“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.