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Opinions of Wednesday, 30 March 2011

Columnist: Kennedy, Arthur Kobina

Stop This Cholera Epidemic

University of Cape Coast, Cape Coast.

The current cholera epidemic started last September-- six months ago. And it keeps spreading and killing more and more everyday.

According to the government, 5,200 cases have been reported with about 67 deaths. Last week, the Ghana Health Service confirmed that with a death rate of 1.5%, Ghana has passed the 1% threshold required to declare an epidemic by 50%.

Despite repeated assurances from government and health officials, it appears that things are getting worse, not better and the authorities are responding to this fast-moving epidemic very, very slowly indeed.

Here are some reasons why we should fear that things are worse than we are being told and may be getting worse: First, the rainy season is just kicking into gear and likely will make matters worse. Second, a lot of people probably have had the disease and either recovered or died on their own without contacting the authorities. Third, despite repeated assurances, the authorities do not appear to have any credible, global plan to tackle this epidemic.

Here is a sampling of official talk. After confirming that we had exceeded the threshold of an epidemic by 50%, the Deputy Director of the Ghana Health Service, Dr Amofa said “We need a holistic strategy to address the sanitation situation in the country. If people don't have potable water, their personal hygiene will be affected. That is a major challenge.” This was a clear admission that after six months of the epidemic, no holistic strategy exists. Then according to the “GRAPHIC”, the GHS official said “the situation was not out of control” Really!!

Then the Korle-Bu officials weighed in. The Head of Public Health for the hospital Dr Amoo told Joynews that a report by the hospital “cites rice and waakye vendors and satchet-water amongst the main sources of infection for patients. He said “our food vendors need to be watched carefully” After six months, should we not be doing more than just watching “waakye” sellers if they have something to do with this epidemic?

Despite the fact that Accra has borne the highest burden in this outbreak, there is no sense of panic amongst AMA officials. According to the Director of Metro Health, Dr Boateng, as reported by Joy, “the assembly hopes to screen all 65,000 food vendors reported to be operating in Accra by the end of the year” The end of the year is nine long months away and we are going to screen vendors ever so slowly while people die? Why?

If you are feeling discouraged already, let me cap this all with the Deputy Health Minister followed by his boss, the Hon. Minister of Health. Mr Rojo Mettle Nunoo, the Deputy Health Minister, during the launching of a public health education campaign revealed that “he would rather blame the bad human practices of dumping waste in water for the cholera epidemic than government failure in fighting the canker” !!!! Sure Honourable, blame the man in the street for the problem and then when it is solved, take the credit for your caring government. Tweaaa!! I am sure the Deputy Minister is just sad that he could not blame this on the NPP too.

To cap it all and to demonstrate the utter haplessness of our authorities in the face of this emergency, the Minister of Health, Honourable Yieleh Chireh “called on Metropolitan, Municipal and District Assemblies to ensure the enforcement of bye-laws on sanitation to control cholera and other communicable diseases”. No order. No sense of urgency. Just pleading with the MMDA's to please enforce the bye-laws while people die-- one at a time.

Obviously, looking at the quotations that I have reproduced here, our government is not yet in action mode on this epidemic.

Factually, while Mr. Nunoo may be right that the disease was caused by bad human practices, he missed the fact that once the epidemic occurred, it was and is the government's responsibility to tackle it. Unfortunately, sections of the media have joined the reckless excuse-making by the government. The normally objective and balanced “DAILY GRAPHIC”, editorialized that “The responsibility of containing this cholera epidemic is far beyond the health authorities and assemblies, as it is everybody”s responsibility.” While indeed, each and every Ghanaian must do their part to contain this epidemic, the government has shown a reckless disregard for the public welfare by failing to lead. The “GRAPHIC” consistent with its proud tradition of forthrightness, should have called upon the government to lead, not made excuses for it.

It is said that facts are stubborn things. The NDC pledged to rid Accra of filth within 100 days of assuming office and duly listed that as one of the crowning achievements of its first 100 days. If Accra was cleaned, why is cholera now running rampant in Accra?

Since this epidemic started, how many “waakye” sellers have been screened and how many have been taken off the streets of Accra by the AMA? How many illegal satchet-water operators have been prosecuted for breaking our laws? What steps have been taken to provide people with potable water during this emergency? What specific steps have been taken to prevent the dumping of liquid waste into our rivers?

Has the President convened an emergency meeting of his cabinet or the affected Ministries to discuss the epidemic? If yes, what was the plan? If such a plan exists, why was the Deputy Director of the GHS calling for a holistic plan six months into the epidemic?

Where has Parliament been in all this? Do they not care that we are perishing? When will they stand up and demand action and accountability from this caring government which is watching us perish even as it reassures us of how much it cares about us?

The time for excuse-making and ineffective talk is long past. It is time for leadership and it is clear that only the President can galvanize this government for some action in this year of action.

Cholera is not a new disease. The factors that contribute to the spread are well-known. Amongst these are the following: -Inadequate environmental management. ? Defecation along the banks of rivers and streams. ? Lack of potable water ? Poor handling of food ? Selling of food near open gutters and poor personal hygiene

Here is what we need to do.

The President must convene a “Cholera summit” with the Ministries of Health, Science and Environment and Local government, as well as the Mayors of the affected cities and Ministers of the affected regions, the Ghana Health Service, the Heads of the Teaching and/or regional hospitals in the affected areas and others that he deems necessary.

When he convenes the meeting, the President must first demand accountability from the group. It will be great if he turns to the Mayor of Accra and asks, “Nii, how many “ waakye” sellers have you screened and how many are off the streets now?”. Then to the Director of the Ghana Health Service, he should ask, “Did you have a contingency plan for dealing with a cholera epidemic?” and then “Since the outbreak, what specific measures have you initiated to help contain the spread and to treat those infected?”

Another question to the group that will be helpful will be “How could the disease leap-frog Ashanti on its way to the north or to the south?”

This meeting must develop an action plan for tackling the epidemic with action-steps and time-lines that will be implemented relentlessly. Within the larger plan, each Ministry, the Ghana Health Service and Metropolis must have their own deliverables and time-lines and we must see the infections and deaths going down, not up. There should be performance, not excuse-making.

Once the plan has been put in place, the President must relentlessly hold people to account.

This President has a poor record of follow-up.

When he took office, he directed his Ministers to declare their assets pronto. They ignored his wishes and nothing happened.

In 2009, he convened an accident-summit that drank a lot of tea and made some fine plans. Accidents just kept going up and nothing happened to anyone. There have been the Anas videos and then Mabry and Johnson and nothing happened. Then this year, there was the Anas video and the expression of outrage by the President. And nothing happened.

This time round, Mr. President, do something because people are dying. You have said repeatedly that you care for us. In this action-year, in this epidemic which clearly “Ye fie asem”, let there be some action. Let us fight this epidemic, together.