THREE individuals, identified only as Jimmy, Priscilla and Elizabeth, recounted how they lost their babies under conditions they described as ‘avoidable’, in different health care facilities in Accra.
With tears in her eyes, Priscilla narrated before a sizeable crowd at a national forum on maternal health, how she narrowly escaped death as a result of bleeding after delivery. At the end of it all, she lost her baby.
Jimmy, who sounded emotional and occasionally had to stop talking to prevent himself from breaking down in tears, recounted how his wife, a first-time mother, nearly lost her life through childbirth and ended up losing the baby at a big government hospital in Accra.
For her part, Elizabeth told the painful story she had narrated many times, about the baby she lost at a private health facility she considered as a first-class one. To her, it was the case of lack of adequate professional and proper care.
In the three narrations and many others which were presented at the forum, one thing that ran through was that, at the time the women needed professional assistance, it was not received or when it was, it came too late, or was not available.
The forum being referred to here had the theme, “Stand Up and Take Action Against Maternal Deaths in Ghana”, and was organised by the Alliance for Reproductive Health Rights (ARHR) in Accra, in collaboration with the Health Platform. That was part of activities marking this year’s “Stand Up and Take Action Against Poverty” commemorated by the United Nations Development Programme (UNDP).
The purpose of the national forum, according to the organisers, was to inspire action among all stakeholders in order to improve maternal health in the country.
The event is very important, now that Ghana has officially indicated that it was not possible for the country to reduce its current child mortality of 451 per every 100,000 live birth births as contained in the 2008 Ghana MDGs report which was launched recently. The MDGs report was produced by the National Development Planning Commission (NDPC) and the United Nations Development Programme (UNDP).
At the launch of the Ghana MDGs report, it came out that while the country is said to be on track to achieving the MDGs I and II which relate to the reduction in poverty and hunger by 2015, it was not likely to achieve goals IV and V, which involved reduction in child and maternal mortality.
Part of the report stated “Maternal mortality rate at 451 deaths at 100,000 live births is high and Ghana is unlikely to attain the target of reducing by three quarters, the maternal mortality ratio between 1990 and 2015, even though maternal health care has improved over the past 20 years.”
The national forum also came off at the time that world leaders were meeting in New York to assess progress made towards the attainment of the Millennium Development Goals (MDGs) by 2015. In addition, the organisers of the national forum launched the second edition of the Civil Society Organisation’s (CSOs) Health Millennium Development Goals (MDGs) monitoring report produced by the Alliance for Reproductive Health Rights.
The content of the report, which was described by participants as excellent, is divided into eight main parts, namely, child health, care-seeking behaviour, sanitation, immunisation and maternal prophylaxis, use of treated bed nets, maternal health, HIV and AIDs and tuberculosis and malaria. The report also addresses the identified goals, targets and indicators of the official MDG list, as well as priorities indicated in the Ghana Health Service’s current Programme of Work (PoW).
The report which was reviewed by the Director of the Local Government Institute, Dr Esther Ofei Aboagye, was officially launched by Dr Rose Mensah-Kutin of ABANTU for Development. It focused on the performance and progress Ghana had made in achieving the health goals of the MDGs from the perspective of beneficiaries in those selected districts in the country.
Giving a review of the document, Dr Ofei-Aboagye named the selected districts as Agona East, Bongo, Builsa, Komenda-Edina-Eguafo-Abrem (KEEA) and Kwahu North.
She said the current report also expanded on the previous effort which involved three districts — Bongo, KEEA and Kwahu-North.
Dr Ofei-Aboagye said the low knowledge of the danger signs in pregnancy as shown in the report was a problem for which efforts to find a solution must be stepped up.
However, she said the report indicated that the fact that more women were participating in ante-natal care was rewarding, while the fact that women recognised the importance of formal facilities in the event of obstetric emergencies was also encouraging.
She also indicated that non-medical factors such as transport challenges to facility-based health care institutions in rural areas, attitude of care givers, differential interpretation of the policy on free maternal care and what the National Health Insurance Scheme paid for and what it did were still barriers to maternal health and, therefore, should not be ignored in discussions aimed at improving maternal health.
Dr Mensah-Kutin, who chaired the programme said it was unacceptable for a woman to be pregnant for nine months only to lose the baby or her life and called for concerted efforts to address the situation, adding that “zero tolerance for maternal deaths should be our target”.
Mrs Elizabeth Vaah, who set up the Vaah Foundation for Maternal Health after she lost her new-born baby in a hospital in Accra early this year, called on policy-makers to stop paying lip-service to maternal mortality and embark on urgent measures to address the issues.
For her part, the Executive Director of ARHR, Ms Vicky Okine, said the apparent sluggish progress in achieving the health-related goals required a new strategy and renewed commitment from both the government and civil society.
In her welcoming address headed: “Five years to move to 2015 - are we on track to achieve health related MDGs?”, Ms Okine said the apparent sluggish progress in achieving the health-related goals required a new strategy and renewed commitment from both the government and civil society.
She, however, acknowledged some initiatives undertaken by the government to reduce the high maternal mortality rate and mentioned the introduction of free maternal care in 2008 and pointed out that it helped nearly half a million more women to receive health care which they would not have otherwise received.
“These gains, notwithstanding, hundreds of people in Ghana and, indeed, developing countries do not get any health care at all, because there are no accessible health centres where they live or they are too costly to reach”, she stated.
Wednesday, September 29, 2010
Wednesday, September 22, 2010
A heart for life - Maintain a healthy heart (Health Page)
Cardiovascular diseases or diseases relating to the heart and blood vessels, are the world’s largest killers, claiming 17.1 million lives a year. In Ghana, more than 60 per cent of adult deaths annually is due to cardiovascular diseases and stroke.
Risk factors for heart disease and stroke include raised blood pressure, cholesterol and glucose levels, smoking, inadequate intake of fruit and vegetables, overweight, obesity and physical inactivity.
In partnership with World Health Organisation (WHO), the World Heart Federation (WHF), organises awareness events in more than 100 countries during each year’s World Heart Day. The events include health checks, organised walks, running and fitness sessions, public talks, stage shows, scientific forums, exhibitions, concerts, carnivals and sports tournaments.
The day is the WHF's most important advocacy event used to promote preventive measures to reduce cardiovascular diseases and stroke through the creation of public awareness of the risk factors of heart diseases and stroke.
The event began in 1999 out of the realisation that all World Heart Federation members could collectively help curb the global pandemic of cardiovascular diseases. Since that year, World Heart Day had been celebrated on the last Sunday of September every year. The annual slogan for the Day is "A Heart for Life", but each year the Day is dedicated to a special theme.
To commemorate this year’s event which falls on September 26 on the theme “I Work With Heart: Maintaining a Healthy Heart at the Work Place ”, organisers of the local event held a press conference in Accra on September 15 to launch a series of events. The programme is co-ordinated by the Ghana Health Service (GHS), the National Cadiothoracic Centre, the Ghana Heart Foundation, World Heart Foundation and its affiliate agencies in Ghana, the German Technical Co-operation (GTZ), among other organisations.
The concern of these organisations is to help people achieve a longer and better life through prevention and control of risk factors relating to heart diseases and stroke in Ghana.
The main function of the heart, according to information made available at the event, is to pump blood throughout the body. The heart, together with the blood vessels, make up the circulatory system of the body which is responsible for distributing oxygen and nutrients to the body and carrying away carbon dioxide and other waste products.
It indicated that indeed, the heart is the circulatory system’s power supply and must, therefore, beat ceaselessly because the body’s tissues, especially the brain and the heart itself depended on a constant supply of oxygen and nutrients delivered by the flowing blood.
