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Medical Care in Cameroon

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Medical Care in Cameroon: Current Realities and Challenges

By GITTEL AYUK Esq.

ABSTRACT

Medical malpractice is an increasingly pressing issue in Cameroon’s healthcare system, where gaps in regulation, insufficient infrastructure, and limited access to legal remedies continue to expose patients to avoidable harm. As the demand for healthcare rises, so does the occurrence of medical errors — some due to negligence, others resulting from human mistakes. This article investigates the landscape of medical malpractice in Cameroon, examining both its legal framework and practical realities.

Cameroonian law recognizes medical malpractice through a combination of statutes, including the Penal Code, which outlines criminal liability for professional misconduct; the 1990 Law on the Practice of Medicine, which mandates malpractice insurance for private practitioners; and various decrees and professional codes that regulate medical ethics. However, enforcement remains weak. Many patients are unaware of their rights, and medical professionals often operate in environments that lack oversight, adequate equipment, or continuous training. Moreover, out-of-court settlements and informal resolutions are common, leading to underreporting of malpractice cases and minimal legal precedent.

This article also highlights the challenges in distinguishing between honest medical errors and actionable negligence — a legal and ethical gray area that complicates both prosecution and defense. While the law provides avenues for accountability, including disciplinary action by professional councils and civil or criminal court proceedings, actual recourse is often slow, inaccessible, or impractical for the average Cameroonian.

Through analysis of legal texts, interviews, and case studies, the article proposes key reforms to improve transparency, accountability, and patient protection. These include stronger implementation of malpractice insurance policies, mandatory reporting mechanisms, public education on patient rights, and capacity-building for legal and medical professionals. The article argues that for Cameroon to reduce instances of medical malpractice and build public trust, a more coordinated and well-resourced approach is required — one that aligns legal standards with healthcare realities on the ground.

I. INTRODUCTION

The white coat symbolizes hope, healing, and trust. It represents care, compassion, and the promise of healing. However, beyond the hospital doors lies a quieter but serious concern—medical mistakes and malpractice. As the healthcare system grows in complexity, so does the need for legal frameworks that ensure both patient safety and medical accountability.

Medical malpractice is a professional negligence by act or omission by a health care provider, where-in the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient[1].

In other words, it occurs when a healthcare provider deviates from accepted standards of care, resulting in harm or injury to a patient. This could be due to;

  • Misdiagnosis or delayed diagnosis
  • Surgical errors
  • Breach of confidentiality.
  • Negligent aftercare or follow-up
  • Birth injuries
  • Not obtaining informed consent

In a country where healthcare access is limited, these mistakes can result in serious physical, emotional, and financial harm.

[1] Garner, B. A. (Ed.). (2019). Black’s Law Dictionary (11th ed.). Thomson Reuters.

When looking at a medical negligence case, we focus on the intention. Usually, the practitioner has no intention of inflicting the patient with such harm, but the fact is the harm still occurs regardless. Never the less, this is usually very difficult to prove, unless in instances where there is an injury or a physical harm and if successfully made, then comes the award of damages.

In Cameroon, the standard of care in the medical field is a critical concern, reflecting the nation’s commitment to patient safety and the quality of healthcare services. However, the healthcare system faces numerous challenges that hinder the consistent delivery of high-quality care. This article explores the current state of medical standards in Cameroon, the legal frameworks in place, and the obstacles that impede the realization of optimal healthcare delivery.​

In the 1964 World Health’s Organization Constitution, the right to health is provided for as a key element. This organization which was established to manage world’s health affairs, declares in its Preamble: “The enjoyment of the highest attainable standard of health to be one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”[1]. The standard of care in Cameroon’s medical field is influenced by a complex interplay of legal, infrastructural, and sociopolitical factors. While existing legal frameworks provide a foundation for regulating medical practice, their effectiveness is undermined by enforcement challenges and systemic issues within the healthcare system. Addressing these challenges requires a multifaceted approach, including legislative reforms, investment in healthcare infrastructure, strategies to retain medical personnel, and the cultivation of a strong patient safety culture. Through concerted efforts, Cameroon can enhance the quality of its healthcare services and ensure better health outcomes for its population [2].

[1] Constitution of the world health organization. 2006. https://www.who.int/governance/eb/who_constitution_en.pdf

[2] Aveling, E. L., et al. (2020). Baseline patient safety culture in Cameroon: setting a foundation for quality improvement. BMC Health Services Research.

II. DRAWING THE LINE BETWEEN MEDICAL NEGLIGENCE AND HONEST MISTAKES.

    In the medical field, not every negative outcome is due to malpractice. It’s important to distinguish honest human error from negligent conduct. A doctor may follow all procedures correctly, and a patient can still suffer complications due to the unpredictability of the human body.

