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Thu, Apr

thoughts from afar

    • Further, the government will have to find innovative ways of funding the NHIS. The current funding structure has seen the scheme chronically indebted to service providers, resulting in threats of service withdrawal.

    Seth Godin argues in Tribes that “leaders lead when they take positions, when they connect with their tribes, and when they help the tribe connect to itself.”

    • On a webinar this week about health policy in the developing world, I was asked what I envisaged healthcare in Ghana will look like in 15-20 years. I was initially pensive...

    James Allen in As a Man Thinketh argues, “A strong man cannot help a weaker unless the weaker is willing to be helped, and even then the weak man must become strong of himself; he must, by his own efforts, develop the strength which he admires in another. None but himself can alter his condition.”

    • Sadly, it comes across that amongst the 275 sitting Members of Parliament whom we queue to vote for on a four-yearly cycle, some are hell-bent on flouting the laws of the land in a manner that will put more lives at risk. Having tested positive for SARS-COV-2 ...

    “Pick a leader who will make their citizens proud. One who will stir the hearts of the people, so that the sons and daughters of a given nation strive to emulate their leader’s greatness. Only then will a nation be truly great, when a leader inspires and produces citizens worthy of becoming future leaders, honourable decision makers and peacemakers. And in these times, a great leader must be extremely brave. Their leadership must be steered only by their conscience, not a bribe.”

  • “The man who cannot listen to an argument which opposes his views either has a weak position or is a weak defender of it. No opinion that cannot stand discussion or criticism is worth holding. And it has been wisely said that the man who knows only half of any question is worse off than the man who knows nothing of it. He is not only one sided, but his partisanship soon turns him into an intolerant and a fanatic. In general, it is true that nothing which cannot stand up under discussion and criticism is worth defending.” James E. Talmage

  • Susan Elizabeth Phillips in Breathing Room argues, “I finally figured out that not every crisis can be managed. As much as we want to keep ourselves safe, we can't protect ourselves from everything. If we want to embrace life, we also have to embrace chaos.”

  • As a young student pharmacist, I fell in love with this classical definition of drugs and poisons, “a drug is a poison at low concentrations and a poison is a drug at high concentrations.” That every drug even the most innocuous is a potential killer is a known fact. I have over the years observed how our country has fallen in love with all manner of legal medicines and the ease with which these medicines can be obtained.

    • But, in reality, this must not be a cause for celebration. It is not because, with a population growth rate of 2.25% ...

    Christophe Galfard in his book, The Universe in Your Hand, argues that “a clock that is moving through space at a very fast speed does not tick at the same rate as a slow-moving watch gently attached to your wrist as you stroll on a tropical beach. The idea of a universal time – a godlike clock that could somehow sit outside our universe and measure, in one go, the movement of everything in it, how its evolution unfolds, how old it is and all that – does not exist.”

    • Unfortunately, the reality is, we are a distance away from this form of openness mainly due to our “winner takes all brand of democracy” and must make the best out of our current circumstances.

    “When we least expect it, life sets us a challenge to test our courage and willingness to change; at such a moment, there is no point in pretending that nothing has happened or in saying that we are not yet ready. The challenge will not wait. Life does not look back. A week is more than enough time for us to decide whether or not to accept our destiny.”

  • Dear NHIS,

    You cannot continue to have a high budget for medicines whilst trying to clear your historic debt. No insurance scheme has survived with a recurrent drug budget of more than 28%. To continue that way means you have little of your capital inflows to invest and nothing left to clear your debt.

  • Dear NHIS,
    It’s me again trying to be a citizen helper. I have been wondering why we still have manual claims for pharmaceutical and medical reimbursement and capitation? In this era of computational software and Apps, this can’t just be right.

  • Opinion is that “the world we build tomorrow is born in the stories we tell our children today.” Over this weekend I have been pondering over a question I often ask myself regarding Ghana, i.e. “What have we done so wrong to deserve such a mess?”

    • The fact is, our health system always makes and breaks our hearts. It does because whilst a lot of good goes on, ...

    According to Saidi Mdala, “bad luck is what results when bad things happen to you unprepared, or when you neglect to do what you have to do when you are supposed to do it.”

    • With Ghana signing up to deliver Universal Health Coverage (UHC) by 2030, we must begin to understand the human resource requirements needed to achieve this and plan to ensure these are available.

