OccupyGhana® Presents An 11-Point Plan For A Comprehensive Emergency Response System In Ghana

OccupyGhana® Presents An 11-Point Plan For A Comprehensive Emergency Response System In Ghana

17th JUNE 2018

OCCUPYGHANA® PRESS STATEMENT

OCCUPYGHANA® PRESENTS AN 11-POINT PLAN FOR A COMPREHENSIVE EMERGENCY RESPONSE SYSTEM IN GHANA

OccupyGhana® joins the nation in grieving for Mr. Anthony Opoku Acheampong, reportedly refused care at seven hospitals in Greater Accra, due to the phenomenon of “no beds.” His desperate family watched him die in a car in front of Lekma Hospital in Teshie, in the early hours of 10 June 2018.

That, by all standards, is utterly unacceptable. It is also inhumane and goes against every ounce of human dignity and respect for life enshrined in the Constitution of the Fourth Republic. Unfortunately, Ghana’s media is rife with such stories.

OccupyGhana® believes that this “No Beds” excuse is a cowardly cop-out, hiding a much deeper problem assailing Ghana’s healthcare system.

While it may be true that a hospital like Korle-Bu Teaching Hospital, which receives the bulk of emergency cases, may suffer from lack of beds, that does not wash where some of the smaller and private hospitals are concerned.

There may be a variety of reasons for hospitals to turn patients away, legitimate or illegitimate. These can include:

  • a true unavailability of beds;
  • lack of the expertise to deal with emergencies due to (i) lack of medical personnel, (ii) medical personnel with inadequate experience to treat said emergency (e.g. trauma) and/or (iii) lack of necessary equipment;
  • the unwillingness of medical personnel to put in the time and effort to help patients;
  • the fear that the emergency case will take up much-needed resources for a long time in smaller hospitals;
  • the fear that the patient would be unable to pay for the care given; and/or
  • the fear that sub-optimal care given in sub-optimal conditions could lead to a bad outcome and lawsuits against the medical facility and personnel.

But none of these gets at the core issue.

The appalling reality in Ghana today is that the country has no functioning and coordinated Emergency Response System. People who need emergency care simply cannot call for help. Even if they can reach a health facility by telephone, there are only 54 – yes, FIFTY-FOUR – ambulances covering a nation of almost 30 million people.

Ghanaians have no choice but to transport their ill loved ones in cars or taxis looking for a hospital where they will be accepted. We see them in traffic almost every day. The apparently callous reluctance of Ghanaians to get out of the way may be as much due to our selfishness, as it may be due to the public not recognising a taxi blowing its horn as an emergency. It may also be due to the indiscriminate and irritating use of sirens especially by politicians.

In such a scenario, most hospitals could be overwhelmed by emergency cases or even surprised by cases that are uncommon in that facility. It is also quite possible that a lot of time is lost until the right hospital is found or a hospital found with beds, further decreasing survival chances of patients.

There is an immediate need for a functioning and co-ordinated Emergency Response Service with a simple telephone number that every Ghanaian can remember. A recent poll shows that only 5% of the population is currently aware of the emergency number for an ambulance.

The Emergency Response Service should connect the caller to a Command Centre set up to direct calls to an ambulance service that is in touch with all medical facilities, and connect to the police, the fire service and NADMO.

OccupyGhana® calls for an immediate action plan to be drawn up by Government to prepare an Emergency Response Service fit for a 21st Century Ghana, within two years. The following points must be included and fully-funded:

  1. An Emergency Response Service with a Command Centre that fields calls, receives data from the hospitals about bed counts and is able to send out ambulances and paramedics to assist, stabilize and if needed transport patients to appropriate hospitals. One simple emergency number is what we need;
  2. All hospitals should be able to care for emergency cases, but in the meantime, designate some hospitals as “Fit to Handle Emergencies;”
  3. Government must shore up the NHIS to allow for every Ghanaian to be given emergency care irrespective of the ability to pay;
  4. Hospitals designated as “Emergency Hospitals” should be equipped properly, including the ability to give Triage care. Equipping hospitals also means making sure they are well stocked with needed emergency drugs. This prevents delays in care that occur as family members go around town hunting for drugs to buy so that their loved ones can be treated in emergencies;
  5. There should be more community hospitals that can provide immediate basic primary and preventative care;
  6. The law should prevent hospitals turning patients away without proper reason and a strategy for dealing with that patient’s care in another facility. Facilities and personnel who refuse to offer care to patients with life-threatening conditions should face sanctions;
  7. All doctors and nurses should be trained to stabilise to a basic level emergency patients, irrespective of the availability of beds and full emergency facilities;
  8. Even though lack of beds is not the only factor contributing to the refusal of care to sick Ghanaians at our hospitals, it is an important contributory factor. In a country where in-patient care still trumps out-patient care for a lot of ailments, having 0.9 patient-beds per 1000 people is on the low side. There are several unfinished hospitals like the UGMC that could add much-needed beds to the total count and alleviate some of the pressure. Even though we support the numerous calls to open these hospitals expeditiously, we also call on government to put in place mechanisms to optimize bed usage in the existing ones or else we would simply have more hospitals that refuse care because of “No Beds;”
  9. Enough paramedics should be trained to be help stabilize and transport emergency cases to hospitals;
  10. There should be programs to educate the population on how to differentiate a true emergency from an illness that can be treated non-emergently. A good triaging system as part of an emergency response service should go a long way to help with this; and
  11. Last but not least, we ask for sufficient ambulances to cover a population of 30 million.

We are mindful of the economic challenges posed by this proposal. But that is no excuse. If Ghana can afford hundreds of government 4×4 vehicles and police escort riders to push them through traffic, then Ghana can afford adequate ambulances to deal with emergencies, AND address our list of points made here.

The tragic and unnecessary death of Mr. Anthony Opoku Acheampong is already blood on our hands. Let us not indict ourselves further; this should be the catalyst for finally building a Ghanaian healthcare service of which we can all be proud.

It is time for Ghana to have a 21st Century Emergency Response System. It is time for the government to ensure this, for medical personnel across the country to deliver the best version of it and for the Ghanaian population to demand it as of right.

Yours in service of God and Country.

OccupyGhana®

Statement on Tramadol Abuse and Addiction

Statement on Tramadol Abuse and Addiction

23rd APRIL 2018

OCCUPYGHANA® PRESS STATEMENT

STATEMENT ON TRAMADOL ABUSE AND ADDICTION

Introduction

Tramadol is a synthetic opioid that is used to treat acute and chronic pain of moderate to severe intensity. It has one-tenth the potency of morphine. It is used worldwide, having originally been developed in 1962 by Grünenthal Gmbh and coming onto the market in 1977.

Tramadol has the potential to be dangerously addictive. However, although it has been reviewed several times by the WHO, it is not a regulated drug.

Thus, the International Narcotics Control Board (INCB), the independent intergovernmental control organ for the implementation of the United Nations drug conventions, has not seen it fit to regulate Tramadol.

It is considered a cheap opioid, used for managing pain. Being regulated would make it difficult for doctors in poor countries to obtain it for legitimate use.

Nevertheless, being an opioid, Tramadol has potential to cause dependence and addiction, through abuse or taking higher doses than recommended.

The Problem

Tramadol has recently become a cause of major addiction in Ghana and other developing nations in Africa and Asia. Without the oversight of the INCB, manufacturers in India and China have been able to flood the market with the drug.

There have been many reports lately about the scourge of Tramadol addiction. Until recently, however, many health workers were unaware of the scale of non-medical use and abuse of Tramadol. Patients addicted to Tramadol present with different symptoms from those addicted to the usual opioids like morphine or heroin. This has led to many doctors misdiagnosing the condition.

Porous borders allow the drug to be brought into the country undetected. Tramadol is a controlled substance in Ghana, meaning that those who trade in it, without medical prescription, do so illegally. The trade in Tramadol has links with organised crime.

