Questions are mounting over the design and safety of Ghana’s hospitals, as new evidence points to deteriorating air quality, unsafe carbon dioxide levels, and ventilation systems that may be fuelling the spread of infections.

A senior lecturer and researcher at the University of Ghana, Professor Ebenezer Prof. Amankwaa, is warning that many of the country’s health facilities are not built to withstand a changing climate.
Air-conditioning, long seen as a symbol of modern, safe, and comfortable healthcare, is now under scrutiny. In many wards, it may be doing the opposite, circulating risk instead of reducing it.

Emerging findings show that carbon dioxide levels in some hospital spaces are rising beyond acceptable limits, with air quality deteriorating in environments meant for healing.

“They leave the AC on thinking it's blowing, but it's not blowing anything. It's just the air that is recirculating in there,” Prof. Amankwaa said.

“We established poor air quality in the OPD, the children’s ward, and the pediatric unit, all had very high CO₂ concentrations beyond the acceptable limit.”
In sealed, air-conditioned wards, air does not circulate, it stagnates. And with it, bacteria, viruses, and heat. The research reveals a sharp contrast: wards with natural ventilation, like open windows and cross-breezes, record significantly better air quality, while enclosed, air-conditioned spaces trap stale, potentially contaminated air.

“We realised that in most of the wards, the air conditioners were not working,” he added. “That creates humid conditions. If someone has an infection, the air simply recirculates pathogens and bacteria.”
The implications are stark. According to Prof. Amankwaa, such conditions may have contributed to fears during the COVID-19 pandemic, when many avoided hospitals over concerns they could contract infections there.
For some patients, the issue is deeply personal. Mothers worry not just about treatment, but about the quality of air their children are forced to breathe.
“As for us adults, we can manage, but what about the children?” one mother, Akosua, questioned. “In the past, we were told too much air was not good for newborn babies. Now the ward has AC.”
Others argue that while air-conditioning should not be discarded entirely, stricter infection control measures must accompany it.

“I prefer air-conditioning in wards because some people are used to it at home,” one patient said. “But there should be protocols, like wearing nose masks, so infections don’t spread.”
As temperatures rise and heatwaves intensify, the debate is shifting from comfort to survival. Are Ghana’s hospitals climate resilient or climate fragile?
“Climate fragile,” Prof. Amankwaa stated bluntly. “We are not building climate-resilient hospitals, and we are not putting up climate-proof infrastructure.”
He argues that the solution may not lie in more machines, but in revisiting time-tested design principles.
“We need to go back to the old architecture,” he advised. “Many older hospital buildings had vents designed to release warm air, while windows allowed cool air in.

Today, those vents are blocked. Everything is sealed, and we are unable to maintain the AC systems we depend on.”
He warns that without proper maintenance and monitoring, conditions inside hospital wards will continue to deteriorate, undermining patient recovery rather than supporting it.

“After two years, you begin to see facilities deteriorate because we are not maintaining them,” he said. “Patients are left in conditions that do not contribute to their healing.”

Air-conditioning may bring comfort. But without proper ventilation and resilience, it risks turning hospital wards into sealed spaces of heat, humidity, and recycled infection.

In an era of climate change, the future of healthcare may depend on a simple but urgent shift: not just cooling the air, but letting it flow.