Kojo Akoto writes: The Hospitals Killing Ghanaians

I have been writing this article for some months now. It is only being published now because I feel we cannot list all the facilities before we give Ghanaians an idea of the waste within the healthcare infrastructure procurement system.

Ghanaians are dying senseless deaths because of poor leadership. Millions of dollars have been sunk into infrastructure that is either completed and unused, way behind schedule or wholly abandoned due to corruption and the ineptitude of leadership in the country.

What is a Senseless Death – Nkwasea Wuo?

Senseless death is one which could have been prevented with straightforward/basic interventions.

Below are some examples:

• If you visit the hospital and there is no reagent for the biomedical scientist to work with to help the doctor diagnose you of typhoid, and they end up treating you for Malaria, and you die, you've died a senseless death.
• If surgeons at the hospital do not have enough oxygen supply to keep you alive and you die, you've died a senseless death.
• If a power outage results in equipment malfunction and you die, you've died a senseless death.
• If there are no ambulances to transport you to a facility or referral centre and you die in a taxi or trotro en route to the hospital, you've died a senseless death.
• About 250 people died in Accra from Cholera in 2014, because facilities didn't have beds and the basic consumables to treat them; they died senseless deaths.
• V. Obeng was pronounced dead on arrival after a taxi driver took him to the hospital. The statesman died a senseless death.
• Need I remind you of how Prof. John Evans Atta Mills died?

If you look at the examples above, it is clear that all of these scenarios require simple interventions with the right tools, consumables and personnel.

However, many Ghanaians lose their lives each year because the health sector has been and is still not getting the needed leadership, planning and execution it requires to ensure efficiency and effective healthcare delivery.

Since January 2018, the team on the Citi Breakfast Show has been tracking 'abandoned' infrastructure in Ghana. Our work has so far revealed that over one billion dollars, $1 billion, has been committed to various health facilities which are done and not functioning, way behind schedule or wholly abandoned.

These facilities in focus, per our initial analysis, when completed could add not less than 5000 jobs in the health sector alone and reach/serve an estimated 5 million Ghanaians.

Specialist services and functions that are in dire need will be given a boost because these new facilities are equipped to enhance the work of specialists.

The facilities would also reduce the pressure on the existing tertiary and regional referral facilities and add an extra 5000-bed capacity to the current figure of about 20000 beds nationwide. That's a whopping 25% increase in bed capacity and a 17% increase in reach and access.

These figures do not take into account the numerous abandoned Community-Based Health Planning and Services (CHPS Compounds) scattered all over the country. In 2014, Ghana had about 3000 CHPS Compounds and planned on increasing the number to about 4000. A number of them have been left to rot in communities that have a dire need for them.

What is wrong with us? Where is the sense of urgency? Do we have no shame?

I am appalled by the consistent failure of successive governments in delivering the goods for the health sector. The health sector and any other sector in Ghana must not be reduced to a procurement playing field that begins projects with the vim of boiling beans and kills actual execution like a silent fart.

Ghana deserves better.
List of Abandoned or Delayed Health Projects wasted years on hospital projects

The University of Ghana Medical Center, Accra – 1000 beds/ seven years

1. Phase One cost $217 million. Phase Two expected to cost $48 million
2. Sod cutting on March 12, 2011
3. Ground-breaking in November 2012
4. Construction started in April 2013, to be completed in November 2015
5. Completion extended to November 2016 and inaugurated in January 2017
6. Expected opening date: July 19, 2017
7. Capacity: 617 beds (Phase One) and 400 beds (Phase Two)

The International Maritime Hospital, Tema – 130 beds/ six years

1. 130-Bed Hospital, Tema
2. The project started in 2012 and completed in 2016 at the cost of GHS46 million.
3. The three-storey facility was estimated at GHC18 million, while medical equipment and installation will cost GHC28 million.
4. The facility includes imaging, laboratory services, oxygen production, MRI and a fully operational morgue with a capacity up to 78 bodies, expandable to 200 bodies.
5. Operations started in 2018

The Komfo Anokye Teaching Hospital Maternal and Paediatric Block, Kumasi – 1000 beds/ 44 years

• The project began in 1974
• It is a 1000 bed facility meant to serve the middle belt and parts of the northern sector
• It has been abandoned due to financial issues
• President Akufo-Addo said he was 'very distressed' about the situation
• Upon completion, it will increase KATH's bed capacity to about 2000.

