Public Agenda (Accra)

20 February 2004

Ghana: Health Crisis Rocks Ghana

Accra — Cerebrospinal Meningitis (CSM), cholera, anaemia, hypertension and malaria ceased public attention this week. After three deaths in the Volta Region, Greater Accra has been put on a cholera outbreak alert.

To avoid a national catastrophe the Ghana Health Service also asked Ghanaians to eat food while it is hot.

This is particularly important in light of a research which has uncovered that a good number of street foods are contaminated.

The Cholera outbreak is however just one of the outbreaks Ghanaian health authorities have to grapple with.

CSM beat the sharpened disease surveillance mechanism of the Ministry of Health (MOH) just six weeks into 2004 and surprised the country's health authorities.

By early this week, 26 people had died from the highly infectious and debilitating disease in the Northern and Upper East regions. A combined total of 306 cases were recorded [181 in the Northern Region and 125 cases Upper East]. All 125 cases in the Upper East were in the Kassana Nakana district, which shares boundary with the country's northern neighbour, Burkina Faso.

The CSM surprise was especially resounding because "Ghana was largely spared the Cerebrospinal Meningitis (CSM) episode last year," Prof. Agyemang Badu Akosa, Director of the Ghana Health Service said at the launch of the month-long Ghana Health Service (GHS) activities to raise awareness about health throughout the country a week ago.

On the back of the grim CSM statistics so far in the northern half and cholera in the Volta region, the Greater Accra Regional Directorate of the GHS alerted the public on Tuesday, about a possible cholera outbreak.

Director of the GHS Greater Accra Regional Directorate, Dr. K.O. Adadey, advised the public to wash their hands with soap before preparing food and after attending to nature's call.

The research by the Noguchi Memorial Research Institute of the University of Ghana and Patience Mensah of Oxford University in the United Kingdom examined a total of 511 Ghana foods and drinks for various bacteria contamination.

"Mesophilic bacteria were identified in 356 food samples (69.7 per cent); and B. cereus, S. aureus and Enterobacteriaceae were found in 28 (5.5 per cent), 163 (31.9 per cent), and 172 (33.7 per cent), respectively. The microbial quality of most foods was within acceptable limits," the report however said.

Government of Ghana, the Japan International Cooperation Agency, the Ministry of Health of Japan jointly funded the study.

"The hygienic aspects of vending operations are a major source of concern for food control officers. For example, stands are often crude structures, and running water may not be readily available. Also toilets and adequate washing facilities are rarely available. The washing of hands, utensils, and dishes is often done in buckets or bowls. Disinfection is not usually carried out, and insects and rodents may be attracted to sites where there is no organized sewage disposal. Finally food is not adequately protected from flies and refrigeration is usually unavailable," said the study done in 2002.

It couldn't be worse. Three people including a JSS student are reportedly dead following the outbreak of cholera, another seasonal and highly infectious disease in the Ketu and Keta districts of the Volta Region.

This came after an outbreak of the disease in neighbouring Togo. Ketu and Keta districts share boundary with the western border of Togo.

"Cholera continues to be endemic in the coastal regions and districts of the country," Prof. Akosa said at the launch.

And on Tuesday, the Greater Accra Health Directorate alerted the public about the possibility of cholera outbreak.

Aside Ghana being the second guinea worm infested country [after Sudan]; it is also one of the world's worst Buruli ulcer affected nations. Indeed, 12 fresh cases of Buruli ulcer were recorded by the Dunkwa District Hospital in the Central Region by January 31, this year.

Buruli ulcer is endemic in at least 1,000 communities across the country and in the Upper Denkyira District where the Dunkwa District Hospital is located; it is endemic in 200 communities.

According to the District Director of Health Services, Dr. Erasmus Klutse the district recorded 109 cases in 2003.

Tuberculosis is gaining grounds after taking a dip, Prof. Akosa said at the launch of this year's GHS celebrations.

Malaria continues as well to have a heavy toll on the population and health facilities. Presently, nearly half (45 per cent) of outpatient cases are due to malaria. Critically, malaria constitutes about 40 per cent of the country's disease burden.

"The general profile of Ghana's burden of disease has remained unchanged for the past 20 years. Infectious and preventable diseases constitute the highest burden of disease and mortality in the country particularly in adolescents and children," Prof. Akosa said.

Indeed, according to the Country Assistance Strategy (CAS) for Ghana 2000-2003 "about 60-70 per cent of the country's health problems relate to communicable and preventable diseases, including epidemics." CAS was a collaborative work by the government of Ghana and the World Bank.

Motor traffic accidents were also taking a toll on the nation. There have been almost a dozen media reports of fatal accidents across the country this week alone. "Road traffic accidents have been on the increase and is now duly recognised as a public health problem," noted Prof. Akosa.

The average life expectancy of 58 years for women and 57 years for men is doubtlessly under severe threat.

Lifestyle diseases such as hypertension and heart diseases, a decade ago classified as diseases of the rich world, are also rising.

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