    Honest mistakes are the errors made without malice or negligence. These are unintentional errors that happen despite a healthcare provider’s best efforts to do the right thing. In these cases, the healthcare provider is not acting recklessly or with disregard for the patient’s well-being. Rather, the mistake arises due to unforeseen complications, miscommunication, or limitations in the healthcare system.

    Examples of honest mistakes include:

    • Diagnostic Uncertainty. A doctor may miss a diagnosis due to symptoms that are rare or misleading, making it difficult to reach an accurate conclusion.
    • Unpredictable complications during surgery: Even with the most careful planning, some surgical procedures may lead to complications that were not foreseeable or preventable.

    In such cases, the healthcare professional has not acted in a negligent or careless manner but has simply made an error that could happen to anyone in the same circumstances. However, aa lot of controversies have arisen as to if there is truly a word like “HONEST MISTAKE” in the medical field.

    The line between medical negligence and honest mistakes can be difficult to draw, but there are several key factors to consider:

    1. Standard of Care: One of the first steps in determining whether an error is negligent or honest is to examine the standard of care. Medical professionals are expected to adhere to the standards established by their peers in the same field. If the error occurred because the healthcare provider deviated from this standard, it is likely negligence. However, if the provider followed established guidelines but still made a mistake, it may be considered an honest error.
    2. Intent: Negligence involves a level of recklessness or carelessness, while an honest mistake is made without any intent to cause harm. If the healthcare professional’s actions showed disregard for patient safety or did not to meet established protocols, negligence is more likely. In contrast, if the error was made despite following reasonable procedures, it could be an honest mistake.
    3. Foreseeability: “was the harm caused reasonably foreseeable?” negligence often involves errors that could have been anticipated or avoided. For example, a doctor failing to review a patient’s medical history before prescribing a medication may be considered negligent. In contrast, honest mistakes are typically those that were unpredictable or outside the scope of normal medical practice. For example, complications arising during surgery that were not foreseeable may be an honest mistake.
    4. Consequences: The severity of the error and its consequences can also be a factor. Medical negligence often leads to significant harm, injury, or long-term health issues. On the other hand, honest mistakes might result in less severe outcomes, although they can still cause serious harm.

    When harm results from recklessness, poor judgment, or ignoring established protocols, it shifts into the legal domain of malpractice. For example:

    • Performing surgery without informed consent
    • Prescribing incorrect dosages due to carelessness
    • Failing to monitor a critical patient despite obvious warning signs

    The challenge lies in proving that the professional’s conduct directly caused the harm—a task that is especially difficult in a system lacking digital records and standardized procedures.

    III. LEGAL PROVISIONS

      Cameroon’s medical profession is regulated by a combination of international, regional, and national legal instruments. Key among these is the Code of Medical Ethics, which outlines the responsibilities and ethical obligations of healthcare providers.

      In Cameroon, the issue of medical malpractice is legally addressed under both civil and criminal frameworks. According to the Cameroon Penal Code, Section 289[1] it criminalizes “unintentional harm” or death caused by negligence, clumsiness, or failure to adhere to regulations. The Penal Code provides that, criminal responsibility is personal[2]. However, with medical practitioners, the law requires that;

      every physician or partnership of physicians shall be bound to take out an insurance policy from an approved national insurance company to cover his or its occupational hazards. The receipt of the insurance policy shall be deposited with the Council of the Association at the beginning of each calendar year[3]. Failure to take out an insurance policy shall, on the instructions of the Council of the Association or the supervisory authority, lead to the temporary closure of the establishment. Such establishment may be re-opened only on presentation of the receipt showing payment of the insurance policy[4].

      To add, civil law provisions allow victims or their families to seek compensation for damages resulting from medical negligence. Civil responsibility arises when there is a breach of contractual obligations or when harm is caused outside the scope of a care contract.

      The law goes further to provide for disciplinary measures. The Cameroon Medical Council oversees professional conduct, with the authority to impose sanctions ranging from warnings to revocation of medical licenses for ethical breaches. The law provides that any infringement of the provisions in the Code of Ethics falls within the competence of the Medical Council of Association sitting as a Disciplinary Board[5]. It is important to mention that, any complaint made against a medical doctor must first of all be investigated by the Disciplinary Board. The Board exercises disciplinary jurisdiction at First Instance within the Medical Association[6].

