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Why Being Part of ‘Let’s Clean Ghana’ Campaign Benefits You More Than Anyone



sesawosuban and Let's clean Ghana

Ghana’s filth is canvassing the cities and towns at an unimaginable rate, so much so that you wonder if anyone cares. On the contrary, almost everyone cares, but only to the extent of complaining about it. We have heard so many complaints and lip-service, a few actions taken here and there in a rather unsustainable manner. Governments and private institutions have played a role in cleaning the filth in our streets, but that also falls short of what is required to keep the streets and marketplaces clean. Let’s clean Ghana.

Read: How Ghana’s government can create employment from the city’s filth

Several campaigns have been launched by government agencies and private institutions to keep Ghana clean. These have seen short-term successes where the streets become clean on Saturdays and by Monday, it’s as if there had never been any form of cleaning exercise.

Who is at the Centre?

It is not difficult to understand that the filth is caused by the individuals who live and/or use the marketplaces and streets, through indiscriminate disposal of waste. By the same understanding, we are able to say that the individuals are primarily responsible for the poor sanitation in our towns, marketplaces, streets and city corners.

Your Role

Rather than blaming governments and government agencies, or looking up to giant corporate institutions to channel their earnings to keeping Ghana clean, it is far easier to change your bad habit about waste disposal and general sanitation in Ghana.

Your Benefits

Wealth is money. It is as simple as that. To make money, you need to be healthy first. Health is the currency of life. It is what takes us to work and back home each day. It is what we need to pursue our dreams. It is as basic to making money as life itself.

Read: Health is money: diseases that cost a fortune

To make money, in the manner we desire, we first as Ghanaians have be part of every movement or campaign aimed at improving sanitation. If you play your role and keep Ghana clean, you are not only improving the sights and scenes of mother Ghana, but also keeping yourself healthy first and all other inhabitants of the country healthy.

Everyone is Involved

Whichever industry you find yourself working, or aspire to work, and wherever you live, there’s no insulation from the effects of the sanitation of the country in which you live and work. It affects everyone equally. So, why not join the “Let’s Clean Ghana” campaign by dutifully executing your role as citizens or visitors to the country. Stop indiscriminate loitering of streets, put all rubbish in trash bins and cover them where necessary, dispose rubbish in a responsible manner, avoid choking the gutters with carrier bags and other forms of waste.

Readers of this blog are usually those seeking career and business advice, and those seeking avenues and opportunities to make money. I find it important to also let you know that to achieve these, you first have to be in good health. Change your bad habit, if it’s not pro-sanitation. Let’s clean Ghana.


The Crazy Myths and Costs of Accra’s Mental Health Care



mental health care in Ghana

The Accra Psychiatric Hospital, Ghana’s prime mental health care unit, has been in the spotlight for some time now. About three hundred mental patients may be released into our communities.

The present Accra Psychiatric Hospital wasn’t built until 1904. Beforehand, untrained attendants used to look after the “lunatics” as it was called a Lunatic asylum. It has a bed capacity of 600. It is however overcrowded due to its increasing population and this places ä huge demand on their limited facilities. The hospital is responsible for treatment, welfare, training and rehabilitation of the mentally ill.

Mental illness has vast examples with common ones in Ghana including; depression, bipolar disease, schizophrenia, Post Traumatic Stress Disorder (PTSD) and Post-Partum Psychosis.

Nurses have been said to abandon the place leaving some patients to lead their own. I understand why they have left. Reports have it that there are no sedative drugs to keep the patients under control when they have episodes. A person who is mentally unstable in an active state of the disease is much more dangerous than an armed man. They can get violent and very difficult to control. The infrastructure at the Accra Psychiatric Hospital isn’t anything to write home about. From a chat with people who have worked there the place is highly infectious and may need restructuring to ensure the safety of the patients and workers. The images I saw on the news reports didn’t say anything contrary. Their website however gives us some good angles.

How Costly is Mental Health?

In 2006, 36.2 million Americans paid $57.5 billion for mental health care. This makes the average cost $1,591. Approximately 9 billion dollars was received for children.

