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When blood is missing: The silent gaps in Ghana’s lifesaving system

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A person donating blood

The call often comes at the worst possible moment. A mother is bleeding heavily after childbirth. A road crash victim has been rushed into surgery. A child with severe anaemia needs an urgent transfusion.

Then comes the message to relatives: “The patient needs blood. Find donors.”

Within minutes, family members begin making frantic calls, sending WhatsApp messages, and appealing on social media. Some race from one hospital to another in search of matching donors. Others simply pray that blood arrives before it is too late.

For many Ghanaians, this is their first encounter with a reality healthcare professionals know all too well-blood remains one of the country’s most critical and vulnerable healthcare resources.

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Despite years of progress, experts say Ghana’s blood collection, storage, and transfusion system still faces significant gaps that affect access, quality, and safety. And in emergencies, those gaps can cost lives.

A system built out of necessity   

For decades, hospitals across Ghana collected blood however they could because patients needed it. There was no law governing blood services. There was simply the urgent need to save lives.

It was only in 2020 that Parliament passed the Blood Service Act (Act 1042), establishing the National Blood Service (NBS) as the agency responsible for ensuring safe and adequate blood supplies nationwide.

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Charity and philanthropy

According to Dr. Shirley Owusu-Ofori, Chief Executive Officer of the NBS, the law marked a major shift toward a coordinated national system. But reforming practices that evolved over generations remains a challenge.

The blood that is not there

One of the biggest weaknesses is Ghana’s continued dependence on family replacement donors. These are relatives and friends who donate blood only when someone they know requires a transfusion.

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The preferred option, experts say, is a strong pool of voluntary, unpaid donors who donate regularly, allowing blood to be available before emergencies occur.

“The blood should be waiting when the emergency happens, not the other way round,” Dr. Owusu-Ofori said.

The numbers reveal the challenge.

The World Health Organization recommends that countries collect at least 10 units of blood per 1,000 people.

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Ghana currently collects about 6.6 units per 1,000 population, an improvement from previous years but still well below the recommended threshold. Yet demand continues to rise.

An estimated 80 to 85 per cent of blood requests in Ghana are for emergencies, leaving little room for delays.

More than a bag of blood

Many people assume donated blood goes straight to a patient. It does not. Every unit must first be screened for infections such as HIV, hepatitis B, hepatitis C, and syphilis. It must then be processed, stored under strict temperature conditions, and transported safely.

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Blood itself is not a single product. Red blood cells, plasma, and platelets all require different storage conditions and handling procedures.

Maintaining those standards requires specialized equipment, trained personnel, and continuous monitoring.

And that is where another challenge emerges.

The infrastructure gap

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Across the country, some hospitals lack adequate blood storage facilities and the specialized equipment required to operate fully functional blood banks. Others depend on nearby facilities for supplies when emergencies arise.

While healthcare workers often improvise to meet patients’ needs, experts warn that blood safety cannot depend on improvisation.

Storage conditions, transportation systems, and quality controls must work every time.

A breakdown anywhere along the chain can compromise blood quality and patient safety.

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Unequal access

Geography presents another challenge. For years, Ghana relied on three major blood centres in Accra, Kumasi, and Tamale to serve the entire country. The arrangement made blood collection and distribution across vast regions difficult and expensive.

To address this, the National Blood Service has established five regional blood centres in the Greater Accra, Ashanti, Northern, Volta, and Central regions.

More are planned.

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But with 16 regions nationwide, large areas still remain underserved.

The result is uneven access to blood and blood products, particularly for facilities located far from regional centres.

Closing the regulatory gaps

The Food and Drugs Authority (FDA) says recent assessments have uncovered compliance challenges across the blood sector.

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According to Dr. Edwin Nkansah, Director of Vaccine Vigilance and Clinical Trials at the FDA, gaps exist across the entire transfusion chain, from donor recruitment and testing to storage and transfusion practices.

To strengthen oversight, the FDA is embarking on a programme to regulate and license selected blood facilities across the country. The aim is not punishment, he stressed, but improvement.

Facilities will undergo audits, receive technical support, and be guided to meet approved standards.

The goal is simple: ensuring that blood transfused in any hospital meets the same safety requirements.

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The missing link

For all the discussions about infrastructure, regulation, and accreditation, experts agree that the biggest solution lies with ordinary citizens.

