Tag Archives: Ghana

GOING RED!!!

Visiting the Korle-bu teaching hospital for the first time, one is met with the curious sight of young doctors walking briskly with ice chests in hand. Could they be selling ice-cream, or is it just their packed lunch?  Valid questions, after all, we have all gone through the ‘lunch box’ stage at one time or another in our lives. Well, far from that, they are actually on their usual ‘blood products run’ that has come to be characteristic of being a house-officer in the country’s premier teaching hospital.

It is an essential service. Doctors move to and from the blood bank all day, securing much needed blood products for their patients. I have not as yet gone on one of those runs, thus have no experience of the intricacies of securing blood for patients. I have however, heard the stories. Doctors begging, literally, to get blood for their patients. All departments in the hospital are competing for these products which are always in short supply. What determines which patient gets it as opposed to the other? It is even worse, if the patient happens to have a rare blood group. The chances of securing your blood products are even slimmer.

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ACCRA GOES RED!!! Blood donation exercise.

Venue:Indafa Park Korle-bu.

Please come donate blood to help save lives.

The process, a patient’s blood is taken for grouping and later cross matching when a transfusion is required. Forms are filled and the request sent to the blood bank. Now, the blood bank being ‘virtually anaemic’ itself then provides the blood products needed by the patient. Demand certainly outstrips supply. Patients relatives our thus required to replace blood products.  That pretty much starts world war III.

For one thing, patients assume they pay for the blood, thus should not be required to replace it. Well, blood is not sold, not in Korle-bu Teaching Hospital. What patients pay for is the processing of the blood. Let’s consider this, the blood bank goes through several processes to get its products. Blood donation exercises, such as Accra goes Red are key. Voluntary blood donation is not common practice in Ghana, thus blood donation exercises are a means of obtaining the products. Then there is the process of ensuring its safety. You don’t want to be transfused with blood infected with HIV, hepatits B, or whatever other infection the donor may have. That is a costly process. I could go on to talk about storage, and everything else that is done to ensure safety of the blood patients are transfused with. This is actually, what you pay for. Curiously, if the blood is not replaced how are we expected to provide for others?

Now, blood! Oh bloody hell! There is so much apprehension with its usage. For religious reasons of course, some persons do not accept blood transfusions. I absolutely respect that. I may not agree, but, we all have the right to whatever religious belief we identify with. Then, there is sheer ignorance. It beats me how people can be so sorely mistaken about something and yet so passionately apprehensive of it. Last weekend, I was involved in a blood donation exercise, I have to say, I learnt a lot. It was a good experience.

ImageThere were a number of people, voluntary donors (the safest type there are) who actually came to the donation site, because they have decided to give blood to help save lives. There were a few people who came to attend to their own business at the mall, but on minimal interaction were convinced and willing to help. One guy was actually quite surprised that he had been convinced to donate. He was like; ‘I better go to heaven for this.’ And am like ‘mannn, you need Jesus for that!’ Cool guy, we had quite an interesting conversation. There were a few who were knowledgeable about the process, and  will straight up say, I donated recently, I can’t safely donate now, or I have been unwell I have malaria. I even had a guy say, I can’t donate, I have hepatitis B. A good number said, I partied a lot last night. I had a lot of alcohol. I loved that some people were aware of reasons why they were not qualified to donate. At least, there is some education out there even though a lot more needs to be done.

On the opposite end of the spectrum however, there were a few misinformed people. For one, fear of the blood being tested for HIV was an absolute put off. He will much rather not know. You can live a relatively healthy life with HIV if you are aware of it and get treatment early. Anyways, to clarify, HIV testing requires extensive counselling before you tell anyone their status. So, no, you won’t get called and told you are HIV positive even though in reality, that would inure to your own benefit. Of course the blood will be discarded. There were also a few people who just felt like they did not have enough blood to give. Again, by way of information, the screening process ensures that you healthy enough to donate blood safely. An Hb less than 12 for a female, or 13 for a male, weight less than 50kg and age less than 17 or above 60 are some reasons why a person, after  the screening process may not be allowed to donate. Simply, there are quantitative ways of determining whether your blood is ‘enough’ thus, subjective assumptions of low volumes of blood, which by the way will leave you in shock and unable to go shopping, just don’t hold water.

