Author Archives: Jonathan Migneault

About Jonathan Migneault

A graduate of Carleton University's journalism program, Jonathan Migneault has worked in a wide variety of print, online and broadcast newsrooms. He started his career as an associate producer for CBC Radio in Quebec City and went on to report local news for The Low Down to Hull and Back News; he has also worked as a staff reporter for The Wire Report. Most recently Jonathan has been a freelance reporter covering a wide variety of topics for websites like OpenFile Ottawa and He hopes to use his skills in journalism to make a difference while working at the Daily Guide in Accra, Ghana as a Media Rights Print Intern.

Development at a cost

Severe erosion in Amedeka.

When tourists visit Ghana they often say the Volta Region is a highlight of their trip. With its lush tropical vegetation and serene beaches to the south, it’s easy to see why the Volta makes such a strong impression on visitors.

But a trip to communities near the Kpong Dam, Ghana’s second largest hydro-electric power generation facility, quickly fades the Volta Region’s idyllic first impression.

When the dam was built in 1981 it displaced several nearby communities. The residents of Togorme and Amedeka, which occupy opposite banks of the Volta River, just south of the dam, feel it has caused more harm than good.

“We sacrificed the land for the construction of this dam but we are not the beneficiary of the dam,” says Christian Ananigo, Togorme’s assembly man.

Erosion has eaten away at the shoreline in both communities. Some buildings now find themselves near a precipice that could worsen if nothing is done to improve the situation.

To generate hydro-electric power water drives a turbine inside the dam and is then released through a spillway. When this happens, the water levels near Togorme and Amedeka can rise up to several metres. The result has been severe erosion.

Officials with the Volta River Authority (VRA), Ghana’s main generator and supplier of electricity, say the erosion in both communities is due to a wide variety of factors. “We can’t say that all erosion of the shorelines is due to our operations,” says Emmanuel Amelor, a manager with the VRA’s environment department. “All activities around the shoreline contribute very much [to erosion].”

VRA spokesperson Gertrude Koomson says they have worked hard to reclaim the shoreline through dredging activities and tree planting. “We have a huge budget for reforestation along the shoreline,” she says. “We are making sure that we don’t deplete the shoreline.”

Once you get past the shoreline the next thing that strikes visitors to Togorme and Amedeka is the poor state of the housing. Togorme was relocated when the Kpong Dam was built 31 years ago. The VRA provided housing for the community but many of the buildings have now fallen into disrepair.

“If you look at our buildings, when you see them they are deteriorating. Some of them are about to fall down,” says Ananigo.

But Francis Boateng, a manager with the VRA’s real estate department, says the houses are no longer the VRA’s responsibility and that maintenance should fall to the homeowners. “VRA has no obligation to refurbish those houses,” he says. “We have done our part. It is your duty to make sure that your house is in a good state of repairs, not VRA.”

Ebenezer Dzabaku, a native of Amedeka, has been critical of the VRA’s presence in the communities. In his recent book, The Volta River: Electric Power Generation and Poverty at the Crossroads, he outlines what he believes to be the VRA’s failure to properly assist the communities after the Kpong Dam was built. Dzabaku says the resettlement houses were built with poor materials, including mud bricks above the foundation. He says the VRA should still maintain the houses because they were not built to last.

Dzabaku says the VRA has also failed to properly compensate the residents of Togorme and Amedeka. “This is a national issue,” he says. “These are people who have sacrificed their livelihood, their whole lives, for the nation. We expect that the nation should make provisions for them.”

Boateng says the VRA has paid out GHC6 million, or about $3.1 million, to landowners surrounding the dam over the years. But Dzabaku says only the chiefs have benefited from the payouts, and the average resident has not seen any of the money.

Some MPs from the region have come out in support of Dzabaku and his fight for fair treatment in both communities. The author prefers to work with the VRA to solve the communities’ problems but others, such as Francis Quarcoo, secretary for the Amedeka Community Representative, say protests against the VRA will be needed for change.

Radio empowers youth in northern Ghana

Voice of the Youth's Prosper Agamboa Adudi

“My studio is so full you could bake a loaf of bread with the heat,” says Awonatey Hippolite, the exuberant host of Voice of the Youth, a new radio show in Sandema, a small town in Ghana’s impoverished Upper East Region.

