Features
SICKLE CELL DISEASE AND COVID-19
“What do I need to do (or know) as a person with Sickle cell disease?” The enquirer is health care student. In response I came across nice piece written by Nitin et al published in the Pan African Medical Journal (Vol 36, May -Aug 2020). The World Health Organization (WHO) has identified sickle cell disease (SCD) as a major concern of public health significance. It has been estimated that around 5% of the global population carry Sickle Cell Trait genes. About two-thirds of the sickle cell disease patients of the global burden reside in sub-Saharan Africa. COVID-19 Pandemic caused by Corona virus 2 (SARS COV2) is having a devastating effect on socioeconomic and health indicators in counties worldwide. The additional financial burden of supporting health care management system in tackling COVID-19 impact at the same time preventing mortality rate of COVID-19 deaths is a matter of great concern to all.
The pathogenesis of the sickle cell disease is attributed to the polymerization of the deoxygenated haemoglobin S(HbS). The polymerization leads to alteration in the normal biconcave shape of the red blood cells making them rigid and more prone for intravascular haemolysis. As a consequence of repeated hypoxia driven polymerization of HbS there is development of cyclic cascade leading to blood cell adhesion, vaso-occlusive crisis and ischaemic reperfusion injury. SCD patients may develop complications such as Acute Chest Syndrome, pulmonary embolism and stroke
About two thirds of new borns born with SCD worldwide are found in sub-Saharan Africa. The sickle cell gene HbSS is commonly identified in Africa in SCD while HbSC and HbS/ beta+thalassemia has been observed in West Africa. SCD had led to the death of about 50-90% of the affected as the disease remained undiagnosed during the childhood. The various studies done in Africa were found that SCD patients have higher mortality rates. In Ghana-the programme to enhance health care for sickle cell disease is a big relief.
The development of knowledge of understanding the pathology and management protocol of SCD has been helpful in management of the disease. The presence of malaria, undernutrition and other infectious diseases also contribute towards mortality rate in Africa. Of late it has been seen that because of the devoted and dedicated health care services provided by the health personnel the mortality rates are declining and this life-threatening disease of children is now progressing to chronic disease of the adult.
It has been observed that pulmonary functions are decreased in SCD. Lung functions are compromised in patients of sickle cell disease and Sickle Cell Trait (SCT). Repeated chest infections in SCD and SCT lead to alteration in geometry of lung parenchyma and physical properties of elastic and collagen fibres thus decreasing pulmonary function parameters such as Forced Vital Capacity, Forced Expiratory Volume and Forced Expiratory Volume 1%. Moreover the pulmonary vasculature is highly sensitive to hypoxia (absence of enough oxygen) driven micro-occlusion of pulmonary vasculature which along with cell adhesive changes may cause pulmonary hypertension and further compromise lung functions]. Persons with SCD have an increased susceptibility to infection. The impaired leucocyte function and humoral and cell-mediated immunity loss have been reported to account for the immunocompromised state in patients with sickle cell disease. The SCD patients being immune compromised are more prone for recurrent chest infections. The major cause of mortality in patients of SCD is acute chest syndrome, pneumonia and acute respiratory distress syndrome.
COVID-19 is the acronym for corona virus disease 19 and has been termed as SARS-COV-2 by International Committee of Taxonomy on Virus (ICTV). The common clinical manifestations observed in patients of sickle cell disease include cough, fever, shortness of breath, loss of smell perception and loss of taste sensation. Most of the patients of COVID-19 may have a mild course of disease while few may develop severe clinical manifestations. The clinical manifestation of severity in COVID-19 patient includes Acute Respiratory Distress Syndrome (ARDS), Pneumonia, Multiple Organ Failure, Septic Shock and Sepsis. The severity of pneumonia manifests with dyspnoea (difficulty or laboured breathing) and tachypnoea (abnormally rapid breathing)
COVID-19 infection can worsen the pulmonary manifestation in SCD patients especially in those having pulmonary complications such as Acute Chest Syndrome, Pulmonary Hypertension and ARDS. COVID-19 infections in SCD can also increase morbidity and mortality risk in these patients.
The main cause of concern in patients of SCD is that these patients are immunocompromised and may suffer from both acute and chronic complications which require hospitalization and close contact with the medical system. There is overlap in clinical manifestations of fever and lung disease in COVID-19 and SCD. The increased complications will amplify health care utilization-e diagnostic, management and logistic challenges. In view of the above facts it is necessary for health care workers to educate SCD patient registered in their areas regarding care and precautions to be taken during COVID-19 pandemic to prevent getting affected with COVID-19 infection. Although the education applies to everyone, there should be more emphasis for persons with SCD.
