Health Essentials
Eating ourselves to the grave
We eat to live, right? A good, balanced and healthy diet, we are told, keeps the doctor away. Food is the only natural and most effective medicine known to Man. The only adverse medical conditions that I know could cause death are bulimia and anorexia. I cook; and I love cooking. Being a vegetarian even makes it more imperative for me to be mindful of what I eat. As a result I frequent the market for my groceries.
What I see in the market these days gives me the creeps. I have taken my time to figure out how some of the foodstuffs we buy are treated, and my findings reveal an astonishing array of ignorance and downright evil intent from some of the traders in our markets.
Let me deal with the easy consumables. In order to maximise profits some traders resort to mixing groundnut paste with cassava powder, locally called kokonte. This gives a bigger volume to the paste and the customer is none the wiser. Assuming you were a diabetic who must avoid starch at all costs, what do you think this will do to your health? Avocado seed is chopped into little bits, dried, ground and mixed with powdered pepper. I am told avocado seed contains medicinal properties, but that cannot be the reason traders do this.
Palm oil is mixed with a toxic red dye to give it a more attractive red colour. Paradoxically, palm oil is one of the healthiest consumable vegetable oils in our parts. The others are groundnut oil, coconut oil, palm kernel oil and Shea butter oil. Similar colouring is done to salted lamb chunks (popularly called tolo-bifi) by the market women for whatever reasons known only to them. That I am a vegetarian does not mean I should not be concerned with what others consume. When my daughters were in the University, and because I had no right to impose my diet on them, I would go to the market to get condiments to prepare soups and stews for them.
Why do these traders do this? Is it because they are ignorant of the consequences of their actions or it is just a diabolic, evil intent to harm their clients/consumers? I once asked a woman who sold salted mutton chunks at the Kaneshie market in Accra if she ate the dyed meat at home. Her response was that because she sold it, it was like she had seen too much of it so it ceased to be a part of her diet.
I bought veal, mutton, crabs, salmon, tuna, tilapia and other smoked fish to cook for my children. Having been brought up near the coast, I knew good fish when I saw one. The only thing I excluded from the meals to my children was cow-hide (wele) because it has no nutritional value whatsoever. It was a delicacy for them though.
Let me take on the cooked food sellers briefly: Personally, I hardly eat from outside my home. However, occasionally I go for sinkafa-da-waakye (cooked rice and beans), but to save firewood, the women add too much of saltpeter (they call it kanwe) to soften the beans fast. Now, kenkey, another staple has joined the fray for saltpeter application, to the extent that kenkey has become so soft you can hardly leave it without refrigeration for a day without it going bad. Just a decade and a half ago I could leave kenkey on my dining table for a week,then heat it up for consumption. Kenkey cannot stay in the fridge for a week nowadays. It turns mouldy rather quickly.
Then is all manner of poisonous seasoning all over the place in the guise of spices. Potassium glutamate readily comes to mind. Some of these things add a false appetising aroma to the cooked food just to entice the consumer. Some of these come in the form of cubes, the favourite of lazy housewives. What has happened to the natural spices of garlic, onion/shallot, kpakposhitor, ginger, nutmeg and cloves blended together?
A health consultant tells me that excessive saltpeter consumption corrodes the mucus that lines the intestinal walls, thus slowing down movement of what we ingest down the digestive track. This, according to her, causes pain as the food rubs against the exposed walls of the intestine. Sadly, our health authorities are more interested in checking the health status of the food vendors not the quality of the food they sell to the public.
Do we blame the poor food vendor? Less than two decades ago Ghana flared Liquefied Petroleum Gas (LPG) into the atmosphere. Then some smart alec decided we could encourage our countrymen to stop cutting down trees for firewood so they could use the LPG for domestic use instead. The reason was to prevent deforestation. Ghanaians bought into the idea and started patronising the LPG, realising it was cheaper than firewood. As I write, LPG is beyond the reach of the ordinary Ghanaian. Petroleum products have become the cash-cow for tax revenue.
Now, back to the traders. In fact, they can be forgiven for some of the stuff they sell. A few years ago I used to buy tomatoes in bulk, spread them out on newsprint on the floor and use them as and when I needed them. Right now, ripe tomatoes cannot last three days in the fridge. Same goes for many vegetables. You cannot keep okra for more than a day; it will develop dark blotches on the skin. Same goes with green pepper, cauliflower and many of the green leafy vegetables.
