I am glad that the Ministry of Health have stated that tests at Noguchi failed to confirm the suspected Ebola case.
While tests are very useful in Medicine, they can be misused, either innocently or deliberately.

I remember visiting a Hospital that shall remain nameless with a group of students from UCC School of Medical Sciences in 2012. When we got there, I decided to visit their Medical ward and to join in their rounds. There, I learned that they had a Cholera outbreak and that the hospital was in emergency mode to deal with the crisis. Aside from the patients, quite a few of the medical personnel were quite scared of the possibility of contracting the dreaded disease.

When I asked the physician on the ground how the Cholera out break had been identified, he cited a specific case. I was curious. I asked whether the diagnosis had been confirmed by a lab test. It turned out that no attempt had been made to confirm the suspected outbreak with scientific laboratory diagnosis. Within hours, it was determined that in the absence of no confirmed lab diagnosis and one suspicious clinical case, the hospital probably did not have cholera outbreak.

In 2008, I also came across a case that I have recounted here before, of a woman of about 30, without any clinical complaints who had gone for an "executive check-up" and based on one EKG, which I later determined to be normal, been told she was having a heart attack.

What troubled me about that case was not that the diagnosis was unjustified-- it was that once the diagnosis had been made, she had been allowed to drive on her own, terrified, to find and terrify her husband too with the false news. After talking to her for 5 minutes and examining the EKG, I was able to assure the terrified family that she was not having a heart attack.

On a ward in Cape Coast, I saw a patient brilliantly diagnosed with Bilhazia and started on treatment. He was discharged a few days later. When I saw the patient a month later for follow-up, I found out that despite the fact that his urine examination had not confirmed the diagnosis and that he had not responded to the medication, he was still discharged with the same diagnosis of Bilhazia.

This, of course, is not unique to Ghana-it is just more common. Last week, I saw a patient who had been told that she had Lyme's disease, based on her symptoms and a test. She was very worried and emotional. It turned out that out of five out of ten bands required to be positive for the diagnosis, she had only one. Clearly, she did not meet the criteria for making the diagnosis.

I have taken the time go over these cases in the hope that it will help all of realize the appropriate place of tests in making medical diagnosis. While sometimes an experienced physician may disregard a discordant test in the face of overwhelming clinical evidence, it is also true that an inexperienced person may mis-read a test to the detriment of a patient. In the case of Ebola, the necessary confirmations should have been obtained before scaring the public.

Finally, it brings home forcefully to me, the words of a US Campaign strategist who taught me so much. "Arthur K" he said, "in Ghana, your big men have firm opinions without data". That, my friends, is our curse.