According to health experts, if the heart stopped pumping blood for more than a few minutes, death will occur.
It was also stated that the heart beats about 100,000 times in a day and about 35 million times in a year. For this reason, during an average lifespan, the human heart is said to beat more than 2.5 billion times.
With the human body containing about 5.6 litres of blood which circulates through the body three times every minute, the heart pumps about 1 million barrels of blood during an average lifespan, which is enough to fill more than three super tankers. This shows how important the heart is to ones survival.
In a statement at the press conference, the Chief Executive Officer of the Ghana Chamber of Mines, Dr Joyce R. Aryee indicated that the heart’s duties were much more broader than simply pumping blood continuously throughout one’s life.
She explained that the heart must also respond to changes in the body’s demand for oxygen, adding that the heart and the rest of the circulatory system can respond almost instantaneously to shifting situations such as sleeping, standing, lying down or when a person was faced with a potentially dangerous situation.
“This indicates that our everyday actions and inaction relate to the heart, and thus at the same time pull an influence on its proper functioning”, she observed.
Dr Aryee touched on the actions of some individuals which ended up affecting the hearts of others or their own hearts negatively and stated that if we all knew about the functions of the heart and how it could be protected, the lives of the more than 17.2 million people lost globally to heart diseases and stroke annually would be saved.
For his part, a renowned Ghanaian Cardiologist, Professor Kwabena Frimpong-Boateng said there was the need for society to lead a healthy life to avoid contracting heart diseases.
Prof Frimpong-Boateng who is also the President of the Ghana Heart Foundation said one was sure to have a healthy heart if one increased his or her physical activities, ate healthy food, avoid habits such as smoking, excessive alcohol intake, burning of fire wood indoors, as well as burning of mosquito coils indoors without following instructions.
He also advised against excessive salt and sugar intake, use of aphrodisiac but urged people to consume food close to its raw state, adequate fruits and vegetables and visit the hospital regularly for checks.
Risk factors for heart disease and stroke include raised blood pressure, cholesterol and glucose levels, smoking, inadequate intake of fruit and vegetables, overweight, obesity and physical inactivity.
In partnership with World Health Organisation (WHO), the World Heart Federation (WHF), organises awareness events in more than 100 countries during each year’s World Heart Day. The events include health checks, organised walks, running and fitness sessions, public talks, stage shows, scientific forums, exhibitions, concerts, carnivals and sports tournaments.
The day is the WHF's most important advocacy event used to promote preventive measures to reduce cardiovascular diseases and stroke through the creation of public awareness of the risk factors of heart diseases and stroke.
The event began in 1999 out of the realisation that all World Heart Federation members could collectively help curb the global pandemic of cardiovascular diseases. Since that year, World Heart Day had been celebrated on the last Sunday of September every year. The annual slogan for the Day is "A Heart for Life", but each year the Day is dedicated to a special theme.
To commemorate this year’s event which falls on September 26 on the theme “I Work With Heart: Maintaining a Healthy Heart at the Work Place ”, organisers of the local event held a press conference in Accra on September 15 to launch a series of events. The programme is co-ordinated by the Ghana Health Service (GHS), the National Cadiothoracic Centre, the Ghana Heart Foundation, World Heart Foundation and its affiliate agencies in Ghana, the German Technical Co-operation (GTZ), among other organisations.
The concern of these organisations is to help people achieve a longer and better life through prevention and control of risk factors relating to heart diseases and stroke in Ghana.
The main function of the heart, according to information made available at the event, is to pump blood throughout the body. The heart, together with the blood vessels, make up the circulatory system of the body which is responsible for distributing oxygen and nutrients to the body and carrying away carbon dioxide and other waste products.
It indicated that indeed, the heart is the circulatory system’s power supply and must, therefore, beat ceaselessly because the body’s tissues, especially the brain and the heart itself depended on a constant supply of oxygen and nutrients delivered by the flowing blood.
According to health experts, if the heart stopped pumping blood for more than a few minutes, death will occur.
It was also stated that the heart beats about 100,000 times in a day and about 35 million times in a year. For this reason, during an average lifespan, the human heart is said to beat more than 2.5 billion times.
With the human body containing about 5.6 litres of blood which circulates through the body three times every minute, the heart pumps about 1 million barrels of blood during an average lifespan, which is enough to fill more than three super tankers. This shows how important the heart is to ones survival.
In a statement at the press conference, the Chief Executive Officer of the Ghana Chamber of Mines, Dr Joyce R. Aryee indicated that the heart’s duties were much more broader than simply pumping blood continuously throughout one’s life.
She explained that the heart must also respond to changes in the body’s demand for oxygen, adding that the heart and the rest of the circulatory system can respond almost instantaneously to shifting situations such as sleeping, standing, lying down or when a person was faced with a potentially dangerous situation.
“This indicates that our everyday actions and inaction relate to the heart, and thus at the same time pull an influence on its proper functioning”, she observed.
Dr Aryee touched on the actions of some individuals which ended up affecting the hearts of others or their own hearts negatively and stated that if we all knew about the functions of the heart and how it could be protected, the lives of the more than 17.2 million people lost globally to heart diseases and stroke annually would be saved.
For his part, a renowned Ghanaian Cardiologist, Professor Kwabena Frimpong-Boateng said there was the need for society to lead a healthy life to avoid contracting heart diseases.
Prof Frimpong-Boateng who is also the President of the Ghana Heart Foundation said one was sure to have a healthy heart if one increased his or her physical activities, ate healthy food, avoid habits such as smoking, excessive alcohol intake, burning of fire wood indoors, as well as burning of mosquito coils indoors without following instructions.
He also advised against excessive salt and sugar intake, use of aphrodisiac but urged people to consume food close to its raw state, adequate fruits and vegetables and visit the hospital regularly for checks.
Monday, September 20, 2010
306,592 vaccinated against H1N1 influenza
Sat. 18-09-2010
THE Greater Accra Regional Health Directorate says it has vaccinated a total of 306,592 people against the H1N1 influenza as of July this year.
The figure comprise 26,687 health workers, 15,811 security personnel, 24,496 pregnant women, 18,836 persons with chronic diseases, 12,867 international travellers and 207,895 members of the public.
As part of the directorate’s efforts to educate the public on the safety of the vaccine, the regional team headed by the Co-ordinator on H1N1, Dr Vera Opata, reiterated in a report that the vaccine, Pandemrix, was highly safe by the World Health Organisation (WHO) standards.
“Pandemrix is what is used to vaccinate people in foreign countries before it was exported to our country”, the reported stated.
To ensure an H1N1 free region, as well as a healthy country, the health service had entreated the public who had not yet received the vaccine to do so at the public hospitals where few of the vaccine were available.
It pointed out of the 306,592 people who had been vaccinated in the Greater Accra Region, 360 persons, making 0.1 per cent had reported any adverse effects.
The report went further to state that all the complaints were based on what was classified as the common side effects such as headache, fever and pain at the site of the injection.
“We are assuring the general public that the vaccine (Pandemrix) is highly safe. Several clinical studies were done to ensure its safety to human beings”, it pointed out.
The report however, explained that the vaccine was for individuals between the ages of 18 and 60, adding that people who had previously had sudden life threatening allergic reaction to certain items such egg and chicken protein, a chemical called formaldehyde, gentamicin sulphate ( a form of antibiotic), as well as soduim deoxycholate should avoid the vaccine.
It also that stated people suffering from severe infection with high temperature (over 38 C) should postpone the vaccination till temperature subsides and also women in the first three months of pregnancy, as well as others who had once been infected with H1N1 influenza and had been treated were all excempted from the vaccination.