We used to keep yams for weeks, but if you take a tuber of yam now you have to ensure you cook the whole tuber else it gets rotten the very next day. Even if the rest is refrigerated it must be cooked within 48 hours. Our agriculture scientists are not telling us what is going on. Is anything wrong with the soil? Does this phenomenon have to do with the agro-chemicals used by the farmers? Why is no one telling us anything?
I saw a video clip of lettuce being washed with detergent. I watched another where what looked like spinach is soaked in some chemical solution so it would look fresh to the consumer. Mango, avocado, orange and papaya are doused with chemicals to speed up their ripening.
I hear there is an Authority on food and drugs. Can someone please tell me what they do? I ask because methinks we are eating ourselves to the grave and no one seems to care about us. Let me also ask if we have standards for the food we eat or the stuff we purchase? Do we have those? We are constantly admonished to eat healthy, yet the things we buy to put together as a meal give us cause for worry. Is it any wonder cases of diabetes are on the rise? Liver and kidney ailments are on the increase. What do the people we put in charge of our very existence do with statistics from our health facilities? Until they wake up to the reality and save us, shall we continue to eat ourselves to the grave?
akofa45@yahoo.
By Dr. Akofa K. Segbefia
Health Essentials
Why Ghana’s ‘no bed syndrome’ is a policy failure, not a clinical failure – Part one
OVER the years, No Bed Syndrome has been a major headache in Ghana’s health system. People have expressed different views and today my friend and classmate Professor Jonathan Laryea takes his turn and makes extremely important contributions that should start a deep conversation.
Professor Laryea writes;
Every few months, Ghana wakes up to a familiar, tragic headline. A prominent citizen, a pregnant mother, or a young accident victim has died in the back of an ambulance. They didn’t die because medical science failed them; they died because they spent their “Golden Hour”, the critical window between life and death, touring the gates of hospitals that had no room to receive them.
The public outcry follows a predictable script: anger at the hospitals, calls for “compassion” from doctors and nurses, and a frantic directive from the minister of health and parliament. A few years ago, the directive was simple: No hospital can turn a patient away. The result? We didn’t create more beds; we simply moved the crisis from the ambulance floor to the hospital floor. That also created another outrage.
It is time to stop blaming the frontline workers and start looking at the math. The “No Bed Syndrome” is not a failure of healthcare workers; it is a failure of a country that has not matched its resources to its population growth. Most recently, an engineer lost his life after being involved in an accident. The ambulance drove around for hours before getting to Korle Bu. Though the outcome was sad, I would venture to say that even if Korle Bu had a bed to treat this patient, the outcome would likely have been the same given the time between the accident and when the ambulance got to Korle Bu. When you have a patient exsanguinating, time is of the essence. Even if he got to the right place in time, the other question is would they have enough blood to resuscitate him without requiring family to donate prior to administering the blood?
The impossible equation
Consider the capital city. Accra has a population of approximately 2.9 – 4 million people, depending on who you ask. To serve this massive, high-density population, there are fewer than 400 dedicated emergency room beds across major public facilities.
Let’s do the math: that is roughly one emergency bed for every 10,000 citizens. That is not a recipe for success. When a system is constantly operating at 110 per cent capacity, “No Bed” isn’t an excuse, it is a physical reality. When we force doctors and nurses to treat patients on the floor, we aren’t “solving” the problem; we are compromising hygiene, dignity, and clinical outcomes. You cannot perform a high-quality resuscitation on a crowded floor. This is a capacity issue. We cannot expect this issue to fix itself. There is the need to increase emergency capacity across the metropolis and indeed across the country.
A system in need of coordination
The second failure is logistical. Ghana has made strides in developing a National Ambulance Service (NAS), but we have failed to give that service a “brain” to coordinate it. Currently, an ambulance driver picks up a patient and begins a desperate, manual search for a vacancy. They drive from Ridge Hospital to 37 Military Hospital to Korle-Bu, burning through the patient’s oxygen and time. In an era of digital transformation, it is inexcusable that our ambulances do not have a real-time, cloud-based dashboard showing exactly where the nearest available specialised bed is located. An ambulance without a coordinated dispatch system is just a high-speed hearse.
Beyond the furniture: The “emergency mindset”
A bed, however, is just a piece of furniture if it is not backed by an emergency pathway. The true “No Bed Syndrome” includes a lack of specialised systems. In modern medicine, the “Golden Hour” dictates that, for example:
• For a heart attack: We must be able to perform cardiac catheterization within 60 to 90 minutes.
• For a stroke: We must have the ability to perform a CT scan and administer clot-busting medication within an hour.
