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Opinions of Sunday, 27 November 2016

Columnist: Hon. Daniel Dugan

Traumatic and sudden death of Verma Annan

Today, I wish to dedicate my page to young and beautiful Verma Marie Annan, a twenty-three year old woman and graduate of University of Ghana, Legon, Accra, who packed bag and baggage and left to Heaven on Sunday, November 20, 2016, the Feast of Christ the King.

Her freak demise has opened up a debate on Social Media about the need to do a lot of medical research in this country:

The Verma Marie Annan Memorial Medical Research

Sometime on or about Wednesday November 2, 2016, All Souls Day, Verma, led by her loving mother, Yvette, reported at the State Insurance Corporation (SIC) medical facility on the Kojo Thompson Road called Bob Freeman Clinic. She was not feeling well and was diagnosed as having contracted malaria.

The twenty-three-year-old graduant was allegedly given an injection of a yet to be disclosed antimalarial drug. She was then put on Coatem, a very powerful antimalarial tablet which has claimed at least one life that I know of, Paa Kow Painstil. Verma obediently started the dosage when she got home. Then she would throw up and swallow blood. By Sunday, her sweet mother was becoming alarmed, and so on Monday November, 7, 2016 they were back to the Bob Freeman Clinic. Immediately the nurses saw the sweet beauty, they decided not to handle her case and insisted that no doctor was around.

The nearest medical facility was C ? J Hospital, and mother and child quickly got there. This facility did good professional work to diagnose the problem – Verma had lost a lot of blood and her blood count was less than 6.0. The hospital could not handle her case and took a vital decision to refer her to Korle Bu.

Meanwhile, someone must donate blood for her. Her sweet young sister, Kathy, quickly volunteered, and was at the Korle Bu Blood Bank to donate. I went to Korle Bu with my donation card, but it was too late in the day, the main office of the Blood Bank was about to close for the day.

By the time Verma arrived at the Korle Bu Emergency Ward, Kathy had the lifesaving fluid ready. But folks, it was during geography lessons in secondary school that I knew that the word bluff was not just an act of deception, but also a geographical feature, a high cliff.

In the case of the word emergency, I am not too sure whether in the medical dictionary it means something else. Verma was wheeled into the ward, virtually tied down. She was restless and in pain. Her folder was handed over to the doctor on duty, by the doctor who accompanied her. Then, what seemed like the reversal of emergency started. Verma was given casual attention, and for three hours, she was not attended to by way of administration of drug, or putting her on blood transfusion. The doctor on duty started looking angrily at his colleague who kept prompting him to attend to Verma.

After over three hours, she was injected to put her to sleep, but still no blood transfusion. The excuse was that the drug was to prepare her system to accept the blood. Meanwhile, on the folder, it was clearly stated that Verma’s blood count was reading 5 point something, and she needed blood immediately.

By morning, her mother phoned to tell my wife that Verma will need another two pints of blood. I was available to go through the process, and was allowed to take two pints from the number of donations I made.

Walking confidently to the Korle Bu in-house blood bank, I was stopped in my tracks when I was told to pay a processing fee of GH¢170. What for? I donated blood without taking a pesewa, so why should I pay when I am taking my blood back? They had processed the blood, and the bag and preservatives came with a cost.

Verma took all my blood and needed more. On Sunday November 13, 2016, when I visited her, she looked okay as she smiled at me.

Thursday, she was on oxygen, and later went into a coma. Saturday, she opened her eyes and moved her finger; it was the most joyous news on the day of Joyful Mysteries.

However, on Sunday November 20, 2016, by mid-afternoon, Yvette called my phone in tears, “Verma has gone!” From that moment to date, the family has never been the same.

Those abroad are still in mourning, and the ones in medical practice or medical research suggested that Verma suffered from G6PD, or in simple language, Glucose 6-Phosphate Dehydrodenase.