It pointed out that like all medicines, the vaccine could cause side effects, although not everybody got them.He went further to state that emergency treatment was available for use in case of individuals experiencing any form of reaction.
“Anybody who experiences any of the side effects should report to where he or she received the vaccination or the nearest health facility”, it pointed out.
THE Greater Accra Regional Health Directorate says it has vaccinated a total of 306,592 people against the H1N1 influenza as of July this year.
The figure comprise 26,687 health workers, 15,811 security personnel, 24,496 pregnant women, 18,836 persons with chronic diseases, 12,867 international travellers and 207,895 members of the public.
As part of the directorate’s efforts to educate the public on the safety of the vaccine, the regional team headed by the Co-ordinator on H1N1, Dr Vera Opata, reiterated in a report that the vaccine, Pandemrix, was highly safe by the World Health Organisation (WHO) standards.
“Pandemrix is what is used to vaccinate people in foreign countries before it was exported to our country”, the reported stated.
To ensure an H1N1 free region, as well as a healthy country, the health service had entreated the public who had not yet received the vaccine to do so at the public hospitals where few of the vaccine were available.
It pointed out of the 306,592 people who had been vaccinated in the Greater Accra Region, 360 persons, making 0.1 per cent had reported any adverse effects.
The report went further to state that all the complaints were based on what was classified as the common side effects such as headache, fever and pain at the site of the injection.
“We are assuring the general public that the vaccine (Pandemrix) is highly safe. Several clinical studies were done to ensure its safety to human beings”, it pointed out.
The report however, explained that the vaccine was for individuals between the ages of 18 and 60, adding that people who had previously had sudden life threatening allergic reaction to certain items such egg and chicken protein, a chemical called formaldehyde, gentamicin sulphate ( a form of antibiotic), as well as soduim deoxycholate should avoid the vaccine.
It also that stated people suffering from severe infection with high temperature (over 38 C) should postpone the vaccination till temperature subsides and also women in the first three months of pregnancy, as well as others who had once been infected with H1N1 influenza and had been treated were all excempted from the vaccination.
It pointed out that like all medicines, the vaccine could cause side effects, although not everybody got them.He went further to state that emergency treatment was available for use in case of individuals experiencing any form of reaction.
“Anybody who experiences any of the side effects should report to where he or she received the vaccination or the nearest health facility”, it pointed out.
Ghana on track to achieve MDGs
15-09-2010
GHANA is said to be on track to achieving the Millennium Development Goals (MDGs) 1 and II, which deal with the reduction in poverty and hunger by 2015.
According to the 2008 Ghana Millennium Development Goals (MDGs) report, which was launched by the National Development Planning Commission (NDPC) in Accra yesterday, available data collected in 2006 shows that Ghana was largely on track in achieving the MDG 1 target by reducing by half the proportion of the population living in extreme poverty.
The report, which was presented by Dr Peter Quartey of the University of Ghana, said that although current data on poverty was not available, trends in economic growth suggested that there was a further decline in poverty between 2006 and 2008.
Dr Quartey said some of the interventions, which had helped in the area of poverty reduction were the Growth and Poverty Reduction Strategy, Livelihood and Empowerment Programme (LEAP), the National Health Insurance Scheme (NHIS), and Micro-Financing Initiative among others.
He, however, indicated that the country was not likely to achieve goals IV and V, which involved reduction in child and maternal mortality, and called for concerted efforts in that direction.
Other targets that the country was having serious challenges with were: Combating HIV and AIDS, malaria and other diseases; and also ensuring environmental sustainability, which are goals VI and VII respectively.
In a critical review of the report, Professor Clara Fayorsey, Head of the Sociology Department of the University of Ghana, urged stakeholders to take cognisance of the micro-economic climate in assessing the progress so far made in the country.
She pointed out that there were times that statistics presented at the national level differed from the actual situation on the ground, adding that “Macro indicators are fine, but do not reflect adequately the micro situation”.
The UN Resident Co-ordinator and the UNDP Resident Representative in Ghana, Ms Ruby Sandhu-Rojon, said the MDGs had become a single development compact providing a remarkable framework for both developed and developing countries to work towards a common goal.
She said the UN system had, since the adoption of the MDGs in 2000, provided financial, technical, advisory, training, logistic and infrastructural support to the private sector and civil society organisations to deliver on the goals.
Ms Sandhu-Rojon commended Ghana for its efforts, saying that the country had been chosen from a few countries to gather evidence for international analysis on the MDG progress, good practices and experiences, as well as challenges and opportunities for acceleration.
In her welcoming address, the Director General of the NDPC, Dr Regina Adutwum, indicated that the 2008 MDG report was the fourth of such reports to be issued by Ghana and explained that there were others in 2002, 2004 and 2006.
She urged the country’s ministries, departments and agencies (MDAs), as well as institutions, civic society groups and individuals, to play their respective roles to ensure that the country moved ahead in terms of target achievement before 2015.
The Chairman of the NDPC, Mr Paul Victor Obeng, said people sometimes assumed that the MDGs were meant for others and rather advised them to consider the goals as their own and do well to ensure that they were achieved.
GHANA is said to be on track to achieving the Millennium Development Goals (MDGs) 1 and II, which deal with the reduction in poverty and hunger by 2015.
According to the 2008 Ghana Millennium Development Goals (MDGs) report, which was launched by the National Development Planning Commission (NDPC) in Accra yesterday, available data collected in 2006 shows that Ghana was largely on track in achieving the MDG 1 target by reducing by half the proportion of the population living in extreme poverty.
The report, which was presented by Dr Peter Quartey of the University of Ghana, said that although current data on poverty was not available, trends in economic growth suggested that there was a further decline in poverty between 2006 and 2008.
Dr Quartey said some of the interventions, which had helped in the area of poverty reduction were the Growth and Poverty Reduction Strategy, Livelihood and Empowerment Programme (LEAP), the National Health Insurance Scheme (NHIS), and Micro-Financing Initiative among others.
He, however, indicated that the country was not likely to achieve goals IV and V, which involved reduction in child and maternal mortality, and called for concerted efforts in that direction.
Other targets that the country was having serious challenges with were: Combating HIV and AIDS, malaria and other diseases; and also ensuring environmental sustainability, which are goals VI and VII respectively.
In a critical review of the report, Professor Clara Fayorsey, Head of the Sociology Department of the University of Ghana, urged stakeholders to take cognisance of the micro-economic climate in assessing the progress so far made in the country.
She pointed out that there were times that statistics presented at the national level differed from the actual situation on the ground, adding that “Macro indicators are fine, but do not reflect adequately the micro situation”.
The UN Resident Co-ordinator and the UNDP Resident Representative in Ghana, Ms Ruby Sandhu-Rojon, said the MDGs had become a single development compact providing a remarkable framework for both developed and developing countries to work towards a common goal.
She said the UN system had, since the adoption of the MDGs in 2000, provided financial, technical, advisory, training, logistic and infrastructural support to the private sector and civil society organisations to deliver on the goals.
Ms Sandhu-Rojon commended Ghana for its efforts, saying that the country had been chosen from a few countries to gather evidence for international analysis on the MDG progress, good practices and experiences, as well as challenges and opportunities for acceleration.
In her welcoming address, the Director General of the NDPC, Dr Regina Adutwum, indicated that the 2008 MDG report was the fourth of such reports to be issued by Ghana and explained that there were others in 2002, 2004 and 2006.
She urged the country’s ministries, departments and agencies (MDAs), as well as institutions, civic society groups and individuals, to play their respective roles to ensure that the country moved ahead in terms of target achievement before 2015.
