GHANA INTERRUPTS GUINEA WORM TRANSMISSION –VEEP DECLARES

The Vice President of the Republic of Ghana, John Dramani Mahama on Thursday July 28, 2011 officially announced at a special ceremony in Tamale in the Northern Region of Ghana, a break in the guinea worm transmission after a long battle of 23 years.

He said Ghana has gone 14 months since it reported its last case of the water borne disease thereby becoming the seventeenth newest country in the world to have broken transmission of the disease.

Going 14 months without an indigenous case of guinea worm, means the nation has passed one incubation period or cycle and therefore broken transmission of the disease. Subject to external verification, which will occur over the next three years, the Ghana Health Service (GHS) now believes that the disease no longer exist in the country.

The battle to eliminate the disease has been waged by the GHS in conjunction with The Carter Centre and many local and international partners. Verification will be done by GHS in collaboration with the World Health Organisation (WHO).

The Vice President also announced that the reward for anyone who can produce a verified case will now be raised from GH¢100.00 to GH¢200.00 (USD$135). “We ask the population to continue to look for the disease in the years to come and are therefore increasing the reward. We have a vast country and therefore guinea worm can also be re-introduced from other countries, so we must keep our guard up with ongoing surveillance”, said Mr. Mahama. Fewer than 1,800 cases of guinea worm exist in South Sudan, Ethiopia, Mali and an isolated outbreak in Chad.

Former United States President and guinea worm eradication leader Jimmy Carter recognized Ghana’s historic achievement by stating, “The Carter Centre and its partners congratulate Ghana on wiping out guinea worm disease from its borders. We look forward to the final eradication of the ancient disease worldwide.” The Carter Centre has worked with GHS since the National Guinea Worm Eradication Program began in 1988.

“Ghana’s triumph over guinea worm disease serves as a reminder to the world and the remaining endemic countries that the greatest challenges can be overcome with hard work, political commitment, and the support of the international community,” said President Carter, founder of The Carter Centre, which has led an international campaign to eradicate the disease.

The Carter Centre began leading the international guinea worm eradication campaign in 1986. The following year, the Centre and Ghana collaborated making Ghana one of The Carter Centre Guinea Worm Eradication Program’s first country partners. Nearly 180,000 cases of guinea worm disease were reported during the country’s first national case search in 1989. This ranked Ghana second in the world in cases at the time.

Strong partnerships throughout the campaign helped the nation overcome many challenges and setbacks, including a massive guinea worm outbreak in Savelugu town in 2007. As a result of redoubled program efforts and reaffirmed national and international commitments, cases were reduced the following year by 85% percent –the greatest single-year reduction of any moderately endemic country in the history of the campaign.

Meanwhile, Guinea worm disease afflicts the world’s poorest and most isolated communities. Also known as dracunculiasis, guinea worm disease is contracted when people consume water contaminated with guinea worm larvae. After a year, a meter-long worm slowly emerges from the body through a painful blister in the skin. The ancient disease is being wiped out through health education and behavioral change, for example teaching people to filter all drinking water and keeping anyone with an emerging worm from entering water sources. There are no vaccines or medicines to prevent or treat the disease.

EAST GONJA DCE WARNS FULANIS

THE PERSISTENT Nefarious activities of alien Fulani Herdsmen in the East Gonja District of the Northern Region are threatening the peace and security of residents in and around the District.

These aliens are alleged to be the brain behind major robberies, killings, indiscriminate raping of women and the burning of farms leading to considerable loss of farm produce stored in the farm houses and those yet to be harvested.

They are also believed to be engaged in the cutting down of economic trees in feeding their animals which is making the area more prone to desertification.

Residents on several occasions have engaged in confrontations with these herdsmen and raised concerns over their continuous stay in the district and have therefore called on the authorities to as a matter of urgency eject them or closely monitor their activities.

Many have blamed them for the poor harvest which had impacted negatively on the food security of the district regarded as one of the bread baskets of the region.

