by Nadia Gouy
– Morocco –
The results of the September 2007 elections were no landmark victory for female representation in the Moroccan legislature – apart from the 30 female lawmakers elected through a 2002-instituted quota system, only four women were able to squeak into the lower house. Yet, for a country that is determined to lead the Arab pack in gender equality, the executive is a good counterbalance. And the new government counts five female ministers along with two undersecretaries, accounting for 19.2 percent of the total ministerial posts – a percentage that earns Morocco the 39th rank, second to no other Arab country, in the 2008 Women in Politics Report jointly prepared by the United Nations and the Inter-Parliamentary Union (IPU).
And, if you are of the opinion that numbers matter little as long as women continue to be assigned ‘soft portfolios,’ an umbrella term that the report uses to refer to ministries of Culture, Youth, Sports, and the like, Morocco seems ready to set the bar high. Two out of the five women were appointed at the helm of two critical positions: the Ministry of Energy, Mines, Water and the Environment was assigned to Ms. Amina Ben Khadra, and the Ministry of Health, a minefield portfolio as it is, to Ms. Yasmina Badou. Assigning the Ministry of Health to Ms. Badou – an enthusiastic reformist and ambitious politician, who, at the age of forty, was already appointed Undersecretary in charge of the Family, Children, and the Disabled in the 2002 government – might be quite sensible, but this same strong-willed character could just as well lead Badou to a pyrrhic victory, one that costs more than it gains.
Just like any Moroccan, I took a deep interest in Yasmina’s proclaimed crusade for reforming the health sector. Born to a family that could pay the doctor’s bill in a city that has the lion’s share of clinics and hospitals, I was under the delusion that high maternal and infant mortality rates were ancient history. Yet, pursuing a Master’s in international development showed me the bitter reality. An ever-ailing health sector, all the more blighted by the flagrant inequalities between the up-to-date private clinics and hospitals and their dilapidated public counterparts, is a good enough reason for Morocco to rank 126th out of 177 countries according to the UNDP-commissioned Human Development Report 2007-08 – this time behind most Arab countries. Among the disquieting facts and figures: the number of physicians per 100,000 people stands at 51 with an extremely disproportionate concentration in the urban areas; among the poorest 20 percent, only 30 percent of births are attended by skilled health personnel compared to 95 percent among the richest 20 percent; the infant mortality rate stands at 62 per 1,000 live births against 24 for the richest 20 percent; and the mortality rate for five years and under stands at 74 per 1,000 infants compared to 26.
The health sector saga does not end there, and Yasmina knows it perfectly well – a litany of ills she dares to name in public. Once sworn in, she decided to wage an unrelenting war against corruption in public hospitals. It is no secret that free medicine is smuggled out of hospitals, that patients must bribe to access basic services, and that doctors will also grease the government palm to be relocated to more prosperous metropolitan zones, much to the detriment of people’s health in remote and rural zones; 250 public clinics have closed in the past few years.
While an anti-corruption campaign was launched by the former minister in partnership with Transparency Maroc, the results were nominal – a slight scratch on the surface. This time, however, a holistic approach is in the making, one that aims to create transparent governance systems. Soon, lists of available free medicine in hospitals will be made public. A hotline for whistleblowers will also be operational shortly.
Mission accomplished? Not when we realize that Madame Minister Badou has a whole host of obstacles to iron out, particularly the resistance of the doctors, hospital employees, staff in the ministry and her own uncompromising character. Ms. Badou stresses in quite a few interviews and press conferences that her detractors are a minority with vested interests and that many stakeholders share her vision. Maybe so, but strikes, sit-ins, and trade union diatribes of Badou’s “inflexibility and refusal to negotiate” show the contrary. While it is true that some strikers’ demands are longstanding, and patients as well as the Ministry of Health are used to marking off some calendar days for possible strikes, it is also true that Ms. Badou’s reforms have their greater share in the tension buildup.
What the lawyer-turned minister fails to realize is that the minority can easily grow into a majority. The minister identifies human resource management as a major hindrance to effective and transparent hospital operations, but forgets that motivation is critical. Has she thought of any incentives for her strained human resources? She does not seem prepared to make any overtures in appreciation of the far-from-motivating conditions nurses, paramedics, interns and ancillary staff work in: poorly equipped and under-staffed facilities, meager salaries and often uncompensated overtime.
The minority can at the right time and under the right conditions galvanize the majority. Will Ms. Badou ignore the brewing storm and instead rely on the support of the unions affiliated with her own political party? Last April during a forum on the proposed health reforms, Ms. Badou called a spade a spade, much to the disbelief of the audience, saying, “Our women deliver like beasts in the public hospitals.” Her bluntness was probably meant to hammer home the inhumane conditions in which some women deliver, but the message backfired. The Public Sector Doctors’ Union (SMSP) demanded that the minister apologize – and did her statement help redress the inhumane conditions by any means?
When the minister paid a surprise visit (ahead of the king’s official visit) to the rundown hospital of Khenifra, a city on the foothill of the Middle Atlas Mountains, she at once discharged the director of the hospital among others. In reprisal, the unions called for a sit-in in front of the hospital to protest against the ministry’s marginalization of the region. A success it definitely was as the unions took advantage of a disgruntled public to flex their muscles.
It’s high time that Ms. Badou think of her partners – the strained human resources – if she hopes to create real change. Top-down management will not serve her cause.
About the Author
Nadia Gouy is a Moroccan Fulbright Scholar, currently interning at the United Nations Development Program in New York. Nadia came to the US to complete her Master’s in Public Administration in International Management at the Monterey Institute of International Studies – an invaluable learning experience that deepened her awareness of the challenges facing her country, and showed her the potential of both positive thinking and proactively searching for opportunities. Nadia holds a Master’s in Translation and a BA in the English Language and Literature from Morocco. Nadia’s dream is to matriculate into a PhD program in Higher Education and Institutional Change at one of California’s universities.
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