The Chairman of the NDPC, Mr Paul Victor Obeng, said people sometimes assumed that the MDGs were meant for others and rather advised them to consider the goals as their own and do well to ensure that they were achieved.
Wednesday, August 4, 2010
Traditional medicine practice provides jobs (Graphic Business)
MORE than 60 per cent of Ghanaians are said to be relying on traditional medicine. In addition, a reliable statistics show that the number of traditional medicine practitioners in the country is more than 20,000.
At the West Africa Health Association (WAHO) Day in Accra on July 9, the Minister of Health, Dr Benjamin Kunbour said the public health sector intended to implement plans on integration of traditional and complementary medicine that had seen continuing development of the programme-of-work (POW) of the health sector for more than two decades.
The theme for the commemoration was "Promoting Quality Improvement and Rational Use of Traditional Medicines".
The Health of Minister said "The integrative health care programme is expected to contribute to job creation, disease prevention and the well being of the population".
The above stated figures is a clear indication in which traditional medicine had been a source of job as well as health care of many Ghanaians.
As part of the commemoration an exhibition was mounted at the premises of the British Council where a wide range of herbal medicines were displayed either for sale or for just for show to the public.
Among the herbal preparations were anti-malaria medicines, medicines for skin diseases, sores, boils, piles, aphrodisiac, bodily pains, body cream, soap and many more.
Prominent among the exhibitors was the Council for Scientific Research into Plant Medicine at Mampong Akuapem which displayed variety of well packaged medicines which syrups, capsules, powders and creams, among other preparations.
Addressing the participants who were mainly traditional medical practitioners, Dr Kunbour touched on an issue which had been a source of worry to many Ghanaians which is the case of advertising ones ability to cure diseases.
He took the opportunity to remind health care providers to desist from claiming publicly their ability to cure certain diseases which is contrary to the law.
"The Food and Drugs Board (FDB) PNDC Law 305B Section 15 Schedule 11, prohibits advertisements for some listed diseases which include severe infectious diseases, diseases related to reproductive health, pregnancies and important/ vital organs of the body”, the Minister indicated.
Under the law, a medical enterprise may make discrete announcements about opening, working hours and services offered but not to go into details concerning certain diseases.
Although clients who benefited from a particular health care facility could advertise the services of such a practitioner, the practitioner involved could not use the same comments by the clients to make advertised claims.
For his part, the Director General of the Ghana Health Service (GHS) Dr Elias Sory who was the Chairman for the occasion said very soon traditional medicine would be seen in the country's public sector health care facilities.
Dr Sory, who personally vouched for the efficacy and efficiency of some local herbal preparations said there was enough evidence to show that traditional medicine had been used effectively in time past adding that the only challenge was the fact that there were no documentation to ensure continues use of such medicines.
Manufacturers were however advised to endeavour to make their products available when the time came to sustain their use in the public health sector.
It be would be wrong for hospitals to start prescribing herbal medicines in hospitals only to realise that their supply was not continues. That would be a disincentive to those who advocated the use of such medicines in the hospitals.
It is important for Agya Kwaku Appiah and his group in the traditional medical practice to take advantage of the move and prove a point to all who do not believe in traditional medicine.
When he was given the opportunity to welcome the participants, the Director of Human Resource at the Ministry of Health, Dr Ebenezer Appiah-Denkyira said there were sound reasons for traditional medicine to be promoted and integrated into mainstream health care.
The Chairman of the Traditional Medical Council, Dr E.N Mensah called for adequate funding for the training of medical herbalists and also advised practitioners to go according to the code of ethics of the practice to win support and respect by all.
The Director in charge of Traditional and Alternative Medicine at the MOH, Mr Peter Arhin stated that the WAHO had support Ghana and the other ECOWAS member-states to develop their individual traditional medicines for the benefit of their peoples.
The Focal Person of WAHO at the MOH, Mrs Emma Osei Agyeman educated the participants on the issues of WAHO and the moves the organisation was making to improve on traditional medicine practice in the member countries.
As part of the event, there was a launch of a new traditional medicine documents for the strategic period 2010 to 2014. There was also an exhibition of some traditional medicines.
July 9 has been set aside to review activities of the West Africa Health Organisation. The day is to promote international collaboration in combating health challenges in the sub-region and facilitate sustainable improvements in health programmes and outcomes.
At the West Africa Health Association (WAHO) Day in Accra on July 9, the Minister of Health, Dr Benjamin Kunbour said the public health sector intended to implement plans on integration of traditional and complementary medicine that had seen continuing development of the programme-of-work (POW) of the health sector for more than two decades.
The theme for the commemoration was "Promoting Quality Improvement and Rational Use of Traditional Medicines".
The Health of Minister said "The integrative health care programme is expected to contribute to job creation, disease prevention and the well being of the population".
The above stated figures is a clear indication in which traditional medicine had been a source of job as well as health care of many Ghanaians.
As part of the commemoration an exhibition was mounted at the premises of the British Council where a wide range of herbal medicines were displayed either for sale or for just for show to the public.
Among the herbal preparations were anti-malaria medicines, medicines for skin diseases, sores, boils, piles, aphrodisiac, bodily pains, body cream, soap and many more.
Prominent among the exhibitors was the Council for Scientific Research into Plant Medicine at Mampong Akuapem which displayed variety of well packaged medicines which syrups, capsules, powders and creams, among other preparations.
Addressing the participants who were mainly traditional medical practitioners, Dr Kunbour touched on an issue which had been a source of worry to many Ghanaians which is the case of advertising ones ability to cure diseases.
He took the opportunity to remind health care providers to desist from claiming publicly their ability to cure certain diseases which is contrary to the law.
"The Food and Drugs Board (FDB) PNDC Law 305B Section 15 Schedule 11, prohibits advertisements for some listed diseases which include severe infectious diseases, diseases related to reproductive health, pregnancies and important/ vital organs of the body”, the Minister indicated.
Under the law, a medical enterprise may make discrete announcements about opening, working hours and services offered but not to go into details concerning certain diseases.
Although clients who benefited from a particular health care facility could advertise the services of such a practitioner, the practitioner involved could not use the same comments by the clients to make advertised claims.
For his part, the Director General of the Ghana Health Service (GHS) Dr Elias Sory who was the Chairman for the occasion said very soon traditional medicine would be seen in the country's public sector health care facilities.
Dr Sory, who personally vouched for the efficacy and efficiency of some local herbal preparations said there was enough evidence to show that traditional medicine had been used effectively in time past adding that the only challenge was the fact that there were no documentation to ensure continues use of such medicines.
Manufacturers were however advised to endeavour to make their products available when the time came to sustain their use in the public health sector.
It be would be wrong for hospitals to start prescribing herbal medicines in hospitals only to realise that their supply was not continues. That would be a disincentive to those who advocated the use of such medicines in the hospitals.
It is important for Agya Kwaku Appiah and his group in the traditional medical practice to take advantage of the move and prove a point to all who do not believe in traditional medicine.
When he was given the opportunity to welcome the participants, the Director of Human Resource at the Ministry of Health, Dr Ebenezer Appiah-Denkyira said there were sound reasons for traditional medicine to be promoted and integrated into mainstream health care.
The Chairman of the Traditional Medical Council, Dr E.N Mensah called for adequate funding for the training of medical herbalists and also advised practitioners to go according to the code of ethics of the practice to win support and respect by all.
The Director in charge of Traditional and Alternative Medicine at the MOH, Mr Peter Arhin stated that the WAHO had support Ghana and the other ECOWAS member-states to develop their individual traditional medicines for the benefit of their peoples.
