Friday, January 18, 2008

EMERGENCY — TOP ON THE AGENDA (Page 34)

Story: Kofi Yeboah

THE hosting of the 26th Africa Cup of Nations, dubbed “Ghana 2008”, will be a major litmus test for Ghana’s preparedness in the management of emergency health situations on a large scale never imagined before in the history of the country.
In 1963 and 1978, when Ghana hosted the tournament, as well as in 2000 when it co-hosted it with Nigeria, the magnitude of the health challenge was in no way comparable to that of Ghana 2008.
The number of teams, fans, stadia and hotels, the euphoria and, indeed, everything connected with the tournament now is far bigger and better than the previous occasions when Ghana hosted the most glamorous sporting event on the continent.
The sharp change in the dynamics of hosting the tournament now underlines the great expectation of everybody as far as managing emergency situations is concerned.
Aware of such a great expectation, the Local Organising Committee (LOC), in conjunction with the Ministry of Health, has made elaborate preparations to ensure the successful delivery of emergency health care, presto!
In Accra, the host city of Group A teams — Ghana, Morocco, Guinea and Namibia — there are eight designated referral hospitals for the tournament.
These are the Korle-Bu Teaching Hospital, the Ridge Hospital, the 37 Military Hospital, the Achimota Hospital, the La General Hospital, the Police Hospital, the Tema General Hospital and the Civil Servants Clinic at the Ohene Djan Sports Stadium.
The refurbished 44,000 capacity Ohene Djan Sports Stadium has been demarcated into four areas according to the various stands, each with a medical co-ordinator in charge.
The VIP stand, to be co-ordinated by St John’s Ambulance Service, has been designated to the 37 Military and Ridge Hospitals, implying that any emergency situation that arises at the stands would be referred to the two hospitals.
A centralised public relation desk has been created to co-ordinate all responses to situations that may arise in order to ensure uniformity in the public pronouncements of the medical team.
That arrangement is to avoid a situations where a minor crisis is turned into a major crisis as a result of unguarded statements.
About seven ambulances have been mobilised from various health facilities in Accra for emergency duties at the stadium. Psychological support is also available at the Korle-Bu, Ridge and Police hospitals.
The refurbished Baba Yara Sports Stadium in Kumasi, with a sitting capacity of 44,000, is the venue for Group B teams, namely, Cameroon, Egypt, Zambia and The Sudan.
The city has a health command team made up the Chief Executive Officer of the Komfo Anokye Teaching Hospital (KATH), as well as the Ashanti Regional heads of the Ghana Police Service, the Fire Service, NADMO and the National Security Service.
Between January 2, 2008 and January 7, 2008, 107 health professionals, made up of doctors, nurses, physiotherapists and pharmacists, were trained in life support and emergency care services, at the end of which a simulation exercise was carried out at the stadium to test the readiness of the professionals.
The Intensive Care Unit (ICU), recovery ward, operation room, medical emergency unit and other facilities have been provided at KATH to deal with cases that may occur.
For trauma cases, a team made up of surgeons, neuro surgeons, trauma orthopaedic surgeons and other professionals, are on call 24-hours.
In addition, the region has also established a functional internal communication system to facilitate the operations of health professionals.
“We have put up a 24-hour service, which we have made available at the polyclinics for all visitors who will be visiting Kumasi around that time”, Dr Asare assures the general public.
There will be six ambulances for the assignment. Two of them will always be available during matches at the stadium, two others to be stationed at vantage positions to serve the fans, one to be designated to KATH and another for the KNUST hospital.
In Sekondi-Takoradi in the Western Region, the host city for teams in Group B made up of Nigeria, Cote d’Ivoire, Mali and Benin, health professionals in the region have also braced themselves up for the tournament.
All doctors and some other health professionals in the regions have been asked to be on a 24-hour standby throughout the period of the tournament.
Medical teams have been constituted at the various referral hospitals, including Effia Nkwanta Hospital and the VRA Hospital, as well as at vantage locations like the Takoradi airstrip and the newly built Essipon Sports Stadium where the action will take place.
The region is expected to have a complement of four ambulances, which would be manned by nine professionals.
The regional health team, numbering about 300, used the league match between Hasaacas and Real Sportive after the inauguration of the newly built 21,077 capacity Essipon Stadium last Sunday, for a dress rehearsal to test their readiness for the tournament.
Beyond providing emergency services, the medical team is also engaged in public education on sexually transmitted infections (STIs) in view of the expectation that sexual activity within the period will increase.
In spite of the human resource and logistical challenges, medical professionals in the Northern Region have prepared to do their best to ensure a successful tournament.
About 75 medical staff have been trained in emergency response. Thirty six people have also been trained for the NAS, while 60 others from St Johns and Red Cross have also been trained in the provision of first aid.
The medical team has put in place a strategic plan founded on an integrated, well-co-ordinated approach involving all the stakeholders.
A command structure has been established and it involves the head command, the middle command and the ground command, with logistics, supplies, press and information on the sidelines.
The head command is led by the Regional Minister with other members being the regional heads of the Ghana Armed Forces, the Ghana Police Service, the Ghana Fire Service and the Director of Health Services.
One critical issue that the nation has to contend with is that with the mobilisation of human resource and logistics at the disposal of the tournament, very little would be left to cater for the health needs of people within the period.
However, information gathered by the Daily Graphic a few days to the opening of the tournament on Sunday indicates that there are some serious problems that could overwhelm medical personnel in the management of emergencies, unless nothing in the magnitude of a disaster happens.
There are serious human resource and logistical problems at the various referral hospitals in the four cities designated for the tournament.
The problems are inadequate medical staff, medicines, ambulances, communication equipment and other necessities required to deliver efficient health care before, during and after the tournament.
Some of the ambulances assembled for the three-week football fiesta are no better than pick-ups because they are not fixed with equipment to make them worth their name.
Moreover, the medical professionals are yet to receive accreditation for the tournament as of last Monday and that is making it difficult for them to finalise their plans for successful execution.
Motivation is very low. There had not been any arrangement for financial reward for the medical teams as of Monday and even drinks to refresh them during preparatory exercises have been the burden of medical authorities, who accused the LOC of being “stingy” as far as addressing that issue is concerned.
In spite of that, the health professionals, in the national interest, are not contemplating any strike, as they are noted for in matters concerning remuneration for their hard work.
Health facilities in the Northern Region, where teams in Group D, made up of Tunisia, Angola, South Africa and Senegal, will be based, are the worst affected.
The regional health administrators have sent an SOS message for the posting of more staff to support the regional medical team, including 10 general duty doctors, an anaesthetist and two orthopaedic surgeons.







