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Cry my beloved Ghana

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Someone said, if we cannot plan for an occurrence as predictable as the annual rains, then what else can we plan for as a country?  God has caused nature to schedule rains for specific periods or months within the year and everybody knows this. 

One need not be a meteorologist to tell that the rains will fall in May and June every year.  Any serious person who has something that the rains can affect, would therefore plan taking into consideration the likelihood of the rains falling.  Therefore to find out that a whole country like ours, had not planned effectively, is mind-boggling. 

The report by the World Bank that fiscal policy measures by the Finance Minister has led to no money being released for the World Bank sponsored project to deal with the perennial flooding situation in Accra, is so disappointing.  The fact that this contributed immensely to the flooding in Accra, is an understatement.

There have been fires in our markets, but who is checking the wiring on a regular basis as a system designed to prevent future outbreaks?  The occurrence of fires in our markets is something that must engage the attention of government and all the stakeholders.

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The causes may be several but if a system of proper fire prevention is in place, l believe the number of occurrences will be drastically minimised.  Electrical wiring for instance has been found to be one of the causes of market fires.  Fire as we know from the experts, can only happen if these three things are present, namely source of heat, combustible material and oxygen i.e. air. 

lf any one of these is missing, there will be no fire.  It has been realised that heat generated in wires have caused fires in the past and therefore, an effective system must be put in place to ensure that, only certain approved qualified electricians, can execute wiring jobs in our markets instead of the current situation where different electricians execute wiring with different types of wires, of different quality, dimensions etc. 

Preventive inspections schedule must also be put in place to endure compliance with uniform wiring standard, as well as adherence to expiry dates of the wires.

What baffles me is why some MCEs and DCEs are still at post while things are deteriorating in their areas of influence and yet the President or the Minister for Local Government seems to be unwilling to relieve them of their positions.  People have lost their lives, official count is about 37 lives, properties worth millions of Ghana Cedis have been destroyed, people’s livelihoods have been destroyed and they are at ground zero.

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We can go on and on and on about the devastating impact of the recent floods.  Suddenly, we have these local authority heads, all over the place, demolishing buildings after the flood.  Is this not insanity?  Where were the LUPSA Engineers who issue permits at the local assemblies? 

If they were doing their jobs, for which they are paid every month, they would have seen people constructing structures at Ramseyer sites.  They would have seen people putting up structures very close to the bank of streams or rivers and could have enforced the regulations, which could have averted the level of impact on lives and property.

One particular issue which drives me crazy is the Kasoa to Mallam Junction stretch of the N1.  The traffic jam between West Hills Mall and Weija Junction is due to the flooding of a place called Ataala.  Anytime it rains heavily, the area floods and vehicles moving from West Hills towards Weija cannot use their normal lane but are forced to switch to the inner lane of those headed towards West Hills Mall from Weija and it did not start yesterday.  I am so, so disappointed. God Bless.

By Laud Kissi-Mensah

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Disqualified — Part 5

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The driver stopped the vehicle at the gate of the large, fenced property along the Nsawam Highway, and Kakraba stepped out to meet the several workers who had gathered to wait for him.

He greeted them and went straight to the point.

“Gentlemen, I am glad to see that you have almost completed the clearing of the land. I’m happy to report that we have concluded all arrangements with Nana Serebour, and construction of the palace will start in a few days.

“I will need you to go and level the ground, and then come back to start this project. Some workers from a construction company will come and join us.

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“My plan is to build twenty houses in four months. Then we will do twenty more until we reach two hundred.

“I am relying on you to help me deliver good-quality work to satisfy our clients and, as I have already indicated to you, I will reward you for your work.”

After an hour’s discussion, he closed the meeting and moved to drive away. Wofa Yaw drew closer.

“Director, can you please spare me five minutes? I would like to discuss a small issue.”

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“Why, Wofa Yaw? Your wife has threatened to leave you?”

“No, Director. My wife will never leave me. This concerns a young niece of mine.”

“I hope it’s something I can help with. Please sit in the car and let me hear you.”

“Boss, my niece, Beesiwa, is a polytechnic graduate, very beautiful and with very good character.