The Focal Person of WAHO at the MOH, Mrs Emma Osei Agyeman educated the participants on the issues of WAHO and the moves the organisation was making to improve on traditional medicine practice in the member countries.
As part of the event, there was a launch of a new traditional medicine documents for the strategic period 2010 to 2014. There was also an exhibition of some traditional medicines.
July 9 has been set aside to review activities of the West Africa Health Organisation. The day is to promote international collaboration in combating health challenges in the sub-region and facilitate sustainable improvements in health programmes and outcomes.
Friday, July 30, 2010
HIV and AIDS — The fear of knowing
Friday, July 30, 2010 (Daily Graphic Pg 16/17)
By: Lucy Adoma Yeboah and Rebecca Quaicoe-Duho
The 18th International HIV/AIDS Conference ended last week in Vienna, Austria, with the chilling disclosure that about 10 million people are in dire need of treatment from the pandemic. In poor countries, the situation is further aggravated by the multiplicity of ignorance, the fear of knowing one’s status and the stigma associated with it. But, in all, Ghana appears to be making giant strides.
THIRTY-SIX-year-old Emelia (not her real name) did not know her HIV status when she got pregnant in 1999. Although she was delivered of a baby boy, he died from complications of pneumonia after a month.
In 2002, she got pregnant again, did not check her HIV status and was delivered of a dead foetus prematurely in her seventh month.
Testifying about her experience in Accra, she said she had always believed she was a healthy person, knowing little about her HIV positive status until her first child died and her second was aborted prematurely.
Today, because of the informed decision to undergo voluntary counselling and testing (VCT), she now has a five-year- old daughter delivered successfully at the Korle-Bu Teaching Hospital and a year-old son delivered at the Ridge Hospital in Accra.
According to Emelia, with her knowledge of her HIV status, she informed her doctor, together with her husband who, however, tested negative, when they were ready to have children.
She was put on special drugs and the two were counselled on techniques of sex without passing on the infection to the husband or the children who might result from the union.
Within a month of close monitoring by her doctor, Emelia got pregnant and was referred to Korle-Bu, where she was put on a prevention of mother to child therapy (PMTCT) when she was 14 weeks into the pregnancy.
With all the effort, her laboratory results proved that she and her baby were healthy and she opted for normal delivery, which was successful.
She repeated the same process for her second child, who is a year old and was negative as of the first test conducted on him when he was six months, although subsequent tests would have to be done to confirm his status.
For Emelia and others like her, the introduction of the PMTCT has facilitated the safe delivery of healthy babies who are HIV free.
Apart from the counselling, it involves the education of HIV positive mothers by health professionals on safe breast-feeding techniques in order not to pass the virus on to their children,
Emelia now encourages all women to arm themselves with the knowledge of their HIV status to help them make informed decisions for the health of their children.
Currently, she belongs to a women's support group made up of those living with HIV and, according to her, through informed choices, they and their children, together with their husbands, are living positively.
Doctor’s perspective
Dr Joseph Oliver-Commey of the Fevers Unit at the Korle-Bu Teaching Hospital said positive cases such as Emelia's were possible if women took the destiny of their unborn children into their own hands and opted for VCT.
According to him, the unit taught discordant couples, that is, couples who have the woman positive and the man negative, the technique of having sex to achieve pregnancy without the woman infecting the man.
He made reference to a case in which a couple who had the woman positive had three children, with the eldest, nine, being HIV positive, the second, seven, negative, while the third, six months, was yet to be tested when it was a year and a half.
He said the PMTCT, which reduced new infection, was doing well in the country and called on pregnant women not to think about themselves alone but also think about the health of their babies to reduce new infections in the country.
He said women whose CD4 count was above 400 were, however, put on prophylactics when they were 28 weeks pregnant, while those who, although positive, had not undergone any treatment, were given a single dose drug to prevent mother-to-child transmission.
Sometimes, according to him, to ensure double safety, babies delivered were put on infant formulas to ensure that they were totally prevented from getting into contact with the virus, as the virus was easily transmitted through fluids, such as breast milk and vaginal fluid.
Treatment
Mother-to-child transmission (MTCT) is when an HIV-infected pregnant woman passes the virus on to her baby.
This can occur during pregnancy, labour and delivery, or breast-feeding.
According to a World Health Organisation (WHO) research, without treatment, around 15-30 per cent of babies born to HIV positive women will become infected during pregnancy and delivery.
A further 5-20 per cent will be infected through breast-feeding.
The PMTCT, according to the WHO, accounted for more than 700,000 estimated new HIV infections in children world-wide annually.
Without intervention, experts say, HIV-infected mothers have a 35 per cent overall risk of transmitting the virus to their children during pregnancy, delivery and breast-feeding.
However, an effective prevention of MTCT can occur when HIV testing and other preventive interventions are made available in services related to sexual health, such as, ante-natal and post-partum care.
Clinical trials have demonstrated that anti-retroviral (ARV) prophylactics, when administered to mothers and their newly born babies, can reduce the risk of MTCT by approximately 75 per cent.
A PMTCT guideline by the WHO indicates that mothers, when identified in pregnancy as being HIV positive, should have a CD4 test to determine whether they need to take medication for their own health or that of their unborn infants. If their CD4 count is below or equal to 350, they are required to start taking anti-retroviral drugs for their own health. If a woman has a CD4 count higher than 350, then she does not need to take medication for her own health. However, she will need to take medication to prevent HIV transmission to her infant.
In a November 2009 HIV and AIDS guidelines on PMTCT, HIV and breast-feeding by the WHO, the international body on health prescribed that all HIV positive mothers, identified during pregnancy, should receive a course of anti-retroviral drugs to prevent MTCT. Also, all infants born to HIV positive mothers should also receive a course of anti-retroviral drugs and should receive exclusive breast-feeding for six months, with other complementary feed for up to a year when the breast-feeding had to be stopped.
According to Dr Oliver-Commey, providing appropriate counselling and support for women living with HIV to enable them to make informed decisions about their reproductive lives and prevent the transmission of HIV from positive mothers to infants during pregnancy, labour, delivery and breast-feeding were gold standards approved by the WHO.
Benefits
The Fevers Unit of the Korle-Bu Teaching Hospital in Accra started the PMTCT intervention in 2005 and since then a lot of HIV positive mothers and their babies have benefited from the service.
A resent survey of 80 pregnant women who underwent treatment at the Children's Hospital at Korle-Bu saw only three being positive, emphasising the recommendations of doctors at the unit that pregnant women opt for VCT to save the lives of their unborn children.
Dr Oliver-Commey said to help reduce MTCT, a single dose of nevirapine was given to the mother at the onset of labour and to the baby after delivery and that roughly halved the rate of HIV transmission.
He explained that it was possible for an infected mother to successfully wean her child, as the ART taken during and after birth was aimed at reducing the viral load, a situation which suppresses the virus, making it impossible to be transmitted.
Many children's lives had been saved since the intervention was introduced, the doctor said, adding that the unit could boast of its oldest child who was currently five and who had benefited from PMTCT and was living an HIV free life.
Today, he said, over 50 women were on PMTCT at the unit, since the hospital was a referral centre and received a lot of cases from other health centres from across the country.
To achieve better results, an integrated HIV care, treatment and support for women found to be positive and their families, known as PMTCT plus (PMTCT+), was recommended by Dr Oliver-Commey.
He said the PMTCT+ targeted partners who, when tested and found to be negative, were encouraged to support their wives who were positive. However, when they were found to be positive themselves, both were linked to appropriate care at the unit.
All is not rosy at the unit, as indicated by Dr Oliver-Commey, as it faced difficult challenges which made it impossible for it to meet recommended WHO standards on PMTCT.