However, the District Chief Executive (DCE) for the East Gonja District, Alhassan Mumuni has vehemently declared that his administration could no longer condone the “unwarranted conduct” of the alien Fulanis whom he said had brought excessive fear and panic among the indigenes especially women and young girls.

The DCE hinted that he put the District Security Committee (DISEC) on high alert to look out for any Fulani herdsman who would cause or even attempt to cause security threats on the lives and properties of the residents.

Late last year and early this year, conflict nearly broke out between the residents of Salaga and the Fulanis, when a man was reportedly butchered by some alien Fulanis.

Hon Mumuni who issued a stern warning to the Fulani Herdsmen in the area to behave themselves or leave the district, bemoaned that the ill behaviour of the Fulanis was preventing most farmers from freely going about their farming activities, since they could not move individually or in isolation for fear of their lives.

According to the DCE, the entire livelihood of the people depend on very investment they had made in their farming business and could not therefore loose them to preventable bushfires emanating from the activities of these Fulani herdsmen and some hunters.

He disclosed that majority of the farmers who cultivated rice, maize, groundnut and yam in commercial quantities, took loans from the banks, credit unions and other institutions which they were supposed to repay in due cause.

Addressing the chief and people of Gidanturu, a farming community along the Salaga-Tamale road at an occasion to commission a GH¢28,000 new market to enhance business activities of the farmers and the community, Hon Mumuni disclosed that majority of the farmers usually store their produce in large quantities in the farm due to unavailability of transport to convey them to the market centres or to await good market prices, but most of these farmers he said loose their farms to bushfires every year and therefore blamed it on the Fulanis.

During harmattan seasons the Fulani Herdsmen in trying to get early germination of grass to feed their cattle always resort to the indiscriminate burning of every available land including farm lands. They sometimes also burn the bushes in search of glasscutter and rats without any cognizance to the end results of their actions.

Some of the herdsmen also set the fires for food preparation in the bush without taking time to quench them as they move along.

The DCE, who announced plans by the District Security Committee (DISEC) to closely monitor the activities of the Fulanis, said a stiffer punishment would visit any of them who would cause any devastating havoc in the district this year.

MENTAL HEALTH SITUATION IN NORTHERN GHANA IN A HORRIFIC STATE

NORTHERN Ghana, with over 60 percent of its population classified under the poorest and mostly underserved in terms of mental health services, does not have a single psychiatric clinic or hospital, although it has a large number of mental patients.

Not only that, there is only one psychiatrist stationed at the Tamale Teaching Hospital in the Northern Regional capital, taking care of patients scattered all over Northern Ghana which comprised of the Upper West Region, Upper East Region and Northern Region – and only 34 out of 600 psychiatric nurses countrywide served the population, estimated at 4,177,798 (2010 PHC provisional results), says BasicNeeds-Ghana, a Non-Governmental Organisation providing support to mentally sick and epileptic patients.

Inarguably, the three regions have a greater number of mentally sick and epileptic patients with many of them roaming the streets of cities and towns. While some of them are put in confined rooms by relatives with little or no attention at all, some are put under the care of traditional herbalists who sometimes subject them to all forms of abuse including (impregnating female patients), according to Yaro Badimak Peter, Country Programme Manager of BasicNeeds-Ghana.

According to the NGO, there are about 15,976 mentally sick and epileptic patients in Northern Ghana. The organisation attributes the increase in epileptic cases in particular in the area to lack of drugs for treatment, stressing that epilepsy is a condition and not a disease or illness which one can contract.

Nationally, it says the country has only fifteen psychiatrists and just four of them were in active service. This gives the ratio of one psychiatrist to 1.7 million people as compared to 1:506 in Kenya and one to a million people in Nigeria. In Kenya, Uganda and Nigeria, where budgetary allocation to mental health was less than Ghana's 2.58 percent, mental care is decentralized and better managed than Ghana's which is focused on centralized institutional care.