All persons with SCD need to be educated regarding COVID-19 signs, symptoms and mode of spread. They should be explained regarding the increased risk of contracting COVID-19 infections in them due to their immunocompromised state. All patients of SCD should be advised to strictly adhere to social distancing, isolation polices, use of face mask, and frequent hand washing with soap to prevent COVID-19 infections. They should keep adequate medication of SCD such as analgesic and antipyretic drugs, hydroxyurea. They can be advised regarding use of clinical thermometer at home as fever is common sign in SCD patient and thereby these persons can take appropriate precautions and medication after seeking telephonic consultation with their health care providers. They can use pharmacy home delivery services in case they require medication during emergency situations.
Until then regularly/daily consume polyphenol-rich cocoa. It is been useful for persons with SCD.
DR. EDWARD O. AMPORFUL
CHIEF PHARMACIST
COCOA CLINIC
Features
Press freedom & the bearded goat

THE journalist is a hunter. He goes after human rats and grasscutters personified, matters about whom he can salt and spice and present as news. The fatter and juicier the catch, the better, because sensation is essentially our cup of tea.

Our job is to sell news and sell it in grand style.
Because the journalist is a hunter and is created with a special kind of nose for sniffing out news, he is usually not welcome in many places. He is seen as someone who has been born to make people uncomfortable.
The problem is that some people don’t want things written about them even if it is promotional and favourable. When it entails publishing their pictures alongside the story, they are doubly scared.
“Please, don’t use my picture. People will think I’ve got money and come for loan,” someone told me.
Anyhow, journalists are seen as intruders, undesirables, born with plenty of okro in the mouth; maybe some also in the nose. Some of my friends are no longer too close because they fear I’d give them full coverage in the Sikaman Palava column. Ha ha ha! What a funny world!
Well, people like my Uncle, Sir Kofi Jogolo, my former classmate and born-mathematician, Kwame Korkorti, and ex-football star cum human-salamander Kofi Kokotako don’t mind featuring in the hilarious inches of this column. Kofi Owuo alias Death By Poverty is one personality who has to be mentioned in this palaver.
These are people who are going to live long, primarily because they see the world as one big ball of fun. When Kwame Korkorti was told that his dear mother was dead at home, he smiled and asked the bearer of the message whether his mother had cooked the afternoon meal before claiming she was dead. Until her death, Korkorti ate his lunch at his mother’s end.
When my Uncle Kofi Jogolo was picked and lost 1,500 dollars and a good amount of Sikaman currency, he didn’t lament the loss. Instead he was amused. In fact, he was almost glad about it, because he grinned from ear to ear, stroked his delicate moustache and congratulated the thief, adding that “He is smarter than I am.” Yeah, Jogolo is the man who employs a Swedish barber to trim his moustache.
And when Kofi Kokotako was unemployed and was nearly hit by an articulated truck, he called the driver a fool. “The idiot should have killed me,” he said to me. “Didn’t he know I was unemployed and suffering?”
Today, Kokotako is employed as a Reverend and is not doing badly at all. Thanks to the regular silver collection.
And what about Kofi Owuo, the celebrated poor man. His wife left him not because he was poor, but because he swore in front of her that he would never prosper.
The following dawn the wife packed bag and baggage and went back to her parents and told them all about her husband’s alliance with poverty. Her parents were bewildered and called the alliance unholy. They had no option than to send back Owuo’s drinks to end the marriage.
Kofi Owuo alias Death By Poverty did not contest the issue. He was more engrossed thinking about how to become poorer than to contest what he called a frivolous matter. The wife could go to hell, he said. These are people longevity smiles upon. Nothing worries them.
Getting back to talking about journalists. I’d say that anywhere there is journalism, the issue of press freedom is not too far away. Is the press free? That’s one question foreigners want answer to when they are on visit.
Well, journalists celebrate a yearly WORLD PRESS FREEDOM DAY to drum home the idea of press freedom as a very important thing in the practice of journalism.
This year’s was celebrated almost a fortnight ago but people didn’t see much of us because we are normally not good celebrants. We should have mounted a float to roam the entire capital, dancing asaboni to brass band music just like PTC did recently.
Although journalists are known to be very good dancers because they walk very much, on that day, they were all busy writing. It was the Minister of Information, Mr Kofi Totobi Quakyi who saved the day by addressing a forum organised to mark the day.
He is a man I’ve always admired since his radical university days. He spoke much on press freedom, cautioning the press not to abuse the freedom granted by the Fourth Republican constitution, but to use it for the progress of society.
Well, press freedom has been defined by many journalists as the freedom to ‘write nonsense’. This definition is not quite accurate. I asked one staff reporter to define press freedom. It took him fifteen minutes to put up something.
“Press freedom is the freedom that is enjoyed by the press that enables journalists to publish or broadcast any kind of material so long as it is absolutely true, is not libelous and slanderous, and is not against the national interest.”
I gave him eight out of 10, a straight A. I guess every journalist is old enough to know that certain things he or she writes is for or against the national interest. We certainly must guard against writing against the national interest; that is very important.
There is also the question of criticising government. The government can be criticized, so long as the criticisms are genuine and the President and his ministers are not insulted and called names. Let us criticize, but let us do it decently so that the journalistic profession can be revered, and its nobility acknowledged. We are not war mongers, are we?
