Preventing Ebola from entering Ghana: What you need to know

Audio By Carbonatix

For Ebola preparedness and response, there are three main strategies:

1. Preventing Ebola from entering Ghana
2. Detecting, confirming, confining and treating (if a case emerges in Ghana)

3. Educating the Public and sharing information

PREVENTING EBOLA FROM ENTERING GHANA

Here is where at KIA and the Points of Entry we need to be vigilant and screen travellers. Port Health staff will need coaching, training and PPE to do this work. Headquarters and RHDs of regions with entry points (borders) are the ones to train the Port Health staff and no one needs instruction to do this.

As part of the training, RHDs are to show how the screening tool circulated by Disease Surveillancd Dept (DSDD) is to be filled and the steps to take if Fever plus another symptom is reported. RHD are to monitor the performance of the Port Health staff in their designated points. Remember there are over 45 points of entry and we have some (14) designated. If a region mounts surveillance on more of its points, that is even better.

At KIA, the Port Health Staff have been trained by office of Dir PHD and are already carrying out screening of those arriving from countries with reported cases. Obviously the work there is improving day by day as Ebola is new to us and we all learning by doing.

The Ghana Airport Company has identified a holding room, created Container-type isolation facility and concluding discussions to install temperature detector.

The Universities are reopening soon. Today we had a meeting at School of Public Health where we discussed how students coming from affected countries can be screened, suspected cases held for specimen collection and if positive what will be done. We also discussed channels of communication and students education. The FELTP residents will have a key role here. Thanks to Prof Afari And Dr Wurapa.

We expect that RDHS in Northern, Brong Ahafo, Ashanti, Greater Accra, Central and Volta regions will pick up similar discussions with authorities in their respective Universities so we can prevent ebola from entering Ghana through students. Note that the first case of H1N1 in Ghana was a Medical Student who returned from UK after vacation.

DETECTING, CONFIRMING, CONFINING AND TREATING

Detecting cases will be in hospitals, clinics, pharmacy shops etc. The clinicians and nurses will need sensitization on the case definition which they must use.

District Directors and Medical Superintendents have a role here and the material (Algorithm) sent to RDHSs will prove useful if shared. RHDs will have to check from health facilities to see the extent and effectiveness of this sensitization.

When a case is suspected, that case has to be sent to a Holding Room where blood specimen will be collected and shipped to NOGUCHI for confirmation. The SOP for lab has been sent to all RDHS and when discussed with the Senior Lab officers in the regions should reach the District Hospital lab incharges for use.

Identifying holding rooms is the responsibility of RDHS working with the Districts and facility incharges.

When NOGUCHI confirms a case, that case must be confined (moved from the Holding Room to an Isolation Centre). Given the specific requirements of such a centre, the Ministry has initiated construction of one at Tema and it is planned that there will be another at Bolga.

Truth is one is needed in every region and I am very unhappy at the pace in deciding and initiating these constructions. The up and down we have made to get this first one started when we have NADMO and the Military on our National Committee who have some expertise that could speed up the process of mounting such tent isolation centres creates frustration and must be voiced out.

In the meantime, RDHS have to idetify existing structures and prepare in case a case is confirmed in your region. We will be happy to hear from RDHSs names of health facilities where the regional Isolation centre is located. Complaining won’t bring isolation ward. Kumasi South Hospital I know has prepared a place and we commend the Management. KATH according to DG GHS, has also prepared a place.

For treatment of cases, the appropriate clinical team has to be assembled. At the moment that has not been done. To make this effective, KATH, KBTH, TTH have to provide experienced Physicians with experience in managing "Fever Units" who will lead the northern, middle and southern zones case management teams. The Minister of Health has to instruct these institutions to provide names of such Lead Drs. In my view unless the DG of GHS pushes this agenda, it wont happen.

I am sure by now the Regions that will commit staff to the Response Team (Clinical care and PH) have received from the Emergency Operating Centre (Office of Director PHD) the propoaed list of professionals to be in the team and from where they will be picked.

Personal Protective Equipment (PPEs) is critical in ebola case management. DSD has prepositioned some PPEs in the ten regions and in the Teaching, Police and 37 Military hospitals and at NOGUCHI. RDHSs have to move to the regional medical stores, get the boxes opened and supervise repackaging and note how many COMPLETE sets are available. For example, when I was given my PPE last week (5 sets), there were no boots and Aprons. So they are incomplete and there is no reason why such incomplete PPE set should be tolerated and accepted. So please, go check your PPEs and notify DG and copy us.

At headquarters we have to keep the pressure to ensure that Ghana buys its own PPEs instead of relying on WHO that has provided the highly inadequate and most times incomplete sets of PPEs. We are grateful to WHO Country office.

PUBLIC EDUCATION AND COMMUNICATION

If your Regional and District Coordinating Councils have not held a meeting to discuss ebola, then that is a disaster to start with. Please do it and lets get your feedback.

The Regional Minister and District Chief Executives can use their influence to help

1. Print many copies of the Posters and Fyers (which soft copies Ag Dir PHD has sent to RDHS)

2. Spread key messages on Radio and by using vehicle-mounted public address syatem (PAS) e.g.Information Service Van, Revenue Collection van etc

The soft copies of materials sent to RDHS must reach DDHSs and those without functional email addresses can be called to come pick up.

At headquarters, it is unbelievable how long it is taking to move from "soft copy ready" to "printing" !! God save Ghana.

In the light of such delays, we have put some twi audio and twi video through whatsApp and nkw gine viral. Please lets use all channels to spread the message. As much as possible we dont need to create panic especially as the disease spreads only through contact with infected person or his secretions and eating or touching contaminated bush meat.

I will end by touching on LEADERSHIP AND COORDINATION

At HQ, the advisory body is the NTCC and the Coordinating point is of Office of Director Public Health.

We have put together a National Preparedness and Response Plan with budgeg almost gh¢5m. This has been reprioritised to gh¢0.9m. As far as I am aware, MoH has released to GHS gh¢50,000 part of which has gone to NOGUCHI (gh¢16,000) and Communication (¢gh19,000). So far my office has received gh¢00.00

The reprioritised total amount of gh¢0.9m has reached MoH (last week) and we hoping disbursement and procurements will start soon. I will suggest RDHSs try to mobilize private sector support (Banks, Industry etc) for some of the activities as printing.

I conclude by saying that ebola is very infectious, it is lethal but we have to position ourselves to deal with it should we get a case. This calls for the contribution of each one of us as Health Professionals. We owe it as a duty to Ghana. We need to take care of our technical responsibilities and keep lobbying the politicians to rise to the occasions. The challenges are many but we must keep doing our work.

Thank you.

kyei-faried

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