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HOW TO Guide

How To with health


  WELCOME  TO  GHANA !


INFORMATION ON HEALTH AND RELATED ISSUES

 
Readers are also invited to read our "Health alerts and advisories"
and "How to with medical providers" pages.
This page of the HELP section lists selected hospitals and Embassies-provided selections of medical providers.

Your inputs to update and develop this page are highly welcomed and will be published after due dilligence.
Do share your experiences about health in Ghana and do not hesitate to write to editor@accraexpat.com.
Your feedback is also highly appreciated. Please write to feedback@accraexpat.com. Thank you.


Introduction
Information about specific high risk health concerns in Ghana
Rainy season

 

INTRODUCTION

Overview of health care in Ghana

When it comes to medical services and standards of health care, Ghana is a very tricky situation to assess accurately given the huge variety of standards with regards to health care facilities.  Unfortunately there is not one health care centre which has all the requirements for every area of health care.  Instead, there are pockets of excellence at a variety of places. At the same time, the ignorance and arrogance, the incompetence and poor training of some doctors and nurses, even in the best clinics and hospitals, is a fact.

It is important to ensure that you have someone with some medical knowledge advising you to the reputable facilities as the risk of being treated inadequately in a local facility in this environment is very high.

In addition it is important to note that the level of health care available deteriorates rapidly once you leave the capital centers of Accra and Kumasi, Travelers and foreigners need to acknowledge the risks of being treated outside of those centers and rather get themselves back to Accra if and when they are severely unwell.

Visit the travel website of the Centers for Disease Control and Prevention.

See this Heath Information for Visitors to Ghana page from the American Embassy (2012).

Recommended vaccinations before moving to Ghana

It is highly recommended that all travelers, visitors and foreigners to Ghana have all their essential vaccinations against the regular illnesses typical to developing countries. The risks faced - general hygiene, food-related hygiene, malaria exposure, eventual animal contact, etc.) are not to be disregarded, athough it varies depending on the type and location of work and the living conditions and location.
- It is assumed that all have received and are renewing DT Polio vaccine,
- Yellow fever vaccination is mandatory when entering Ghana for anyone above 9 months old. The vaccination card is often checked before entering the Immigration hall.
- Hepatitis A & B, Typhoid and Meningitis are advised vaccinations when traveling or moving to any developing country. MenAfriVac for meningintis was specifically designed for Africa. Pills (Vivotif) as Typhoid vaccine are available in Switzerland (affordable and no injection – active on children above 6),
- Rabies, although not a full vaccine, is recommended if one will be in contact with animals. The extra time the pre-contact vaccine buys can be critical. One must then get the post-contact rabies shots but they are not always available, even in Accra. Ultimately, should you feel your risk of exposure to rabies will be high, you may want to bring and stock the post-contact shots.

Prevention through hygiene, especially about food, is essential. Eating healthy and exercising helps too. Fresh fruits and vegetable are easily available (see the “How To not starve the first days” page)

INFORMATION ABOUT THE SPECIFIC RISK HEALTH CONCERNS IN GHANA

Tropical Diseases

As all tropical countries and third world environments there are a host of different diseases – Ghana is no exception. Bear in mind however that there are diseases in all countries not just the developing world and often the increased rates of illness are not due to more disease per se but due to the lack of access to reputable health facilities instead.

With sensible precautions in the right areas health risks in Ghana can be minimized.  Ensuring clean bottled drinking water at all times is a huge area where one can avoid contracting the whole host of water borne diseases found here.

Only eating food at reputable restaurants and not from vendors on the side of the road would also avoid exposure to food borne illnesses.

Malaria in Ghana

The following is not to unduly frighten readers but to create awareness of how dangerous malaria can be. According to the Ghana Ministry of Health, in 2009 budget, an amount of GHS 921 million was allocated to the health sector, out of which nearly ninety percent was spent on malaria alone. Available statistics indicate that about ninety percent of deaths due to malaria in the world occur in Africa. According to WHO, Ghana had an estimated 7.2 million cases of malaria in 2006, out of which 3.9 million occurred among children less than five years (the largest cause of under five deaths, at 26%).

Malaria is a disease that is transmitted via the bite of a mosquito that transmits a parasite known as Plasmodium into the blood stream. There are various types of the parasites but the most common type in Ghana is the Plasmodium Falciparum, transmitted by the female anopheles mosquito. Symptoms of malaria include: fever, chills, joint pains, sweating, headache, pallor, fatigue, nausea, vomiting, in some cases, flu-like symptoms and diarrhoea.

Prevention is far better than medication. However, one can take prescribed anti-malarial medication until accommodation issues and prevention set-up are settled. It is not recommended to take preventive medication for longer than a couple of months or a short-stay as none of the pills have been tested for usuage of more than 3 months. Malarone is considered best but is costly.

For prevention, everyone is encouraged to take precautions all year-long, especially during the rainy season, by taking into consideration the following measures:
1)      Using of insecticide repellents, especially when outdoors and at night. It is best to bring them from abroad (Anti-Brumm from Switzerland is excellent). Burning Citronella oil in a burner for essential oils works well and is natural (safe for kids).
2)      Using insecticide-treated mosquito nets, at least for children beds. The most active time for mosquitoes to bite is during the nighttime hours,
3)      Wearing long, protective clothing when going outdoors, especially in the evening and early morning. Avoid dark-colored clothes/fabrics which mosquitoes are attracted to,
4)      Ensuring that windows and doors in homes are closing well and have intact mosquito nets,
5)      Keeping surroundings clean and draining stagnant waters (where mosquitoes breed),
6)      Regularly fumigating outdoor areas of the house. Unless you are using a recommended company, first check and research which chemical is used. When living in a compound, ensure fumigation is taken care by property management,
7)      Covering any cisterns or holes where the mosquitoes can hide and breed.
Sleeping with AC or at least a fan helps to keep mostquitoes away.

