The stark reality of unment need in Togo
An interview with LAPTOP scholar Dr. Kossivi Afanavi
Interviewed in 2014
As a young boy in Togo, Kossivi Afanvi watched a television documentary in which a doctor performed emergency surgery to save the life of a dying a teenager. Right there and then, he decided he too would help save lives. Today, not only is he a qualified general practitioner and pediatrician, he is also the Health Director of the Lacs District in Togo, on the Benin border. In addition, he is Assistant Professor in Global Health at the University of Lomé, teaching logistics, health marketing and epidemiology to nurses, midwives and medical students. Kossivi recently received one of the Coalition’s two LAPTOP scholarships, awarded for study of any course listed in the LAPTOP database of supply chain management courses.
Reproductive Health Supplies Coalition: What are the major RH challenges facing your country?
I oversee the local warehouses – there are frequent stockouts in RH supplies and general health products too. Central warehouses are often inaccessible and it is not uncommon to wait for three months for an order; sometimes it never gets to us. In addition, the religious and cultural stigma surrounding the use of condoms and contraceptives force these products underground, thereby giving rise to a black market for family planning commodities, and all the risks it brings.
There is also a great need for trained health professionals. In my district, we have 15 health professionals per 10,000 population – far short of the 23 recommended by WHO as necessary to ensure an 80% coverage rate for skilled birth attendance.
How easy was it for you to enter the medical profession?
I come from a poor family; we are three boys and five girls. My mother’s family grows yams and vegetables for a livelihood. My father abandoned my mother and we had to survive. We had great difficulty paying school fees. I paid my way through university by tutoring and cooking for a friend in exchange for food and board, and working as a nurse while I studied.
What do you do in your daily work?
As a Health District Director, I have to plan, implement, monitor and evaluate all health activities, strategies and approaches in my district in keeping with national health policy. I also advocate for funding and make sure the 26 health centres under my care have qualified human resources, quality medicine and health technologies.
What will you learn in your course?
Ensuring effective supply chains is a new and highly evolving subspecialty in Health Care Management. It is all about assuring timely access to quality products in a world constrained by limited resources. It is also about determining which health technologies make sense for public health interventions in the developing world? These are some questions my course will help me address.
How much more effective do you hope to do once you have finished your course of study?
As a teacher, my first instinct would be to consolidate what I learn into course material for the medical students I teach. At a strategic level, I will be better informed to advocate, and influence political decisions and policymakers. And as overseer of 26 health centres in my district, I will be able to apply my skills to better managing supply chains.
And your vision?
In 2004, I founded an association called “Doctors for a Better World”. The association works toward the ICPD concept of complete well-being -- a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. To this aim, Doctors for a Better World focuses on healthcare management, including supply chains and risk management and we are about to publish the first issue of our scientific journal, Better World Medicine, due in January 2013. Registered in 2006, Doctors for a Better World is a Togo Ministry of Health partner.
I work toward the day when every child can grow up happily with both parents. My mum used to tell us repeatedly never to give in to despair. Again and again in life, I realize that she was right. There really is no room for despair.
I work toward the day when every child can grow up happily with both parents.