On a hot Thursday afternoon a half dozen young Canadians quietly watch Hippolite as he fades in and out of upbeat Ghanaian high-life music between his every phrase. They are volunteers with a charity called Operation Groundswell and are here to see Hippolite’s guests: a panel of four recent high school graduates from the community.

Prosper Agamboa Adudi is the group’s de facto leader. At 24, he is older than his peers by at least five years.

“Poverty is killing us,” Adudi says as a lone microphone squeaks its way toward him. He and his friends are on the air for the second time to discuss issues that are important to them. Today’s topic is drug and alcohol abuse. Adudi goes on to say that some of his friends would “drink themselves out” and describes how serious the problem is in Ghana’s north.

Adudi decided to start Voice of the Youth with his friend Isaac Bukari to empower young people in Sandema and the surrounding region. For today’s roundtable discussion they are joined by Azantilow Awoboro and A. Vida Akan-Yaaminyum.

“We need to get ourselves united as youth,” says Adudi when asked why he started the program. “That’s what brings about development.”

Adudi has been able to book some time each week on Radio Builsa, the region’s local station. “Most people predominantly listen to radio stations [for information],” he says. “We can’t possibly be moving around house by house.”

With that powerful medium he hopes to cover a number of issues important to young people in the Upper East Region. Those topics include unemployment and migration from the north to large cities like Accra and Kumasi.

To tackle both problems Adudi says Sandema’s leaders need to step up and give youth the opportunities they need to start their lives after school. “People who have a lot of experience and have gone far in life should be doing this,” he says. His friends say more work apprenticeships and activities—such as organized sport—are needed to empower local youth.

Adudi has faced his own share of challenges to get where he is today. He says he lost his parents when he was about nine years old but didn’t go into the details. He was later taken in by the Horizons Children’s Centre, a Canadian charity that provides food and shelter to orphans in Sandema, and given the chance to attend school.

“Now I’m done with high school and I’ll be getting myself into university,” Adudi says. But first he wants to give others the same opportunities he was afforded thanks to the Horizons Children’s Centre.

He says young people can wait up to six months to get their results after junior high school. It can also take as long as a year for Ghanaian students to make the transition from senior high school to university. “They can be influenced during this time to do things they wouldn’t do while in school,” says Adudi. “Drinking, smoking and just doing things that would retard their progress.”

Adudi hopes his program can provide a forum for young people to be active in the community and productive during those periods of transition.

Voice of the Youth is still in its infancy but already shows signs of growth. At the end of the first show five listeners called in to discuss topics affecting youth. After the discussion about drug and alcohol abuse that number doubled to 10 callers. If Adudi has his way the response from Sandema’s youth to the program could very well heat up just as much as Radio Builsa’s tiny studio.


Ghana makes inroads against child mortality

Mothers bringing their children to get vaccinated at the La General Hospital in Accra. Photo by Jamila Akweley Okertchiri.

Ghana has taken a major step toward reducing its under under-five mortality rate with the introduction of two new vaccines for rotavirus and pneumococcal disease, but a UNICEF official in the West-African country says it won’t be enough to  meet the fourth Millennium Development Goal (MDG).

That goal is to reduce the under-five mortality rate by 75 per cent between 1990 and 2015. Currently, 80 children out of 1,000 do not make it past the age of five in Ghana. The country would have to cut that number down to 40 deaths per 1,000 to achieve the fourth MDG.

“Ghana is doing a lot but I don’t think it’s enough,” said Dr. Anirban Chatterjee, UNICEF’s chief of health and nutrition in Ghana. “I think there is definitely scope and need for more improvement.”

Rotavirus and pneumococcal disease are the leading causes of diarrhea and pneumonia in young Ghanaian children. Together they account for close to 25 per cent of under-five mortality and are behind only malaria as the leading causes of child deaths in Ghana.

