Prevention saves lives – Meningitis in a resource constrained setting -by Dr. Teddy Totimeh – A physician in Accra, Ghana

Four students have died. One after the other over a ten day period. And the diagnosis is only certain now, after they died. In a country with 5000 doctors, multiple teaching hospitals, a Ministry of Health, and a Health Service, this is not acceptable. Especially if the country has had 60 years to build a system. It is not right. If there was a war going on, it would be excusable. If there was famine, civil unrest, natural disaster… maybe, this would be easy to ignore. Not in this Ghana. Not at this time.

On the other hand, considering that there are 2 newly built, multimillion dollar, appropriately commissioned centers of excellence in the same city waiting for medical staff to start working in them months after completion; and that there are 3 hundred physicians newly trained, who have been sitting at home for six months unemployed. There are municipal hospitals in regional capitals run almost completely by physician assistants… it is not surprising, that 4 students will die, in rapid succession, and we have no idea why.

And in 2017, we are able to yield our intellects to rumors of spiritual deaths, and panicked desertions of schools, distributing potentially infected patients, unscreened, into the wider society without prophylaxis. In 2017, we still have no way of anticipating the meningitis season, and vaccinating the vulnerable populations in the endemic areas, and educating them so that if students in crowded dormitories in these areas present at the hospital with fever and chills, there is someone there prepared to make the diagnosis and administer treatment.

And we have a media, with reporters, repeating the theories debunked decades ago, about heat causing meningitis. We have communication departments in the Ministry of Health, Ghana Health Service, Ghana Education Service and there is not a single public service announcement on meningitis. And four students have died already! We have a media blitz on galamsey (illegal gold mining) and our impending water deprivation, and not a single poster on meningitis in the meningitis season, so that whoever first saw those four could have resisted the urge to dismiss the students as malaria infected. It was BBC which broadcasted the tens of deaths in nearby Nigeria, just weeks ago. It was BBC which informed listeners about a new strain, that had become more virulent in this epidemic. We have media that monitor the global news. We have strategists who follow the infectious disease trends. And not even the multiple deaths in the country next door, could alert us.

Four students have died of a preventable disease. And no one will resign, no one will take responsibility, not the headmaster, not the nurses at the sick bay, not the physicians who missed the diagnosis, not the governmental agencies who did not inform. No one will step up and say why this should not happen in a civilized country, and why it should not happen again because something can be done about it.

Four students have died. And this week the students have come back to the school in their numbers for academic reasons… some exam coming up. And someone in leadership at the school is on radio, and acting surprised that the students actually turned up. And I have not heard anything about the screening that is supposed to have started as the students started turning up, or the vaccines that are being arranged to be transported to the locality, or the strain of bacteria that has been isolated, and if it is the same as killed scores in nearby Nigeria.

And 4 students have died already.


Posting from Teddy Totimeh a colleague working in Accra, Ghana