Every unit of blood starts with a donor. Yet voluntary blood donation remains far below what the country requires.

Health officials estimate that if just one per cent of eligible Ghanaians donated blood regularly, shortages could be dramatically reduced.

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That would mean fewer desperate appeals from hospital wards and fewer families scrambling for donors during medical emergencies.

A race against time

Ghana has made important strides in strengthening blood services. Collection rates are improving. Regulatory oversight is expanding. New regional centres are being established. Yet significant gaps remain.

And for the mother experiencing postpartum haemorrhage, the accident victim on the operating table, or the child awaiting a transfusion, those gaps are not statistics. They are the difference between life and death.

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Until safe blood is available whenever and wherever it is needed, Ghana’s blood system will remain a critical work in progress—one whose success depends not only on regulators and hospitals, but also on the willingness of citizens to roll up their sleeves and donate.

Because when blood is missing, every second matters.- GNA

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Health Essentials

Cancer; a burning desire to reduce risk

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When it comes to cancer risk factors; ALL RISK FACTORS ARE NOT CREATED EQUAL. Someone may have several risk factors but remain perfectly fine while another may have only one or none yet end up with breast cancer or other cancers.

We cannot say with certainty that we can do all it takes to prevent cancer BUT we can do a lot to reduce our risk.

TEN (10) TIPS TO CANCER RISK REDUCTION

  1. Weight Control – being overweight or obese increases risk to SEVERAL cancers.
  2. Smoking – cigarette smoking predisposes one to several cancers including lung cancer. Other forms of air pollutants serve as risks too.
  3. Alcohol – limit intake or avoid. It has the power to expose one to several cancers as well especially when we can’t apply brakes to how much we consume.
  4. Healthy Eating
    1. Limit intake of processed food and sugar
    2. Limit intake of red meat
    3. Fruits and vegetables should be a mainstay of our diet.
    4. An antioxidant rich food like cocoa should be part of our food. The purer the cocoa, the better
    5. Fibre in your food is crucial.
  5. Exercise – on its own reduces risk for breast and colon cancers directly and many others through weight control.
    1. Also increases immunity.
  6. Cancer Screening – be regular so cancers can be detected early and managed aggressively.
  7. Vaccinations – take vaccines where needed e.g. Hep B vaccine or vaccine against HPV (human papilloma virus accounts for the majority of cervical cancers)
  8. Know your Family History
    1. Anyone in your family with a cancer? Necessary to be on your guard but also remember that you may be the first person in your family with a particular cancer.
    2. Start your family early and breast feed for as long as possible to reduce risk of breast cancer.
  9. Check exposure to Ultraviolet Light and other forms of radiation. Protect your skin.
  10. Practice SAFE SEX
    1. HPV infection leading to cervical cancer is commoner when one is exposed to sex early, directly or indirectly has multiple partners but NOT everyone follows this rule. As in many situations, outliers do exist.
    2. Conditions such as HIV/AIDS may suppress your immune system if not managed appropriately.

Do add two (2) others of your choice and send to me via email. Together we can protect ourselves.

  1.  
  2.  

Will treating H. Pylori infections be a game changer too?

ALWAYS remember that CANCER PREVENTION HAS NO QUICK FIX – we need to follow these points over and over.

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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/ Medics Clinic

(dressel@healthessentialsgh.com)

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*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 – WHERE YOU LIVE SHOULD NOT DETERMINE IF YOU LIVE.”- WHO

By Dr. Kojo Cobba Essel

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Health Essentials

DUMP these medicines; Save lives!

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some unused medications

Accidental poisoning of children at home, starting point of drug abuse by teenagers at home and uninformed self-medication have one thing in common; in all three unused or unwanted medicines are likely culprits. The harm we cause when we fail to properly dispose of medicines we do not need is crippling.

So many people have out of fear or anxiety converted their homes into mini-pharmacies where medicines that are supposed to keep us alive are stocked. COVID-19 worsened this practice and no-bed syndrome also plays a role.

Some of these medications may end up complicating our conditions as we self-diagnose and treat ourselves with what “the all-knowing “social media curb-side doctors prescribe.

From “blood-thinners” including aspirin to steroids, antibiotics, assorted supplements, ivermectin, hydroxychloroquine and even tanks filled with oxygen have found their way into homes. People including children will now “consume” some of these medicines and any left-overs may be accidentally taken, given out to family and friends with “similar” symptoms etc.

