In simple terms, a medical evacuation, abbreviated as evasan or medevac, is the extraction by an air, land or naval unit of a person suffering from a health problem. The term was originally used primarily in a military context. However, it must be recognised that medical evacuation is a rather delicate activity that requires continuous learning but also taking into account the human specificities of Africa where things are built slowly and where human relations and warmth are important.
In 2008, the Cameroonian Head of State committed himself to modernising the technical facilities of certain reference hospitals in the country. This commitment has been translated into action since the beginning of this year, by the launch of haemodialysis and dialysis centres, carried out at the time by the former Minister of Public Health André Mama Fouda, in the localities of Garoua and Bamenda in particular. This was to improve the care of patients in remote areas. For urban areas, the reference hospitals (general hospitals, gyneco-obstetrics), had the reputation of being provided with qualified personnel and high-tech equipment.
However, despite all these provisions, the number of medical evacuations abroad, from which state employees benefit, remains high. With well codified provisions, according to the texts of 13 September 2000 setting out the modalities for exercising the right to health of civil servants. « Before, it was enough for state employees to present themselves to the Minfi (Ministry of Finance). Now, the government has set up a national health council that decides on medical files. It is co-managed by the Minsanté (Ministry of Health) and the Minfi, » says the Minsanté.
Despite all these measures, what do we see today?
We still remember the medical assistance convention signed on 26 October 2016, by the Director General of the CNPS (National Social Security Fund), Noël Alain Olivier Mekulu Mvondo Akame, and the Director General of Tunisia Medical Services (TMS), Slim Maraoui, in the presence of the Tunisian Ambassador to Cameroon, His Excellency Jalel Snoussi, at the headquarters of the National Social Security Fund, Cameroon’s social security body, located in Yaoundé.
Indeed, in recent years, despite the improvement of the technical platforms of its four health structures across the territory (the Essos Hospital Centre in Yaounde, the Medical and Social Centres of Maroua and Garoua, as well as the Maternal and Infant Prevention (PMI) of Bertoua), while multiplying training to optimize the skills of its practitioners, the CNPS has had to resort to medical evacuations in Europe, notably in France and Great Britain.
What is important to remember is that this agreement was to ensure that the evacuees proposed by the CNPS received the medical care and surgical procedures necessary for the pathology justifying the medical evacuation. In addition to these services, medicines, consumables and equipment required in accordance with international norms and standards and in line with the requirements of medical ethics. Biological and radiological check-ups, CT scans, MRIs, transfusions, haemodialysis and any cardiovascular exploration should also be covered.
Is this an insult to the health personnel?
« Medical evacuation, once reserved only for soldiers, has suddenly taken on a different connotation, and for what purpose? Who knows? Nowadays, medical evacuation consists in transferring the civil servant, his spouse, his legitimate children or adoptive children, from a first intervention hospital to a public or private, national or foreign hospital of higher class, at the taxpayers’ expense. It is recognised that in the sub-region, Cameroon has internationally renowned specialists in several medical disciplines. Why the increase in the number of medical evacuation cases? In view of this gloomy picture, not to say a situation that impoverishes the country, can we deduce that our technical health facilities do not meet the standards? Or is it a way of diverting funds or being safe from any legal proceedings, with the complicity of certain friends or party comrades? Is this not also an insult to the health staff? » said Roger Tono, a retired nurse.