Ghana has become the first African country to introduce both vaccines at the same time. Both are given to young children before they reach four months of age. The GAVI Alliance, a public-private global health partnership, has helped fund the vaccines, which will be available for free to all Ghanaian children. More than 400,000 Ghanaian children are expected to be immunized against both diseases.

The two new vaccines are expected to prevent 12,000 pneumonia-related deaths and another 10,000 deaths from diarrhea, said Dr. Antwi Adjei, program manager of the expanded program on immunization with the Ghana Health Service.

On April 26, Ghana’s health minister, Alban S. K. Bagbin, said in a press statement that the new vaccines will give Ghana the extra push it needs to meet the fourth MDG by 2015.

But for UNICEF, efforts to improve the nutritional health of children need to happen in concert with vaccinations to reduce the under-five mortality rate. Chatterjee said malnourishment can sometimes double or triple the chances of dying from a condition like diarrhea or pneumonia. “[Malnourished children] are more susceptible to contracting the disease, having the sever forms of the disease and also to dying of the disease,” he said.

Exclusive breastfeeding for the first six months of a child’s life is one way to prevent malnourishment in that crucial period. UNICEF has promoted the practice because it also helps create immunity to early childhood killers like pneumonia and diarrhea.

In Ghana, 63 per cent of children are exclusively breastfed during that period. Many women do not breastfeed their children because they are not aware of the benefits or work in an environment—such as the informal sector—where it is difficult to do so.

Adjei said the Ghana Health Service has regular cooperation between departments such as vaccinations and nutrition. In the second week of May, the Ghana Health Service’s various departments meet for Child Health Promotion Week to develop new strategies and programs related to child health.

One big challenge for the Ghana Health Service will be to reach all children with the rotavirus and pneumococcal disease vaccines. About 87 per cent of children under one in Ghana have been immunized for tuberculosis, poliomyelitis, tetanus, hepatitis B, measles and several other childhood diseases. Reaching the last 13 per cent has proven difficult.

“Wherever a person is, we have a responsibility to reach them and vaccinate them,” said Adjei. “Against rising costs it makes it more and more difficult.”

Some isolated communities around Ghana’s Lake Volta, for instance, can only be reached by boat. The Ghana Health Service reaches these small communities at a much greater cost than urban populations.

A small number of Ghanaians also do not take vaccinations due to religious or traditional beliefs. Adjei said the local Twi dialect has only one word for ‘medicine’ that does not differentiate between preventative vaccines and drugs used to treat diseases. He said it is difficult to overcome such beliefs. “Fortunately for us they are isolated cases.”

The new vaccines have just started to roll out across Ghana. La General Hospital, in Accra, was one of the first institutions to offer the vaccines in the capital on Friday, May 4. About 40 mothers were gathered at the hospital with their crying infants in tow, as they waited for their turn for inoculation.

Cynthia Noonu, a nurse at the hospital, said the mothers have been very cooperative. La General Hospital is ready to receive a different group of mothers each week. The vaccines will be rolled out to different hospitals in Accra, and across Ghana, in the coming weeks.

Gladys Otabil was at La General Hospital with her two-month old son Gabriel. “All I understand by the addition of the two vaccines is that they will protect my child from any disease and sicknesses,” she said. Otabil added that she was also advised to breastfeed her son for his first six months of life.

Ghana’s prisons: ‘universities of crime’

Thanks to poor conditions, and a focus on punishment instead of rehabilitation, Ghana’s prisons have become “universities of crime,” says an ex-convict.

“Our prisons nowadays are not for reformation but rather training people to become notorious criminals,” says the ex-con, who has just recently been released from prison and wants to remain anonymous.

According to Amnesty International, many of the issues with Ghana’s prison system stem from overcrowding. The human rights organization says the country has 13,500 prisoners but only has the facilities to accommodate 8,000. About 3,000 of those prisoners are on remand and have not yet been to trial. Ghana’s prison system, in fact, is operating at 170 per cent capacity.

Ghana’s government is building a new prison in the town of Ankaful that will be able to accommodate 2,000 prisoners, but that won’t be enough to solve the problem, says Amnesty.