In Ghana, if you have a stroke or heart attack, your survival depends more on your luck and your traffic route than on a standardised medical protocol. If a patient reaches a bed but the CT scanner is broken or there is no Cardiac Catheterisation Laboratory or the Catheterisation laboratory is unstaffed/unresourced, the “syndrome” has simply moved from the ambulance to the ward. We have failed to develop the specialized “hubs” required to treat these time-sensitive killers. Accident cases are even worse. The ability to give blood emergently to exsanguinating patients does not exist. Some patients need immediate surgery; for example, patients with gunshot wounds and stab wounds. Sending such patients to a facility where they cannot do emergency surgery is unhelpful.
We must develop a system for triaging patients to the right facilities. There is a need to do a thorough evaluation of our healthcare delivery system and redesign a system that works for Ghanaians. It looks like we have done a patchwork of modifications to what Governor Guggisberg left us and after 69 years of self-governance, we have failed to redesign a system that works for modern-day realities.
Prof. Jonathan Laryea is a Professor of Surgery at the University of Arkansas for Medical Sciences in Little Rock, Arkansas. He is board certified in General Surgery, Colorectal Surgery and Clinical Informatics.
He is a graduate of the University of Ghana Medical School (Class of 1997).
Health Essentials
Children Believe, Norsaac present medicines, medical equipment to three Health Directorates
THE Northern, Upper East and Savannah Regional Health Directorates have taken delivery of various medicines and medical equipment to improve care for pregnant/lactating mothers, adolescent girls and children under five years.
The medicines and medical equipment, worth GH¢1.6 million, were procured with funding support from the Canadian Government through Global Affairs Canada.
They included Combined Iron (III) Hydroxide Polymaltose and Folic Acid – 5,500 Boxes, Mebendazole (Wormalex 400mg) – 10,000 Packs, Albendazole (400mg) – 20,000 Packs, Combine Ferrous Sulphate and Folic Acid (Folidyn Tab mp) – 2880 cartons, Tarring Weighing Scale- 18 pieces, Digital Thermometer – 108 pieces, and Height Rod in CMS/Feet HOM Stadiometer – 27 pieces.
The rest were Blood Pressure Monitor Digital, Andon- 27 pieces, Ultrasonic Pocket Doppler, 1.5v Sonotrax Basic – 9 pieces, Glucose meters – 54 pieces, Glucose meter stripes (50’s)- 500 pieces, Delivery set (used for facility-based delivery) – 27 pieces, Hb Testing System/URIT -12 – 36 pieces, Hb Test Stripes (50’s) – 800 pieces, Weighing Scale, Hanging (Salter) HOM- 27 pieces.
Some 96,374 individuals comprising pregnant/lactating mothers, adolescent girls and children under five years in nine districts in the three regions are expected to benefit from the medicines and the medical equipment.
A total of 54 health facilities in the nine districts, namely Bole, Sawla-Tuna-Kalba, East Gonja, Tolon, Kumbungu, Nanumba South, Builsa South, Kassena-Nankana West and Kassena-Nankana North, are to benefit from the supplies.
They were donated by Children Believe, an international NGO, under the Championing Nutrition and Gender Equality (CHANGE) project, which is funded by Global Affairs Canada.
The CHANGE project is being implemented in partnership with Norsaac; the national implementing partner, amongst other governmental agencies.
The overall objective of the project is to improve nutrition for the poorest and most marginalised, especially women and adolescent girls.
Madam Esenam Kavi De Souza, the Country Director, Children Believe, speaking to hand over the medicines and the medical equipment to the authorities of the Ghana Health Service (GHS) at the Regional Medical Stores in Tamale, said it was geared towards achieving the project’s commitment to improve women’s leadership and control resources for community and individual gender equitable nutrition practices.
The authorities of the GHS in the Upper East and Savannah Regions also received their share of the donated items in their respective regions.
Madam De Souza said the gesture followed assessments conducted with the GHS to identify the most critical healthcare needs in the targeted communities. She said the intervention was designed to ensure that the support would make a meaningful difference in healthcare delivery for the poorest and most marginalised populations in the targeted districts.
Dr Chrysantus Kubio, the Northern Regional Director, GHS, who received the items, said they would significantly improve health service delivery in the beneficiary districts in the region.
He said as part of the project, motorbikes and laptops were also supplied to the districts to facilitate the work of health personnel and improve data analysis for health services.
He lauded the project saying such partnerships were crucial in supporting vulnerable populations, who faced financial barriers to healthcare and expressed appreciation to Global Affairs Canada and the implementing partners for their support. —GNA