One area in which journalists are not spoken well of is the complaint that they misquote people. Journalists sometimes misquote people, but in four out of five complaints it turns out that nobody is misquoted after all.
When we interview people they say things unreservedly and we publish unreservedly. When the publication is out and their friends or superiors read it and accuse them of having said too much to the press, then they start claiming they were misquoted.
We have encountered these ‘misquotation palaver’ every now and then and reporters are usually accused of this transgression. However, when they bring out their note-books or recorders, it is realised that they wrote nothing out of the way. “Book no lie”.
My advice to people who deal with the press is that if they do not want anything written, they shouldn’t say it. What they want to say is OFF-RECORD, then of course, there is no reason to say it. When you say it, you’re taking a risk. In that instance, you can’t also claim to have been misquoted or words put into your mouth.
And it isn’t every journalist who would be circumspect in matters that are supposed to be off-record, because journalists often want to be as sensational as possible to make their stories saleable. So say just what you want to see published and you won’t later regret it and claim you were misquoted.
Well, I’m not holding brief for journalists, because a few of us are notorious for colouring our reports sometimes sand-papering the words so much that they look very bright in front of readers.
As I once said, when the police tells one such notorious pressman that the thief stole a brown goat, the pressman would want to know whether the goat was bearded. Of course, the police would say ‘Yes’.
However, in the press report, it appears, “A gang of notorious goat-thieves were apprehended in the early hours of yesterday. In the car in which they were riding was a brownish-red goat having a long beard. Upon further examination, it was realised that the goat also had a greyish moustache.”
When the story appears, the police are naturally disturbed. A single thief turns out to be a gang of thieves. The goat also becomes a chameleon and changes colour to brownish-red. And a moustacheless goat overnight wears a greyish moustache whether you like it or not. Luckily the journalist does not add that the moustache was trimmed by a Swedish barber.
Yes, we have a few of such mischief-creating, chronically notorious journalists. But they are one in a hundred. In any case, we make the world. And we shall always do our best to make it a happy place to live in.
This article was first publish on Saturday, May, 20, 1995
Features
Mindset change: The Greater Works factor- Part 2
When I hear of people who are of the opinion that they cannot make it in life unless they travel abroad, l become sad.
Whenever I see on TV, news of people, that is migrants who have drowned in the Mediterranean Sea, while attempting to cross to Europe, l become filled with sadness and then anger.
The underlying factor is desperation born out of loss of hope, in life. When an individual tends to believe that his only hope of making it in life is to travel abroad, the risk of dying at sea, does not deter him or her.
The role of some pastors on shaping the mindset of people, especially the youth, leaves much to be desired. You hear them declaring on various media platforms how they can pray for you to get a visa to travel abroad, instead of encouraging them to find something to do to improve their lives as the Bible teaches that God will bless the work of their hands.
The GREATER WORKS CONFERENCE is geared towards renewing the minds of people with a specific focus on people of African descent to rid themselves of the negative perception of lack of capacity to excel in life.
Pastor Mensa Otabil believes that every human being, no matter the skin colour, was created in the exact image of God and therefore has the capacity to do exploits.
The whiteman was not created in the image of God while the Blackman was created in the image of something other than God. The Black person therefore can achieve whatever the whiteman can achieve.
The development in terms of industrialisation that is lacking which has generated unemployment for the youth, is due to lack of effective leadership. The lack of moral integrity in society, is what is causing the lack of job opportunities, which is as a result of corrupt acts which drive away private investment.
A culture of inferiority complex exists which needs to be dealt with, so the African can develop the self worth necessary for personal development which can then result in capacity deployment to avhieve personal goals.
Success in life begins with the individual’s recognition that he or she is capable of achieving the dreams he or she has conceived in his or her mind. The Bible teaches that the fear of the Lord is the beginning of wisdom, and the knowledge of the holy is understanding according to Proverbs 9:10.
Christianity was the driving force behind the development of Europe because no society can sustain development without high moral values. GREATER WORKS therefore is a deliberate project to shape the minds of people, especially the youth, who will become the leaders of our future, to prioritise morality in their daily lives.
This is the only way to see a massive transformation in every aspect of our lives as Ghanaians and Africans in Ghana and the rest of the continent.
Since the inception of the GREATOR WORKS CONFERENCE, it has made a lot of impact in the lives of many people from the youth up to the senior citizens level. I recall the testimony of a church member who was motivated and pursued higher education and became one of the youngest Chartered Accountants in this country. Year after year, the impact of the conference has been enormous and lives in Ghana and across the continent, are being transformed.
Black people have started regaining their self confidence and the youth have started getting into areas that previously were considered out of bounds. At a personal level, certain ideas that some years ago, l would have not dreamt about suddenly has become realistic dreams.
The Christian lifestyle has impacted on my children and those close to me. Mindset change starts with one individual, then another and then gradually it spreads like a viral infection until a critical mass is attained and them a massive impact. There is hope for the future.
By Laud Kissi-Mensah
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