    Jay Asher in “Thirteen Reasons Why” states, “no one knows for certain how much impact they have on the lives of other people. Oftentimes, we have no clue. Yet we push it just the same.”

    • Since the start of the COVID-19 pandemic, there has been an acceptance that the only way to end it and return society to some sense of normalcy was going to be through the discovery of viable vaccines.

    Robert Sears in “The Vaccine Book: Making the Right Decision for Your Child” states “most anti-vaccine books claim that all shots are bad, the diseases aren’t really anything to fear, and as long as you live a natural and healthy lifestyle, you don’t have to worry. I think this is a very irresponsible approach to the vaccine issue. Vaccines are beneficial in ridding our population of both serious and nonserious diseases.”

    • Truth is, as a people we are not by default law abiding. Even when the laws are strictly enforced, we have the penchant for finding ways of breaking them.

    “Instead of fleeing God’s scrutiny, David welcomed it. It’s like he was saying, “Look, God, since I can’t hide from you since you know my very thoughts before I think them, I want you to fully know me. Be in the very core, the essence of my being. If you’re going to know me, then know everything about me!” Will Davis Jr

  • “This light of history is pitiless; it has a strange and divine quality that, luminous as it is, and precisely because it is luminous, often casts a shadow just where we saw a radiance; out of the same man it makes two different phantoms, and the one attacks and punishes the other, the darkness of the despot struggles with the splendour of the captain. Hence a truer measure in the final judgment of the nations. Babylon violated diminishes Alexander; Rome enslaved diminishes Caesar; massacred Jerusalem diminishes Titus. Tyranny follows the tyrant. Woe to the man who leaves behind a shadow that bears his form.”

    • The Potential Beneficiary of the COVID-19 Pandemic

    “When faced with a radical crisis, when the old way of being in the world, of interacting with each other and with the realm of nature doesn’t work anymore, when survival is threatened by seemingly insurmountable problems, an individual life-form or a species will either die or become extinct or rise above the limitations of its condition through an evolutionary leap.”

    • This coupled with a fluctuating Cedi and inflation puts many at the risk of destitution in old age. Ironically, the current financial sector mess makes it even less appealing to suggest otherwise to those who fail to save.

    Ray Bradbury, in The Illustrated Man, explains, “We’re all fools,” said Clemens, “all the time. It’s just we’re a different kind each day. We think I’m not a fool today. I’ve learned my lesson. I was a fool yesterday but not this morning. Then tomorrow we find out that, yes, we were a fool today too. I think the only way we can grow and get on in this world is to accept the fact we’re not perfect and live accordingly.”

    • If we do not, we must be aware that unless we find a way of saving for our old age, stealing from the public coffers to build our geriatric war chest in anticipation of the inevitable or have faith in our ...

    “Man’s lives are not progressions, as conventionally rendered in history paintings, nor are they a series of facts that may be enumerated and in their proper order understood. Rather they are a series of transformations, some immediate and shocking, some so slow as to be imperceptible, yet so complete & horrifying that at the end of his life a man may search his memory in vain for a moment of correspondence between his self in his dotage and him in his youth.”

  • Chaim Potok in Davita's Harp opines, “Everything has a past. Everything; a person, an object, a word, everything. If you don’t know the past, you can’t understand the present and plan properly for the future.” This is a view I strongly agree with.

    • A look at the contract signed with Sheik Al Maktoum’s group should leave you concerned. It must because of the people involved in the contract. We hope you are aware that it is now public knowledge that ...

    The last few weeks have been marred by the controversy regarding the importation of Sputnik-V vaccines to Ghana. We doubt if we will have to remind you of the issues that have been raised by many concerned citizens regarding the contracts that have been entered into with the private office of Sheik Ahmed Dalmook Al Maktoum of United Arab Emirates. We want to set off by saying that no one can fault you for wishing to get vaccines urgently in an attempt to meet your target of vaccinating 20-million Ghanaians (60% of the population) by the end of 2021.

    • This is why I believe a second look should be taken at how leaders of the GHS and similar institutions are appointed. My view is that as a minimum, ...