In Ghana, a study conducted in 2013 at the Psychiatric unit of the Ho Municipal Hospital, placed the prevalence of mental illness at about 13%. It said that most patients are seen on outpatient basis and the treatment was an economic burden to the patient and their families. The household cost for a three month period was estimated at $ 34,518.27. This included direct costs like medical and non-medical costs as well as indirect costs like reported lost time by patients and their families. Both patients and their household were affected emotionally. Caregivers lost productivity because they eventually  lost their jobs. The cost of drugs might as well be the highest contributor to this burden. See cost of mental care in Ghana.

The drugs commonly used in treating mental patients include; Carbamazepine, Diazepam and olanzapine. Government provides these drug to the facilities at no cost at all. The patients don’t pay for the medicines however   there must have been a problem with their store keeping because why  wait for medications  to finish, from my bit on pharmacy management, a stock should have a minimum stock level and that means a requisition has to be made once the quantity on hand reaches that level. That’s none of my business.

The issue could be because the facility is solely government dependent. This means they can’t in anyway make money for themselves or charge for their services. If the MOH is occupied with other supposedly “pressing” issues, and therefore the mental facility could just be one of the many health sectors which would be ignored.

I found my way into talking to health workers who have worked in the Psychiatric Hospital before and some who are still working with the mentally unstable; and they have few suggestions for anyone who will listen.

The Accra Psychiatric Hospital Could be made Autonomous.

This is because they have seen rich families who have the capacity to afford care for their mentally ill family member, leave them there and never look back because government is in charge. Even if government does subsidize mental health, the families should be involved in rehabilitation process to enable the patient adjust to the outside well once they get better. If made autonomous, they hospital can make money and care for them properly.

Abolish “Custodial Treatment“.

This type of treatment has been found to be anti-therapeutic and may not necessarily help inpatient rehabilitation. See Community Mental Health.

In custodial treatment, rehabilitation centers hold people with mental illness for a life-time. This is not only a human rights. It has also been evidenced to fail by inadequate treatment services, repeated ill treatment to patients, inadequate inspection and quality assurance procedures and ABSORPTION OF LIMITED FINANCIAL RESOURCES FOR MENTAL HEALTH CARE. Most countries worldwide are working on terminating this custodial care as a form of treatment. Anyone who is admitted could be charged a fee to facilitate care. This will provide a source of capital to the facility and reduce dependence on government.

There could be a 1 cedi tax mental health levy on all government workers. This could go far to provide constant support for these facilities alleviating issues with provision of medicine and food.

I am not sure how the government provides support for these facilities but these ideas could be good enough to bring a great improvement in mental health care system in Ghana.



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Health is Money: Ladies, Breast Cancer Could Wipe Your Bank Accounts



breast cancer in Ghana
Different Types of Breast Cancer

Different Types of Breast Cancer

I am a young woman yet to enter the child birth phase yet I wonder a lot; if my babies will suck the life out of my breasts. Of course some years ago mothers used to breast feed their babies for as long as they had milk while they weaned, but modern society has been taught to breast feed for at most six months.  This brings me to other reasons why I worry about having breasts –breast cancer.

The Many Cancer Questions

Types: Cancer comes in different ways and honestly I think new ones crop up each day. Common cancers include; lung cancer, anal cancer, breast cancer, adrenal cancer, skin cancer, the list could be endless really.

What causes cancer? Known causes of cancer include genetics, lifestyle factors like smoking tobacco, diet and physical activity, some infections and chemical radiation.

Breast cancer is seemingly one of the most common cancers with a large number of African women suffering from this condition –diagnosed and undiagnosed. This does not exclude men from falling prey to this after all, all men still have breasts. When the cells in the breast begin to grow out of control they form tumors.

These tumors may be malignant or benign. Malignant tumors are the cancerous ones which can break away and spread to other areas of the body and cause havoc there too. Most breast cancers start from the ducts that carry milk to the nipples (ductal cancers). Others from the gland that produces the breast milk (lobular cancers).

It’s important to note that not all breast cancers come with lumps though lumps in ones breast are often assumed as the only symptoms to look out for. Sometimes lumps are benign and not cancerous, just abnormal growths. They still increase a person’s risk of getting breast cancer.

Main risk factors for breast cancer include; being a woman, aging, drinking alcohol, being overweight, having children, using birth control, not breast feeding long enough, having dense breast tissue and genetics either familial or mutated. See Risk factors of breast cancer. These however does not spell doom to all growing women.