“The prisoners have got to go somewhere and that means you have to remove the remand prisoners at a much faster rate,” says James Welsh, a coordinator for health and human rights with Amnesty International, who published a new study on Ghana’s prison system called Prisoners Are Bottom of the Pile: The Human Rights of Prisoners in Ghana.

Welsh visited six prisons in Ghana with his colleague Lisa Nikolaus. “We saw cells where in order to sleep, the prisoners had to lie on the floor on their sides, taking up the entire available space,” he says. One remand prisoner told him, “Our cell –the place where we sleep—is where we urinate and go to the toilet. You don’t get any privacy. You have to use the bucket.”

Amnesty has recommended quick hearings for prisoners on remand to help reduce the prison population and improve overall conditions. There have been reports of prisoners who have been in remand for more than 10 years because they cannot afford a lawyer. “The policeman even forgets about you,” says the ex-convict.

Welsh says overcrowding could be reduced by wider use of non-custodial sentences such as fines and community service. But fines must be set at realistic levels, he says.

The ex-con says sentences for less serious crimes, such as theft, should be reduced. It’s not uncommon, he says, to meet someone who has been in prison or five years for stealing a cellphone. He says people who are locked up for petty crime often graduate to more serious felonies by the time they return to society. “If you develop your prison inmate who is in there for petty crime to become an armed robber you know that one day you are all at risk.”

While Ghana has not put a prisoner to death since 1996, the country still has 138 inmates on death row.

The overcrowding issue is compounded by other problems in Ghana’s prisons. Many of the buildings in the system are falling apart due to a lack of regular maintenance. In some prisons flooding is a regular occurrence.

Ghana’s prisons used to spend only about $0,30 on food per prisoner each day. That amount has been increased to almost $1 a day but Amnesty says it’s still not enough. The ex-con says the food was the worst part of his three-year prison experience. He says there would often be insects in the food and that a dog would not eat it if it had the choice.

Lawrence Amesu, Amnesty’s director in Ghana, bringing Ghana’s prisons up to an international standard comes down to a need to preserve human dignity. “This is because even though the inmates have committed crimes they are still human beings and they should continue to be accorded the dignity that they deserve.”

Health Services Workers Union makes inroads in Ghana

Abu Kuntulo holds PSI's Trade Union Award 2011

In Ghana fewer than 10 per cent of workers belong to a trade union. While the minimum wage has almost doubled since 2008, at 4.48 Ghana cedis per day, or about $2.54,  it remains low by international standards.

Many workers—especially the large number of farmers in the rural regions—don’t even make the minimum wage because 90 per cent of the country’s workforce is informal.

But if you ask Yaw Baah, the deputy secretary general of the Ghana Trades Union Congress, the West African nation has a good union environment. It only needs more workers to be part of the fold.

“Since 1992 things have changed for everyone,” says Baah, referring to the year Ghana enacted its current constitution. “We have the freedom to outreach. In some countries union members get killed because they try to negotiate a good deal for their members. It doesn’t happen in Ghana.”

It is in that environment that the Health Services Workers’ Union (HSWU), winner of Public Services International’s Public Service (PSI) Trade Union Award 2011, has managed to make solid gains in the areas of migration, salaries and retirement benefits. PSI is a global trade union federation that brings together 650 unions in 148 countries.

“It’s an exemplary union with stable leadership,” says David Dorkenoo, PSI regional secretary for Africa. “Other unions are actually learning from them.”

The HSWU represents about 16,500 paramedics and support staff who work in Ghana’s government hospitals. Workers in the country’s Christian and Muslim hospitals also fall under the union’s umbrella.

The union was founded in 1966 after the government at the time dissolved the Health and General Hospital Workers Union, which encompassed all of Ghana’s health workers.

“[The union was] so strong that the government could not withstand the demands of the workers,” says Abu Kuntulo, the HSWU’s general secretary.

The doctors, nurses and paramedics each split up forming their own associations.

In recent years the HSWU has worked with other public sector unions in Ghana, including the nurses and doctors, to improve the country’s single spine salary structure for public service employees. The new salary structure, first instituted in 2010, normalizes salaries based on a person’s qualifications. A paramedic with five years experience in the northern city of Tamale, for instance, makes the same as a colleague with the same qualifications in the capital of Accra.

