Research

Cervical Cancer; The worst nightmare of every woman

By Ama Afrah

Screening and Prevention of cervical cancer
Until 1940, cervical cancer was the leading cause of death until the introduction of PAP TEST. Cervical cancer has become a preventable cancer since the discovery of the Human Papillomavirus (HPV) as the cause of almost all cases of cervical cancer. Vaccines for HPV was first approved in 2006 after discovery of the virus.

Pap test which has been approved as the most specific of all cervical cancer screening tests, involves looking at a sample of cells from the cervix under a microscope to see if there are any that are abnormal. It is a good test for finding not only cancer, but also finding cells that might become cancerous in the future. Other advantages of the Pap Test is that other infections apart from HPV can be picked up; Chlamydia, Herpes simplex virus, bacteria, parasitic infections (genital schistosomiasis), yeast or Candida infection as well as a woman’s hormonal status since the cells that makes up the ecto-cervix and vagina mature under influence of female hormones (estrogen, progesterone).

PAP test is part of a routine pelvic exam at recommended intervals.
Pap test is most reliable than colposcopy; there are more false positives and false negative associated with colposcopy.

RECOMMEND GUIDELINES OF SCREENING FOR WOMEN BETWEEN AGES 21-65:

• Women should not be screened before age 21 (if sexual debut was10 years, you are to start before age 21 years).

• Women 21 to 29 should be screened with the Pap test alone (conventional or liquid-based) every three years. HPV testing should NOT be used for screening in this age group.

• For women 30 and over, the preferred approach is the Pap test plus HPV testing (“co-testing”) every five years. Continued screening with the Pap test alone (without HPV testing) every three years is an acceptable alternative. While screening with HPV testing alone is promising, at this time it is not recommended for most clinical settings.

• Screening is not recommended for women over age 65 who have had at least three consecutive negative Pap tests or at least two negative HPV tests the last 10 years, with the most recent test in the last 5 years. Women in this age group who have a history of cervical pre-cancer (CIN2 or a more severe diagnosis) should continue routine screening for at least 20 years, even if this extends beyond age 65.

• Women who have undergone a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer or pre-cancer should not be screened anymore.

• Women who have been vaccinated against HPV should follow the age-specific recommendations in these guidelines (for unvaccinated women). Currently, there are no alternative screening recommendations for women vaccinated against HPV.

The new guidelines are not intended for women with a history of cervical cancer, exposure to DES during a pregnancy, or women who are immunosuppressed (e.g. HIV positive).
It is important for women to know if a Pap test was performed because it is possible to have a pelvic exam without a Pap test. It is also important that women know and understand their Pap test results and follow through with any recommendations made by their healthcare provider.

Some abnormal Pap tests will be followed by colposcopy (examination of the cervix using a magnifying device to see the cervix more clearly) and biopsy of any abnormal appearing areas on the cervix. Any pre-cancerous areas can then be seen and, if needed, treated by a woman’s healthcare provider.

Current cervical cancer screening guidelines state that women with a slightly abnormal Pap test result (called “ASC-US”) and a negative HPV test can be screened again with co-testing in 3 years, or with the Pap test alone in 3 years. Women with a negative Pap result but a positive HPV test can either be rescreened with co-testing in one year, or tested with a test that can determine specific types of HPV (HPV16 and HPV 18).

FDA approved the HPV DNA test for women 25 and older for use alone to help a healthcare professional assess the need for a woman to undergo additional diagnostic testing for cervical cancer. The test also can provide information about the patient’s risk for developing cervical cancer in the future.
Using a sample of cervical cells, the cobas HPV Test detects DNA from 14 high-risk HPV types. The test specifically identifies HPV 16 and HPV 18 for now.

Screening for cervical cancer, whether with the Pap test or HPV test, remains a critical prevention step. However, the FDA approval in 2006 of the first vaccine to prevent cervical cancer represents the opportunity to eradicate this cancer. Now there are three vaccines, all given in a series of three injections into the muscle tissue over a 6 month period.

VACCINES

Cervarix targets two HPV types, 16 and 18, and is approved for females ages 9-25. These two high-risk HPV types cause about 70 percent of cervical cancers an even higher percentage of some women.

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The Suspected Identical Twins: Tuberculosis(TB) and Chronic Pulmonary Aspergilloses(CPA).

By Rachael Lamptey

Has one wondered why some patients who present same signs and symptoms as TB tests negative for TB? So, what is the underlying cause? This has been a puzzling question for health personnels over the years.

