Health Essentials
Why Ghana’s ‘no bed syndrome’ is a policy failure, not a clinical failure -Part 2
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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)
There are thousands of diet plans and some people change them almost as often as they change their underwear. We have fallen in love with pills and injections all in a bid to fast-track the wellness dream. The plastic surgeon’s blade and even prayers have all been called upon to perform miraculous acts. Is there a single path to achieving Wellness or has man found that wonder pill yet?
Is the result of an annual medical examination all that is needed to determine how well one is? Can you have great reviews in the clinic yet feel tired and unhappy? Does wellness obey the all or none law or is it a whole spectrum where majority of us fall within?
Wellness involves at least six (6) areas or pillars that we need to balance since they all work together to make us the best versions of ourselves.
When we fall short in any one of them, it may have consequences in other areas but we don’t need to be perfect in any area; balance is all that is needed. The era of lockdown for instance brought to the fore the importance of Social Wellness; many of us felt isolated when we had to avoid our work colleagues for weeks on end. Even the output of some of us dipped. Oh, you surely are not alone. Even people you detested meeting in the office you now longed to spend time with. Breathe a sigh of relief; that feeling is normal, nothing untoward is happening to you. The majority of us humans are social beings and we blossom when surrounded by family and friends and hugs and handshakes are the norm.
The Six Pillars of Wellness.
- Physical
- Mental
- Social
- Financial
- Digital
- Spiritual
Physical Wellness
Are you taking proper care of your body? Do you exercise, eat right and get your regular medical examinations?
Avoid awkward postures like sitting slouched forwards or bending at the waist to pick an object. Surely you are washing your hands regularly with soap and water. Have you noticed the loud silence from cholera when handwashing was fashionable during the pandemic?
Mental Wellness
The way you think, act or feel falls into this category but it is definitely not an island on its own. Your physical well-being and all the others impact on your mental health.
Time to relax, sleep, manage your time, enjoy nature and be kind to others. These together with deep breathing and laughter, go a long way to keep your mental health in great shape.
Social Wellness
The relationships we have and the way we interact with others. Your mental health, physical health all impact on your relationships. When you exude happiness, people give it right back to you. Build strong relationships; just a few trustworthy people who you can share your challenges with will go a long way to stabilise your mental health and pave the way for all others to flow. When you feel unduly stressed do you have anyone you can speak to before getting professional help? Do not be a loner.
Financial Wellness
How secured is your money? Are we prepared for emergencies in an uncertain future? We need baseline financial security to be able to get all the other pillars working seamlessly. How can you eat well or get medical examinations done with no financial backing? Finances tend to be one of the greatest stressors in life. Do not ignore the need for financial stability, you need it more than you can imagine. Speak to someone who can assist you plan your future TODAY.
Digital Wellness
What measures are you taking that aim at regulating and improving healthy use of technology? If you set virtual meetings, training programmes etc. all day because you are working from home, then when do you get to rest your mind, eyes and back from prolonged sitting among many others? One thing will lead to another. Many of us can hardly unplug. Our phones are on 24/7 and we think sleep is a luxury. NO! Inadequate sleep will open the floodgates to a tonne of health challenges including stress, overeating, alcohol abuse, fatigue and even accidents from fatigue.
Get sleep; it’s a lifeline!
Spiritual Wellness
Are you connected to a greater being who provides us with a sense of purpose, values, principles, morals and beliefs among many others?
If you asked for my opinion, I recommend God. Speak to him daily (prayer) and he will set you on the right path.
In all things do not specialise in one or a few of these pillars of wellness. We should all aim at getting a fair balance in each area and we can be the very best of ourselves. Now do not put unnecessary pressure on yourself; everyone has challenges but taking one step at a time and always remembering that we need different aspects to make life the best that it can be.
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
(www.healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, 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 Essentisals of Health & Wealth.’
Thought for the week – “Defining health and wellbeing; The World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ (WHO, 1948).”
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It appears I am stuck in sleep mode; last week we discussed sleep hygiene and now it’s napping. Could it be my brain doing its best to make me understand it needs more sleep?
Many of us developed a love for afternoon naps while in school because it was mandatory to “sleep” after lunch. It may have been a luxury to get restful sleep in one’s junior years but our brains got the message: sleep after lunch to get a boost in energy to prepare you for the rest of the day.
As the years rolled by sleeping after lunch, for instance, has become a mirage but everyone loves a “power nap”. The French do a great job when it comes to their afternoon break.
If you enjoy your naps, you may have experienced that feeling of extending your sleep once you go beyond half an hour. It’s that feeling of no turning back. On the other hand, if you nap for just about 30 minutes you seem to have a new lease of energy.
I love naps whenever I get a chance to squeeze one in, but school had siestas that lasted about an hour so sometimes I love to revisit the days of old. A new research finding is, however, about to trample on that glorious time spent hitting on the snooze button and being at peace with the sheets, chair or even bench or floor in some instances.
We all appreciate that getting enough sleep is key to good health but this study suggests that long daytime naps may not be in your best interest.
The researchers found that long naps in excess of 40 minutes and excessive daytime sleepiness were associated with an increased risk for conditions such as high blood pressure, diabetes, obesity and high cholesterol; collectively referred to as metabolic syndrome.
The research showed that people who napped for less than 40 minutes were not at increased risk for metabolic syndrome. In fact, those who napped less than 30 minutes had a slight decrease in risk.
The findings seem to point accusing fingers at those of us who nap for over 40 minutes; that is when the problems seem to begin. I am sure you can confidently guess what happens when people nap for over 90 minutes; the risk of developing metabolic syndrome increased by as much as 50%.
“The review also found that napping for more than an hour or being overly tired during the day were both linked with a 50 percent higher risk for type 2 diabetes.”
“However, the study only found an association between these factors, and did not prove that excessive sleepiness and long naps actually cause metabolic syndrome or diabetes.”
Is it possible that those of us who nap for long periods of time also avoid physical activity and probably over-indulge in comfort foods, hence increasing the risk for these lifestyle diseases?
One thing is certain, you cannot go wrong with a short nap; it can be extremely satisfying. So while the scientists continue to explain and maybe confirm these findings, let us limit our naps to 30 minutes. If you have extra time take a walk or get some work done.
This may be a reminder that too much of even a good thing may be harmful. Sleeping has great benefits including reducing our risks for developing heart and blood vessel diseases such as stroke, it improves our immunity and also enhances our performance in all spheres of life.
Just as sleeping in excess of 9 hours at a time has been linked with bad outcomes, excessive daytime napping is now getting its “day in court”. Moderation in all things must be key!!
A nap is essential for every individual
A 20-minute nap in the early afternoon may:
• Ease your stress
• Sharpen your memory
• Help you react faster
• Improve your job performance
• Boost your energy
• Lift your mood
• Make you more alert
How long did you nap today?
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERY DAY 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)
Dr. Essel is a medical doctor with a keen interest in Life Style Medicine, 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 – “Sleep is an important component of our healthy lifestyle, as well as diet and exercise,” says Dr. Tomohide Yamada. “Short naps might have a beneficial effect on our health, but we don’t yet know the strength of that effect or the mechanism by which it works.”
References:
- WebMD News from HealthDay by Robert Preidt
- Extract from “The Importance of Obtaining Adequate Sleep” by Dr. Obo Addy
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