Public Display Of Hospital Attire And Infection

The picture you see is a healthcare provider/nurse taken from part of a busy street in Accra – Ghana. For the purposes of this write-up, I followed this nurse who had closed from work to the Tema lorry park to board a public transport popularly known as trotro.

Wearing of hospital/healthcare facility attire at public places such as the market, public transports, and cafes, among others has become a common practice among some healthcare professionals in Ghana. Is it fashion or ignorance?

You are likely to come across some of these professionals stuck in a public transport in close contact with other passengers onboard, on their return from work.

I am sure you have also encountered a number of our nurses flooding our market squares in uniforms after work. Well, I had encounter such ugly scenes on countless occasions where I had to shop with nurses at supermarkets who had close from work and came to the supermarket in uniforms (names of supermarkets withheld). What is their motivation for wearing their attire in public places? Is it to attract public attention about the fact that they are associated to the “perceived noble profession?”

I don't really know why our laws seemed to be relaxed on this irresponsible health behavior on the part of some of these healthcare providers who should have known better. Not only is the behavior irresponsible, but also a huge recipe for the transmission of various communicable infections. What some of these healthcare providers carry on their attire into the public is so enormous. However, it's impossible to spot such pathogens with our naked eyes – that is the danger! Dr. Betsy McCaughey, founder of the Committee to Reduce Infection Deaths once said: “It's not what medical professionals bring into the hospital; it's what they bring out”.

One worrying aspect of this risky health behavior, especially among some nurses is that most of them carry out their clinical tasks at various healthcare facilities without wearing coats. They will quickly pick their bags and jump into public transports; some even do not wash their hands before leaving their healthcare facilities.

Do you remember the last time you sat close to that nurse in uniform from work? I am tempted to believe it may not be that long to recollect. What about exchange of pleasantries with a hug with the nurse in uniform from work? You may not be a victim on that one, but you might have witnessed some on a number of occasions. Do you know you are also highly susceptible to picking some pathogens from the seat the nurse/clinician in uniform from work left for you in the commercial vehicle? Yes, it's highly possible.

The high temperature we record here in Ghana is also a favorable condition for easy transmission of communicable infections from the irresponsible public display of hospital attire to the unsuspecting public. On a sunny day in Ghana, in a “trotro” or market places like Agbobloshi, Mankesim market, Sunyani Wednesday market, Kumasi Kejetia, just to mention a few, you would usually spot people sweating like “pregnant fish”. The infection transmission inference is that, with a wet skin coming into direct contact with the hospital attire of that clinician in such places would attract more pathogens to your skin (if there are any) than with a dry skin – transmission becomes easy in that case.

What about Ebola? Do we have to go to sleep because Ebola has been controlled to the minimum acceptable level? For me, the answer is no, but per this alarming rate of regular public display of hospital attire, it suggests our authorities are saying we are immune to possible outbreak of Ebola and other communicable diseases and so safety measures must be relegated to the ground. I have always said that most of our leaders in Ghana are immediate oriented leaders. Prevention, being proactive and visionary leadership has been thrown to the dogs after the demise of Dr. Kwame Nkrumah. Majority of our leaders are the kind that would always sit and fold their arms and wait for the unfortunate to happen, react to it and then go back to sleep. Such vicious cycle continues unabated.

Why would medical doctors cover themselves in that manner when treating Ebola patients? Do you know what happens to those Personal Protection Equipments (PPEs) after working on a patient? They are usually destroyed. Why don't the medical doctors parade themselves in public places with such attire/ PPEs? PPEs worn by doctors when treating Ebola patients are considered as highly contagious. The same could be said about the uniform of a nurse coming out of the healthcare facility after work.

This behavior of nurses especially, and other healthcare providers has gone on for far long unchecked. I have no doubt that most of our healthcare providers serve as major vehicles for the transmission of most of the communicable diseases Ghanaians battle with today – playing a major role to increasing our disease burden.

Elsewhere in the world, some healthcare organizations have specific infection control policies that forbid the wearing of clinical uniforms in public places. What then is the position of the Ministry of Health and the Ghana Health Service on the exposure of the public to infection by constant display of clinical attire by some nurses and other healthcare providers in Ghana?

One of the reasons accounting for our huge annual budget allocation to curative health is as a result of some of these irresponsible behaviors that go unchecked.

In a related development, I suggest that authorities who sat down to draft Ghana's Public Health Bill have disappointed us, and have failed to safeguard population health against hospital acquired infections (nosocomial infections). Part One (1) of the Bill, which talks about communicable diseases with its section 17 stipulating “Regulations as to diseases of communicable nature “, which is expected to have captured prohibitions and sanctions on hospital acquired infections, rather went silent.

Let us all wake up and fight against this act of parading public places with hospital attire in Ghana. Do not be left out because you may be the next victim to being infected by coming into contact with such highly suspected infected attire.

Prevention is the only guarantee for better health.

Let us stay healthy to build a healthy nation.
Gbolu Mawuli Samson
Email: [email protected]
+233 241115660