The doses of Tramadol approved by the FDA for use in Ghana are 50mg and 100mg. The strengths illegally sold on the streets, popularly called TRAMOOR among the youth, tend to be much higher (200mg, 225mg, 250mg).

It has also been reported that Boko Haram and ISIS fighters ingest Tramadol before attacks to increase risk-taking behaviour and make death painless.

Teenagers and young adults are most at risk of abusing and becoming addicted to Tramadol. It is being used to enhance sexual prowess, increase athletic ability and allow prolonged physical labour. The abuse of the drug by some drivers could play a role in motor vehicle accidents. Ultimately, the addiction to the drug results in depression, an increase in risk-taking behaviour, seizures and even death.

Without exact numbers, it is difficult to estimate the extent of the problem, but it could easily be designated a public health problem.

Recommendations

OccupyGhana® is calling on the government to urgently take steps to tackle the illegal trade in Tramadol. We recommend a three-pronged approach – medical, law enforcement and prevention and rehabilitation.

We ask the Ministry of Health to appoint a group to research the extent of the problem. The group will train doctors to recognize signs of Tramadol addiction and take steps to treat these patients. Consideration could be given to setting up addiction treatment centres.

We ask the Law Enforcement agencies to investigate how these drugs are coming in and to take steps to stop the large shipments from India and China. The Narcotics Control Board, FDA and Pharmacy Council should ensure that licensed chemical sellers do not sell Tramadol or that it is not sold over the counter. Tramadol should only be obtainable with a prescription from a licensed medical provider.

We ask for programmes to educate the general public about the drug and its addictive potential. This should involve pharmacists, doctors, teachers, and pastors. Consideration should be given to programmes of rehabilitation.

Though not part of the three-pronged approach, another option to look at would be petitioning the International Narcotics Control Board (INCB) to add Tramadol to the list of opioids it controls. The cost of obtaining it for cancer and post-surgical patients will be a much lesser evil than the scourge of rampant Tramadol addiction.

Tramadol addiction presents a health problem of grave severity and it behoves the nation to get on top of it before it becomes an uncontrollable epidemic.

In service for God and Country.

OccupyGhana®

OccupyGhana® Calls On Government To Immediately Address The Filth Engulfing The Country

OccupyGhana® Calls On Government To Immediately Address The Filth Engulfing The Country

1st MARCH 2018

OCCUPYGHANA® PRESS STATEMENT

OCCUPYGHANA® CALLS ON GOVERNMENT TO IMMEDIATELY ADDRESS THE FILTH ENGULFING THE COUNTRY 

OccupyGhana® has noted with concern the huge swathes of plastic and other solid and human waste engulfing our country, especially our capital. It is rapidly reaching an alarming state and photographs taken after the recent downpour in parts of Accra in the morning of Wednesday 14th February 2018 have thrown this looming and potentially disastrous health and security problem into sharp focus.

We have also been monitoring how the matter of sanitation is being addressed by Government and we are concerned about Government’s commitment to resolve it

It appears that in spite of the establishment of the new Ministry of Sanitation & Water Resources, little has been done to confront and remove the filth engulfing our country. The reality is that by the Local Governance Act, 2016 (Act 936) and its predecessor statute, issues of sanitation are to be handled by the Metropolitan, Municipal and District Authorities (MMDAs). There are also the provisions of the Community Water and Sanitation Agency Act, 1998 (Act 564), and the functions assigned to that Agency. This legislative dilemma is compounded by the Environmental Sanitation provisions under Part Five of the Public Health Act, 2012 (Act 851), falling within the remit of the Ministry of Health. We therefore have doubts as to what the Ministry will do and achieve when it technically has no legislative mandate to handle sanitation anywhere in the country, unless its role is to coordinate the activities of all the legislatively-mandated bodies on issues of sanitation.