At the moment, there are only two ambulances assigned to the 21,077 capacity newly constructed Tamale Sports Stadium, far less than the minimum complement of five ambulances. There is no X-ray equipment at the Tamale Regional Hospital.
Health officials in the region are not enthused about the fact that although a fully-equiped doping centre has been provided at the stadium, nobody has, as yet, been trained to handle the facilities or conduct a doping test.
In the Western Region, the major problem has been lack of equipment at various health facilities. There are no communication equipment to facilitate activities of the regional medical team.
In Kumasi, expansion works on some facilities at the Komfo Anokye Teaching Hospital (KATH), including the Accident and Emergency Centre, have not been completed, although it has been improvised with a recovery ward of 10 beds.
Health officials there say they are fed up with empty promises by the LOC in providing funds.
Even in Accra there are problems of lack of emergency and ward beds in almost all the referral hospitals.
The Korle-Bu Teaching Hospital, the Ridge Hospital and the 37 Military Hospital, which are the first-level referral facilities, are all congested.
On the other hand, the Police Hospital, the La General Hospital, the Achimota Hospital, the Tema General Hospital and the Civil Servants Clinic at the stadium, which are required to provide emergency support services, lack the capacity to deal with large cases.
The shortcomings notwithstanding, the health workers have braced themselves up for the task ahead, marshalling all available human resource, the National Ambulance Service (NAS), the Ghana Red Cross Society (GRCS) and the St John’s Ambulance Service.
After a review and harmonisation meeting in Accra last Monday of the health sector in respect of the four host cities, the combat readiness of medical practitioners to provide emergency relief services was very convincing.

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