When any of the symptoms are experienced, a prompt presentation to a reliable health facility is advised for early detection and treatment in order to avoid complications. It is recommend to not self-medicate as this increases the chances of complicated malaria but should there be a delay in detection, one can start treatment, for example with Coartem from Novartis which is easily found in Ghana and can be kept at home in the refrigerator at all times.

Cholera - learn about the ongoing situation in the Health Alerts & Advisories page

Cholera is a severe and often fatal disease if not immediately treated and can be prevented by ensuring proper hygiene.

Cholera is an acute diarrhoeal illness caused by a bacteria; Vibrio cholera that can result in a profound and rapidly progressive dehydration and death. Humans become infected incidentally but, once infected we act as vehicles for spread. Ingestion of water and food contaminated by infected human feces is the common means of acquiring the disease.

The main symptoms are profuse painless watery diarrhea and vomiting of clear fluid. These symptoms usually start suddenly, one to five days after ingestion of the bacteria. The diarrhoea is frequently described as "rice water" in nature and may have a fishy odor or somewhat sweet inoffensive odor. An untreated person with cholera may produce 10-20 liters of diarrhea a day with fatal results. If the severe diarrhea and vomiting are not aggressively treated it can, within hours, result in life-threatening dehydration and electrolyte imbalances. Cholera is diagnosed by identifying the bacteria in stool. The mainstay of treatment is rapid replacement of fluids and electrolytes. Antibiotics are also given to shorten the course and duration of the symptoms but people will recover without them if they are adequately rehydrated.

PREVENTION
Less than 1% of people who contract cholera will die from it, if it is treated quickly and properly. Cholera is easily preventable if proper sanitary and hygiene practices are followed. Provision of safe water and facilities for proper disposal of faeces, and preparation and storage of food under hygienic conditions are essential in the prevention and control of cholera.

Outbreaks of Cholera are most common in areas described in Ghana as Zonga which basically means slum areas. Expatriates are therefore unlikely to be in such an area.
People living in such areas who are known as "“transmitters" of a disease can exhibit little or no symptoms of a disease but carry and can act of vectors of a disease.

Avoid eating cold meals from roadside chop bars and restaurants.
Consider the establishement you are in before accepting ice in a drink and ordering any salad or othe raw food.
Drink from unopened bottled water.
Do no leave any uncovered food in your house as insects may be been previously in contact with Cholera infected matter.
Properly store of food.
Always wash hands when entering your home and after visiting any washroom.

VACCINE
Injection and oral vaccine are available in some countries, however it’s not much recommended because it provides immunity for a few months only and also immunity is not very reliable.

Report to your doctor immediately if you have vomiting and diarrhea.

See updates about cholera on the "Health alerts and advisories" page.

Buying Reputable Medications

Most medications can be fairly easily found in Ghana except for some specific medications, or new medications on the market or those which are extremely expensive.  Due to the heat and humidity it is essential to always buy your medications from a reputable source where you can be sure that the cold chain and storage temperature of the medications is well respected. 

In addition be aware that in this environment there are plenty of fake medications and cheap brands which have flooded the market here and they may not be recommended.

Avoiding Self Medicating

Unfortunately in Ghana almost all medications can be purchased easily over the counter without a prescription even those which are strictly only under doctors’ orders only in most other countries. This makes for self diagnoses and self treatment very common and also very risky. We would like to warn families that whilst in most countries fevers can easily be managed and self treated that in this environment it is a huge risk to try and self diagnose and treat and self treatment already begun can also make for difficult diagnostics once you reach a doctor as medications can mask and suppress normal symptoms and clinical presentations. 

People should be encouraged to avoid self treatment for malaria or other disease without a reliable diagnosis being made through a full blood counts. Increased abuse by individuals with antibiotics and malaria treatment increase drug resistance both individually and on a community level.

Dangerous roads and dangerous driving

Ghana has a significantly high incidence of road traffic accidents. This is the results of a disastrous combination of unmaintained vehicles, poor driving, and bad roads. In addition villages are located close to major roadsides making for additional hazards of people and animals crossing roads.

In order to minimize risks on the roads in this region people are asked to avoid driving outside of the major cities at night, to practice defensive driving skills at all times and to ensure their vehicles are always well maintained.

RAINY SEASON

The regular seasonal rains start in June (and last till October), bringing the relief of coolness but along with that always come the additional risk of unwanted puddles and stagnant water bodies to increase the breeding grounds for malaria mosquitoes.

We would like to take this opportunity to remind people of the risk of malaria and that whilst the majority of early diagnosed cases of malaria are easily treated and resolved that people still die each day in Africa from complicated or cerebral malaria. 

We remind people especially pregnant mothers and small children not to place themselves at any additional risks by not sleeping under mosquito nets.  We emphasize that even though you live in a quality house with nets on windows and air-conditioning, mosquitoes can be are tiny: if you can get in and out your house on a daily basis so can they.

The Malaria chapter above includes advice on prevention. Be sure to be well aware of all the side effects of malaria preventative medications should you wish to go this route of prevention.



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