      Furthermore, administrative sanctions apply to medical personnel employed in public hospitals. When this happens, the hospital is vicariously liable for any harm caused by its employees, including medical doctors, interns, residents, and medical students working or training under its supervision. If the healthcare professional is a civil servant, misconduct may lead to disciplinary actions, including dismissal from the Civil Service. As public officials, medical doctors are subject to a graded system of disciplinary sanctions, which include:

      • Warning or Reprimand (Mise en garde / Blâme): Written warnings or formal reprimands recorded in official documents.
      • Suspension: Delayed career advancement for up to one year or a demotion by one or two ranks. It also includes, lowering of class and rank or temporary suspension from service for a period not exceeding six months.
      • Dismissal (Déchéance): Permanent dismissal from public service.

      These measures ensure accountability among medical personnel operating within public healthcare institutions[7]. Despite existing laws, enforcement is often lax due to bureaucratic inefficiencies and lack of political will. This has led to persistent unethical practices among healthcare providers[8].

      [1] Law No. 2016/007 of July 2016. Relating to the Penal Code of Cameroon.

      [2] Section 74(2) of Law No. 2016/007 of 12 July 2016), Relating to the Penal Code of Cameroon.

      [3] Section 15(1) of Law No. 90-036 of 10th August 1990 relating to the Organization and Practice of Medicine.

      [4] Section 15(2) of Law No. 90-036 of 10th August 1990 relating to the Organization and Practice of Medicine

      [5] Section 58 of Decree No. 83/166 of 12 April 1983 on the Medical Code of Ethics of Cameroon.

      [6] Section 41 of Law No. 90-036 OF 10 August 1990 Relating the Organization and Practice of Medicine in Cameroon.

      [7] Decree No. 94/199 of October 7, bearing the general status of the State’s Public Service, section 94.

      [8] Constraints to the Regulation of Medical Malpractices in Cameroon | Justice and Law Bulletin

      IV. THE PRESSURE ON HEALTH CARE PROVIDERS

        In Cameroon, healthcare professionals are struggling with immense pressures stemming from systemic challenges, including inadequate staffing, limited resources, and socio-political instability. These factors not only compromise the well-being of medical personnels but also heighten the likelihood of medical errors and malpractice. Examples include:

        1. The Burden on Healthcare Workers

        Cameroon faces a critical shortage of health personnel, with fewer than seven nurses per 10,000 inhabitants, significantly below the World Health Organization’s recommended threshold. This deficit is sometimes caused by the migration of trained professionals seeking better opportunities abroad, leaving the remaining workforce overburdened and susceptible to burnout. Thus, the pressure of more work and fewer staff [1].

        A study conducted in the Fako Division revealed that a significant number of healthcare workers experience burnout syndrome, characterized by emotional exhaustion and reduced personal accomplishment. Factors contributing to this include long working hours, inadequate sleep, and high patient loads [2].

        The intense pressure on healthcare workers has direct implications for patient safety. These workers are usually overworked and suffer from fatigued, thus may make errors in diagnosis, treatment and patient management.

        b) Impact of Sociopolitical Crises

        The ongoing Anglophone crisis, particularly in the North-West and South-West regions, have led to the closure of numerous health facilities and disrupted access to medical services. The violence has not only destroyed infrastructure but also instilled fear among healthcare workers and patients, further limiting the availability and utilization of healthcare services. As a result, the few healthcare providers available, have many patients to constantly attend to[3]. This can be illustrated in the case of Joan a 46-year-old woman, who was injured in a motorcycle accident, but due to a lack of better facilities and resources, her injury became infected and her leg was amputated. She lost her job as a cleaner and presently faces extreme hardship[4].

        c) Inadequate Infrastructure and Resources

        Many healthcare facilities in Cameroon are plagued by outdated equipment, limited medical supplies, and poor sanitation. These deficiencies severely compromise the quality of patient care and heighten the risk of medical errors. In situations where hospitals lack the necessary tools or capacity to treat patients, referrals to other facilities are common. However, the delays caused by these repeated referrals can lead to critical deterioration of a patient’s condition in some cases resulting in loss of life or complications such as severe blood loss. In Douala, a sergeant died following a surgical procedure that was allegedly conducted without proper preoperative assessment. The family raised concerns about the anesthetist’s failure to take an adequate medical history and the prolonged delay in referring the patient to a better-equipped facility[5]. ​

        [1] https://apnews.com/article/cameroon-doctors-nurses-immigration-canada-2becf962f5b207e20b2ca9d8a84fd3b3

        [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC10764971/?utm

        [3] United Nations Office for the Coordination of Humanitarian Affairs. (2023). Cameroon: Crisis causes health-care challenges. ​OCHA

        [4] Cameroon: Crisis causes health-care challenges | OCHA

        [5] Negligence in private hospitals in Cameroon on the rise? – Cameroon News Agency