We have taken note of the National Sanitation Campaign launched by the President in November 2017, which does not appear to have made any real impact in resolving the problem yet. Under this campaign, there were to be:

  1. Introduction of automated street sweepers.
  2. The formation of a National Sanitation Brigade.
  3. Appointment of Sanitation Marshalls and Deputies in Municipal and District Assemblies; these appointments were to have been made within one week of the announcement by the President.

None of these initiatives appear to have started, with no clear cut time frame on when and how the Ministry of Sanitation & Water Resources intends to roll out the program.

The President also indicated that he and the Minister for Monitoring & Evaluation would evaluate the performance of all Metropolitan, Municipal and District Chief Executives (MMDCEs) and publish the results of their performance. We think that it would be very apt if the agreed Key Performance Indices used to evaluate them are published so that as Citizens we can monitor and score our MMDCEs on sanitation issues.

We also call upon our MMDAs and Ghana Police to rigidly enforce our laws regarding littering the environment, refuse disposal and open defecation, and charge and prosecute offenders. There are the specific provisions under sections 13(3) and 14 of the Local Governance Act, which empower them to enforce the provisions of section 296 (1) of the Criminal Offences Act, 1960 (Act 29) and section 56 the Public Health Act. These laws contain the penalties for breaches. We see no reason why the laws should not be strictly enforced and offenders punished. We urge the MMDAs and Ghana Police to enforce them without delay.

We urge the Government, acting through the MMDAs, to confront this menace before the impending rainy season, which comes with diseases such as cholera, a direct consequence of poor sanitation. OccupyGhana® is convinced that as a people we should ingrain the practice of keeping our surroundings clean on a continuous basis and not restrict it to periodic nationwide clean up exercises. To achieve this, the bodies tasked with sanitation responsibilities by law, must strictly apply our sanitation laws, carry out intensive and sustained public education and build a new positive attitude in our citizens toward caring for and protecting the environment. This must be done without any further delay.

We also urge Ghanaians to desist from littering the environment, refrain from disposing refuse improperly and stop the practice of open defecation. We must all strive as a people to live up to our dying national maxim: “Cleanliness is next to Godliness”.

The fight for a clean environment cannot be delayed further.

Let us Keep Ghana Clean!

OccupyGhana®

STATEMENT TO THE HEALTH MINISTER ON THE OUTBREAK OF INFECTIOUS DISEASES IN SENIOR HIGH SCHOOLS

17TH DECEMBER 2017

OCCUPYGHANA® PRESS STATEMENT

STATEMENT TO THE HEALTH MINISTER ON THE OUTBREAK OF INFECTIOUS DISEASES IN SENIOR HIGH SCHOOLS

Infectious diseases play a significant role in the health of Ghanaians. These diseases, some of which are highly contagious, are fortunately preventable and treatable. Their control however demands sustained and well-financed public health measures. A lack of such measures, their inadequate finance or incomplete implementation can lead to deaths.

It must be noted that some of these diseases are endemic to certain areas of the country while others occur everywhere. Some like meningitis tend to be seasonal while others like malaria may occur year round. What is common to all these diseases is that they are often found in places where people live in close proximity with each other. Our boarding schools and universities are such institutions that come to mind.

OccupyGhana® notes with concern the outbreak of infectious diseases in senior high schools in various parts of the country with at least 8 fatalities this year. In particular, we refer to the outbreak of H1N1 Flu in Kumasi Academy where 4 students have died and many others taken ill and hospitalised, and Meningitis in Koforidua Sec. Tech., Damango Snr. High School, and most recently Bawku Sec. Tech. School.

The questions that arise from these events are whether Ghana has adequate and well-financed public health measures to deal with these outbreaks and if these measures, if available, are implemented properly.

In a nutshell, these measures should include:
• a vaccination or prophylaxis program to protect against contracting these diseases,
• practices that help in protecting one from contracting them,
• a centre manned by trained professionals that monitors the incidence and outbreaks,
• a good reporting system that allows outbreaks to be reported,
• a team that responds to these reports of outbreaks,
• an incident manager to supervise the management of each outbreak,
• an effective way of quarantining affected individuals or communities,
• an effective way of tracking down individuals who may be carriers,
• a clear way of reassuring the public about the measures taken, and their safety and those of their families
• a program to treat the sick and
• measures to get the outbreak under control.