Friday, 1st February 2019, in commemoration of World Aspergilloses Day, Fungal Infection Care Ghana (FIC Ghana) in collaboration with Medical Journalists Association Ghana ( MJA Ghana) organized an awareness seminar in Korle bu Teaching Hospital in the Medical conference room. This seminar was themed ‘Considering Chronic Pulmonary Aspergilloses (CPA) for improved Tuberculosis (TB) management’ Guest speakers were Prof. David Denning, Professor of infectious disease in global health- Manchester University, UK and Doctor Rita Oladele, Consultant Clinical Microbiologist/Mycologist, Nigeria.

According to Dr. Oladele, CPA is estimated to affect 3 million persons worldwide and has case fatality rates of 20-30% short term and 50% over 5years period. Aspergillus is a type of fungus that lives with us in our environment especially in moist areas. This fungus forms molds on walls, foods and they multiply greatly in empy or uncompleted houses.

One can be affected by breathing it into the body. After which the lungs becomes the targeted organ, growing in its cavities and to the extent of forming moulds in the lungs. Some signs and symptoms are coughing out blood, weight loss, tiredness, shortness of breath and chest pains which are the also same signs of TB she explained to the attendants. However some people showed no signs of CPA but had the fungal moulds in their lungs during the research in Nigeria from June 2014 to May 2015 according to Dr. Oladele.

During the research it was revealed that some patients with suspested chronic TB tested negative for TB but were positive to the fungal infection. Some cured TB patients developed CPA after some years. Moreover, it was astonishing to know that healthy persons were at more risk of getting TB than people living with AIDS she explained.

Prof. Denning took the attendants through the second section in a video as he explained how the distinguish CPA from TB and showed the new test kits for testing CPA.

In addition Prof. G. T. Odamtten, Professor in the Department of Botany, University of Ghana raised an awareness that most of Africa’s microbial challenges are from the fungal family. From the food we eat to the air we breath. He encouraged health science personnels and researchers to invest into this area.

Always with the life of your patient in mind, let all health personnels unite to research beyond what is already known so as to give the best care to patients said Dr. Oladele as she concluded.

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All about the Malaria Vaccine…

RTS,S/ASOI (RTS,S) is the world’s first malaria vaccine. The vaccine has been shown to provide partial protection against malaria in young children. The vaccine acts against plasmodium falciparum, the world’s most dangerous and prevalent malaria parasites.

The vaccine has been recommended by WHO for pilot introduction in selected areas of three African countries which includes Ghana, Kenya and Malawi. The vaccine will begin trial in Ghana on the 1st of March, 2019. The vaccine has been evaluated for use as a complimentary malaria control tool that could be added (and not to replace) to the core package of WHO recommend preventive, diagnostic and treatment measures.

Things you need to know…

Children under 5 years

The child must be vaccinated before he or she turns 36 months old (6th, 7th, 9th and 24th months after birth to achieve maximum results

The vaccine must be given through the Intramuscular route at the left upper thigh.

Controversial DNA Scientist, James Watson, honors revoked…

“Inherently gloomy about the prospect of Africa because all our social policies are based on the fact that their intelligence is the same as ours- where all the testing says not really” Said James Watson in a magazine when he was interviewed. He further stated that “People who have to deal with black employees find this is not true”. He argued that genes cause a diference on average between blacks and whites on IQ test.

James Watson, the Nobel Prize-winning DNA scientists was stripped of several honorary titles (Chancellor emeritus and honorary trustee) by the Cold Spring Habour Laborateor, New York, which he once headed in 1968.

This was done in reaction to Watson’s remarks in a television documentary aired earlier this month where he still stood by the comments he made in 2007.

About James Watson

He shared a 1962 Nobel Prize with collaborator Francis Crick and scientist Maurise Wilkins for discovering in 1953 that DNA was a double helix shaped like a long twisting ladder. This discovery was key in determining how genetic materials works. The double helix become a recognised symbol of science and Waston became famous far beyond the scientific circles.

Source; CCTN

Time to rewrite “The Anatomy Books”…

A new blood vessel unknown to the medical fraternity has been discovered. These newly discovered blood vessels cross from the bones’ surfaces to their internal cavity. This discovery promises to shed more light on bone diseases example osteoporosis and condition involving the immune system. Several areas of science has seen major discoveries but the human anatomy is not usually seen as an ongoing area of major discoveries. Matthias Gunzer of University of Duisburg-Esten in Germany says “It’s totally crazy. There are still things to find out about human anatomy. We have discovered blood vessels in new place that we did not know about before”. The team made their discovery by using chemicals in a mouse bone to make it transparent. Tiny red blood vessels were seen crossing the bone shaft. Thousands of these capillaries dubbed trans-cortical vessel.