        V. WHY PATIENTS STAY QUIET.

          Medical malpractice is a silent crisis in many parts of the world, and Cameroon is no exception. While hospitals and healthcare workers are expected to provide safe, ethical, and professional care, the reality is that mistakes, some of which are life threatening often do occur. Yet, in far too many cases, patients remain silent, even when they are clearly victims of medical negligence. Patients sometimes stay quiet due to;

          1. Lack of Awareness

          Many patients do not understand what constitutes medical malpractice. They may attribute pain, complications, or even a loved one’s death to “fate” or “God’s will,” rather than negligence or error. Without proper education on patient rights and professional medical standards, victims often cannot recognize when they’ve been wronged — let alone seek redress.

          • Fear of Retaliation

          In smaller communities, patients fear being labeled “troublemakers.” Some worry about being denied future care or mistreated if they lodge complaints. Others are intimidated by the idea of challenging respected health professionals or institutions, especially in public hospitals where care is often already hard to access.

          • Cultural and Social Barriers

          In many African societies, including Cameroon, there’s a cultural reluctance to question authority especially figures like doctors, who are seen as almost infallible. Patients often feel they do not have the social standing, confidence, or voice to confront medical personnel or institutions. They feel, they may be “too powerful” for them to challenge or question their actions.

          • Financial Constraints

          Taking legal action for medical malpractice is expensive. Court fees, lawyer fees, and the costs of obtaining expert medical opinions put justice out of reach for most. This economic barrier forces many to suffer in silence rather than pursue accountability.

          • Weak Complaint Mechanisms

          Even when patients are willing to speak out, the process is unclear. Many don’t know where to file a complaint — or whether it will be taken seriously. The disciplinary boards and medical councils that should be handling such cases often lack visibility, accessibility, and transparency.

          • Delayed Justice or Inaction

          In the rare cases where complaints are filed, they are often met with bureaucratic delays or total inaction. Long, drawn-out investigations discourage others from speaking up. Victims are left emotionally and financially exhausted. As a result, they either abandon the cases, or withdraw from it, reinforcing the perception that it’s “not worth it.”

          VI. CHALLENGES IN ADDRESSING MEDICAL MALPRACTICE.

            Medical malpractice presents a growing concern in many healthcare systems, particularly in developing countries like Cameroon, where structural, legal, and systemic shortcomings often leave victims without redress. While the consequences of negligent or substandard medical care can be severe, ranging from prolonged illness to permanent disability or death — holding healthcare professionals accountable remains a complex task. Despite the existence of ethical codes and legal provisions, many malpractice cases go unreported, uninvestigated, or unresolved due to numerous barriers. These challenges range from inadequate legal frameworks and poor enforcement mechanisms to cultural attitudes, limited public awareness, and institutional resistance.

            1. Absence of Malpractice Insurance

            Most healthcare providers in Cameroon do not have malpractice insurance, leaving patients without adequate compensation avenues and practitioners exposed to personal financial risk. This absence discourages reporting and accountability.

            • Cultural and Institutional Silence

            There exists a culture of silence within the medical community, where errors are often underreported due to fear of blame and retribution. This environment discourages transparency and hinders the implementation of corrective measures. A study assessing patient safety culture in Cameroon found low positive response rates for non-punitive responses to errors, indicating a need for cultural change.

            • Inadequate Training in Medical Ethics and Law

            Medical education in Cameroon often lacks comprehensive training in ethics and legal responsibilities. This gap leaves healthcare professionals ill-prepared to navigate the ethical dilemmas and legal implications of their practice, increasing the likelihood of malpractice and negligence in the field. A practical case where in, a five-year-old girl died due to an incorrect dosage of anesthesia, highlighting the dire consequences of negligence in pediatric care[1]. ​

            • Limited Role of Professional Associations and Access to Legal Recourse

            Professional bodies like the Cameroon Medical Council are responsible for overseeing and regulating medical practice. However, their ability to enforce professional standards and discipline errant practitioners is often limited by inadequate resources and insufficient autonomy, which weakens their regulatory effectiveness. Additionally, patients face numerous challenges when trying to take legal action against healthcare providers, including the high cost of legal services, lengthy and complex court processes, and limited awareness of their legal rights. These barriers discourage many from pursuing justice, resulting in many cases of medical malpractice going unaddressed[2].