The Police Hospital, Accra – 120 beds/16 years

1. In 2003 a contract was signed between Ghana government and the International Hospitals Group. The project was estimated at 23.7 million pounds then.
2. The first phase was to take 24 months. About 120 beds. 11 consulting rooms and about a 200 capacity mortuary.
3. After periods of no action and legal battles the contract was reviewed to about 46 million pounds in 2009.
4. The Parliament of Ghana approved a loan of GHC 135 million between HSBC Bank Plc and the Government of Ghana and supported by the United Kingdom Government's Export Credit Guarantee Department in 2012. The project deadline was reviewed to end of 2015.
5. We are in 2018, 16 years on…..no functioning hospital.

The KNUST Teaching Hospital, Kumasi – 800 beds/ 16 years

• The project started in 2007 to be completed in 2013
• The cost was estimated at $125 million
• It is an 800-bed capacity hospital
• President John Mahama in 2016 gave the assurance that he will seek funding to complete the project which had at the time stalled due to lack of funding
• Vegetation has overtaken the 71-acre site

Euroget De Invest, 9 Hospitals in various locations – 1310 beds/ ten years

1. Euroget is an Egyptian project management and the financial group which was engaged by the GoG to deliver nine hospitals nationwide, at the cost of US$686 million.
2. MoU was signed in April 2008 and Parliament approved it in November 2008.
3. In April 2008, EDI signed a memorandum of understanding with Ghana represented by the Ministry of Health (MOH) and the Ministry of Defence to design, engineer, construct and equip nine hospitals with a total capacity of 1,310 beds.
4. 500 Bed Military Hospital in Kumasi at Afari, near Abuakwa – $180 million Deadline October/December 2016, reviewed to 2017 and still stalling
5. 250 Bed Sawuah hospital (Ashanti Regional Hospital) – $64 million Deadline December 2016
6. 160 Bed Wa hospital (Upper West Regional Hospital) – $61 million
7. 100 Bed Madina hospital
8. 60 Bed Konongo hospital
9. 60 Bed Twifo Praso
10. 60 Bed Tepa hospital – Began in 2013 – $36 million
11. 60 Bed Nsawkaw
12. 60 Bed Salaga

The Bank Hospital, Cantonments/Accra – 70 beds/4 years

1. 70 Bed Hospital
2. It was earmarked for completion in 2017, and the Bank of Ghana said on the project was on schedule. – BoG Annual Report 2016
3. Construction started in 2014 by the Universal Hospitals Group and completed in 2017.
4. Recruitment was initially done and is currently under review.
5. The hospital is part of the capital expenditure commitments of GH¢445.8 million.

“Capital expenditure commitments include capital expenditure contracts that have been awarded but have not yet been executed. The major projects ongoing include the construction of the Hospital, the Data Center and the Guesthouses. – BoG Annual Report 2016.”

6. The BoG Governor says they are discussing the operational model to use and that there will be a meeting this week to decide on the operational model after which we will know the way forward.

Design, construction and equipping of 6 district hospitals and integrated I.T. systems in Ghana. This project which, is currently ongoing is a turnkey arrangement with Messrs NMS Infrastructure and Barclays Bank Plc, London at an estimated cost of US$175,000,000.00

The beneficiary communities are listed below;

1. Sekondi Takoradi Municipality
2. Abetifi District
3. Garu-Tempane District
4. Kumawu District
5. Fomena District
6. Dodowa District about $30m

Construction has completed for the Dodowa in the Greater Accra Region is ready, handed over in 2016. The construction programme for Shai Okuduko District Hospital at Dodowa began in earnest in October 2014, following resolution of initial statutory hurdles with construction effectively complete in March 2016, suggesting a construction period of under 18 months from greenfield site to the fully-equipped functional hospital.

Other Facilities
The Ofankor Health Center that was built as part of the construction of the Pokuase/Awoshie Highway was completed in 2016/2017 and has since been abandoned.

The Bekwai District Hospital project has also stalled due to financial constraints.

In the Volta Region, the Akatsi District Hospital project has also been abandoned.

Conclusion:
It is heart-breaking that 44 years on, the Komfo Anokye Teaching Hospital Maternity and the Paediatric block is still not completed.

It is even more annoying if one considers the fact that the scheduled project execution periods for these facilities collectively is over one hundred years. The sum of the years spent on these projects is 108 years.

Aren't we ashamed that about 5 million stands to gain from proper execution of these projects yet no sense of urgency is being attached to them?

Aren't we ashamed to see the political class and the rich fly out to seek medical care while the majority of Ghanaians struggle to get world-class medical services?

The listed projects above collectively would add over 5270 beds to the current national capacity of 20000 beds, approximately 25% of the total capacity of the healthcare system.

The total cost of these projects is over 1 billion dollars. The funding for most of these projects are loans with interest.

Ghana deserves better.
Better healthcare.
Better infrastructure.
Proactive leadership.
May we not die any senseless deaths due to bad leadership.

# TheNonsenseMustStop
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By: Kojo Akoto Boateng/citinewsroom.com/Ghana