical education in Cameroon. The posture has led to a lack of trust in what government is doing because it is believed that it is tainted with personal, selfish considerations. Indeed, it has led to actors looking for somebody to rescue them from the government!
National product approval and certification is obviously good for any country engaged in the great catch-up development race of the 21st century. But it should be a system that encourages competition and excellence, not blocks them. What we urgently need today is not the sort of confused actions the ministry of Higher Education has engaged in the medical education sector. We need an all-encompassing approach defined in a national education forum that charts out strategies for an education system that can make Cameroon a talented player in the biotechnology, technology, medical and other professional and industrial sectors.
Asonganyi Tazoacha is a professor,teaching at the Faculty of Biomedical Sciences,University of Yaounde 1,Cameroon

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