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Policy · Revelation
Episode #49
Reminder of the dilemma
A — You accept the nomination to reform the health system since the assembly.
B — You stay and treat your patients, refusing to sacrifice the concrete to hope.
If you chose A
This choice reveals a faith in institutions: you believe that the law can structurally change what your hands alone will never be enough to repair. But he also exposes a hubris — the belief that a legislative mandate will produce more good than an entire life of care.
If you have chosen B
This choice honors the first oath — that of Hippocrates, the direct link between your skills and the survival of others. But it also reflects a mistrust of politics, and perhaps a resignation: to accept that the system will remain failing due to lack of competent voices to reform it.
This dilemma crystallises a fundamental tension experienced by thousands of competent African professionals: should we act in the urgency of the field or in the slow pace of politics? Senegal, like many countries on the continent, suffers from a double deficit — This is the case for practitioners in the underfunded areas and for technicians in the Chamber. Laws on universal health coverage, on the allocation of hospital budgets, on the training of caregivers are often drafted without the expertise of those who live these realities on a daily basis. To accept the nomination is to bet on leverage: a single well-designed law can transform the health destiny of millions of people. The American example, that of a superpower unable to guarantee equitable access to care despite its wealth, shows precisely what happens when policy makers are disconnected from medical realities. But to stay is to reject the logic of individual sacrifice in the name of a hypothetical collective good. Because politics in Africa — as elsewhere — Often crush good intentions. How many technicians entered politics with ideals came out compromised, neutralized, or simply forgotten? The risk is real: losing both the health centre and integrity. There is also this question that no one asks: why should we choose? Why does a system oblige its most useful citizens to mutilate professionally to fill their own shortcomings? This dilemma is the symptom of a state that has not yet
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