There are 600 psychiatric nurses and 115 community psychiatric nurses when Ghana needs 3000 personnel for each of the two categories of health professionals, BasicNeeds-Ghana said in one of its research publications.

A 2003 government report dubbed “Mental Health Profile (Ghana)” showed that Ghana has only three psychiatric hospitals available to the over 24 million population – the Accra, Pantang and Ankaful hospitals – all of which are under-funded, overcrowded and located in the urban and better-developed South of the country.

The distance to cover when traveling by road from Wa, Bolgatanga and Tamale, all regional capitals of the three regions of the North, to any of the public psychiatric hospitals in the nation’s capital is 417, 505 and 404 miles, respectively. Transportation fare ranges from US$20 to US$30 and the journey could last for about a whole day or beyond 24hours. This is due to the long distances the vehicles have to cover coupled with the bad nature of the road networks leading to each of these hospitals.

The Accra Psychiatric Hospital for instance, was built in 1906. It has capacity for 800 patients but currently houses an estimated 1000 inmates.

Ankaful Psychiatric Hospital also built in 1965 in the Central Region of Ghana, has a capacity for 500 beds but currently has 150 in-patients. The reduction in the number of in-patients is due to dwindling number of nurses and doctors there.

The Pantang Hospital on the other hand, was commissioned in1975 to decongest the Accra Psychiatric hospital. The original intention of the then Head of State Dr. Kwame Nkrumah, according to the report, who initiated the building of Ankaful and Pantang hospitals was to provide a Pan-African Mental Health Village for Research. As the report put it, “It was a grandiose project that would have recruited experts from Africa”. Currently, the hospital has a capacity for 500 beds but accommodates 450 patients. It has a vast land with a number of uncompleted wards, bungalows and junior staff accommodation left in the bush, it said. Both Ankaful and Pantang have nursing training schools attached, producing Registered Psychiatric Nurses.

The report added that, there are two private hospitals in Kumasi in the Ashanti Region – Pankrono Neuro-Psychiatric Hospital and Adom Clinic at Santase.

In the nation’s capital Accra, there is one private hospital –Valley View Clinic and in the Port city of Tema, The Alberto clinic.

However, BasicNeeds-Ghana observes that, inadequate funding constrains these public institutions’ ability to maintain and upgrade their facilities. The overflowing records department of the Pantang Hospital, according to the organization, has apparently not been refurbished since it was constructed in 1975. All of the records of the 43,170 patients treated to date are maintained here, in paper form, it added.

At another institution, the organization revealed that, the carpentry department in the occupational therapy unit has virtually no functioning tools and lacks sufficient wood for patients to work with.

Despite the gravity of these statistics, mental health continues to suffer neglect in terms of practical, sustainable action that could benefit poor, marginalized people with mental illness.

These days mental health treatment is viewed as a right, but many people still consider the treatment of mental conditions as a privilege. Due to these changes, Ghana is revising its mental health law. The new mental health bill drafted in 2004 and completed in 2006, though delayed for many years, seeks, when finally passed into law, to improve the care of poor, vulnerable people with mental illness or epilepsy, safeguard their human rights and promote their participation in restoration and recovery.

The pending Bill, which has been hailed by the World Health Organization (WHO) as one of the best legislations worldwide, also seeks to ensure that adequate provision of resources has nine parts consisting of a Mental Health Board, a Service, a Review Tribunal (to review mental cases), Visiting Committee, Voluntary Treatment and Involuntary Treatment. The other parts of the Bill are the Rights of a Person (to take a look at human right abuses and discrimination associated with mental health), Protection of the Vulnerable Group and Miscellaneous provisions. The Bill would further de-emphasize institutional care and help place mental care on the National Health Insurance Scheme (NHIS).

The W.H.O requires that mental healthcare should start from self-care through informal community care, primary healthcare, community health service, regional and finally to long stay facilities. But sadly, the opposite is what prevails in Ghana.