    If someone can show me that what I think or do is not right, I will happily change, for I seek the truth, by which no one was ever truly harmed. It is the person who continues in his self-deception and ignorance who is harmed.” Marcus Aurelius

    • I would conclude by asking, “if spending potentially 38% of our total health expenditure or 2.4% of our GDP on otherwise useless medicines does not push us to rethink our national approach in this area, what would”?

    Roy T. Bennett in The Light in the Heart argues “Do not let the memories of your past limit the potential of your future. There are no limits to what you can achieve on your journey through life, except in your mind.” The 25th of September 2019 was World Pharmacists Day, celebrated this year with the theme “Safe and effective medicines for all.”

    • ... one can only wonder how as a nation we can expect these children to aspire for social mobility when by default we are conspiring to tie their arms behind their back.

    “Maybe it’s a whole lot less about focusing on the fact that we’re all victims and a whole lot more about the changing the fact that we’re all careless, as that is what victimized all of us in the first place.”

    • The youth cannot wait for a yet to be identified appointment time to take over the reins. We are not doing just fine, and that message must be sent without any ambiguity. In fact, it is delusional and deceitful to ...

    The late Alvin Toffler one of the renowned futurists of the twentieth century had this view of how society treated the youth; “The secret message communicated to most young people today by the society around them is that they are not needed, that the society will run itself quite nicely until they – at some distant point in the future – will take over the reins. Yet the fact is that the society is not running itself nicely… because the rest of us need all the energy, brains, imagination and talent that young people can bring to bear down on our difficulties. For society to attempt to solve its desperate problems without the full participation of even very young people is imbecile.”

    • In essence, our stupidity is fuelling the malaria economy. I have stated elsewhere that if malaria treatment was a tax, all Ghanaians by default will be tax compliant.

    “Without realizing that the past is constantly determining their present actions, they avoid learning anything about their history. They continue to live in their repressed childhood situation, ignoring the fact that this no longer exists, continuing to fear and avoid dangers that, although once real, have not been real for a long time.”

    • Considering that on average, the lag time between the taking of samples and the communication of test results in Ghana is approximately seven days, it can be implied that a person who is sampled and later confirmed as positive could cause the transfer of the infection to at least 40 people before he receives his test results and is put in mandatory isolation especially if they are symptomless.

    Having fought many viruses for a career, Peter Piot after fighting off COVID-19 opined, “Many people think COVID-19 kills 1% of patients, and the rest get away with some flu-like symptoms. But the story gets more complicated. Many people will be left with chronic kidney and heart problems. Even their neural system is disrupted. There will be hundreds of thousands of people worldwide, possibly more, who will need treatments such as renal dialysis for the rest of their lives”.

  • According to Friedrich Nietzsche “A thinker sees his own actions as experiments and questions--as attempts to find out something. Success and failure are for him answers above all.”

    • Then there is the matter of the security services. Are they trying to tell us that in this day and age, they lack the ability to infiltrate criminal niches? Or am I to believe that because the finger points at deviant white-collar criminals with little respect for the welfare of our citizens, they have also become numb?

    On the 6th of March 1957, Ghana’s first President Kwame Nkrumah opined, “the black man is capable of managing his own affairs.” In that independence speech, he also claimed that “we must change our attitudes and our minds.  We must realise that from now on we are no longer a colonial but free and independent people.”

  • According to Dr Rob Long “The use of silly and meaningless safety language matters, it creates a distraction and delusion that safety and risk are being addressed. We may feel good about speaking such words but they dumb down culture and distract people from taking safety seriously.”

  • Dean Koontz in his book, The Good Guy argues, “Given enough time, you could convince yourself that loneliness was something better, that it was solitude, the ideal condition for reflection, even a kind of freedom. Once you were thus convinced, you were foolish to open the door and let anyone in, not all the way in. You risked the hard-won equilibrium, that tranquility that you called peace.”

  • Dear Friend,

    H.L. Mencken in a rather sarcastic tone argued. "In the present case, it is a little inaccurate to say I hate everything. I am strongly in favour of common sense, common honesty and common decency. This makes me forever ineligible for any public office of trust or profit in the Republic. But I do not repine, for I am a subject of it only by force of arms." He had a real point then and continues to do so now. There are many in this land who are by default ineligible for any public office. They are because they have refused to be part of the status quo and go against the norm.

    • If you are a reader who has gotten this far and are in midlife with no idea what your chronic health status is, get yourself checked.