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My favourite, however was a guy, who claimed to be a pharmacist. To him blood transfusions are bad. Apparently, it is lazy doctors who resort to transfusion, instead of going with more appropriate therapy. Of what therapy he was speaking, I have no idea. Supposedly, there is a lot of research backing his claim, he just could not cite any. For one, you have to do better than that when you want to debate me on anything. For a pharmacist, I was disappointed at his line of thought. His argument was simply fleeting between the laziness of doctors and religious reasons why transfusions are inappropriate. Of course I wasn’t going to debate him. Maybe if he had a sound argument I just might have indulged him.

Now, the argument about haematinics ( blood tonics) is quite common. If I may, blood products are used in every field of medicine. Let us start with obstetrics and gynaecology. The foetus obtains its iron(and everything else) from mom’s blood, then there is the possibility of intra and post-partum haemorrhage (bleeding). In paediatrics, that neonate ( less than 28 days old) may be severely jaundiced, requiring an exchange blood transfusion. Yes, we do take out aliquots of the baby’s blood and replace with our blood products to treat the underlying condition. Shall we move on to surgery? Well, for one thing the anaesthetist will not touch the patient  if the Hb is low. The surgery just doesn’t happen, until all parameters are within normal range. Unless of course you will much rather have your surgery without anaesthesia

Accident centre/trauma unit, now if you ever happen to be involved in an accident and  lose a lot blood, by all means, allow me to scoop some Kontomire stew into  your mouth. After all, the green vegetables help the body to produce blood. In these situations, lost blood needs to be replaced immediately, else the patient will exsanguinate. Oh sorry, that is the option for the lazy doctor. When a pregnant woman is bleeding or someone’s cancer has a high probability of  spreading to other organs without immediate surgery, let’s just pour in the haematinic and wait for the body to go through its natural blood producing process. Shall we? Haematinics and other therapy have their place, and are used. After all, the blood bank barely ever has enough blood. I fail to comprehend how it can be assumed that blood products will be used for patients who don’t need them, just because doctors are lazy. Blood products like all other therapy, are only used when indicated and if there is no available alternative.

ImageNow, haematology. For persons with haemophilia, deficient in clotting factors, and who can pretty much bleed into their joint and anywhere else till it is destroyed. What is a doctor to do?  Freeze-dry factors? Well, they are prepared from blood too, shall we at this point shift the goal post, after all, it is not blood?  Anyways, we barely have that here, thus, make do with fresh frozen plasma (FFP), which is one of the products obtained from donated blood to help these patients, whose blood just won’t clot, to stop bleeding .

Of course sickle cell and thalassemia. There is a reason Hb genotype SS, is actually called sickle cell anaemia. Your red blood cell last 120 days on average, but in some persons living with the disease, it may be as low as 10 days, and in thalassaemia, not enough red cells are even produced to start with.  Again, what is a doctor to do? These persons need routine transfusion, to stay alive. Or we could just watch the sickle cells destroy every organ in the body and eventually kill them. There are several other indications for blood transfusion in a sickle cell patient, such as, in the acute management of a stroke.

That is not for everyone. Most of us do okay with daily haematinics, but a smart doctor always gives the best therapy to his/her patient. If blood products are indicated, certainly they must be used. Well, till our pharmacists come up with alternatives that are of course affordable enough for the average sickle cell patient in a lower-middle-income country like Ghana.

Till then, I suggest we just keep calm, read up and get accurate information, then make informed decisions about blood donation and transfusion.

ACCRA GOES RED. Currently ongoing at the new southern area blood bank. Indafa park Korlebu. Please pass by and give this precious gift to help save lives. The blood bank is always open to you to donate. Alternatively, pass by the Accra mall on the last Saturday of each month. (There is a mobile team stationed there)  Please spread the word, share this, educate a friend about blood products and their essential role in the field of medicine.Image

Regards,

Sefakor-Enam.

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PERSONALITY PROFILE- PROF. KONOTEY-AHULU.

“…the patient is most important. There is a lot of focus on the disease. I focus on the patient… Do u know about my achiever’s foundation? Persons living with sickle cell disease like you. Medical students, doctors, even consultants meet up and share their experiences living with the disease…”-Prof. Konotey-Ahulu.
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Professor Konotey-Ahulu and yours truly. If you can tell me the biography of the Kardashian clan from before Kim got famous, and you don’t know of this man, it is really unfortunate. As he says, HTGT-Here today gone tomorrow. The passing of Prof Kofi Awoonor (RIP) reminded him again of HTGT. We have living African legends to celebrate. to inspire our youth to greater heights. Get ready to be blown away!