He indicated that although it was ideal that HIV positive women went through caesarean sections (CS) to prevent the mother transmitting the virus to the baby when delivering, the problem in the country, however, was that a lot of hospitals and clinics did not have the capacity to perform CS on HIV positive mothers and, therefore, referred them to the three teaching hospitals and other few health facilities that provided the service.
Risks
Dr Oliver-Commey indicated that most of those women ended up opting for normal delivery because they would have to join a long queue of women who were also waiting for CS to be performed on them, placing their babies at a higher risk of being infected with the virus.
However, he pointed out, when babies were born through the normal delivery process by an HIV infected mother, within the first week they were taken through an early infant diagnosis with polymerise chain reaction (PCR), which is a device used to determine their status, or they were put on ART and linked to the Child Health Department where they were referred to special clinics for children exposed to HIV.
Those babies were then tested after a year and a half when, by then, they were believed to have shed off their mothers anti-bodies and were able to produce their own anti-bodies.
In spite of the availability of life-saving interventions for both mother and child, some pregnant women who test positive for HIV refuse to avail themselves for medical care.
Stigma
That deadly decision could be attributed to the fear of stigmatisation people who are known to have contracted the virus go through.
Some of the women take that decision, having at the back of their minds the notion that their partners may abandon them if they get to know of their status.
At a recent review meeting organised by the Ghana AIDS Commission (GAC) in Accra, a private midwife and proprietress of God’s Gift Maternity Home at Ekumfi Ekrawfo in the Mfantseman District in the Central Region, Madam Gifty Mante, talked about how some pregnant women who tested positive pleaded with her to keep the information to herself.
The sad aspect of the situation, according to her, was that those HIV positive pregnant women failed to return to the facility for the needed medical care which could save them and their unborn babies. For fear of stigmatisation, they would rather prefer to keep the infection to themselves and die, instead of visiting the hospital where they could be provided with anti-retroviral therapy for their survival and that of their babies.
The fear of others knowing about their predicament was enough to keep them away from the appropriate medical care.
A typical example could be drawn from the case of a member of an association of People Living with HIV (PLHIV) in Koforidua in the Eastern Region (Matthew Chapter 25) in which a middle-aged woman narrated to journalists how her husband of 15 years abandoned her and her children when he got to know that she had tested positive for HIV. Her husband refused to heed a doctor’s advice to also go for counselling and testing but left her and went ahead to stay with another woman.
Currently, health workers the world over are trying hard to prevent as many babies as possible from getting infected by their mothers.
Another member indicated that she was dismissed from a private school where she was teaching and also ejected from her rented accommodation when a nurse allegedly told her employer about her HIV status.
The provision of anti-retroviral therapy in the public healthcare system started in Ghana in June 2003 at two pilot sites in the Manya Krobo District. This was part of a comprehensive care package that also included the provision of Counselling and Testing, and Prevention of Mother to Child Transmission (CT/PMTCT).
Currently, 138 sites are available nation-wide for the administration of ART and other HIV prevention services, including PMTCT.
A success story of that programme (PMTCT) could be found at the St Dominic Hospital at Akwatia in the Eastern Region where the hospital was considered the first health facility in Ghana to prevent the highest number of children from being infected with HIV from their HIV-positive mothers.
Statistics
Reports from the hospital gathered in 2009 indicated that only one out of 32 babies whose mothers were HIV positive and were, therefore, put on treatment under the PMTCT tested positive.
The figure represents 96.9 per cent of the children whose mothers received the intervention.
The Head of the Public Health Department of the hospital, Dr Nana Owusu-Ensaw, said as part of the preventive measures, mothers of the children were given special medication during labour and their babies placed under formula feeding for 18 months.
He said that was to prevent the children from being breast-fed, which could have exposed them to HIV infection from their infected mothers.
In an interview with The Mirror, Dr Owusu-Ensaw said the PMTCT programme was established at the hospital in 2005 to educate all pregnant mothers on HIV and AIDS due to the high prevalence of MTCT of HIV in the district and the country as a whole.
He explained that from July 2007 to May 2008, 62 children born to mothers who were given special care during labour were put under monitoring for 18 months.
Dr Owusu-Ensaw said out of the 62 children, 32, which stood for 51.6 per cent, could be traced, while 30, representing 48.4 per cent, could not be traced and were, therefore, not monitored.
He said after the 18-month period, the 32 children who were traced were tested for HIV and that was when it came out that only one had the virus.
Negative
“That means 31 of them, which represents 96.9 per cent, were negative, while the remaining one, which is 3.1 per cent, was positive,” he stressed.
Dr Owusu-Ensaw said the facility was able to trace those 32 children because they were placed under formula feeding which was given to them by the Public Health Unit of the hospital free of charge.
“The above results indicate that PMTCT works and we hereby encourage all pregnant women to undergo HIV testing to know their status so that interventions can be put in place to save their babies,” he said.
He said a challenge involved the high cost of baby formula for feeding the babies, noting that one baby consumed about six tins a month.
He also said monitoring the mothers was expensive in terms of the transportation cost involved and expressed concern over the issue of pregnant women who gave wrong addresses for fear of stigmatisation, which resulted in the inability to trace them.
That, according to the doctor, was why some babies could not be traced for final testing after the 18-month period.
The first AIDS cases were reported in Ghana in 1986. By the end of September 2003, a cumulative total of 72,541 AIDS cases had been reported. This figure is probably 30 per cent of the estimated AIDS cases in the country. Current estimates, however, put the actual number of cases closer to 370,000.
Cases have been reported in all the 10 regions, as well as in all age groups. There are, however, important regional variations in the reported AIDS cases. This can be attributed to various factors, such as the composition of the population of the regions, availability of public health institutions, the stage of the epidemic and the health seeking behaviour of the people.
To eliminate stigmatisation and discrimination against PLHIV, the Director-General of the GAC, Dr Angela El-Adas, and the other officials in her outfit has, on numerous occasions, spoken against that, knowing very well that if not stopped, it will continue to hamper control of the pandemic.
By: Lucy Adoma Yeboah and Rebecca Quaicoe-Duho
The 18th International HIV/AIDS Conference ended last week in Vienna, Austria, with the chilling disclosure that about 10 million people are in dire need of treatment from the pandemic. In poor countries, the situation is further aggravated by the multiplicity of ignorance, the fear of knowing one’s status and the stigma associated with it. But, in all, Ghana appears to be making giant strides.
THIRTY-SIX-year-old Emelia (not her real name) did not know her HIV status when she got pregnant in 1999. Although she was delivered of a baby boy, he died from complications of pneumonia after a month.
In 2002, she got pregnant again, did not check her HIV status and was delivered of a dead foetus prematurely in her seventh month.
Testifying about her experience in Accra, she said she had always believed she was a healthy person, knowing little about her HIV positive status until her first child died and her second was aborted prematurely.
Today, because of the informed decision to undergo voluntary counselling and testing (VCT), she now has a five-year- old daughter delivered successfully at the Korle-Bu Teaching Hospital and a year-old son delivered at the Ridge Hospital in Accra.
According to Emelia, with her knowledge of her HIV status, she informed her doctor, together with her husband who, however, tested negative, when they were ready to have children.
She was put on special drugs and the two were counselled on techniques of sex without passing on the infection to the husband or the children who might result from the union.
Within a month of close monitoring by her doctor, Emelia got pregnant and was referred to Korle-Bu, where she was put on a prevention of mother to child therapy (PMTCT) when she was 14 weeks into the pregnancy.
With all the effort, her laboratory results proved that she and her baby were healthy and she opted for normal delivery, which was successful.