    In Laura Ingalls Wilder’s opinion “the real things haven’t changed. It is still best, to be honest, and truthful; to make the most of what we have; to be happy with simple pleasures, and have courage when things go wrong.”

    • In the end, the options they choose invariably harms a lot of people. Estimates indicate that for each attempted or successful suicide, between 135 and 150 people are directly affected.

    “There comes a time when you look into the mirror and you realize that what you see is all that you will ever be. And then you accept it. Or you kill yourself. Or you stop looking in mirrors.”

    • Finally, know your children’s friends and their families. Though our society has deviated markedly from the communal approach in child upbringing, we must not jettison the useful aspects of that approach of yesteryears. We should all be able to speak to other parents...

    “Stories you read when you're the right age never quite leave you. You may forget who wrote them or what the story was called. Sometimes you'll forget precisely what happened, but if a story touches you it will stay with you, haunting the places in your mind that you rarely ever visit.” Neil Gaiman, in “M Is for Magic.”

    • There were indications at this point that there was a concerted effort by well-organised groups some linked with organised crime and international terrorism to create a new generation of youthful tramadol addicts who they could manipulate and control in furthering their ulterior motives. Their target groups were teenagers living in slums and rundown areas and those in second cycle institutions.

    Criss Jami argues in Killosophy that, “Deceit for personal gain is one of history's most recurring crimes. Man's first step towards change would be thinking, counter-arguing, re-thinking, twisting, straightening, perfecting, then believing every original idea he intends to make public before making it public. There is always an angle from which an absolute truth may appear askew just as there is always a personal emotion, or a personal agenda, which alienates the ultimate good of mankind.”

    • I grew up on academic campuses and my experiences on these citadels of knowledge have been instrumental in shaping my views about life. Sometimes, I am inclined to believe that I have forgotten about ...

    “First, they came for the Communists and I did not speak out because I was not a Communist. Then they came for the Socialists and I did not speak out because I was not a Socialist. Then they came for the trade unionists and I did not speak out because I was not a trade unionist. Then they came for the Jews and I did not speak out because I was not a Jew. Then they came for me and there was no one left to speak out for me.”

    • Whilst Africa should continue in its quest to obtain enough vaccines for its population, the present situation demands that citizens whether vaccinated or not strictly comply with all the COVID-19 protocols if this third wave is to be controlled.

    “I have not always chosen the safest path. I’ve made my mistakes, plenty of them. I sometimes jump too soon and fail to appreciate the consequences. But I’ve learned something important along the way: I’ve learned to heed the call of my heart. I’ve learned that the safest path is not always the best path and I’ve learned that the voice of fear is not always to be trusted.” Steve Goodier

    • We have had to pause and ask ourselves, “for a disease where avoiding infection relies more on personal and social behaviours, is community spread a concern in our society? In this, we have concluded that many of the behaviours we are supposed to adapt to stay safe are not our default predisposition.

    Victor Hugo argues in Les Misérables that “teach the ignorant as much as you can; society is culpable in not providing free education for all and it must answer for the night which it produces. If the soul is left in darkness, sins will be committed. The guilty one is not he who commits the sin, but he who causes the darkness.”

    • As the world watches in anxiety and sees China go through these hurtful situations, we all need to be mindful of the choices we make. This is because our health system currently is not robust enough to handle a mass epidemic.

    “We have within us the power to choose how we respond to a hurtful situation. We cannot control the actions of others, but we can control how we will respond. As we understand our power to choose, we see that we are in control. Our life is not a result of our environment or upbringing, but a result of our choices. We have the ability to determine the kind of life we want to live and the type of person we wish to be.” Cameron C. Taylor

    • Already, health officials have indicated that identified contacts of an infected person will have to self-isolate.

    With six confirmed cases of Coronavirus (COVID-19) in Ghana, it is likely that there could be localised person to person transmission.

    • In Africa, the number of new cases seems not to be rising. However, in Ghana serological studies that were undertaken by scientists at the University of Ghana have indicated that the prevalence rate of the virus in the general population is about 20%.