Professor Felix Israel Domeno Konotey-Ahulu, is one of the world’s foremost experts on sickle cell disease. He, in collaboration with some colleagues, undertook research that led to the discovery of Haemoglobin Korle-Bu and Haemoglobin Osu-Christiansborg. (Exactly, it goes beyond HbSS and HBSC). Oh, he actually coined the term gnatopathy. (Yeah, that’s who I’m talking about)

I heard about the good professor many years ago and I knew I had to meet him. There simply, in my opinion, is no one, who has as much knowledge on this condition as he. It was a pleasure  meeting and interacting with him.

Professor Konotey-Ahulu was one of the recipients of the Dr. Martin Luther King Jr. Foundation Award “for outstanding research in Sickle Cell Anaemia” in 1972, and in 1976, received the Guinness Award for Scientific Achievement in the Commonwealth “in recognition of his work in applying science to the service of the community”. He also received the 1999, Third World Academy of Sciences Award for outstanding work in the Basic Medical Sciences. In the citation to this award “his outstanding contributions to haemoglobinopathy” were mentioned, but also his “first description of some 5 new physical signs in clinical medicine” and  invention of the ‘Male Procreative Superiority Index’  (MPSI) which shed light on aspects of  African anthropogentics, among others. In 2008, he received the Ghanaian state award, The Order of the Volta-Officer for “distinguishing himself in medicine/research into sickle cells”These are but a few of the many awards he has won over the years.

In 2004, Professor Konotey-Ahulu was named one of the 100 greatest Africans of all time, in a publication by, New African, a popular monthly based in London. The list included greats like Nelson Mandela, Kwame Nkrumah, Kofi Annan, Martin Luther King, W E B Du Bois among others. Prof Konotey-Ahulu requested that he be replaced by Dr. J E Kwegyir Aggrey, about whom he wrote an article in the same publication later that year. (link below)

Professor Konotey-Ahulu, is well travelled, holding lectures in many countries all over the world. He was Annual Visiting Professor to Howard University College of medicine, and Honorary Consultant Physician to Howard University’s Centre for Sickle cell disease, Washington DC. In 1998, He was appointed ‘Chief visiting clinician/scientist, Kenya Medical Research Institute (KEMRI)’ where he is on the editorial board of the African journal of Health Sciences. Between 1965 and 2001 he published more than 185 articles, editorials, book reviews and comments. (261 with 10 yet to be published at last count)

A prolific writer, he was at one time, the Editor of the Ghana Medical Journal. He was also a member of the WHO Expert Advisory Panel on human genetics and a temporary consultant to the Commonwealth Secretariat’s Medical department in London. Among his published works, are a 643 page book titled THE SICKLE CELL DISEASE PATIENT and a 32 page booklet titled, SICKLE CELL DISEASE-THE CASE FOR FAMILY PLANNING. Having visited many sub-Saharan African countries, studying AIDS, he published a 227 page book titled, WHAT IS AIDS?

He is a visiting consultant physician at Cromwell Hospital, London and Valco Trust Hospital Ghana, where he is involved in community work and adult education in the local languages. He was an external examiner in the University of Ghana Medical School’s department of Medicine and Therapeutics. Professor Konotey Ahulu was appointed Kwegyir Aggrey Distinguished Professor of Human Genetics by the University of Cape Coast, Ghana in April 2000.

Professor Konotey-Ahulu is very active on new media. His website www.sicklecell.md is a very credible source of information for persons living with sickle cell disease and everyone interested in the subject.  There is a blog associated with the website. Please check it out sometime. He is also quite active on Facebook and Twitter, please like or follow his pages.

Prof. Konotey-Ahulu  is Ghanaian, born in Odumase-krobo on 12TH JULY 1930. He is married to Mrs Rosemary Konotey-Ahulu with 3 adult children and several grand kids. His early education was in the Gold Coast (Ghana). He proceeded to the United Kingdom for his premedical and medical training. After which he returned to Ghana. Most of his graduate work was  in the United Kingdom, but he always returned.  Professor Konotey-Ahulu is a devout Christian and has even written a hymn. He was also one of the founding fathers of Korle-Bu Community Chapel (Accra Chapel).

I am really very grateful for the opportunity to meet Prof Konotey-Ahulu and for all the work that he has done and is still doing in the area of sickle cell disease. I read his work, and I am impressed with the passion with which he educates people and corrects the misinformation out there. I wish him the very best, good health and  many more years of life.

Sources:

[pdf] Felix I D Konotey-Ahulu FGA Key achievements.

[pdf] DR FELIX I D KONOTEY-AHULU, CURRICULUM VITAE. September 2002.AD

http://www.modernghana.com/newsthread/132669/52/8289

WHY DE-BOARDINISE ME? STRUGGLES OF THE SICKLE LIFE.