When the single spine salary structure was first introduced it had a lot of kinks to work out.

“As of now no one can actually say that he is satisfied [with the pay structure],” says Daniel York, the HSWU’s industrial relations officer for the Greater Accra Region. York says a lot of the problems come down to a lack of clarity. “At the moment nobody can actually tell you this is my salary at the end of the month,” he says.

The single spine salary structure has 25 pay scales. Through negotiations with the government the HSWU was able to ensure that all of its members would not start lower than the fifth level.

Ghana’s public sector workers were able to negotiate for an overall increase of 18 per cent to the new pay structure in 2010. In 2011 that amount was increased by an additional 20 per cent and they have achieved another 18 per cent increase in 2012.

“The reason we have managed to obtain all these increases is because we negotiate as one body,” says Baah. “That has given us some strength that we could not imagine.”

Baah says one of his friends, who has been a teacher for 18 years, was able to save money for the first time in 2011. He falls under the single spine salary structure.

With representation across Ghana, the HSWU has had to face a fair number of challenges. Kuntulo says the union’s biggest challenge at the moment is reaching workers who may be apathetic or misinformed about the union’s work.

Caroline Boateng, a HSWU member who works in registration at the Civil Service Polyclinic in Accra, says she does not see much from the union apart from the monthly deductions to her paycheque from union dues. “I’ve paid the money and I’ve not benefited.”

But Boateng says the switch to the single spine salary structure has been better than what she received before. “But it should be best,” she says.

Kuntulo says he and his team are working on improving communication at all levels. “We need effective communication, not at the national level, not at the regional level, but at the branch level,” he says.

Baah says that Ghana’s unionized workers, who work in the formal sector, generally have a better quality of life than people who work in the informal sector. Most union members, for example, make more than the country’s minimum wage.

For Kuntulo, winning PSI’s Public Service Trade Union Award just means the HSWU has more work to do to live up to its international reputation. He says the key to that success is teamwork and hard work. “We have sleepless nights,” he says.

Clash over gay rights in Accra

Gay rights have been pushed to the forefront in Accra after a group of young men, allegedly armed with canes, cutlasses, stones and broken bottles attacked party-goers in the neighbourhood of James Town on Sunday, March 11.

“They beat some of our lady friends who were not able to run,” says Hillary, a 27 year-old gay man who uses the alias to protect his identity. “They beat them, took their phones and money and striped them naked.”

Hillary and his friends took refuge with a local NGO called FIDA and Accra’s Domestic Violence and Victim Support Unit.

The Ga-Mashie Youth for Change, the group that crashed the party, claims the gathering was really a wedding ceremony between two women. “We invaded the place with the intention of stopping them but did not to hurt anyone or beat them,” says Daniel Wettey, coordinator with the youth group. “We want to register our feelings against [homosexuality].”

But Hillary and other gay members of the community have left the neighbourhood fearing for their lives.

In Ghana religion, especially Christianity and Islam, dominate the social discourse. As in most African countries, homosexuality is a taboo frowned upon by most and strongly opposed by others.

In November 2011, Ghana’s president, John Atta Mills, said he would never support any attempt to legalize homosexuality in the country. He was responding to British Prime Minister David Cameron’s promise to cut foreign aid to countries that do no respect gay rights.

Under Ghana’s laws homosexual acts are illegal if they are performed “in public or with a minor.” The country’s criminal code uses vague language when it refers to sexual misdemeanors. It reads:  “Whoever is guilty of unnatural carnal knowledge— (a) of any person without his consent, is guilty of first degree felony; (b) of any person with his consent, or of any animal, is guilty of a misdemeanor.”

While Ghana’s constitution protects a person’s human rights “whatever his race, place of origin, political opinion, colour, religion, creed or gender,” it makes no mention of sexual orientation.

Nana Oye Lithur, executive director of Ghana’s Human Rights Advocacy Centre, says she was surprised when she first heard about the attack in James Town. “We have three generations of gays and lesbians in that community,” she says.

Hillary says the Human Rights Advocacy Centre was one of the few human rights groups in Accra that stood up for him and his friends after the attack.