    “Very few beings really seek knowledge in this world. Mortal or immortal, few really ask. On the contrary, they try to wring from the unknown the answers they have already shaped in their own minds; justifications, confirmations, forms of consolation without which they can’t go on. To really ask is to open the door to the whirlwind. The answer may annihilate the question and the questioner.” Anne Rice in The Vampire Lestat

    • We cannot allow our society to become sitting ducks in an epidemic; the nature of which the world is still trying to elucidate and understand.

    “Conspiracy theories are really attractive. Figuring out patterns is one of the things that get your brain to give you a nice dose of chemical reward, the little ping of dopamine and whatever else that keeps you smiling. As a result, your brain is pretty good at finding patterns and at disregarding information that doesn’t fit. Which means it’s also pretty good at finding false patterns, and at confirmation bias, and a bunch of other things that can be fatal. Our brains are also really good at making us the centre of a narrative because it’s what we evolved for.”

    • Today, the race to find a vaccine against COVID-19 is on and again human trials will be required. We hope that this time, Africa redeems itself and fully plays its part in the writing of history.

    “My scars remind me that I did indeed survive my deepest wounds. That in itself is an accomplishment. And they bring to mind something else, too. They remind me that the damage life has inflicted on me has, in many places, left me stronger and more resilient. What hurt me in the past has made me better equipped to face the present.” ― Steve Goodier

  • Honourable, I greet you with this open quote. “Man doeth this and doeth that from the good or evil of his heart; but he knows not to what end his sense doth prompt him; for when he strikes he is blind to where the blow shall fall, nor can he count the airy threads that weave the web of circumstance. Good and evil, love and hate, night and day, sweet and bitter, man and woman, heaven above and the earth beneath--all those things are needful, one to the other, and who knows the end of each?” H. Rider Haggard

    • Also, healthcare donor funding directly fuels corruption. There are many anecdotal reports of funded projects being completed by bureaucrats with data riddle with forged documents and ghost name payments with the bulk of the funds sleazed by those at the top.

    Dambisa Moyo in Dead Aid opines, “Africa is addicted to aid. For the past sixty years, it has been fed aid. Like any addict it needs and depends on its regular fix, finding it hard, if not impossible, to contemplate existence in an aid-less world. In Africa, the West has found its perfect client to deal with.”

    • It is well known that our healthcare delivery system relies predominantly on a manual backbone. However, it is mind-boggling that the problem persists in an era of technological abundance.

    “Humanity does not suffer from the disease of wrong beliefs but humanity suffers from the contagious nature of the lack of belief. If you have no magic with you it is not because magic does not exist but it is because you do not believe in it. Even if the sun shines brightly upon your skin every day, if you do not believe in the sunlight, the sunlight for you does not exist.”

  • Lucille,

    According to Mahatma Gandhi, “your beliefs become your thoughts, your thoughts become your words, your words become your actions, your actions become your habits, your habits become your values, and your values become your destiny.” In short where we are today as a country is an epidermisation of our beliefs and thoughts over the years. Today I would try and answer the simple question you put on your wall, “what are Ghanaian values?”

  • Written By Kwame Asiedu - “To be robbed and betrayed by a fiendish underground conspiracy, or by the earthly agents of Satan, is at least a romantic sort of plight - it suggests at least a grand Hollywood-ready confrontation between good and evil - but to be coldly ripped off over and over again by a bunch of bloodless, second-rate schmoes, schmoes you chose, you elected, is not something anyone will take much pleasure in bragging about.”

    • It is now clear that there is considerable awareness of the menace of tramadol and other opioids. We are all aware of the impact it is having on our youth and the parallel society it is creating. However, we have failed to move from the awareness stage ....

    Malcolm Gladwell in David and Goliath argues, “The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.”

  • Kilroy J. Oldster in Dead Toad Scrolls suggests, "Courtrooms are battlegrounds where society's bullies and the oppressed clash, where the victims of abusers seek recompense, and where parties cheated by scallywags seek retribution. Because of the high stakes involved, the parties are not always honest, and justice depends upon an array of factors including the prevailing case precedent, the skills of the legal advocates, and the merits of each party's claims and counterclaims."

    • I am under no illusion that unless the blame game is dropped, the NPP government will be incapable of operationalizing all these health facilities before the next general election.