Previously, few blood vessels are known to enter the bone at its ends or half way along. These newly discovered capillary blood vessels cover the whole bone making most of its blood supply. The team also spotted these trans-cortical vessels in the human thigh bone too.  Similar discoveries was made between the brain tissue and the bone marrow inside the plates that make up the skull last year by a a group of medical scientists. When mice were made to have meningitis, immune cells from their skull used these route of blood vessels to reach the brain responding to damage. It is however not known if the human skull has similar network.

Source: Nature metabolism; DOI;10.1038/S42255-018-0016-5

MEASLES, A THREAT TO PREGNANT WOMEN By Wright Amesimeku


All over the world, giving birth to a healthy baby is the dream of every parent. This dream is however a nine day wonder in some part of the world. Giving birth to a healthy baby starts from the very top of government through to the family of the expectant mother. Certain policies by the government concerning healthcare delivery have a huge impact on healthcare. Antenatal and postnatal care delivery services have been very helpful in this regard. Most expectant mothers are expected to attend to these services once every month. The overall objective is to help the mother deliver a healthy baby without any complication to the mother and child.

In some parts of the world, these services are free to all expectant mothers even though there may be factors which affects these services. “The woman at the maternity ward is in labour. Kindly call Aunty Joyce (Aunty Joyce was the midwife on duty) immediately, says the student nurse to a colleague in the facility. Within a short period of time the midwife was in. Hello Aunty Rebecca, everything will be fine. Kindly push hard, yes push … this went on and on till she delivered a bouncing baby boy. Oh, shouted by the midwife, there is a second, Kindly push again, push harder … On and on she delivered a bouncing baby girl. There was joy in the eyes of Aunty Rebecca, the expectant mother. The husband came and he was immediately assign some tasks to do regarding the mother and the twins”.  This took place at the Denmida Health Services Clinic at Dansoman Russia, Accra-Ghana on Wednesday, 15th of August 2018. Aunty Rebecca said “I took my antenatal very seriously because this was my first pregnancy and through that most of my pregnancy related issues were addressed. I am very grateful to God and to the staff. Thank you”.

Several factors goes into a successful delivery without any pregnancy related risk which any prospective mother must follow. Antenatal care delivery service is important in delivering a healthy baby even though most pregnant women in Ghana have issues attending to this service. “Our roads are very bad. I get so tired going to the hospital and due to the bumpy nature of the road, I am afraid it might lead to me having a forcibly induced labor” Says Grace Awotwi at Twifo Praso. This and several reasons were raised by some expectant mothers refusing to go in for these services. Theresa Osei was one of the pregnant who delivered all her seven at home and this being her first time coming for Antenatal clinic made her happy because she learnt so many things through the antenatal education given by the midwives. When she was asked why she did not attend any of the ANC programs for her other children, she said, “The roads were very bad then. Now, it is somehow better. That’s why I came”.

Education has been a key area in the ante and postnatal care services in various facilities. Most pregnant women are taught on several topics which helps to ease delivery. One topic that is taught is vaccination. They are advised to allow their babies to be vaccinated. One contagious disease taught to the expectant mothers so they get their babies vaccinated is Measles. Before 1963, approximately 2.6 million deaths were recorded every 2 to 3 years during major epidemics of measles. Measles is among the leading cause of death among children globally, mostly children under the age of 5 years. Even though there is a safe and effective vaccine, approximately 89,780 children died of this disease last two years. More than 41,000 people have been affected with this disease with 37 deaths recorded in only Europe last year. This numbers shows how serious the disease is and therefore all mothers must make it a point for their children to be vaccinated.

Measles is caused by a virus in the paramyxovirus family and normally passed through direct contact and through the air (spreads by coughing and sneezing, close personal contact or direct contact with infected persons nasal or throat secretions). This disease affects only humans and greatly affects the respiratory tract negatively. This disease then spreads through-out the whole body. This deadly virus could stay active in the air or on surfaces for 2 hours. Overcrowding and poor hospital infrastructure could accelerate the spread of measles.

This contagious disease could lead to death. Death sets in when there are complications. Complications such as encephalitis, blindness, severe diarrhoea, ear infections, and severe respiratory infections such as pneumonia. Complications are however intense with children under the age of 5 years and adults over the age of 30 years. Individuals that are malnourished and those who lack vitamin A could have severe complications. Immune-compromised individuals are not left out.    

Fever (a rise in temperature) is usually the first sign of measles. This happens after 10-12 days after exposure to the virus and last about 4-7 days. During the initial onset of the disease, one can develop a runny nose, a cough, red and watery eyes and a rash which eventually spreads to the hands and feet. The rash last for 5 to 6 days. Getting this infectious disease is not a death sentence but not reporting on time could lead to complications above. There are no specific antiviral treatment for measles but effective treatment could prevent certain complications. Taking in plenty of fluid during the disease is essential. This will replace the lost of fluid during vomiting and diarrhoea. Antibiotic should be given to treat eye and ear infection. Vitamin A supplement must be giving to all children affected with measles 24 hours apart. This has shown to reduce death by 50%.