Glucose 6-Phosphate Dehydrogenase deficiency is a condition in which the red blood cells break down when the body is exposed to certain drugs or stress of infection. It is hereditary, which means, it is passed down in families.
When a person lacks or does not have enough G6PD – the enzyme that helps the red blood cells to work properly – the red blood cells get destroyed, and this leads to a condition called hemolysis.

This condition can be brief, since the body continues to produce red blood cells which have normal activity. The red blood cell destruction can be triggered by infections, severe stress, certain foods such as fava beans, and certain drugs like, antimalarial, aspirin, nitrofurantoin, nonsteriodal anti-inflammatory drugs (NSAIDs), quinidine, quinine and sulfa drugs. Other chemicals such as those in mothballs can also trigger hemolytic episodes.

G6PD deficiency is common in blacks, and it is speculated that 20% of Ghanaians have that condition, which does not display any signs until the red blood cells are exposed to certain chemicals in food or medicine, or to stress. Symptoms may include dark urine, enlarged spleen, fatigue, pallour, rapid heart rate, shortness of breath, and yellow skin colour (jaundice).

Blood tests and other tests can be done to check the level of G6PD. And treatment may involve administering medicines to treat an infection, if present; stopping any drugs that are destroying the red blood cells, and transfusion in some cases. In most cases, hemolytic episodes go away on their own.

In the worst scenario, though rarely, there may be kidney failure or death.
In the case of Verma, death came within three weeks. She was to graduate with her colleagues on Friday November 18, 2016. She could not make it, and on the day when her mates were celebrating in a party mood, she just packed bag and baggage and exited this stage on earth.

The first daughter of her mother, she was every family members’ pride. She was a God-fearing and humble lady who was made Girl’s Prefect in Achimota School. In Legon, she carried herself in the same manner, and had so much of full life ahead of her to become one of the greatest women in this country.

In order to keep this hope alive, some family members and friends did all they could to contribute one way or the other to see her through her ailment. Her sweet mother spent all her money on drugs, and in one day alone, she bought almost GH¢1,000 worth.

Verma departed this life, replacing her absence with so much pain and confusion, and in all this, what effective role did the medical staff play to keep her alive, or dispatch her painlessly to the life hereafter?

If, indeed, she had G6PD deficiency, why did it not show earlier in life, since it is obvious she might have contracted malaria many times before?
In testing her blood to find out whether she had malaria parasites, Bob Freeman Clinic could have gone further to test for G6PD levels, and this I assume they did not, I may be wrong.

Why was she asked to continue treatment with a strong drug, Coatem, immediately after being given an injection of another strong antimalarial drug?
Why did Bob Freeman refuse to handle her case, when it was obvious what they had done to the young lady?

C ? J Hospital took her, and after diagnosing the problem, did the right thing to refer her to a bigger and better medical facility, in Korle Bu.

Why did the staff at the emergency ward look relatively indifferent, when, as professionals, they should have jump at it to help the poor lady? Why did they not quickly put her on blood transfusion, when her history had it that she was dangerously low on blood?

Verma Marie Annan is gone, gone without saying good bye and without rewarding her mother’s efforts in single-handedly bringing up the only two children she had. Verma is gone forever without her graduation picture hanging on the wall to make her mother proud.

But her memories could live on with a G6PD awareness and research project. People must check their G6PD status, and it must be made compulsory for all medical facilities to check patients’ status before administering strong drugs.

The Ghana Health authorities could honour the memory of this unsung heroine, who died just as she was about to enter the stage of adult life. A selfless woman, who took on boys and girls in her area who were preparing to sit the Basic Education Certificate Examination (BECE) and West Africa Senior Secondary Certificate Examination (WASSCE), and she did this without charging any fee.

Verma may not be in the medical field, but her sudden death should trigger of the need to have our G6PD status known, so that we can avoid what we need to avoid. For if, indeed, 20% of Ghanaians have G6PD deficiency, it should be a national priority, so what about a Verma Marie Memorial Medical Research into the silent killer?

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