Early stages may show no lump because it may be too small to feel or cause changes to notice on your own. The first symptom is mostly a lump the individual or doctor can feel. The following could also be symptoms of breast cancer: swelling of part or all of the breast, breast pain, nipple pain, redness or thickening of nipple or breast skin, nipple discharge other than breast milk and lump in the underarm.




Treating breast cancer in females has different approaches which include; surgery, radiotherapy, chemotherapy, hormone therapy and biological therapy

Surgery is usually the first type of treatment for breast cancer. The types of surgery are; removing the lump only, known as breast conserving surgery or removing the whole breast which is called a mastectomy.

Breast conserving surgery ranges from removing just the lump, the lump and a little extension around it to removing up to a quarter of the breast. This is dependent on the type of cancer, size of the tumor, amount of tissue surrounding tissue that needs to be removed and the size of the breasts.

Mastectomy involves removing the breast tissue and sometimes the lymph nodes in the under arm. After the breast are removed reconstructive surgery can be carried out simultaneously or at a later time.

Radiotherapy is the use of radiations to treat and kill all forms of cancer cells. It is commonly done after surgery. It can be done to the whole breast, the chest wall or the armpit area.

Chemotherapy involves using cytotoxic (anti-cancer) medication to kill cancer cells. It may be done before surgery to shrink the tumor (neo-adjuvant chemotherapy) or after surgery (adjuvant chemotherapy). It is also an outpatient therapy which will reduce hospitalization. These drugs may however be given via a drip too once every 2 or 3 weeks over a few hours for about 4 to 8 months to give the body rest. Common medications used here include fluorouracil , methotrexate and cyclophosphamide .

Hormone therapy includes the removal of the ovaries through surgery or chemotherapy to top the hormone production. It can be used alone where other treatment options are not suitable. Oestrogen and progesterone are the dominant hormones in women and is suspected to stimulate breast cancer growth.

It is added to chemotherapy and both are used after surgery  for management. This will reduce the production of hormone or stop its effects. Common medications used here include Tamoxifen ,anastroler,exemestane and letrozole.

Biological therapy is another treatment approach for breast cancer. Here medications attack the human epidermal growth factor 2 and stop its effects. A typical example is Trastuzumab

Like all other cancers the stage will determine the treatment required. Surgery and radiotherapy is enough for a local therapy. If the cancer is spread, systemic treatments may be needed and this involves chemotherapy, hormone therapy and biological therapies. See stages of breast cancer.

Cost Of Treatment

The cost of breast cancer treatment and follow up care can be a financial strain for patients and their families. Breast cancer is a disease which could be treated with expensive surgery then some medication for maintenance. This is all dependent on the stage of the cancer. Increased stage of diseases implies increased cost while earlier diagnosis seems to decrease costs involved.

In 2010 the costs of treatment in the United States was about $16.5 billion and is expected to increase to $20.5 billion by 2020. Breast cancer cost increase with survival. The average cost per patient between stages 1 and 2 was about $82,121 and stage 3 was about $129,387 in that same year. Health insurance is available for patients in the United States.

In Ghana, Korle-Bu Teaching Hospital is the most easily accessible public health facility with a cancer center. Drugs are required daily if tablets are being used. Breast cancer is hardly treated with monotherapy and tablets are given mostly in combination before or after surgery or radiotherapy.Each drug can cost between GH¢ 200 and GH¢700 each month. For chemotherapy, a drug vial can cost as low as GH¢8000 and this is used in a space of about 8 or 9 weeks of sessions and if several combinations are being used it can all lead to almost GH¢30,000.

You have some control

Is there a way perhaps I could escape this predicament? Breast cancer cannot be prevented but reducing risk is possible, it starts with a person’s diet. Eating right, reducing alcohol consumption, regular exercising and it is important that nursing mothers’ breast feed .


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Health is Money: Diseases that cost a fortune – Hypertension



Place your index and middle finger (first two fingers from your thumb) on the inner side of your wrist. Feel the thump there? That is your pulse. It is a measure of how fast the heart beats when supplying blood to the entire body each minute. The heart is expected to have about 75 to -80 beats per minute.