Routine measles vaccination for children is available. The measles vaccine is protective for 50 years. The disease can be deadly when complication sets in. “During my first delivery, they told us the vaccine measles is finished. I had to go and come back in two weeks to get my two kids vaccinated. For my last born, Julia, I taught she was vaccinated until now. I am very worried”. Said Patience Boateng, Julia’s mother who attended the Princess Marie Children’s hospital on 26th of August, 2018. Mothers must ensure their children are vaccinated. They should also make it a point to attend all ante and postnatal care delivery services. People who recover from this contagious disease are immune for life. Kindly take note that the measles vaccine is not expensive and free.

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 Kindly visit www.mjaghana.org for references OR

www.wamesimeku@bloggerspot.google.com OR

Wright Sanitatis Blog

RHESUS DISEASE: WHAT EVERY PREGNANT WOMAN SHOULD KNOW??? By Rachael Naa Koshie Lamptey.

One of the greatest aim of an expectant mother is to carry her nine months pregnancy and to deliver successfully, a healthy baby with zero complication. Most women after the first baby dream of delivering another baby without any complications. However, such dreams and hopes of motherhood are shattered and leave most women in pain, self-anger while others are ridiculed by their relations or society. Awula Naa of Chorkor, a suburb of Accra said “I was ridiculed by the society. I was told I was not a complete woman because I am not capable of delivering a baby and bringing it home. These comments shattered my dreams of becoming a mother of many children”.


There are lot of programs instituted by the World Health Organisation through the Ghana Health Service to curb such complications. Programs such as Ante Natal Care (ANC) and Post Natal Care (PNC) delivery are very important for any pregnant woman. Attending to such care delivery system minimises or helps the midwives’ or paediatrician rule out any pregnancy related complications. However, some women in Ghana are unaware of such programs as a result fall prey to some pregnancy related complications. “I have not heard of any programs instituted by the government to look into this complications and where our health centre is located is far. Due to the poor nature of our road, I usually prefer delivering at home” Said Beatrice Nyamekye in the Central Region.


Aside the fact that most women are unaware of ANC or PNC, certain factors prevents most women from going for ANC or PNC. “I know I am supposed to go for ANC at least once every month but our road is not good. I get too tired and some do not get any transport back. I have decided to do that once every three months”. Said Grace Bonti, an expectant mother. One of such complications most women fall prey to is the physiology of rhesus immunization.


Most expectant women understand that knowing their blood group is paramount to delivering successfully without any complication but do not know the importance of the ‘rhesus’ factor. The Rhesus (Rh) factor is part of the human blood systems and is the second important human blood group system after the ABO blood group system. The Rhesus factor is an antigen that surrounds the red blood cell. It is present in about 85% of humans which makes them test positive while those who do not have it are negative. The knowledge of the rhesus group factor in pregnancy is important because it may cause rhesus incompatibility also called the rhesus disease. Rhesus incompatibility occurs when a person with Rh negative blood group is exposed to Rh positive blood group thereby producing rhesus antibodies to fight against any rhesus positive blood group reintroduced into the blood. Therefore, a pregnant woman with the Rh negative can be sensitized by her Rh positive baby if there is bleeding from baby to mother at any point during the pregnancy from an induced or spontaneous abortion, trauma, early separation of the placenta, invasive obstetric procedures and even through a normal delivery.


A baby inherits its Rhesus blood group system from either from the mother or father. Babies who have the same Rh factor with their mothers do not affect their mothers when their blood gets into contact with their mothers blood. This includes women with Rh positive but carries a baby with Rh negative blood system. However, the biggest concern is when Rh negative mother carrying her first Rh positive baby. As baby’s blood is exposed to mother either through birth or an abortion, antibodies will be formed in a mother within 3 days after delivery. If no medical intervention is done then the mother becomes permanently immune against any Rh positive baby she will carry for the rest of her life. The first Rh positive baby lives but the next either becomes a miscarriage or the baby is born with severe jaundice immediately after birth as a result of mother’s Rh antibodies destroying the red blood cell of the baby.


Rh negative women who undergoes unsafe abortion (as defined by the laws of Ghana) may have the next babies to be at higher risk of the rhesus disease because less precautions are taken, no laboratory investigations are done and more over it is not supervised by a qualified health personnel. This can make the woman to live in a guilt of being punished.