            The ongoing case of Moussa Njoya vs. Biyem-Assi District Hospital[3], who on March 31, 2024, took his five-year-old son to the Biyem-Assi District Hospital in Yaoundé due to severe ear pain. He alleges that the hospital staff demanded payments for a new medical booklet, a weekend consultation fee of 2,800 CFA francs, and the purchase of medical gloves before providing any medical attention. Despite these payments, Njoya claims that his son was not examined by a doctor, and medications were prescribed without a proper consultation. Furthermore, he accuses the hospital’s director, of disclosing his son’s medical information on social media, breaching medical confidentiality. In response to these events, Moussa Njoya filed a lawsuit against the Biyem-Assi District Hospital and its director, citing:​ violation of medical confidentiality, serious harm to the dignity of a minor, engagement in dangerous activities, harm to the dignity and honor of the minor’s parents

            This case highlights critical issues in Cameroon’s healthcare system, particularly concerning patient rights, medical ethics, and the enforcement of medical confidentiality. It underscores the need for:​

            • Strict adherence to medical ethics and patient confidentiality.
            • Improved patient care and communication within healthcare facilities.
            • Legal reforms to address and prevent medical negligence.​

            The outcome of this case could set a precedent for how similar cases are handled in the future, potentially leading to significant changes in healthcare policies and practices in Cameroon. This is not merely a personal dispute—it is a mirror reflecting deep-rooted challenges in Cameroon’s healthcare system. Allegations of medical negligence and the violation of medical confidentiality, especially involving a child. This case underscores the urgent need for stricter regulatory oversight, better patient care protocols, and legal accountability within medical institutions. As the courts deliberate, this matter should serve as a catalyst for national dialogue and reform, reminding both practitioners and policymakers that public trust in healthcare is earned through transparency, dignity, and respect for the law.

            VII. POLICY RECOMMENDATIONS.

              Silence should never be the cost of survival. A healthy system is one where patients should not only receive care but should be heard, respected, and protected. To ensure this is done, the following are proposed;

              1. Strengthen Legal and Regulatory Frameworks

              Existing and outdated health laws should be review and update to clearly define medical malpractice, liability standards, and patient rights. Making sure practitioners and patients understand what is deemed as an honest error and what is a malpractice. In so doing empowering professional regulatory bodies, such as the Cameroon Medical Council, with legal authority and adequate resources to act as an advisory and investigative body to discipline malpractice cases independently and transparently.

              Furthermore, creating specialized medical negligence tribunals or designating units within administrative courts to handle malpractice cases efficiently.

              • Improve Patient Awareness and Access to Legal Remedies

              Conduct nationwide awareness campaigns on patient rights, medical ethics, and available complaint procedures. Establish free legal aid clinics or partner with human rights organizations to provide pro bono legal services to indigent patients.

              • Enhance Training and Continuing Medical Education

              To do this, ethics and patient safety should be made key components of both undergraduate and continuing medical education. There should also be an introduction of a mandatory annual training for healthcare workers on professional standards, communication, and patient care protocols. This could lead to a culture of self-reporting and peer accountability in medical institutions.

              • Strengthen Hospital Infrastructure and Resources

              The state and private health care individuals should invest in the modernization of healthcare facilities, including adequate supply of drugs, equipment, and staffing. They could also establish standardized protocols and checklists for procedures to minimize preventable errors.

              Furthermore, improve working conditions and workload distribution to reduce burnout and negligence among health workers.

              • Encourage Transparent Data Collection and Reporting

              The creation a national database, to help track patterns and inform policy decisions. This also requires hospitals to maintain incident reports and conduct internal audits on patient safety practices.

              • Strengthening Out-of-Court Settlement Approaches.

              The adoption of alternative dispute resolution methods, such as mediation and other informal settlement approaches, to handle minor malpractice claims more efficiently and at a lower cost. Trained health facility persons or legal officers to resolve patient grievances at the institutional level before litigation. This will go a long way to save time and also prevent the floodgates of cases at the courts.

              VIII. CONCLUSION

                Medical malpractice remains a serious concern in Cameroon, reflecting broader systemic issues within the healthcare and legal systems. While healthcare professionals are essential pillars of society, they must be held accountable when negligence results in harm. Equally, patients must be empowered to understand and defend their rights through access to justice and transparent health policies. Strengthening medical ethics, improving training, enforcing accountability, and reforming legal processes are vital steps toward restoring trust between healthcare providers and the public. Ultimately, safeguarding human dignity and patient safety must lie at the heart of any health system worthy of public confidence.

                [1] Negligence in private hospitals in Cameroon on the rise? – Cameroon News Agency

                [2] https://lawjournals.celnet.in/index.php/ijhml/article/view/578?utm_

                [3] “Moussa Njoya vs. Biyem-Assi District Hospital: First Hearing Scheduled for November 5.” StopBlaBlaCam, 21 Oct. 2024”