We all run the risk of abusing drugs and unfortunately some may end up indulging in “hard drugs.”

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Prior to COVID-19 many of us had turned our homes into dumping sites for medicines and we have now expanded our range of supplies. We seem to develop “unholy” attachments to drugs and end up keeping them for years even when they have long expired. I have had several unpleasant requests to identify a drug that is partly decomposed and has no name on its container. Unfortunately I have on all occasions refused to even make an attempt. My trade may teach me many things about humans and medicines but it also teaches me to be wary whenever I attempt to play Sherlock Holmes especially with medicines that are not labelled.

I took another look at “DUMP”, which is acronym for “disposal of unused/unwanted medicines programme.” I must admit I was extremely impressed with the usefulness of the DUMP. Many countries have tried a variety of approaches including self-disposal but I think the option that is being promoted in Ghana by Dr Edward Amporful, Cocoa Clinic and other patrons is exceptional. In my candid opinion every hospital, company and home should adopt this programme.

All you need to do is to return all unused/unwanted or even expired medicines to participating hospitals. Put these medicines in labelled receptacles or bins that are provided. You do not need to disclose your identity, just walk away because your work is done. The necessary arrangements have been made with the relevant regulatory bodies for the safe disposal of such medicines.

Sounds absolutely simple yet this has the potential to save lives; that baby who could have accidentally swallowed some of these medicines is still alive and the teen who would eventually have been hooked on stronger drugs is spared the agony.

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I think bins should be in all offices so that staff could drop off their medicines and the appropriate steps taken. Market places could also have these bins available and locked and properly secured to prevent people taking the boxes away. Even homes can have a similar bin for discarding and then periodically taken to participating hospitals/clinics. Unused or unwanted medicines should not find their way into a First Aid Box, they don’t belong there.

How do we amass “riches” in unused, unwanted or even expired medicines?
• We may not adhere to the right dose of the medicine thus we end up accumulating medicines at home.
• Sometimes our healthcare provider may make changes to medicines especially when we have chronic diseases such as high blood pressure but we do not return the old ones to the hospital but instead keep them at home.
• Sometimes we react to a drug and stop taking it, leaving the excess at home. I am not sure why we keep these at home when we are aware we are no longer going to use them.
• …and now we stock medicines for fear that we may not have access to some when we have an emergency. Our excuse is that many people are hoarding social-media proposed life-saving medication. After all we are all still learning.

In support of ‘DUMP’
• A frequent cause of accidental poisoning of children at home is having unused/unwanted or expired medicines within their reach. I have seen children rushed to the emergency room for this reason. Some were lucky to live while others had their exciting life cut short. Start DUMP today and help save lives. Even adults sometimes end up with complications because they assumed a drug was used for something completely different.

• People tend to play doctor or pharmacist at home because they pass on unused medicines to family and friends. This is often the starting point of uninformed self-medication. Many people are unaware that doses and types of medicines needed do not depend only on having an illness that appears similar to what another person on a particular medicine was given.

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• When unused or unwanted medicines are improperly disposed of, they may eventually end up polluting water bodies etc. Start DUMP and make a statement on protecting our water bodies.

• Drug resistance is often a consequence of abuse of medicines such as antibiotics and anti-malarias. Kofi starts medicine required to be taken for one week and feels better after three days so he stops. A few days or weeks later Awo appears to have a similar illness so Kofi gives her the medicines left for four days. The process of developing drug resistance has just taken off.

• Keeping expired medicines at home may lead to unsuspecting people taking them and they may end up with additional problems.

• Improper storage of medicines may affect its potency. A typical example is keeping medicine that needs to be refrigerated in a hot room instead. Return these medicines.

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We could jeopardise our health or that of others just because we are keeping unused or unwanted medicines. STOP. THINK. JOIN DUMP TODAY! You will be saving lives.

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/ Medics Clinic

*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.’

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Thought for the week –“IN CASE OF AN EMERGENCY you may need someone to be alerted. Since majority of us own cellphones, plan your own rescue by saving this person’s phone number preceded with “ICE.”  An example is ICE Kojo Essel.The more people we have who know about “ice” the better for us all. Spread the news!!”

References/Credit:
• Dr. Edward Amporful, Cocoa Clinic.
• www.healthessentialsgh.com

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