Advanced knowledge in blood grouping systems lead to the discovery of RhoGam which is a medication given to Rh negative mothers to prevent the formation of antibodies in her. Immediately after delivery blood tests are run on mother for the presence of antibodies and on the baby to know it’s Rhesus factor. If baby is negative as her mother than no treatment is required but if the baby is positive, RhoGam is given to mother within the first 3 days after delivery. This test is to be done for every baby the Rh negative mother delivers. For Rh negative woman who undergoes an abortion would be given the same treatment within 3 days. Now, RhoGam is not only after birth but at 28 week of pregnancy in case there could be any little bleeding that may not be noticed.


The best way to deal with issue is for both partners are to test for their blood group and Rhesus factor so that if the mother is at risk, partners can plan and prepare for before conception and the birth of their children. Regular visits to the antenatal clinic and attending scheduled dated for postnatal clinic. Moreover, don’t hesitate to go to registered health facility for a safe abortion.


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Mental Health Authority (MHA) Launches Guidelines to improve Mental Health Care in Ghana

 

The Mental Health Authority has launched nine set of guidelines and policies to guide the delivery of mental healthcare in Accra on the 19th of December 2018.

The protocols are expected to guide mental healthcare delivery within the Ghana health service and to also regulate the activities of people in the informal areas such as the Faith Based Organizations who handle mental health cases.

The Chief Executive of the Mental Health Authority, Professor Akwasi Osei, in his presentation on the nine protocols, described the launch of the guidelines as a significant milestone for mental healthcare and for Ghana’s development.  He added that the guidelines are a foundation for building a new paradigm for mental healthcare in the country.

The Chief Director of the Ministry of Health, Nana Kwabena Adjei Mensah, who officially launched the guidelines, in his address, stated that the launch of the guidelines is one of the several initiatives that will soon be implemented to enhance mental healthcare delivery in Ghana. “Soon, the legislative instrument will be passed and the mental health board will be constituted and inaugurated. A funding mechanism will also be established’’ he said.  He emphasized these initiatives will give a positive face to mental health in Ghana.

BasicNeeds Ghana, a civil society in mental health called for the active implementation of the guidelines to prevent it from becoming dormant.

The protocols include but are not limited to guidelines for Conducting Peer Review at Psychiatric Hospitals, Integrating Mental Health into General Health Care Systems, Code of Conduct and Disciplinary Procedures, Communication Strategy On Stigma Reduction and Discrimination Against Persons with Mental Illness in Ghana and a Staff Charter.

Present at the launch was the Medical Journalists’ Association- Ghana and BasicNeeds Ghana.

Golda Grace Asante Speaks on her exit from the GAC

One on one with Golda Grace Asante | Many have lauded her work at the Ghana AIDS Commission for various reasons.

Her knowledge, skill in displayed during delivery of presentations, her passion and many more.

She has been described as the “Vice President of HIV and AIDS” and her voice has been replete on several radio and television stations across the country.

Now wonder she won the overall best worker, Senior Category at the 2015 awards given by the Commission to staff.

The success story of a continuous reduction in prevalence in the Eastern Region can not be told without her. It therefore came as a shock to many when her exit from the Ghana AIDS Commission was announced.

Some shed tears and still do, many journalists couldn’t believe the news, students in the Senior High Schools especially in the Eastern Region of Ghana would simply miss her.

I present to you an unedited first part of my interview with Grace Golda Asante.

This interview couldn’t as well end without sad imotions from the champion of positive response to HIV. Read on……

SG: Good afternoon and good to see you again, It’s like you are no more at the Ghana AIDS Commission officially.

Golda: Yes

SG: What happened?

Golda: Well, ermmm, I have been working with the Ghana AIDS Commission for a long time,…ermmm….for the past six years I was seconded from the local government service to them.

Normally, secondment is two years and one additional year. So after three years, because of our hard work and our dedication, the Commission requested that, we continue working with them, also they were finding it difficult getting clearance and so they were depending on seconded staff, that is why I had to stay a bit more which is quite unusual but it tells you that we were doing a lot, and so our services were needed.

And so after six months, they got clearance and before then, I have also had my promotion to the position of a Director and so once you are a director at the Local Government Service, we don’t have many women as Directors at the Local Government Service, and it was obvious that the demand of my service was very very needed, and it was high as well, so I made up my mind to come back to the Local Government Service, that is my parent organization, to continue my good work and so that is why I have exited the Ghana AIDS Commission.

SG: Of course definitely not good news for many people especially the media with whom you have interacted so well over the years but lets talk about your award and then we’ll come back to your work at the GAC, is it coincidental?