Lithur filed a complaint with the police, but says they have been slow to respond. A police investigator told her he wanted to engage with the community before pressing any charges. She also approached the Commission on Human Rights and Administrative Justice; an independent body set up by Ghana’s government to protect human rights, but was turned away. “They said they were in a meeting and that we should come back Monday,” she says.

“Why can’t the law protect us?” Hillary asks in frustration. “We are all Ghanaians and we all have rights that must be protected.”

Superstition has contributed to the prejudices against gay people in James Town. “[Homosexuality] isn’t something good,” says Comfort Quartey, a 32 year-old resident of the neighbourhood who says she was once a lesbian. “It draws people back and it gives bad luck. When something good is coming your way it hinders it.”

Hillary disagrees. “They can’t tell us that we are bringing bad luck,” he says. “What about those sleeping with other people’s wife? Are they bringing good luck to the community? Are we the ones who tell them to impregnate people? They should stop putting the blame on us and they should wake up from their slumbers and get themselves busy with something. We work for our money so they should also get up and go and find themselves something to do.”

The Ga-Mashie Youth for Change sent a petition to James Town’s police commander to go on a demonstration against “sodomy and lesbianism” in the community. The petition reads in part: “With the recent trends of sodomy and lesbianism eating into the moral fiber of the Ga Mashie community, we the youth for change in the community wishes [sic] to create awareness of immorality of such acts and demonstrate peacefully against such acts throughout the Principal Street of the Ga-Mashie community.”

The protest is planned for Friday March 30 at Mantse Agbonaa Park in Accra.

Lithur says Ghana’s institutions need to take a stand to protect the rights of homosexuals. “Government needs to reduce homophobia,” she says. “It is not about legalizing homosexuality. I believe it’s about understanding issues related to homosexuality. Whether we like it or not we have homosexuals living in Ghana.”


Kidney disease: a ‘silent killer’ in Ghana

Richard Kusi Yeboah on dialysis at Korle-Bu Teaching Hospital. Photo courtesy of Janet Donkor

He says he feels weak. Plastic tubes protrude from his arms and connect to a rectangular machine next to his bed. They are coloured crimson with his blood.

Richard Kusi Yeboah is only 15 years old, but he spends 12 hours every week at the renal unit in Accra’s Korle-Bu Teaching Hospital. In early 2011 his kidneys failed. He has been on dialysis ever since.

“I don’t play the games they play [in the school yard],” says Yeboah as he lies in a hospital room that smells like the sterile disinfectant you would find in a dentist office. “I play with my friends normally. I don’t run but sometimes I go for a walk.”

He lives with his mother, Janet Donkor, who has struggled to raise funds for the dialysis that keeps her son alive. Each session—and Yeboah must go three times a week—costs 140 cedis, or about $81. Korle-Bu asks that patients leave a 5,000 cedi deposit before they begin the treatment. That’s about $2,300. Donkor had to borrow money from her mother for the deposit.

“The majority [of Ghanaians] cannot afford renal replacement therapy,” says Dr. Vincent Boima, a kidney specialist at Korle-Bu.

Renal replacement therapy comprises of dialysis and an eventual kidney transplant, which is the only way for someone with kidney failure to live a normal life.

Boima says some families have lost everything they own paying for dialysis. Once they lose all their possessions they also lose their loved one because they can no longer afford a kidney transplant, which can fetch a price as high as 40,000 cedis, or roughly $23,000.

Donkor is a single mother. She wants to donate one of her kidneys to her son but cannot afford the operation. She has pleaded local media to help her raise the money she’ll need to donate her kidney to Yeboah.

“He can’t go on like this for the rest of his life,” says Donkor. “I don’t have anybody. I only pray to God for help.”

Ghana’s National Health Insurance Scheme does not cover renal replacement therapy for patients who have chronic kidney disease. The government says the treatment is too expensive and would put too great a toll on the system.

But kidney disease is a growing problem in Ghana. Boima says 10 per cent of all hospital admissions in the country are now kidney-related.

In 2010 Korle-Bu handled 2,121 kidney-related cases. In 2011 that number shot up to 2,687 cases—a 31 per cent increase.

