The Health Of The Nation At 50 Years

I recently visited the neighborhood where I grew up in Accra, then known as Kokompe, near the UTC Department Store, and I was shocked by what I saw. The place is jammed with people, crawling over each other like ants.

There are boxes and kiosks being used as sleeping accommodation and as shops. The only public tap we had which served as well at the time of Independence has been broken down for years and water is hard to come back. There was one public toilet then. We called it the ‘bomber’ because of the noise it makes when the solid waste hits the bottom of the pit. The same public toilet exists but with a queue outside.

Population

The problem we have is not so much the absolute numbers of people but the inability of the economy to keep up with the rate of population growth. At the time of Independence, we were about six million people. As at 2006 we are about 22 million.

It is estimated that our population will double every 23 years and this is set like a clock. Even if we are able to stop ourselves from reproducing from now, the moment already generated will carry on for a while. This has however has not been brought home to us by the population experts.

They have spoken to us about the phenomenon in family planning terms as if we are interfering with God and his commandment to multiply. And with vast stretches of land in Ghana unoccupied, the urgency of the situation does not come home to many people.

The youthfulness of the population is a problem as well, as nearly 50 per cent of the population is depen-dent on someone for their livelihood.

The economy and skirt length

The economy must have been excellent at the time of Independence. This is borne out by the long, free flowing skirts the lady wore. It is said that the economic prosperity is directly linked to the skirt length of ladies, for they can afford the length of cloth needed for the skirt.

More importantly, there is less competition to reach the pockets of men by the exposure of their vital parts to attract them. Perhaps these days, it will be how tiny the arms of the 'spaghetti blouses' are or how low the neck of the blouses is cut.'

As children, we often climbed on tables to peep over the wall into the yard of the UAC Ltd in Cowlane to watch the men practise ballroom dancing with the ladies in their long frocks.

Survival

One of the ways in which the health of the nation is measured is by how long its citizens expect to live at the time of birth. The population experts call it Life Expectancy. At the time of Independence it was 48 years for women and 47 years for men. It was not any different from Malaysia who had Independence, at about the same time as us.

Over the years this figure has increased to 58 years for women and 56 years for men. In contrast, the average Malaysian is expected to live to be 73 years! The strange phenomenon about this measurement is that it is always higher for women than for men. A friend says it shows how we men suffer for the women to enjoy.

I believe that women are better created than men and they should therefore not seek equality with us. They should just go forward and express themselves.

Another measure relates to survival of infants and children. This is measured by how many children die before age one and age five years for every children born. The figures are 133 and 250 per 1000 live births, respectively. This figure has halved to 64 and 110 respectively as at now.

Compare this with Malaysia which had similar figures at Independence but now has figures standing at 10 and 18.

Diseases

Malaria is a killer for all foreigners who have not lived long enough to have acquired the necessary immunity. The newborn child is a stranger to this world after the comfort of its home in the womb. His protection against malaria lasts for only six months after which it is vulnerable like the white man.

Measles was also a killer and often the mortuary was full of children who have succumbed to it. Not so now, a major achievement for the public health service. I believe there has been no death due to measles for the past two years.

Ghana is famous for discovering ‘Kwashiorkor’ in 1936 by Cisely Williams a British medical officer who once worked in what is now the Princess Marie Louise Hospital (PML). However we have not found an antidote to it. About one quarter of children still suffer from the disease which is essentially a nutritional problem due to lack of protein.

Can you believe that it is even worse in the coastal areas where fishing is their main occupation.

Whilst we are struggling with these diseases, there are also those associated with the West. Heart diseases such as hypertension, stroke and heart were little known. Diabetes was also a rare condition. But all of that has changed. These conditions are not only an urban phenomenon but can be found in rural areas as well.

Health care development.

The blueprint for developing health care was modeled on the concept of Basic Health Care. This involved rapidly building a network of health posts supported by health centres and polyclinics. It was designed by an Israeli called David Brachot.

District hospitals were built with support from regional hospitals and teaching hospitals.

The medical schools were conceived and implemented, sometimes in very controversial circumstances. For example, the University of Ghana, Mmedical School was to be built by a foreign country but this was changed at the last minute and Ghanaian specialist mobilized to take control

The hospitals were extremely clean. Patients were fed by the hospitals and no food was allowed from outside. I was knocked down by a taxi driver who was running away from a policeman on a motor bike. The car veered off the road and hit my paralyzed limb. I was once admitted at Korle Bu Hospital. I was fed three times a day and given oranges as snack in between. No food was allowed from outside, much to the anger of my mother. Any food brought for us by parents was confiscated by the nurses.

The exciting programme was the school health program. We lined up every morning and got our nails inspected. The hair was examined for lice.

Do you know why people who are deemed unintelligent are cdescribed as lousy? Lice can distract from learning as you scratch your hair and thus end up not paying attention in class. Such persons end up invariably at the bottom of the class!

Professor Adjei is the Deputy Director General of the Ghana Health service and Visiting Professor, Aberdeen University.