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“Unfortunately, her parents virtually forced her into a relationship with an idiot based in the US, which affected her badly. She has now recovered from that experience and, Boss, I am respectfully asking if you would find a job for her.

“I promise you that you will never regret it.”

“Well, Wofa Yaw, let me meet her and speak with her. I may be able to help, maybe not in the way you expect, but let me meet her.

“I will not be back here for another week, but I will be at the office throughout next week. You can come with her.”

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On Monday morning, Wofa Yaw and Beesiwa were seated at the office by nine o’clock. Three young ladies welcomed them warmly, offered them soft drinks and assured them that Kakraba would be there shortly.

They then returned to their desks and sat behind computers with large screens displaying various building designs.

Kakraba walked in and greeted them warmly. After chatting briefly with the three ladies, he ushered Wofa Yaw and Beesiwa into his office.

“Director, this is my niece, Beesiwa. I mentioned her to you when you came to Nsawam.”

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“Yes, indeed. Madam Beesiwa, you are very beautiful, just as your uncle said. Wofa Yaw is my colleague.

“We have just started a building project that will take about three to four years. He mentioned that you have a small problem, so I said I would like to meet you and see how I can help.

“So, Beesiwa, please tell me a little about yourself.”

Beesiwa described her childhood, her school experience, her brief work at the bank and the nasty episode with Sammy Abrokwa, which shattered her peaceful life. She also explained how she had been recovering from the experience.

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“I am really sorry to hear this,” Kakraba said. “Now, here is what we are going to do.

“We are a small but very busy company. The three ladies out there spend most of the day on site and come back to report on their work in the morning.

“I have three main projects. The big one is an estate project in Nsawam, where your uncle is one of my main colleagues. I need a personal assistant who can take care of my activities, especially when I am not in town.

“Now, we will have to start with trust. Based on what I know about Wofa Yaw, and based on what you yourself have told me, I think we can start on a sound basis.

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“So, Wofa Yaw will take you to my home. You can move into one of the four guest rooms.”

“Sir, I have taken some computer lessons, and I have even done graphics and web design,” Beesiwa said.

“Fantastic! I will give you a good phone and a laptop. I will also arrange computer lessons for you.”

“Now, Wofa Yaw, take her home. My sister, Kuukuwa, will meet you and show you around, and then you can return to Koforidua.

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“When would you like to start work?”

“Sir, I would like to start today, but I would need to go and bring my things.”

“No problem. Take a taxi to my house, meet my sister, and let me know what you decide.”

Later that day, Kakraba and the three ladies met with some bank officials to conclude the sale of the three buildings at Adabraka.

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They closed at five-thirty and, after rewarding the ladies for their hard work, Kakraba got home just after dark.

He was surprised to find Kuukuwa and Beesiwa sitting at the table enjoying supper.

“What’s happening here?” he asked. “Beesiwa, I thought you would return to Koforidua.”

“She changed her mind,” Kuukuwa said. “We went to the mall and bought a few things for her. Then we came back to cook. She has made some nice changes to your bedroom and cooked a couple of interesting dishes. Sit down; we will serve you.”

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“Well, I certainly can’t refuse that. It’s been a busy day.

“So, what’s the plan now? Will Beesiwa go to Koforidua tomorrow, gather her things together and come down?”

“No, I will stay here for a while,” Beesiwa replied. “Kuukuwa bought me the things I need, so I may go back next week. I’m ready to start work. What would you like me to start with?”

“Well, you can come to the office tomorrow morning, meet the three girls and get a feel for what we do.

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“Since you are living here, at least for now, we can discuss the plans for the next few weeks.

“Sometimes there are gaps when I travel up north. You can take care of things from now. I think the girls would like having someone like you around.”

By Ekow de Heer

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The biological realities of breast excision – Part 1

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A frequent question following breast surgery is whether human tissue possesses the regenerative capacity to restore an excised organ.

From a strict physiological standpoint, a completely removed breast cannot regrow. Unlike certain organisms that can regenerate complex limbs or organs, adult human tissues—particularly specialised glandular structures—lack the cellular machinery required to rebuild an entire organ after its total surgical removal.