From all the reports of what happened in Kumasi Academy a few weeks ago, several issues become apparent:
• there is a reporting system that allows outbreaks to be reported to the Ministry of Health/ Ghana Health Service (GHS),
• the response from the GHS was adequate,
• it is unclear if autopsies were done on all 4 deceased students,
• diagnosis of the cause was rapid,
• quarantining of the affected students and areas was not good. The President visited the school in that period,
• there seems to be no vaccines available for the H1N1,
• there was a breakdown in adequate communication to the public about the outbreak and the measures being taken.

Considering these listed observations, what has happened at several schools so far, and the fact that we have entered the annual season for meningitis and outbreaks are expected in the meningitis belt, we respectfully ask the Minister of Health to provide answers to the following questions:
• Are our public health measures against infectious diseases well-funded?
• What steps has the ministry taken to protect the public and SHS students from meningitis?
• Have teachers and school staff been educated about meningitis?
• Have students been immunised against meningitis and other preventable infectious diseases?
•Do the schools have isolation guidelines and established links with health care facilities?
• Is there an effective communication strategy with the public and the media and who are the frontline communicators?
• Are the response teams allowed to quarantine affected individuals or even communities? Do we need the help of the military for that?
• Is there always an Incident Manager designated to manage the control of these outbreaks?
• What steps have been taken to enhance sanitation and hygiene and reduce congestion in schools?
• Could the GHS publish protocols to deal with outbreaks for schools?

Infectious diseases, though devastating in their effects, are also controllable and preventable. Let’s all work together to get a handle on them for a healthier Ghana for God and Country.

OccupyGhana®

OccupyGhana® Condemns Sexist Action Against Pregnant Nursing Student

OccupyGhana® Condemns Sexist Action Against Pregnant Nursing Student

12th May, 2017

OCCUPYGHANA® PRESS STATEMENT

OCCUPYGHANA® CONDEMNS SEXIST ACTION AGAINST PREGNANT NURSING STUDENT

OccupyGhana® is shocked and dismayed at the news that a nursing student at the Gusheigu Midwifery Training School was on Wednesday 10th April 2017, prevented from writing an exam because she was 4 months pregnant.

This unconstitutional practice, which has gone on for years, is apparently based on a rule in the student handbook in our Nursing and Midwifery Training Schools. The rule demands that pregnant women defer their courses while those who abort their pregnancies are dismissed (Daily Graphic, May 28 2016)

It is regrettable that pregnancy discrimination persists, even though CHRAJ declared as illegal, the barring of pregnant students from writing exams in a case involving the same Nurses and Midwifery Council just last year.

We unequivocally condemn this sexist, archaic and totally unacceptable practice and emphasise that pregnancy must not be a barrier to the education of women. It is in clear violation of the Constitution’s anti-discrimination provisions.

We note that the Nursing and Midwifery Council has condemned the action of the Principal and we expect that this will be immediately followed by the strongest possible sanctions to serve as a deterrent to other schools. In addition we would fully support the student, Mrs. Cecilia Awuni, should she decide to seek legal redress.

Yours in the service of occupying minds for God and Country

OccupyGhana®

OCCUPYGHANA ASKS: PROPOSED EBOLA VACCINE TRIALS – 12 QUESTIONS FOR THE FOOD AND DRUGS AUTHORITY AND THE MINISTRY OF HEALTH

OCCUPYGHANA ASKS: PROPOSED EBOLA VACCINE TRIALS – 12 QUESTIONS FOR THE FOOD AND DRUGS AUTHORITY AND THE MINISTRY OF HEALTH

OccupyGhana has observed with much concern, the ongoing brouhaha and sheer confusion over the proposed Ebola Vaccine Trials.Throughout the nation, in homes, on the media and even in Parliament, we have observed concern that has morphed into fear simply because the required information has not been made available.

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