Golda: I don’t really think so, I think that over the years we have done a lot, even in 2015, I was adjudged the best worker for the year, senior category, so it tells you that over the years we have been building on the good work we are doing and so well, they felt that with my exit, they had the opportunity to really acknowledge people who have over the years distinguished themselves and pushed the national response to HIV and AIDS, they couldn’t have done that without recognizing the good roles we have played over the years:

Especially in strengthening the decentralized response to HIV and AIDS and you know…. some of the good things that we have done marshaling a lot of resources technical, financial, and then human as well to respond to the HIV epidemic.

SG: Obviously, for all those who have worked around you and your team, some would say this is even long overdue. But one thing that stands out in the work you have done with your team, till your exit, is how you were able to move the media to really carry on the message, it was as if you have used the media to replace a lot of the NGOs who were receiving funding to work in the area of HIV and AIDS, and we do know that, that kind of funding isn’t available anymore. How did you do that?

Golda: Okay, thank you, like you rightly said, the way we have responded to the AIDS or HIV epidemic right from the beginning, years ago, you know….. at every point in time, we are changing our strategy.

So we started with awareness and I normally refer to it as the noise time, where everywhere you will see the floats and everywhere we were talking about HIV.

And it worked for us because we needed to create the awareness. Then we moved a bit from awareness to behaviour change and interventions, and when we got there, we realized that the funds were reducing and so we have been doing targeted programming, where we target either a population, location or something and then we provide services, but if you look at where we started and the strength in our finance and you compare it to now, it is like things have drastically changed, and the funding is becoming something.

It is scarce now, and so, we had a lot of civil society organizations, local NGOs, community based organizations working those times, but as I have already explained, things were changing.

At first we used to have like twenty NGOs working in a community. Now we don’t even have one. But before 2014 we had like two organizations working in each community.

Now the money is not forth coming, and so we needed to strategise. So you realize that not much is been heard apart from what the Technical Support Units were doing with the Ghana Health Service.

There is a big gap when is comes to the role of Civil Society Organizations because since 2014 the Ghana AIDS Commission has not had money to engage them in Community Education, however, we are on the ground, we are community people and we see the kind of things going on.

Now people even think that HIV is no more, people are into casual sex, people are into multiple concurrent partnership, people are into all kinds of things, including female sex work and Men who have sex with men and who are also bisexuals as well, and so if you look at the kind of things happening in terms of other indiscipline in terms of sex and sexual intercourse, you realize that we were sitting on a time bomb and we needed to do something.

And so, that is why I decided that I needed to rally some media persons who have a passion for health and HIV interventions, so for the past two years they have been there for me and fortunately we were blessed with US Embassay and PEPFAR for that matter and they came to support us and so even though I had some interaction with media guys and so almost every week they were doing something for me, you hear my voice here, you hear my voice there, trust me they were so excellent and that is what has kept the Eastern Regional Response to AIDS.

And with PEPFAR coming in, PEPFAR tried to train about twelve of them and so we chose those who have been supporting the response, we brought on board a few others, I was part of the training, we tried to do some strong advocacy for them to know the money wasn’t forth coming and we didn’t have money but they should take it as part of their corporate social responsibility and even though I didn’t get all the twelve people working, I think ten of them distinguished themselves, radio, print, online TV and they took special interest and they took special interest and delight in  our work.

And so every week they will call, different topics, the importance of Knowing your HIV status, the 90-90-90, Basic facts about HIV , prevention strategies , what are the opportunities for people when they test positive, how can they be retained in care, importance of the anti retrovirals, and this work, if you don’t have passion, even as a technical coordinator or a focal person, you cannot do it, because it is work that you are not being paid for, to sit down and to plan what you would say for a week without repeating yourself.

This one is coming, that one is calling, and you don’t want to repeat yourself, it takes a lot of work, but because of our passion we did that, we planned very well, we know whom we are talking to say, Rite fm about, we know what we are talking to Eastern fm about, ermm radio one, Bryt fm, Ghana Health News, you know….

All of them were on board and it has really worked for us. The other thing too is that, they had networks and so if www.ghanahealthnews.com puts something online, other people will also take it, and then others will see it and take it, others had colleagues in other regions who would take their works and so it was like in a day I had to prepare myself that I would talk to about three or four media houses including other people outside Eastern Region, and that is how we see progress in the work we we were doing.

Because the NGOs are not working. They, you need to give them money to work, but the radio stations have wide listener-ship and coverage, so if you engage them, you know that your message will get to so many people, so, in effect this is how we engage the media.

Of course we can’t say we replaced the CSOs with the media but of course the media had held the fort for the Eastern Regional Response to HIV and AIDS

SG: Okay, so I was at the National HIV and AIDS Research Conference and when the Annual Sentinel Report was been presented, the work you have done really showed up, the figures spoke something, it was very loud and clear, now just this year we are hearing that the rate at which young people are getting infected, I am talking about new infections among young people have gone up, what happened?