But Dr. Charlotte Osafo, the head of Korle-Bu’s renal unit, says the increase is due at least in part to more awareness of kidney disease. More patients are coming forward for treatment.

Boima says kidney patients often arrive at Korle-Bu “crash landing.” The kidney disease has progressed to the point where they must be put on dialysis right away to survive.

The three main causes of kidney disease in Ghana, and around the world, are diabetes, hypertension and inflammation of the kidneys. The first two can be controlled through diet, exercise and the right medication if they are detected early enough.

Korle-Bu has 135 patients who are regularly on dialysis due to kidney disease. The youngest is eight years old and the oldest is in his 70s. The hospital has 18 dialysis machines. “These machines are under real pressure,” says Boima. “In the near future they will break down.”

A basic dialysis machine costs about $20,000.

In addition to Korle-Bu, Ghana has one other kidney centre at Komfo Anokye Teaching Hospital in Kumasi. A local charity called the Christian Council of Ghana is raising funds to build a third kidney centre at 37 Military Hospital in Accra.

Rev. Fred Deegbe, the Christian Council’s general secretary, says appeals from the families of people suffering from kidney disease encouraged the group to build the new centre. He says it should be ready by the end of 2012.

Boima says kidney disease is a “silent killer” that kills people when they are often in their most productive years. Most people with kidney disease in Ghana are in between the ages of 20 and 50. He says Ghana should follow South Africa’s lead and at least cover treatment for patients under the age of 40.

Donkor is desperate for a solution in the near future. She cannot afford to keep her son on dialysis indefinitely.

“For the past year I’ve struggled to take care of him,” she says. “I won’t let him die.”

Hospital overcrowding a ‘time bomb’ in Ghana

Korle Bu's Children's Block. Photo courtesy of Jamila Akweley Okertchiri

“This was a time bomb waiting to happen.”

That’s what Dr. Philip Amoo had to say after three children died following a bacteria outbreak at Accra’s Korle Bu Teaching Hospital. Amoo is the head of Korle Bu’s public health unit and said the “time bomb” was due to overcrowding at Ghana’s largest hospital.

Christiana Akyfo, a nurse with the Ghana Health Service’s quality assurance department, says the deaths at Korle Bu could have been avoided with the proper precautions.

The bacterium that caused the outbreak was Methicillin-resistant Staphylococcus aureus. It is more commonly called MRSA, or, as Amoo says, “the devil of hospitals.”

MRSA is usually harmless to healthy people, says Amoo. To a sick child with a weakened immune system, though, it can be deadly.

Children infected with MRSA will often develop boils and show symptoms of a fever or pneumonia. Because those symptoms are common with many other diseases, it can be hard to detect without a blood test.

Following blood tests, doctors at Korle Bu discovered that five sick children had been infected with MRSA. Two of them made a full recovery after a strict treatment plan. The other three died, but hospital officials have not determined if their deaths were due directly to the infection or a result of their underlying conditions.

On Jan. 27, parts of the children’s ward were evacuated and a three-phase decontamination effort began in earnest. There were 152 children staying in the ward that day.

The ward was re-opened two weeks later on Feb. 13.

The spread of the infection, and the children’s deaths, have raised alarms about the state of Ghana’s hospitals, and Korle Bu in particular.

The incident prompted the Parliamentary Select Committee on Health to visit the children’s ward and discuss plans to prevent future outbreaks and Korle Bu.

On Feb. 21, Alban S. K. Bagbin, Ghana’s health minister, recommended that Korle Bu’s board of directors be dissolved.

Akyfo says poor hospital infrastructure is the main culprit when it comes to the spread of deadly infections, “Renovation comes as an afterthought”. Korle Bu was built in 1923.

The older infrastructure means ventilation is compromised, which can help spread pulmonary infections.

Akyfo further states, while many health practitioners in West Africa have praised Ghana’s National Health Insurance Scheme, the system creates more paperwork for hospital staff, which increases wait times for patients.

Most paperwork is still processed manually in Ghana. Hospitals have been slow to adopt electronic systems for administrative tasks. Because improving infrastructure can be expensive, though, training staff to better handle paperwork and be familiar with infection control procedures, is the road most taken by Ghana’s hospitals.

