Outside the Sylvanus Olympio Hospital in the center of Togo's capital, Lome, assorted mattresses lay on the grass next to full garbage bags. As several patients drag themselves from one building to another, an open door offers a view into one of their rooms. The beds are packed together and the acrid smell of a cleaning agent is sharp enough to cause a headache.

A young nurse passes by and says: "Look at this, some people lie on the ground. There are supposed to be social services but [the administrations] doesn't care. People are suffering and dying."

Concerned for his security, the nurse doesn't want to give his name or explain why he is speaking so quietly. But his anger is obvious, which is why he joined the opposition and supported recent demonstrations calling for the resignation of President Faure Gnassingbe.

Togo's president has been in power for more than 12 years. Before that, his father, Eyadema Gnassingbe, ruled this tiny West African nation of 7.6 million people for 38 years until his death.

For this reason, 14 political parties as well as civil society organizations have been agitating for the end of the family's 50-year dynasty. One of them is David Ekoue Dosseh, a surgeon at the forefront of the new movement known as "Togo Citizens Stand Up" ("Front Citoyen Togo Debout").

Doctors scarce in the Togo's rural areas

The 48-year-old surgeon, who is also a trade unionist, has been critical of the country's health system and working conditions for health staff for years.

"In the capital Lome, we have about four doctors for 10,000 inhabitants but as soon as you leave Lome, it is less than a doctor for 10,000 patients," he said. 

Dosseh has many more examples about what he calls the country's "catastrophic health system." 

But other sectors such as education aren't any better. One in three Togolese above the age of 15 can't read or write. Around 58 percent of the population lives below the poverty level and survive on less than $2 (1.70 euros) per day.

In West Africa, Togo is the only country without two-term presidential limits. 

"Why does Togo have to remain an exception? I don't want to be an exception but rather a citizen like everyone else," Dosseh told DW.

Lack of regional support 

It looks unlikely that regional bodies such as the African Union or the West African Economic Community, of which Gnassingbe is currently the chair, will act on people's demands for a change of power.

As for the Togolese government, it has now said it is prepared to hold a referendum on limiting presidential terms. Gnassingbe's change of face was announced in early September as anti-government protests spread through the country.

Nathanael Olympio, an opposition politician and the interim president of the Togolese People's Party, sees the proposed referendum as an insult because, if passed, it could allow Gnassingbe to stay in power for another two terms. 

"The referendum is based on a law that was created by the government," he said. He also doesn't believe the government will abide by the results.

"Whether the answer is 'yes' or 'no' the regime will still remain in power," Olympio told DW. 

Controversy over term limits

The opposition has good reason to be wary of government changes to the constitution. Back in 1992, Togo's constitution was amended to limit the presidency to two five-year mandates and thus ten years in total. But that law was then changed in 2002 to allow Eyadema Gnassingbe, the current president's father, to run for a third term. 

"The most important thing is that we remain tough," says opposition leader Jean-Pierre Fabre. "I have a stance that I will not waver from and that is also the stance of the people."

According to Fabre, it is high time for Gnassingbe to leave.

"We need to negotiate his abdication," he told DW, "and a transitional government should then prepare for new elections."

Up to 100,000 people have attended demonstrations calling for Gnassingbe to step down, giving strength to the opposition's position. In the past, protests have quickly subsided. Now, they seem never ending.

But continuing the demonstrations is an economic strain for the protesters, who lose out on income every time they take to the streets. If the economic pressure becomes too great, this could eventually lead to the end of the resistance.

Opposition politician Nathanael Olympio is nevertheless confident.

"With all the commitment and the dedication from the people we have today, we will celebrate the end of the year as a democracy," he says confidently.

But there is still another scenario. Faure Gnassingbe could also remain in power until the end of his mandate in 2020 and then chose not to seek re-election.