Golda: That was a national figure but I don’t doubt it because I have a special program in schools and my interactions with students over the past one year since last year, you know we have been working with, but we started a special program targeting them, and we started it last year September and we have been to many schools and trust me, my interaction with them, we need to get up and do something, we really need to because……I am not surprised that new infections among them is increasing because……ermmm there isn’t much education on HIV and AIDs, not much education on that, and even if……you see, as part of their school lessons, especially the science students, they talk about HIV and AIDS but that is different, what they learn in school is for exam purposes.

For behaviour change, you need to take it to a different level and that is what is missing. And in effect even education, I mean general education on HIV has gone down, so what do you expect so I always tell people that the mode of transmission of HIV, the major route of HIV infection is unprotected sex with an infected person.

And so the major route is the weakest part of man, everybody is having sex, it is a different thing to talk about sex in marriage, that is a different thing all together, but when it comes to sexual intercourse, every one is having sex, and nowadays even eight years and nine year olds are having sex, I have pupils in class four and class five who are sexually active.

And so if you look at their sexual life, adolescents, their sexual life and you compare to the kind of education and knowledge which can translate into behaviour change, it is either not there or it is very small, so what do you expect, that is where we are now.

And the other thing is how adults are even feeding or taking undue advantage of young girls and having sex with them and even in the schools it is something else, when you interact with student girls, how male teachers are on them, it is terrible, and that is why I support the recent action that Ghana Education Service took by sacking ten teachers and some two or three who are non teaching staff and I support them and for me, it is long overdue, because you see these young girls 13, 14, 15 years in senior high and teachers are threatening them, if you don’t do this we will fail you and all that, even in the tertiary institutions, look at the Ashanti region, where the students were bold enough to testify, by the time we realized instead of them to be protected, their pictures were all over in the social media.

It is so so disheartening, so even their self confidence, we try to kill it because you see, if they report, the the way the atmosphere is so stigmatizing, and intimidating such that, these young girls can not come out to testify. And when they testify, what happens, GES will just post them to another district.

And so what happened over the past few weeks where teachers have been sacked, i think that we need to see more of those things, justice must be fast for these girls, and until we do that, these teachers will just be sleeping with girls.

These teachers will just be sleeping with girls and students, because of the things they have to go through they will just keep quite, I think that education has gone down, not just education, but appropriate education, which is age appropriate and culturally appropriate, it means that, wherever they are, we should look at where they are, we should look at the environment, we should loot at the atmosphere and provide them with the appropriate education that would change their behaviours, until that, trust me.

Look, I was in one school, it was a boys school and normally when I go there, I normally do the education and it takes between two to three hours, it is very interactive and I go there with trained health workers and social workers including a person living with HIV and social workers who would do one on one counselling, and we have time, it is like a whole day in the school.

We have time to spake to the boys and girls, in one school I spoke to 55 boys, All of them have girlfriends, this is excluding what my other colleagues and trained nurses had done. I just sat down and said let me talk to these 55 boys on a subject.

Are you in a relationship, and of the 55, it was three that said, they were not in a relationship and by the time we finished, they were in a relationship, and some had three girlfriends and you ask them why and they would tell you why they are dating someone in this school, that school and someone in their house, and close by, it is terrible. We cannot respond to HIV the way we are going now, nothing is heard about it, people are doing their own thing, and occasionally we go and give figures.

To be continued……

Interview by Sylvanus Gatorwu

ACHIEVING AGENDA 90-90-90 PRAYER CAMP DILEMMA

In his book, one minute after you die, Erwin W. Lutzer quotes:

Tom Howard says that when we face death we are like a hen before a cobra, incapable of doing anything at all in the presence of the very thing that seems to call for the most drastic and decisive action.

“There is, in fact, nothing we can do,” he writes. “Say what we will, dance how we will, we will soon enough be a heap of ruined feathers and bones, indistinguishable from the rest of the ruins that lie about.

It will not appear to matter in the slightest whether we met the enemy with equanimity, shrieks, or a trumped-up gaiety, there we will be.

When men are confronted with the issue of death, they are indeed capable of anything.

These words of Tom Howard are the words that rang in my mind as I listened to Golda Asante narrate the experiences of some persons living with HIV in prayer camps.

Prayer camps in the country have proven to be problematic than helpful, in their handling of health issues.

In the work of the Social Accountability Monitoring Committee (SAMC) in the Eastern Region to verify for themselves the harrowing conditions of people living with HIV in prayer camps, 77 prayer camps were visited by the committee.

During a forum to make known the findings of their work, it came to light that a lot of these Pastors and or Prophets who promise a cure to HIV have little or no idea about what HIV is.