She repeated the same process for her second child, who is a year old and was negative as of the first test conducted on him when he was six months, although subsequent tests would have to be done to confirm his status.
For Emelia and others like her, the introduction of the PMTCT has facilitated the safe delivery of healthy babies who are HIV free.
Apart from the counselling, it involves the education of HIV positive mothers by health professionals on safe breast-feeding techniques in order not to pass the virus on to their children,
Emelia now encourages all women to arm themselves with the knowledge of their HIV status to help them make informed decisions for the health of their children.
Currently, she belongs to a women's support group made up of those living with HIV and, according to her, through informed choices, they and their children, together with their husbands, are living positively.
Doctor’s perspective
Dr Joseph Oliver-Commey of the Fevers Unit at the Korle-Bu Teaching Hospital said positive cases such as Emelia's were possible if women took the destiny of their unborn children into their own hands and opted for VCT.
According to him, the unit taught discordant couples, that is, couples who have the woman positive and the man negative, the technique of having sex to achieve pregnancy without the woman infecting the man.
He made reference to a case in which a couple who had the woman positive had three children, with the eldest, nine, being HIV positive, the second, seven, negative, while the third, six months, was yet to be tested when it was a year and a half.
He said the PMTCT, which reduced new infection, was doing well in the country and called on pregnant women not to think about themselves alone but also think about the health of their babies to reduce new infections in the country.
He said women whose CD4 count was above 400 were, however, put on prophylactics when they were 28 weeks pregnant, while those who, although positive, had not undergone any treatment, were given a single dose drug to prevent mother-to-child transmission.
Sometimes, according to him, to ensure double safety, babies delivered were put on infant formulas to ensure that they were totally prevented from getting into contact with the virus, as the virus was easily transmitted through fluids, such as breast milk and vaginal fluid.
Treatment
Mother-to-child transmission (MTCT) is when an HIV-infected pregnant woman passes the virus on to her baby.
This can occur during pregnancy, labour and delivery, or breast-feeding.
According to a World Health Organisation (WHO) research, without treatment, around 15-30 per cent of babies born to HIV positive women will become infected during pregnancy and delivery.
A further 5-20 per cent will be infected through breast-feeding.
The PMTCT, according to the WHO, accounted for more than 700,000 estimated new HIV infections in children world-wide annually.
Without intervention, experts say, HIV-infected mothers have a 35 per cent overall risk of transmitting the virus to their children during pregnancy, delivery and breast-feeding.
However, an effective prevention of MTCT can occur when HIV testing and other preventive interventions are made available in services related to sexual health, such as, ante-natal and post-partum care.
Clinical trials have demonstrated that anti-retroviral (ARV) prophylactics, when administered to mothers and their newly born babies, can reduce the risk of MTCT by approximately 75 per cent.
A PMTCT guideline by the WHO indicates that mothers, when identified in pregnancy as being HIV positive, should have a CD4 test to determine whether they need to take medication for their own health or that of their unborn infants. If their CD4 count is below or equal to 350, they are required to start taking anti-retroviral drugs for their own health. If a woman has a CD4 count higher than 350, then she does not need to take medication for her own health. However, she will need to take medication to prevent HIV transmission to her infant.
In a November 2009 HIV and AIDS guidelines on PMTCT, HIV and breast-feeding by the WHO, the international body on health prescribed that all HIV positive mothers, identified during pregnancy, should receive a course of anti-retroviral drugs to prevent MTCT. Also, all infants born to HIV positive mothers should also receive a course of anti-retroviral drugs and should receive exclusive breast-feeding for six months, with other complementary feed for up to a year when the breast-feeding had to be stopped.
According to Dr Oliver-Commey, providing appropriate counselling and support for women living with HIV to enable them to make informed decisions about their reproductive lives and prevent the transmission of HIV from positive mothers to infants during pregnancy, labour, delivery and breast-feeding were gold standards approved by the WHO.
Benefits
The Fevers Unit of the Korle-Bu Teaching Hospital in Accra started the PMTCT intervention in 2005 and since then a lot of HIV positive mothers and their babies have benefited from the service.
A resent survey of 80 pregnant women who underwent treatment at the Children's Hospital at Korle-Bu saw only three being positive, emphasising the recommendations of doctors at the unit that pregnant women opt for VCT to save the lives of their unborn children.
Dr Oliver-Commey said to help reduce MTCT, a single dose of nevirapine was given to the mother at the onset of labour and to the baby after delivery and that roughly halved the rate of HIV transmission.
He explained that it was possible for an infected mother to successfully wean her child, as the ART taken during and after birth was aimed at reducing the viral load, a situation which suppresses the virus, making it impossible to be transmitted.
Many children's lives had been saved since the intervention was introduced, the doctor said, adding that the unit could boast of its oldest child who was currently five and who had benefited from PMTCT and was living an HIV free life.
Today, he said, over 50 women were on PMTCT at the unit, since the hospital was a referral centre and received a lot of cases from other health centres from across the country.
To achieve better results, an integrated HIV care, treatment and support for women found to be positive and their families, known as PMTCT plus (PMTCT+), was recommended by Dr Oliver-Commey.
He said the PMTCT+ targeted partners who, when tested and found to be negative, were encouraged to support their wives who were positive. However, when they were found to be positive themselves, both were linked to appropriate care at the unit.
All is not rosy at the unit, as indicated by Dr Oliver-Commey, as it faced difficult challenges which made it impossible for it to meet recommended WHO standards on PMTCT.
He indicated that although it was ideal that HIV positive women went through caesarean sections (CS) to prevent the mother transmitting the virus to the baby when delivering, the problem in the country, however, was that a lot of hospitals and clinics did not have the capacity to perform CS on HIV positive mothers and, therefore, referred them to the three teaching hospitals and other few health facilities that provided the service.
Risks
Dr Oliver-Commey indicated that most of those women ended up opting for normal delivery because they would have to join a long queue of women who were also waiting for CS to be performed on them, placing their babies at a higher risk of being infected with the virus.
However, he pointed out, when babies were born through the normal delivery process by an HIV infected mother, within the first week they were taken through an early infant diagnosis with polymerise chain reaction (PCR), which is a device used to determine their status, or they were put on ART and linked to the Child Health Department where they were referred to special clinics for children exposed to HIV.
Those babies were then tested after a year and a half when, by then, they were believed to have shed off their mothers anti-bodies and were able to produce their own anti-bodies.
In spite of the availability of life-saving interventions for both mother and child, some pregnant women who test positive for HIV refuse to avail themselves for medical care.
Stigma
That deadly decision could be attributed to the fear of stigmatisation people who are known to have contracted the virus go through.
Some of the women take that decision, having at the back of their minds the notion that their partners may abandon them if they get to know of their status.
At a recent review meeting organised by the Ghana AIDS Commission (GAC) in Accra, a private midwife and proprietress of God’s Gift Maternity Home at Ekumfi Ekrawfo in the Mfantseman District in the Central Region, Madam Gifty Mante, talked about how some pregnant women who tested positive pleaded with her to keep the information to herself.
The sad aspect of the situation, according to her, was that those HIV positive pregnant women failed to return to the facility for the needed medical care which could save them and their unborn babies. For fear of stigmatisation, they would rather prefer to keep the infection to themselves and die, instead of visiting the hospital where they could be provided with anti-retroviral therapy for their survival and that of their babies.
The fear of others knowing about their predicament was enough to keep them away from the appropriate medical care.
