From an institutional point of view, the fact that veterinary services were considered of equal importance alongside seven other MoFA technical units at the local government level, was perceived by vets as unfair and unreasonable. Several of my informants reported a profound dissatisfaction around the processes through which the Ghana veterinary system currently uses – or rather, is constrained from using – its internally-produced knowledge to inform policy and take action for improving animal health, given the institutional misalignment described above. I asked my participants how they saw their influence towards ‘policy makers’ or others who had power to change the way animal health was practiced. There were, in my participants’ answers, contradictory versions of who these powerful people were and who could lead change.
Some thought that the VSD had enough power to make change. A former senior officer of the VSD HQ offered the example of rabies as a long-lasting problem for vets in Ghana: ‘Rabies control is not
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you get things done faster’.#83 He added that if he had been the VSD Director, he would change things for good because the title would confer on him the necessary power to do so.
Some, however, thought that only politicians had enough power to change the way Ghana reacts to and controls outbreaks. A senior vet and university lecturer told me he was convinced that MoFA, like for him the ministry was a separate entity, took all decisions related to disease control. He complained that the VSD Director actually had very little power even though the VSD was far more aware of the animal health situation in the country. He suggested that the norm was MoFA making decisions, and that these decisions were often inappropriate for the situations at hand.#38
For this participant, the fact that those making decisions were different from the people with the necessary veterinary knowledge, explains the mismatch between policy and the animal health challenges frequently experienced on the ground. When researching policies on disease management, it was very hard to identify who was in a position to bring about change. I was repeatedly told that these details were confidential and my encounters with highly-positioned vets were seldom and limited to greetings. The VSD was constrained in its ability to bring about policy change and its decisions focused on the management of endemic animal diseases as defined by its limited capacity and its scarce resources. Any new decision regarding an emerging or very serious threat would come from above the VSD and only after it had wrought considerable damage and garnered public attention (Waldman et al., 2016).
The most common approach for most vets, in their efforts to influence policy change, has been through proactive lobbying. In fact, government vets openly talked about exerting pressure on policy makers positioned higher than the VSD, but this did not seem to bear much fruit:
A senior vet from the VSD HQ: ‘We use friends of vets who are parliamentarians to push it [policy and legislation in favour of developing veterinary services]’ #19
A veterinary surgeon: I am complaining every single day! You have to lobby all the time! #18 Another veterinary surgeon: Every time I have represented the VSD, we fight! #68
A National Disaster Management Organisation (NADMO) officer in charge of endemic animal diseases: I want to buy some airtime on national radio and invite vets from the VSD [HQ] to argue
Since constant lobbying did not lead to satisfying change, vets engaged in reforming their institutional status into an ‘authority’ (discussed in Chapter Two) which they hoped would provide them with sufficient autonomy to play a greater role in zoonosis management. In June 2014, a lawyer consultant – who had been recruited to guide the formulation of a new livestock health and production policy (introduced in Chapter Two) – had drafted a workable text, following guidelines from international standards like the OIE Terrestrial Animal Health Code.131 I attended the meeting where this text was
discussed:
Observations: The VSD Director asked why new, stronger authority was being proposed for the
VSD. The consultant replied: ‘That way, when regulations need to change, there is no need to go to Parliament, the VSD can just amend the regulations’. Answering another question, he also declared: ‘The VSD will be its own authority. Therefore, it must be enabled to act and not have to wait for all the authorisations coming from above in the Ministry. It will be a real public institution on its own and will be able to act easily and fast’. Another participant supported this idea, claiming that ‘within an authority, heads are competent and not appointed like that’, implying that the leaders taking animal health decisions at the time were not technically competent in animal health. Yet another participant asked provocatively: ‘But when does the authority fall back to the Ministry so we avoid conflicts of interests?’ The consultant indirectly replied: ‘When an emerging issue is not covered by the Act’. The act here referred to the legislative text making the VSD an authority.#4
It is interesting to note here that this meeting was part of a process of developing ‘new policy’ and not directly related to the legal or institutional status of the VSD. Yet the ensuring discussion, and the consultant’s understanding of vets’ needs, as reflected in the new policy, indicates the importance of gaining institutional autonomy through stronger legal status if vets were to have greater influence on both policy, and its implementation.
By fighting their way ‘out of the local government’, like the MoH and the Ministry of Education had done previously, Ghanaian vets thought they were regaining their institutional autonomy (starting in 2015), after years of advocacy. Such phenomena carried out by professionals are not unknown nor unexpected. Currie et al. (2012) show that elite professionals in the health care sector – when faced with external threats to their privileged position and status – sometimes carry out ‘institutional work’ to maintain the institutional arrangements which preserve their professional dominance, power and autonomy, often based on a pre-existing model of medical professionalism.
However, institutional change alone has not provided a satisfactorily adequate sense of autonomy for the vets, and they are still energetically fighting for this. This ‘feeling’ of a lack of autonomy at a
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practical level is the result of decades of eroding prestige for the profession, which could not be made up for with one institutional change.
In 2014, while I was doing research amongst the vets, a promising narrative which emerged at the national level and subsequently relayed downward through regional staff went like this: once the vets were officially recognised as an authority in their own right, local veterinary budgets would increase significantly and vets would finally get the financial support they deserved. Like many other vets, Afia hoped that once the district-level VSD was officially autonomous, and ‘out of the local government’ in 2015, she would experience some relief from the scarcity of resources she had long been dealing with.#56 But, even after the law was passed in January 2015, district vets in the region I visited reported experiencing hardly any change, and the staff remained in precarious situations. For technicians and other less-qualified vets, the financial marginalisation of the veterinary unit strongly persisted, as illustrated in the following comment from John, addressing his regional vet director: ‘You
said that we were full officers now but the situation on the ground doesn’t change’.#75 Moreover, from meetings I attended at regional vet offices, it was still unclear to district vets where they were to obtain resources to carry out their work.
In sum, regarding interactions with other stakeholders, autonomy for vets also means gaining the respect and financial resources they feel they deserve and ending the interference of non-vets in their work. Despite the newly adopted institutional arrangements, veterinary autonomy continued to be experienced as elusive, and very limited.