This can however increase when the blood vessels develop narrow lumens from fatty deposits or there is low blood volume which cause the heart muscles overexert themselves. Hypertension is a disease commonly associated with older people about 40  or 50 years and over but recently there has been an widening gap and this trickles the age group range to as low as 25- 30  years.

Hypertension is an increase in the pressure with which blood flows in its vessels beyond the normal levels which is anything between 120/80 to 140/90 for an adult. These two figures will barely make sense if you haven’t had some scientific background. Simply put, the top figure is the measure of the minimum pressure when the heart muscles contract and the lower one is pressure when they relax.

What does it mean to be diagnosed?

So if you go for a checkup at any health facility and you blood pressure is anything above 140/90, should that mean panic? Not yet. To be diagnosed as hypertensive there needs to be at least 6 consistent readings above the normal range. There are different stages and types of hypertension.

There is the prehypertension, primary hypertension, secondary hypertension, and isolated systolic hypertension, hypertension in pregnancy, urgent hypertension and hypertensive emergency. Whichever one you may be diagnosed with, the medication used all come from the same classes. It is important to treat hypertension because untreated hypertension, could lead to stroke, heart attack and in emergencies, death.

Is it Treatable?

Treating hypertension encompasses a variety of classes of medications because a singular approach may meet certain strong uncontended failure.

Medicines used include beta blockers, calcium channel blockers, angiotensin converting enzymes inhibitors and angiotensin receptor blockers. To some patients it’s just atenolol, losartan or lisinopril that has been given to help their situation. Each class functions differently to reduce blood pressure. These medications are used in combination to ensure a better outcome. These medications are always going to need refilling and hence either monthly or bi-monthly patients will need to go back to a general practitioner to fill out prescriptions for their medications. They may also use any local pharmacy to check their blood pressure upon purchasing their medications.

Cost of Treatment

In 2010, a survey in the United States of America patients showed the average cost was US$733 per adult. This cost could be divided between the medication costs, hospital visitations and emergency situations. There is insurance coverage available for all these cost. There is private insurance and government insurance for those cannot afford the private insurance. See expenditures for hypertension

Cost of Treating Hypertension in Ghana

Hypertension is quite common in Ghana and it could be because of the wonderful taste buds which crave taste for fast foods which for some reason may be suggestive of a person’s wealth. Well the good news is that the local pharmaceutical industries produce hypertensive medications right here in Ghana so there will be some affordable ones.

There are possibilities of getting medication for as low as  GH¢10 each month however  for some unknown reasons some people’s bodies reject these medications and hence foreign brands from the United Kingdom and Germany which are more expensive become the only option. These foreign medications can cost as high as GH¢200 monthly. So in a year, the cost can be between GH¢120 to GH¢1200 for a single medication but most usually use at least 2 medications and can at times need as high as 4 different hypertensive drugs.

Hypertension is not a lone walker. It comes with other chronic diseases like diabetes and cholesterol which will also need their own special medications. These will increase medication costs even further. Private insurance companies in Ghana do make provision for hypertensive patients but they limit this grace by dictating which brands they are willing to pay for. These costs are aside the hospital visitations and emergency situations. The positive part of this is that government insurance also pays for some hypertensive medications so that treatment is fairly affordable. The profitability however may be affected by the instability of the National Health Insurance Scheme in making payments and may cause supply of the medication to not meet its demand.

Why not Prevent it altogether

Hypertension is very preventable. Adjustments need to be made in certain lifestyles like adaptation to the Dash diet. This is the diet recommended for all hypertensive. Dash diet incorporates more fruits, vegetables and low-fat dairy with less salt (sodium) in the diet. The diet includes more whole grains like brown rice, wheat pasta and wheat bread. There should be a reduction in alcohol intake to only 2 drinks for men and one for women. Intake of saturated fats like butter, cream, cheese and eggs will also be reduced. It is imperative to maintain a healthy weight to improve blood pressure and this makes regular exercise a must on all fronts.

It is assumed that the more a patient adheres to lifestyle changes and sticks to medication the lower the costs will get. But why wait to live on the edge of life before you take better care of yourself, why wait till your body begins to warn you, if you are already in the habit of drinking excessively, eating “rich foods”    or letting your taste buds dictate what you will eat. Maybe it’s about time for a turn around. Health is wealth. Enjoy your fast foods once in a while but also put in some fruits, vegetables and exercise.


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