Launching a photo-book in Tamale, the Northern Regional capital, on the horrific state of mental health situation in Ghana particularly Northern Ghana, Yaro Peter, stressed the need to highlight the living conditions of persons with mental health problems saying “there are human rights issues to such lives that cannot be ignored”.

He indicated that, a significant number of Ghana’s population experience one form of mental illness or epilepsy, disclosing that Ghana has 2.4 million people who experience one form of mental illness with only 2 percent having access to care, hence the need to advocate the concerns of people with mental problems.

According to Yaro Peter, people with mental health problems contribute to a large proportion of persons with disability, globally estimated to be 650 million people.

The 37-paged photo-book highlighting the lives that most people with mental illness or epilepsy and their care-givers, including some of the people that work in the sector live, was produced from a project called “Ghana – A picture of Mental Health”, which was funded under the Mwananchi Grant Scheme managed by participatory Development Associates of Ghana.

The photo-book depicted horrific situations whereby mentally challenged persons have been chained, legs pinned through tree trunks, confined or kept in partially-enclosed porches or rooms, shackled and among others. Those in confined rooms eat, sleep and answer nature’s call there.

The collection of photos does not just portray the disgusting treatment and living conditions under which persons with mental disorders or epilepsy have to undergo, but also to show the humanness and hidden potential that people who are currently ill, or have stabilized in their condition, as well as their primary care-givers, have to contribute to their own wellbeing and those of their families.

Most of these people in the photo-book were once teachers, traders, hardworking wives or husbands, lovely children of parents and families. Unfortunately, the social stigma so often associated with mental illness or epilepsy, poverty and inadequate healthcare facilities have conspired to rob these people of the care and support they deserve.

The photo documentary clearly revealed that there is much to be done to improve the situation of people suffering from mental illness and epilepsy in Northern Ghana. As Yaro Peter reflects, “Mental health in Ghana is in an orphaned state.”

All the same, he is happy that all is not lost, as increasing attention is being given to mental health issues and the welfare of people with mental disorders. He told this journalist that, “I hope parliament would pass the mental health bill before Ghana’s presidential and parliamentary elections next year, which is 2012. The Parliamentary Select Committee on Health has been touring some countries including the United Kingdom and South Africa to understudy how mental health services were being implemented there.”

In Ghana, the top ten mental problems often found with patients on admission at psychiatric hospitals according to the 2003 government report include schizophrenia, substance Abuse, depression, hypomania, acute organic brain syndrome, manic depressive psychosis, schizo-affective psychosis, alcohol dependency syndrome, epilepsy and dementia. According to psychiatry experts, cannabis admissions are higher each year and there are more men using drugs than women. This is cultural as Ghanaians frown on female drug users. The multiple drugs used involved cannabis, cocaine, heroin and alcohol.

BasicNeeds Ghana since its establishment in 2002 has reached 18,838 people with mental illness or epilepsy from over 18,700 families, together with 18,335 care-givers in Northern Ghana and some parts of Accra.

Currently, the organisation is working actively with 17,603 people with mental illness or epilepsy, all of whom are receiving regular treatment. 4,681 of them who have stabilized have been trained or being trained in vocational skills; 2,014 people are operating small businesses; 1,032 are engaged in horticultural activities; and 8,476 of them are involved in several different income generating activities to cater for themselves.

The organisation is a pioneer development agency in mental health in the country. Its Mental Health and Development model uses a holistic and multi-faceted approach, facilitating treatment and stability for poor people with mental illness and epilepsy, working towards reducing poverty through sustainable livelihoods and promoting human rights.

Meanwhile, mental health practitioners and organizations working in the field as well as observers are hopeful that it will not be long before Ghana and its citizens enjoy quality mental healthcare and people with mental illness or epilepsy and their care-givers and families actively participate in development processes and benefit from them.

By Joseph Ziem