Korle Bu has announced that it has secured a $54 million loan to build a new emergency ward.

Dr. Amoo claims that while overcrowding will always be a problem at the hospital—because it gets referrals from across the country—the new ward will be in a modern building, will be easier to clean and will have modern ventilation.

At Holy Trinity Hospital in Accra, though, overcrowding is the furthest thing from the doctors’ minds. The private hospital is a far cry from the under-funded halls of Korle Bu.

“We don’t think sanitation is a problem for us,” says Dr. Felix Anyah, the hospital’s director general. “We don’t think overcrowding is a problem for us.”

Patients at Holy Trinity, who are generally well-off Ghanaians, wait in air-conditioned rooms plastered with flat screen TV sets to keep them occupied.

Anyah says the hospital has never had an outbreak of any infectious ailment. “If there’s an outbreak here it will cost us more,” he says.

While the public hospitals have more limited resources than their private counterparts, Akyfo argues new hospitals being built in Winibo and Lekma, in Ghana’s Western region, are addressing many if the infrastructure issues that have plagued Korle Bu.

As for Korle Bu: “The modern building [for the new emergency ward] will assist greatly but we are worried about the hygiene practices and surveillance,” says Amoo.

The Fulani children of Accra

Aisha is a six year-old Fulani girl who lives in Accra.

Adeeza is 15 years old. Her family traveled to Accra about two months ago from Niger. Her mother tells her she should not speak with me and my colleague but she goes on telling her story. They left their village– where she says they lived comfortably– at six o’clock in the morning one day and arrived in Accra at one in the afternoon the next day. It was her older sister who said they could find a better life in Ghana, one of the most stable countries in the region. Instead, she and her siblings beg for money from dawn until dusk.

Adeeza does not go to school but she does read the Koran every day at a local mosque. Her dream is to become a successful businesswoman.

She is one of the Fulani children of Accra.

They are a common  site in Ghana’s capital. Children as young as five beg for food or money as their parents observe from the wayside sitting idly.

They are members of a nomadic ethnic group spread out throughout West Africa that elicits both pity and scorn from the locals. While most enter the country illegally, Ghana’s government does not have sufficient resources to deport them in large numbers or provide services for the children.

“We don’t have the human resources to do our work well,” says Mariama Yayah, the director of Ghana’s Department of Children. Yayah says that as a signatory to the United Nations’ Convention on the Rights of the Child Ghana has a duty to protect the Fulani children from discrimination whether they hold Ghanaian citizenship or not.

Every day Fulani children are a visible part of Accra’s street life as they weave their way through dangerous traffic begging for money or selling small goods to help support their families.

Aisha, a six year-old Fulani girl my colleague Berlinda met one evening, still had to collect 50 Ghanaian pesewas from strangers before she would be allowed to end her day of begging for change in the hot West African sun.

Daniel Asare Korang, the programs manager for the Human Rights Advocacy Centre in Accra, says he has seen no action from Ghana’s government to assist the Fulani people. “I don’t think there has been any deliberate effort targeted at these people to incorporate them or improve their standard of living,” he says.

Korang says the issue is complicated when the Fulani come from countries that are not part of the Economic Community of West African States (ECOWAS). “If you are part of the ECOWAS community then you have right to establishment,” he tells me. Once a person from any country has lived in Ghana for 10 years, they gain Ghanaian status and are privy to all the rights that come with citizenship.

Still, Yayah says it is one thing to recognize those rights on paper, but quite another to defend them on the streets of Accra. “When it comes to implementation and enforcement [of social services] that’s where the problem is,” she says.

As many Ghanaian citizens live in abject poverty, the social and economic condition of foreigners does not make it very high up the list of priorities. The government’s resources are limited when it comes to most of the services people depend on every day. Setting funds aside for social protection system is a difficult task, as Yayah puts it.

Children like Aisha and Adeeza don’t have the opportunity to go to school because they must provide for their families. It’s a cruel irony that by working to help feed their families today they may very well be sabotaging the only chance they have to break free of the cycle of poverty.