A typical example could be drawn from the case of a member of an association of People Living with HIV (PLHIV) in Koforidua in the Eastern Region (Matthew Chapter 25) in which a middle-aged woman narrated to journalists how her husband of 15 years abandoned her and her children when he got to know that she had tested positive for HIV. Her husband refused to heed a doctor’s advice to also go for counselling and testing but left her and went ahead to stay with another woman.
Currently, health workers the world over are trying hard to prevent as many babies as possible from getting infected by their mothers.
Another member indicated that she was dismissed from a private school where she was teaching and also ejected from her rented accommodation when a nurse allegedly told her employer about her HIV status.
The provision of anti-retroviral therapy in the public healthcare system started in Ghana in June 2003 at two pilot sites in the Manya Krobo District. This was part of a comprehensive care package that also included the provision of Counselling and Testing, and Prevention of Mother to Child Transmission (CT/PMTCT).
Currently, 138 sites are available nation-wide for the administration of ART and other HIV prevention services, including PMTCT.
A success story of that programme (PMTCT) could be found at the St Dominic Hospital at Akwatia in the Eastern Region where the hospital was considered the first health facility in Ghana to prevent the highest number of children from being infected with HIV from their HIV-positive mothers.
Statistics
Reports from the hospital gathered in 2009 indicated that only one out of 32 babies whose mothers were HIV positive and were, therefore, put on treatment under the PMTCT tested positive.
The figure represents 96.9 per cent of the children whose mothers received the intervention.
The Head of the Public Health Department of the hospital, Dr Nana Owusu-Ensaw, said as part of the preventive measures, mothers of the children were given special medication during labour and their babies placed under formula feeding for 18 months.
He said that was to prevent the children from being breast-fed, which could have exposed them to HIV infection from their infected mothers.
In an interview with The Mirror, Dr Owusu-Ensaw said the PMTCT programme was established at the hospital in 2005 to educate all pregnant mothers on HIV and AIDS due to the high prevalence of MTCT of HIV in the district and the country as a whole.
He explained that from July 2007 to May 2008, 62 children born to mothers who were given special care during labour were put under monitoring for 18 months.
Dr Owusu-Ensaw said out of the 62 children, 32, which stood for 51.6 per cent, could be traced, while 30, representing 48.4 per cent, could not be traced and were, therefore, not monitored.
He said after the 18-month period, the 32 children who were traced were tested for HIV and that was when it came out that only one had the virus.
Negative
“That means 31 of them, which represents 96.9 per cent, were negative, while the remaining one, which is 3.1 per cent, was positive,” he stressed.
Dr Owusu-Ensaw said the facility was able to trace those 32 children because they were placed under formula feeding which was given to them by the Public Health Unit of the hospital free of charge.
“The above results indicate that PMTCT works and we hereby encourage all pregnant women to undergo HIV testing to know their status so that interventions can be put in place to save their babies,” he said.
He said a challenge involved the high cost of baby formula for feeding the babies, noting that one baby consumed about six tins a month.
He also said monitoring the mothers was expensive in terms of the transportation cost involved and expressed concern over the issue of pregnant women who gave wrong addresses for fear of stigmatisation, which resulted in the inability to trace them.
That, according to the doctor, was why some babies could not be traced for final testing after the 18-month period.
The first AIDS cases were reported in Ghana in 1986. By the end of September 2003, a cumulative total of 72,541 AIDS cases had been reported. This figure is probably 30 per cent of the estimated AIDS cases in the country. Current estimates, however, put the actual number of cases closer to 370,000.
Cases have been reported in all the 10 regions, as well as in all age groups. There are, however, important regional variations in the reported AIDS cases. This can be attributed to various factors, such as the composition of the population of the regions, availability of public health institutions, the stage of the epidemic and the health seeking behaviour of the people.
To eliminate stigmatisation and discrimination against PLHIV, the Director-General of the GAC, Dr Angela El-Adas, and the other officials in her outfit has, on numerous occasions, spoken against that, knowing very well that if not stopped, it will continue to hamper control of the pandemic.
Thursday, July 29, 2010
'Devote more resources to curb HIV'
Wednesday, July 28, 2010 (Daily Graphic Pg 23)
Story: Lucy Adoma Yeboah, Vienna, Austria
The 18th International AIDS Conference has ended in Vienna, Austria, with a call by Archbishop Desmond Tutu of South Africa to African leaders to devote more resources to curb the spread of HIV on the continent.
In a video conference, Archbishop Tutu said "The HIV issue is a human rights issue. HIV prevention, treatment, care and support is a human right priority, as much as a challenge for leadership as is it to vulnerable communities".
He said 5.5 million precious lives still in need of treatment in poor countries had to be assisted, adding that “Our leaders, especially in Africa, have a key role to play not only in mobilising resources creatively, but in influencing attitudes, laws and philosophies".
He indicated stated that in spite of these challenges, accessibility to treatment could healp address the issue of stigma associated with HIV.
Archbishop Tutu observed that doom and gloom had been the order of the day as the global recession had spread a blanket over much of the world, adding that fortunately "a ray of hope has come from an unexpected quarter”.
He explained that although there was no cure for HIV and AIDS yet, there was treatment to make the disease treatable and manageable.
"Lives can be saved, children need not be orphans, parents can continue to provide for their families. The hopelessness of the past can be transformed into hope for the future" he said.
He said there were great possibilities, adding that much had been achieved in the area of anti-retroviral therapy and called for support in supplying drugs and other treatment items.
For her part, Dr Patricia Perez , Chair of the Global Network of People Living with HIV (GNP+), said lack of resources allocated to HIV and AIDS had been evidenced throughout the event.
"Let us look for money to stop the epidemic among the resources that nations allocate to buying weapons. For instance, US60 billion will be wasted in armaments in Latin America by the end of the year" she said.
Among other speakers who addressed the closing ceremony were both the Chairman and the Local Chair of the event, Dr Julio Montaner, and Dr Briggitee Schmied respectively.
Story: Lucy Adoma Yeboah, Vienna, Austria
The 18th International AIDS Conference has ended in Vienna, Austria, with a call by Archbishop Desmond Tutu of South Africa to African leaders to devote more resources to curb the spread of HIV on the continent.
In a video conference, Archbishop Tutu said "The HIV issue is a human rights issue. HIV prevention, treatment, care and support is a human right priority, as much as a challenge for leadership as is it to vulnerable communities".
He said 5.5 million precious lives still in need of treatment in poor countries had to be assisted, adding that “Our leaders, especially in Africa, have a key role to play not only in mobilising resources creatively, but in influencing attitudes, laws and philosophies".
He indicated stated that in spite of these challenges, accessibility to treatment could healp address the issue of stigma associated with HIV.
Archbishop Tutu observed that doom and gloom had been the order of the day as the global recession had spread a blanket over much of the world, adding that fortunately "a ray of hope has come from an unexpected quarter”.
He explained that although there was no cure for HIV and AIDS yet, there was treatment to make the disease treatable and manageable.
"Lives can be saved, children need not be orphans, parents can continue to provide for their families. The hopelessness of the past can be transformed into hope for the future" he said.
He said there were great possibilities, adding that much had been achieved in the area of anti-retroviral therapy and called for support in supplying drugs and other treatment items.
For her part, Dr Patricia Perez , Chair of the Global Network of People Living with HIV (GNP+), said lack of resources allocated to HIV and AIDS had been evidenced throughout the event.
"Let us look for money to stop the epidemic among the resources that nations allocate to buying weapons. For instance, US60 billion will be wasted in armaments in Latin America by the end of the year" she said.
Among other speakers who addressed the closing ceremony were both the Chairman and the Local Chair of the event, Dr Julio Montaner, and Dr Briggitee Schmied respectively.
Subscribe to:
Posts (Atom)
