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Opinions of Wednesday, 22 October 2014

Columnist: Adjei-Kyeremeh, Nathanael

Hosting AFCON 2015 amidst Ebola: A Trojan horse

The Minister of Sports, Mahama Ayariga informed the nation of a letter from The Confederation of African Football (CAF) urging Ghana to consider hosting next year’s African Cup of Nations (AFCON) should Morocco go ahead to pull out from hosting the games. Mr Ayariga has subsequently indicated Ghana is ready to host the 2015 games.

Ordinarily a football nation like Ghana should be happy to host Africa's prestigious tournament. Football a sports that was largely seen as the nation’s unifier is currently suffering for want of unbridled national support. The Dzamefe commission has brought to the fore corruption and rot in the Football association that led to our disgraceful performance in the just ended World Cup.

On top of this Ghana is just about entering an IMF program which is likely to proffer some tough measures on austerity, juxtaposed to the elusive solution to the endless cycle of "dumsor". In essence we are in trying times and the least on the mind of the average Ghanaian is a football tournament we never even budgeted for.

Even if situations were much better and we would have loved to host this, the one most important reason to refuse this "gift" to host AFCON is Ebola.

Ebola has currently ravaged Guinea, Sierra Leone, and Liberia. Senegal and Nigeria have just managed to contain it. World Health Organization warns new cases of Ebola virus could reach 10,000 a week in West Africa by December, nearly 10 times the current rate.

With Ebola nearly out of control in the West African subregion, it’s no surprise that Morocco asked that CAF postpones the tournament and threatened to decline hosting if CAF refuses.

Curiously, Ghana's Sports Ministry considers the nation ready to host the AFCON even in the face of the Ebola threat, a stance that has received lots of commentary over the weekend.

The Ghana Medical association has warned government on the danger we risk. The head of Noguchi Memorial Institute for Medical Research (the only centre able to test for Ebola in Ghana) Professor Kwadwo Koram has also opposed the decision to accept to host the tournament.

These are the reasons Ghana shouldn't host AFCON 2015.

Screening methods are not foolproof

The time it takes for a person to be infected by the virus and show symptoms is between two to twenty-one days. This means a person could have been infected more than two weeks before showing any symptoms like fever. Our screening methods may not be able to detect fans who are still in the incubation period. This is a point GMA forcefully made.

Ghana will live on the edge for the entire tournament and Noguchi will be overwhelmed

Every foreigner with a fever will be a suspected case. Do we have enough isolation centres to keep such people? Do we have adequate staffing to handle this? The answer is no.

Our hospitals are simply not ready

The media has given us reports of several hospitals where health care workers bolted when Ebola was suspected. Sadly there hasn't been much done beyond the rhetorics to prepare and psyche the health worker at facility level on stepping forward to deal with an Ebola victim. Many hospitals don't have the WHO standard Personal Protective Equipments (PPE), those who have some form of PPEs are not so comfortable in its usage (that is, in wearing and removing the PPE without exposure).

Our lack of experience in handling viral Haemorrhagic Fever in general may decrease our sensitivity even in identifying a real Ebola case and increase our fears when we confirm one. If a patient could hide his travel history it will take extra efforts to think of Ebola, let alone introduce the needed measures to prevent spread among hospital workers. The mass hysteria that will befall the nation should it record her first case in a tournament period will likely end the tournament abruptly, so why host in the first place?

Our general unpreparedness in handling outbreaks and emergencies

The National Disaster Management organization (NADMO) boss Mr Kofi Portuphy recently revealed that his staffs, usually at the frontline of disasters, are not ready to risk their lives for Ebola. How we have handled the Cholera epidemic which has killed over 170 Ghanaians portends how unprepared we are for large outbreaks.

Dr George Amofah a former Deputy Director of the Ghana Health Service in disagreeing with hosting AFCON writes:

"While the country may be able to deal with an isolated case or two occurring at the same time, the opportunity for multiple 'hot' spots emanating from multiple exposures (various stadia) spread across the country will definitely overwhelm our capacity to deal with any eventuality."

The difficulty to do contact tracing in a tournament setting

Prof Kwadwo Koram in arguing against hosting the tournament opined “Each stadium holds, 20,000, 40,000 people. If you have even one case coming up from the stadia, you’re completely at a loss to try and locate all those who had contact with the victim.”

In a packed stadium will you remember the person you sat closely with?

The cost involved in dealing with a possible outbreak

It is very expensive to handle an Ebola outbreak. Nigeria with the help of the Centers for Disease Control and Prevention and the World Health Organization, was able to contain the outbreak, with 19 confirmed cases and only seven related death, but at a huge cost.

Jim Yong Kim head of the World Bank, in illustrating how Nigeria fought Ebola said "it cost them $13 million and more than 200 physicians [and] 600 other health workers. They had to do 19,000 home visits taking temperatures in order to get it controlled."

There is still a lot we don't know about Ebola

This current outbreak has surprised many a scientist. Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, US and a Pulitzer winner for her coverage of Ebola in 1995 in Zaire says Ebola "has broken all the rules". We know that Ebola spread through direct contact with bodily fluids including sweat, semen, saliva of infected persons; we also know that there is currently no known vaccine and up to 70 percent of victims have died in this current outbreak. Sadly what we still don't know about Ebola terrifies us.

Government of Ghana more than contemplating on hosting the AFCON must address the risk of Ebola importation even now. A study suggested Ghana was at most risk of an Ebola importation by October ending. We must protect our borders and continue with the massive public education, to know the scientific nature of the disease, we must encourage behavioural change including frequent hand washing, and reviewing frequent handshakes at large gatherings. We can't take any chances.

Ghana must say no to CAF and advice CAF to postpone the tournament. There is no cowardice in running away from real danger, so the sages say.

Like the People of Troy, who accepted the wooden horse laden with Greek soldiers into their impervious city, we shouldn't learn belatedly that we accepted a gift—to host AFCON 2015, which spelt our doom.

Dr Nathanael Adjei-Kyeremeh

St John Of God Hospital, Duayaw Nkwanta