De-boardinisation! Isn’t that punishment, reserved for the most disobedient, disrespectful, trouble-causing, simply, deviant students?  Punishment meted out after others have failed?  Is this not a decision resorted to only after a person has had several ‘visits’ to the disciplinary committee? Why would a straight A student be lumped up with this group?

This is how it plays out in most senior high schools in Ghana. Somehow, without doing anything wrong, I found myself being asked to leave the boarding house. All it took, the headmistress asking that I invite my parents to her office.

My offense you wonder? I happen to fall sick once too often. Like there was a stipulated number of times each student was allowed to fall sick. Sorry, I didn’t get the memo! Basically, all it took was, me being a person living with sickle cell disease, and like the students who did everything, from stealing to leaving school without permission, I got thrown out of the boarding house.

Apparently, there were too many students and the school was not willing to take ‘the burden of caring for a sick student.’ Notice that I am quoting. That would be my headmistress. She then proceeded to go through a list of students with ‘special needs.’ Turns out, I was just a nuisance she would rather not bother about. Suffice it to say, my mom was in tears at the end of that meeting.

She took her precious little nuisance out of their care. Oh I was incensed. Was ready to fight them but she would rather not,she was really hurting. I was still under 18. Could not have done it on my own, thus, we let it go, and I continued high school as a day student.

I believe determination and focus rather than the school you attend or the course you read,or the challenges you encounter along the way are what determine if you will make something of yourself or not.Image

Having said that, Sickle cell placed limitations on my choice of high school because my mom wanted me close to ensure that I was healthy, even though I could probably have gone anywhere with my grades. I find it  laughable then, that after settling, they found it within themselves to de-boardinise me. Oh well…

Having gone through all the challenges, missing school and exams. Sickness and hospitalization. After all that, I make it to senior high school, and what do you know? I am not even going to be given a fair playing-field  to make it to university? Seriously?

Give me a reason why they were right to de-boardinise me and I will give you 10, why their reasoning was flawed.

Medicine and science have progressed so much, it is even astonishing what we can achieve now. Yet, someone happens to have sickle cell disease and you treat them so unfairly. We might as well go back to being hunters and gatherers, live in caves. then we can justify our atrocious behavior!

Dedicated to the high school student currently fighting her de-boardinisation for having sickle cell disease. I did not fight  when it was done to me, and several others have suffered the same ordeal. Keep fighting. It starts with you, be the change you want to see in the world.

Sickle Life? Really?

HI guys,                                                                                                                                             hope you are all well and staying healthy, living and loving each day for the blessing that it is.

I guess you are wondering, why ‘sickle life’? What is sickle life? Simply, it is my life.The daily struggles living with the sickle cell condition. The ups and downs. Yes, I said ups, because there are many, even though I battle daily with this genetic disorder.

So, who am I? Well, I answer this question everyday that I have breadth. I am African, specifically, from  Ghana, West Africa, but fundamentally, I am human, the one thing that unites us all, and to me, the only description that really matters.

I have been living the sickle life for 23 years, with all its challenges, however, for everyday that I am alive, I am very grateful, for an opportunity to live another day to the fullest. to make it count.

Non-conformist, is another description I use for myself. Simply because, I will rather create a path and walk it alone, than follow others, knowing that, more often than not they have no idea what my peculiar circumstances are.

Driven, passionate, that is who I am.Sickle cell disease may be considered a disability to some, but to me, it is another stepping stone to greater heights.The drive to be better than most, arose from the realization, very early in my life, that sickle cell, is no excuse for failure. Thus for every moment that I am healthy, I go all out to achieve success.

Thus, the brain behind sickle life,23 year old lady, who happens to have sickle cell disease. Life is the focus. Living each day to the fullest, making each day count and certainly not allowing myself to be limited by other peoples perceptions of this disease.

And oh, I also happen to be a fourth year medical student. Saved this for last, because really, it is not my identity. The point here is, my passion and drive, as well as my non-conformist attitude have brought me thus far. If you have sickle cell disease or know anyone with it, you have a fair idea of how much school I have had to miss, examinations I have missed or written in absolute pain, but despite all that, I have made it to medical school and I am thankful. It has been difficult, but I am not one to quit.

All I seek to do, is inform and educate you about Sickle cell disease, in a manner that is easy to understand. share my experiences with you, and ultimately get you to get tested to know your sickle cell status and hemoglobin genotype, so that you can make informed life choices.

Thank-you.