It turned out that while some of these Prayer Camps do well in collaborating with health institutions in referring the sick,  others camp the sick, including people living with HIV, and others having TB with the promise of a cure.

Unfortunately however, some of these after interactions with the SAMC team proved to have little or no knowledge about what they were curing.

In a rather sad tone, Golda Asante, A Technical Coordinator with the Ghana AIDS Commission who led the team, lamented the conditions.

She said, “…….again it was alarming that, even some of our Pastors or church leaders who claim and they go to radio stations, and many other places that they cure, they don’t even have basic information about HIV, and so you keep on wondering what they are curing”

She went on to state some of the false perceptions these camp leaders have “……if you have many people saying that, you can get HIV through dirty environment, eating bad food, and eating with persons living with HIV, then it is a source of concern”

Obviously, many of these prophets and prophetess, are toying with the lives of many clients who in the search for a cure end up in their camps.

The troubling side of the issue is with the living condition within which these clients spend their days at the camps.

Golda gave a gist, “…..with our visits, you see many people lying on uncemented floor, they are on the sand, and seeking healing, you may go there with a condition and end up with another”

Touching on the miracle side of ARTs Golda did not miss words, “with the Anti retroviral drugs, it is the best miracle we have for now. You can add prayer and I believe in God, “

Currently, through the (Preventing Mother to Child Transmission) PMTCT in the antenatal clinics, mothers who test positive are aided through treatment to deliver babies who test negative to the virus. This according to Golda is also a miracle of God.

Click here to listen to Golda speak

 

She urged the public not to limit miracles only to that which happens in the church room.

On her part, the Chief Executive Officer of SOCIOSERVE who was with the team equally lamented the harrowing conditions of some of these camps.

Speaking exclusively to MJA’s Sylvanus Gatorwu, she didn’t miss words.

AGENDA 90-90-90

Click here to listen to the interview.

“Several things worried me, I think the biggest one was why today, we still have people who are ill being kept in prayer camps in very unhygienic conditions. Some of the conditions were very, very,  very heartbreaking.”

Describing some of her observations, she went on to say, “you see people who are ill and they are laying on the bare floor, in the sand, with rain water sipping under their mat.”

As to why people would allow themselves to go through such in this dispensation of time, she was blunt. “…. they are lying there because the Pastor, the Prophet, or the Bishop says that, that is where they have to be. And they are lying in the open, are suffering from mosquito bites, wind, the sun and anything.”

BIRTH ATTENDANTS AT CAMPS

Madam Sackey recounted the situation of a Traditional Birth Attendant in a camp “The most heart breaking is the prophetess we visited who was also a TBA and she had nearly 50 pregnant women on admission!”

Traditional Birth Attendants are not entirely new in the country. The challenge has been how they handle complications which obviously are beyond them.

Madam Sackey in a broken voice poured out her heart in concerns “…..and I was thinking if you are pregnant, what are you doing here? If you having a baby and the baby is breech, what can this woman do for you? She can’t do anything for you. If you start bleeding, what can this woman do for you? She can’t do anything for you.” She lamented.

She went on “If you get pregnancy induced hypertension, she can’t do anything for you?”

She went on “If you get gestational diabetes, she cannot help you, but they were there, and they were under her care!”

According to Josephine Sackey, her biggest challenge was the believe on the part of the clients in these camps, their believe that they can be helped to deliver safely in such conditions.

On the issue of faith she quizzed on why the faith on an individual should become a disadvantage.

She added her voice to the call for religious leaders to seek knowledge.

She called on the state, civil society the media, to come together “to educate our people, to empower them to know that, the fact that you believe in God doesn’t mean it should go to your disadvantage.”

According to her, prayer should not bar one from seeking medical help.

The AGENDA 90-90-90 would be under serious threat if such conditions should continue.

On regulations, she agreed, it is time to regulate the activities of these camps. She called on legal minds to begin to look at how this could possibly be done.

She however said, it was daisy on how to handle the issue of churches and camps joining associations that can in turn regulate and oversee their work, because of freedom of association.

But she was keen on the regulation of their activities because, “there are extreme human rights abuses of vulnerable people going on in these camps”

She lastly called on the ministry of gender and women to come in to see how they can join in the regulation of these camps.

As there are “sick People in heart breaking conditions in prayer camps.”

Going forward, Golda was optimistic that the challenge of these camps can be overcome through training, training and training.

She said, the Commission was going to look for funding, and embark on a vigorous training of all stake holders involved in the positive response to HIV.

She believes once all the stakeholders are brought on board to know when to refer a person living with HIV, so they can pray while taking their ARTs, progress could be made.