Tag Archives: hospitals

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.

Health & Fuel: A follow up on Malawi’s shortage impact on health services.

The inaccessibility of oil in Malawi causes a considerable slowdown in regard to the overall productivity of the country. While hospitals have developed strategies to ensure continuous access to resources, their employees and patients are still queuing up nearby the pump.

According to Dr. Themba Mhango, the director at the Queen Elizabeth Central Hospital (QECH), some patients are unable to attend appointments due to fuel shortages.

“At the moment about 50% of the patients with diabetes who are booked to come for sight-saving laser treatment are defaulting and when we call them to trace them, they almost always say it is due to no fuel or the cost of transport that has increased.” Said Dr. Mhango.

Malawi’s shortage has been going on for three years now. With people sometimes waiting six to eight hours without any guarantee of accessing the fuel, life has just taken another pace has lining up for gas is now part of everyone’s weekly reality.

QECH is a 1 300 bed public hospital receiving about 500,000 patients per year and spending nearly 2 million kwacha (approximately 12 500 Canadian dollars) a month on fuel. They managed to work around the shortage by creating contacts at gas stations so owners can inform them in advance whenever a delivery is about to happen. However, their work is still indirectly affected by this situation.
“Some staff may report for duties in the morning and then later disappear because they have gone queuing for fuel at the gas station.” Explains Dr. Mhango.

At Mwaiwanthu hospital, recent agreements with the Minister of Health have highly enhanced the life of the management team who no longer fear fuel shortages during the frequent power outages.

“It takes about 20 liters to run the hospital’s generator for six hours. Before this January, we had to find the fuel ourselves. Now we prepay for the fuel who is delivered to us.” explains Dr. Edgar Kutchindale, admitting that although this is a privilege it does not cover any of their staff members. Individuals must still queue up to buy gasoline or are forced to buy it off illegal vendors which requires them to pay up to three times more than the original price.

In the past few weeks, police attempted to implement better security on black market and began arresting the dealers who are keeping the oil in their houses. According to Christian Sidande from the Malawi Human Rights Commission; 1000 liters were confiscated last week.

These new interventions by the authorities appear to be favorable for the buyers. “With the outlawing of consumers buying fuel in containers has strangled the black market, hence we are seeing an improvement in the availability of fuel supply, we can ably fill up our vehicles at the gas  station,”  said Dr. Mhango.

However, for Mr. Sidande, the recent availability of fuel is only a temporary balm on a wound.

“In the last two weeks 90 million liters were bought by government. Their problem as eased a little for a short period of time but the president admits still not having a solution yet.” Said Sidande.