Instead, the body heals the surgical site through processes such as scar tissue formation and re-epithelialisation rather than complete cellular regeneration.

What a mastectomy actually removes

To understand why natural tissue regeneration does not occur, it is important to examine the surgical scope of a mastectomy.

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Depending on the type of procedure and the medical reason for surgery, a mastectomy may involve the removal of:

Glandular architecture: The milk-producing lobules and ducts that form the functional core of the mammary gland.

Adipose tissue: The fatty tissue that contributes to breast volume, projection and contour.

Other breast tissue: The extent of tissue removal varies according to the type of mastectomy and the need to achieve appropriate surgical clearance.

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Because specialised breast structures are physically removed, the body does not rebuild a complete mammary gland. Instead, healing occurs through tissue repair and scar formation.

Distinguishing residual tissue from “regrowth”

Patients or observers may notice changes in the chest area after surgery, sometimes leading to misconceptions about tissue regeneration.

Skin- and nipple-sparing procedures

Modern breast surgery may preserve the outer skin envelope or, in selected cases, the nipple-areola complex. Small amounts of breast tissue may remain depending on the surgical technique. Any changes in remaining tissue due to hormonal fluctuations represent residual tissue responding to the body, rather than the regrowth of a completely removed breast.

Adipose accumulation

Weight gain after surgery can increase the amount of subcutaneous fat across the chest wall. However, this is part of general body fat distribution and does not represent the regeneration of a mammary gland.

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Modern reconstructive pathways

Because a completely removed breast does not naturally regenerate, modern medicine offers reconstructive options aimed at restoring physical symmetry, contour and body image.

The two main approaches are implant-based reconstruction and autologous, or tissue-based, reconstruction.

Implant-based reconstruction

Implant-based reconstruction uses synthetic medical devices, typically filled with silicone gel or saline, to rebuild the breast mound following a mastectomy.

The two-stage process: This approach may begin with the placement of a temporary tissue expander to gradually create space and stretch the surrounding tissues. A later procedure may then be performed to place a permanent implant.

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Recovery profile: Implant-based reconstruction generally involves a shorter initial surgery and recovery period compared with procedures that require tissue to be harvested from another part of the body.

Long-term considerations: Breast implants are not lifetime devices and require ongoing medical monitoring. Some patients may need additional procedures over time because of complications or changes in the implant or surrounding tissue.

Autologous or tissue-based reconstruction

Autologous reconstruction uses the patient’s own living tissue to create a new breast mound. Tissue may be transferred from another part of the body, commonly the lower abdomen, using procedures such as a DIEP flap.

Natural look and feel: Because the reconstruction uses living tissue, it can provide a natural warmth, texture and softness. The tissue may also change with the patient’s body weight over time.

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Long-term durability: Once healing is complete, autologous reconstruction can provide a long-lasting result without the need to replace an implant. However, some patients may still require further procedures.

Complex surgery: This option usually involves a longer operation and recovery period. In microsurgical procedures, surgeons may need to reconnect tiny blood vessels to establish blood flow to the transferred tissue.

Direct comparison

When choosing between these two reconstructive pathways, patients and their surgical teams must consider several physical, medical and lifestyle factors.

Surgical burden: Implant surgery is generally less invasive, while flap reconstruction involves surgery at both the chest and the donor site.

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Foreign material versus native tissue: Implants involve the use of a medical device, while autologous reconstruction uses the patient’s own tissue.

Recovery: The recovery timelines and rehabilitation requirements differ significantly between the two procedures.

Recovery and physical rehabilitation

Recovering from breast reconstruction requires patience, careful pacing and, in some cases, structured physical rehabilitation.

Because implant-based and autologous tissue-flap procedures involve different surgical techniques, their healing timelines and physical therapy milestones can vary considerably.

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Understanding these differences is important for patients considering reconstruction, as the choice involves more than restoring physical appearance. It also requires careful consideration of recovery, long-term monitoring, lifestyle and individual medical needs.

Part 2 will examine recovery timelines, physical therapy milestones and other factors patients should consider when choosing between reconstructive options.

By Robert Ekow Grimmond-Thompson

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