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
This week I bumped into Deborah, one of my avid readers and I promised her I will be writing this weekend. So Deborah, this is for your reading pleasure and to pick some golden nuggets for the future.
The quest to find the best way to make one’s golden years, happy, exciting, healthy and a time most people look forward to continues unabated. One factor that keeps popping up is the need to grow friendships with people more than 20 years younger than yourself.
Do not take this for granted. It is a form of “social security” since these close friends who are much younger than you will step in to support you in more ways than you can ever imagine.
Some conditions may make life challenging for older adults but knowing these Geriatric Giants helps us to take the necessary steps to reduce our risk.
“Geriatric Giants” refers to a group of chronic health conditions that are common in the elderly, typically 65-year-olds and older.
These conditions quite often co-occur and can impact on the independence, dignity and overall wellbeing and quality of life of an elderly person.
These Geriatric Giants include:
- Impaired Intellect/ Memory (e.g. Dementia)
- one of the major battles we need to deal with is challenges with memory
- Exercise, adopt the Mind Diet, build a great social network and enjoy time outdoors
- Keep reading and solving puzzles for as long as possible
- Instability – leading to much feared falls
- A good reason to indulge in Balance Training and Core Strengthening exercises from today
- Ensure your home is safe; avoid clutter such as cables crisscrossing floors, toys etc. These are all trip hazards and should be avoided
- Many healthy, happy and fun-loving older adults have died soon after a fall with its attendant complications.
- Do whatever it takes to avoid falling
- Immobility (opening the doors to pressure sores, joint stiffness)
- Even when you are unable to move about on your own it is important to get support to change positions as often as possible or get an appropriate mattress or bed that prevents prolonged pressure over any single point.
- Make sure you passively or actively move joints daily.
- Incontinence (urine, faeces or both)
- This is one of the reasons older adults prefer to stay at home and avoid going out to meet friends etc.
- Iatrogenic Disorders – adverse effect of medication
- Quite often most older adults are on several medications and some side effects such as drowsiness may seem to cause more unhappiness and may even lead to falls.
- Inappetite – this may result in poor nutrition
- This may also be linked to loss of teeth thus making chewing very difficult or limited.
- The loss of smell and taste may also reduce the amount of food one may willingly eat.
The power to reduce the impact of the Geriatric Giants starts now and should be a lifetime commitment. It is never too early to start making the appropriate lifestyle modifications, nor is it too late to reduce the impact of the giants on one’s life.
Other conditions that significantly impact on the lives especially of the elderly are:
- Sleep Disorders
- Good sleep has the power to give us energy, improve our thought pattern and even helps us to make good choices.
- Good sleep sets the tone for a healthy life
- Constipation
- This is a challenge that confronts quite a number of older adults.
- Movement, fibre and lots of water go a long way to reduce the stress that frequent constipation generates.
- Fraility
- Muscle loss is real and as we age, we lose a significant percentage of our muscle plus our bones also become brittle.
- Make sure strength training is part of your exercise schedule
- Polypharmacy
- Another headache that needs to be confronted head-on
- Everyone especially older adults need a good primary care physician or a general practitioner who can coordinate all medicines from the different Specialists who may be attending to an elderly person. This ensures that unnecessary medicines are dropped
The goal of care at all times is to optimise the quality of life. As family, professional caregivers and friends we should always show respect so that the dignity of the elderly is preserved at all times. For those of us who are not yet in the age group with such challenges, we need to start the conversation about the type of care we will prefer and take steps to stay healthy and independent for as long as possible. The goal should be a long Healthspan and not just a long Lifespan.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “There is no magic formula to being happy but making a conscious effort to be happy goes a long way.” – Dr. Kojo Cobba Essel
By Dr. Kojo Cobba Esse
The call to action
We must move beyond the cycle of temporary outrage. I propose a four-point blueprint for the Ministry of Health and the government:
1. A Digital Bed-Tracking Command Centre: Legally mandate all public and major private hospitals to update a live, digital bed-registry every hour. The NAS must be able to see a vacancy before they move. This must be matched with the available resources and services so that the right patient will be sent to the right facility.
2. Strategic Capacity Expansion: We must stop building “prestige projects” and start building high-volume stabilisation centres. We need a targeted investment to triple the ER bed count in Accra and Kumasi within 24 months. This should then be extended to other regional capitals.
3. Specialised Emergency Hubs: Designate specific hospitals as “Centres of Excellence” for Cardiac and Stroke care (and for other health emergencies), ensuring they have 24/7 imaging and intervention capabilities as well as the requisite expertise to manage these conditions. Policy makers must incentivise public-private partnerships to ensure that a heart attack in Accra or Kumasi can be treated with the same urgency as one in New York.
4. Develop a nationwide trauma system: This is extremely important because trauma is a major cause of deaths in Ghana. In the US, each state has a statewide trauma system with three levels. Level 1 trauma centres are usually University Teaching hospitals that provide comprehensive trauma care and also play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research. Level II trauma centres are expected to provide initial definitive trauma care for a wide range of injuries and injury severity.
Level III centres provide definitive care to patients with mild trauma. Having such systems is imperative to ensure proper treatment of trauma patients.
Even for those who survive trauma, disability is a major assault on economic potential and viability. Importantly all this cannot happen with a cash and carry system. Emergencies should be managed under a different model to save life and limb first. Obviously, there is a need to ensure that healthcare facilities will be able to recover their investments in emergency care, and that balancing act needs careful consideration.
Frontline clinicians are often forced to bear the public’s anger for infrastructure deficits they did not create and cannot fix. This is a failure of governance, not a lack of clinical care. Responsibility lies with the policy makers who manage the nation’s resources.
The “No Bed Syndrome” is a systemic disease. It cannot be cured with a directive from the Ministry of Health, parliament or a lecture on ethics. It requires a blueprint, a budget, and the political will to treat this like the menacing threat it is.
It is safe to say that non-emergent healthcare is excellent in Ghana for the most part if you can afford it. However, emergency care is suboptimal. We had a sitting president die from an emergency health issue and a former vice president also die from an emergency. If that is not enough warning, it is clear that anyone can be a victim of an emergency.
If we do not act, the next ambulance driving aimlessly through the streets of Accra could be carrying anyone, including the very people who have the power to fix this issue.
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 Clinic Informatics.
He is a graduate of the University of Ghana Medical School (Class of 1997)
