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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.

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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.

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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.

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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)

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The eye is indeed the lamp of the body

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There is a scripture that is found in Matthew 6:22 which says that the lamp of the body is the eye and therefore the eye must see well to enable the body to get to its destination.  

What most people do not know is that behind the scenes, there is a strong interaction between the eyes and the brain before a picture becomes clear.  The state of mind therefore is crucial to the eye seeing clearly to enable the body to process accurately the information the eyes are feeding it for proper identification of what the eyes see. 

This is similar to how a person behaves i.e. what informs the decisions that forms in the mind that results in the actions that a person performs.  The actions of a person does not therefore just happen but is as a result of things that went on in the mind, which in most cases resulted from information passed on to it by the eyes either consciously or unconsciously.

There are so many issues that affect our society which makes one wonder, whether the people who displayed such acts were created by someone or something other than God. 

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How can a person see a beach created by God with beautiful beaches and fresh air blowing all around, decides to defecate at such places, and therefore desecrate the environment?  lt is simply mind boggling? 

When other people in other countries who dwell on the coast are using their beaches for tourist attraction purposes as a means of livelihood and also to promote environmental health, some people living around our beaches, have turned them into rubbish dumping sites and toilets. 

It is a very sad situation and the earlier we did something about it the better.  It is a national emergency that must engage the attention, first of the government and then the citizenry, where religious bodies and NGOs must play a critical role.

The things we focus on in this country, needs to be addressed.  Our minds which processes the info the eyes send to the brain, must be disciplined.  There are certain behaviours that a disciplined mind can ignore even when the eye has provided info to the brain.  One of the things a disciplined mind does, is the avoidance of a second look, which is critical for every person who wants to avoid adultery or fornication. 

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Once a person is not blind, he will see things.  The boobs, the ‘shankus’, the coca cola shapes, the light complexioned, the dark complexioned etc. the eyes will definitely see and report same to the brain.  What the brain or the mind decides to do or instructs the eye to do is the issue. 

It can decide to instruct the eye to take a second look and let the mind drool over it or say ignore it and that will be the end.

If the mind becomes trained to focus on environmental issues like clean environment, the eyes will automatically be reporting on insanitary conditions to the brain as and when it sees them.  The mind will pay attention to such data and begin to process them and to identify solutions to deal with the reported insanitary conditions. 

There is the need to encourage citizens to train the mind to focus on the right thing so that in tandem with the eyes, focus will be maintained.  When the mind is so trained, it communicates with the eye to also focus on hood things that helps in both are spiritual life and our secular lives, for indeed the eyes are the lamp of the body.  God bless.

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 Arming the Sikaman journalists to the teeth

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THE relationship between New Times Corporation (NTC) and African Concrete Productions (ACP) is based entirely on matters of the stomach. Each depends on the other in a dietary symbiosis, reinforced by the close proximity of each other

At lunchtime, you’d see a particular set of Times workers marching regimentally to ACP to face the wall. You’d think they are soldiers. It has long been declared that the company manufactures the best kokonte in the Greater Accra Region. ACP is, therefore, a culinary haven for those NTC kokonte fans, both male and female.

As the NTC kokonte warriors cross the border to ACP, you’d see some ACP banku fanatics dancing joyously to NTC. They are lucky folks because they do not have to obtain visa to enter into ‘Times’ to attack the balls of banku with precision and accuracy. They also claim that the lightsoup at ‘Times’ is arguably the best in West Africa.

So the relationship between the two entities was quite cordial and based practically on stomach palaver, until ACP workers staged an industrial revolution, whereupon the managing director, accountant and estate manager were allegedly stripped naked and locked up in a room. An insurgency had began in earnest.

An ACP worker came to ‘Times’, this time not to eat banku and okro. He had come to inform newsmen that juicy stuff awaited them at ACP. It could make a front page lead story.

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A camerawoman and a female reporter were accordingly dispatched to go and bring back news, juicy news as juicy as kokonte and groundnut soup.

Sikaman Palava
Sikaman Palava

I was driving to work when I espied the familiar camerawoman clicking away outside the ACP premises. I didn’t see any ‘Times’ reporter but angry workers who were on the verge of getting violent. I slowed down and the driver behind blew his horn at me like a lunatic. I drove on.

Later, I heard the reporter and camerawoman were harassed and brutalised. The report came,. “The camerawoman, Mrs Salome Adonu-Agbottah and reporter Mrs Doreen Allotey, in an attempt to retrieve the camera which the workers had seized from them were severely beaten. They were manhandled and almost pushed into a big gutter opposite the company’s premises.

BRUISES

“….The camerawoman had bruises on her body, her hand bag was destroyed and the money in it stolen. Mrs Allotey’s watch was also snatched and her feet stamped on.”

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Luckily, it was not her nose that was trampled upon. She has a beautiful nose.

The bad news was received with extreme sorrow. If the victims had been men, it would not have seemed too bad. But to brutalise women is just unacceptable. The New Times Corporation has not stopped mourning the incident which has been condemned in many circles.

Some people keep asking me why Times sent females to cover a potentially violent demonstration. I tell them they might as well ask why CNN’s amazon, Christina Amanpour, is assigned to cover the carnage in Bosnia-Herzegovina and Rwanda. She is always on the frontline in jeans and jacket.

Journalism is a potentially hazardous profession, and once you accept to study and practise the trade, you might as well bone up to face any assignment as long as your superiors feel you are capable of handling it or you have demonstrated the capacity to handle it. Both males and females can be assigned anywhere, anytime just like policemen and women are assigned.

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The only difference between cops and pressmen is that the latter are armed only with a pen and the former with a gun. The question is should newsmen also arm themselves so that in any event of an assault they would not be found wanting in self-defence? They can’t adequately defend themselves with a pen and a jotter. A pen cannot even disfigure an opponent’s upper lip.

Photo-journalists have particularly suffered violence. Spectator ace-cameraman Vincent Dzatse was severely assaulted by AMA men when he attempted to take pictures of their indiscretions.

Sports cameraman, P. K. Arthur has been beaten more than once at the sports stadium when riots errupted and he wanted to capture it on his lenses.

Some sports journalists have been banned from entering the Accra Sports Stadium by supporters because in their comments, they didn’t write “sense”. Some supporters once nearly lynched Christian Abbew, Spectator Sports Editor, near a courtroom. He was stoned like the biblical Stephen. He had gone to defend a contempt charge.

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I think it is time journalists met and discussed how best to defend themselves in any event of an attack by individuals or mobs. In the pursuance of their duty, they must be free from harassment and assault.

Some journalists go to work and return home with a black-eye or a double fore-head. It is just not right. Something has to be done about it. I think journalists should be armed. But first we must be trained in the use of firearms so that our warning shot do not hit below the belt. What about training in Kung Fu?

This article was first published on Saturday, October 17, 1998.

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