    “The greatest scientific discovery was the discovery of ignorance. Once humans realised how little they knew about the world, they suddenly had a very good reason to seek new knowledge, which opened up the scientific road to progress.” Yuval Noah Harari

    • A look at the leadership of these bodies indicates that they are all appointed at the behest of the Executive President and fall under the domain of Article 71 officeholders. Thus, all these leaders have a tenure whose apron strings are tied to the umbilicus of our political establishment.

    “There is nothing more deceptive than an obvious fact. Tell people there’s an invisible man in the sky who created the universe, and the vast majority will believe you. Tell them the paint is wet, and they have to touch it to be sure.” George Carlin

    • Sadly, our society has been late in coming to terms with this new reality. Starting from the individual citizen, very few of us are conversant with our basic health information

    According to Brian Tracy, “all successful people men and women are big dreamers. They imagine what their future could be, ideal in every respect, and then they work every day toward their distant vision, that goal or purpose.”

  • “The best thing for being sad," replied Merlin, beginning to puff and blow, "is to learn something. That's the only thing that never fails. You may grow old and trembling in your anatomies, you may lie awake at night listening to the disorder of your veins, you may miss your only love, you may see the world about you devastated by evil lunatics, or know your honour trampled in the sewers of baser minds. There is only one thing for it then — to learn. Learn why the world wags and what wags it. That is the only thing which the mind can never exhaust, never alienate, never be tortured by, never fear or distrust, and never dream of regretting. Learning is the only thing for you. Look what a lot of things there are to learn.”  T.H. White in The Once and Future King

    • Interestingly, following the release of the respective manifestos of the NPP and NDC, it appears as though this reality is lost on us. In the area of health, ...

    Paulo Coelho in The Devil and Miss Prym states, “in the first place, you shouldn’t believe in promises. The world is full of them: the promises of riches, of eternal salvation, of infinite love. Some people think they can promise anything, others accept whatever seems to guarantee better days ahead, as, I suspect is your case. Those who make promises they don’t keep end up powerless and frustrated, and exactly the fate awaits those who believe promises.”

    • In the end, when tragedy strikes, we have a litany of jokers parading in the name of the anointed, lining up to remind us of their premonition. The effrontery is that these supposed anointed see all the recklessness and lawlessness that fuels their trade but do precious little to remedy the situation, knowing perfectly well that these death traps if remove would almost render them jobless.

     Novelist Steve Goodier, rather candidly opines, “I have not always chosen the safest path. I've made my mistakes, plenty of them. I sometimes jump too soon and fail to appreciate the consequences. But I've learned something important along the way: I've learned to heed the call of my heart. I've learned that the safest path is not always the best path and I've learned that the voice of fear is not always to be trusted.”

    • The raising of red flags is the first step in reviewing the frequency and probability of occurrence of the particular ADR. If the probability of it occurring in those using the medicinal product exceeds that of the general population, most regulators will institute a review of the newly licensed medication and restrict its use further.

    “Very few beings really seek knowledge in this world. Mortal or immortal, few really ask. On the contrary, they try to wring from the unknown the answers they have already shaped in their own minds — justifications, confirmations, forms of consolation without which they can’t go on. To really ask is to open the door to the whirlwind. The answer may annihilate the question and the questioner.”

    • According to Mr Agyeman-Manu, the government was committed to quality healthcare delivery in the country, and so it was working tirelessly toward completing six new hospitals at Tepa, Sewua, Konongo, Kumawu, Fomena and Boaman, all in the Ashanti Region.

    The Minister of Health, Kwaku Agyeman-Manu, says government will no longer expand existing nursing training schools in the country, apart from the specialised ones, because of lack of budget line for the provision of infrastructure in those schools.

  • In the last week I have experienced at first hand albeit from a distance what happens where indiscipline reigns. I will try and craft a piece that encompasses the level of indiscipline and decadence that epitomizes the country we all call Ghana.

  • “The word ‘slavery’ and ‘right’ are contradictory, they cancel each other out. Whether as between one man and another or between one man and a whole people, it would always be absurd to say: “I hereby make a covenant with you which is wholly at your expense and wholly to my advantage; I will respect it so long as I please and you shall respect it as long as I wish.” Jean-Jacques Rousseau, The Social Contract

    • This supposed new normal is going to be lived in a world where economies are shrinking, unemployment is rife, jobs are hard to find and the current model for transacting all manner of business will not be fit for purpose. More importantly, ...

    In Niccolò Machiavelli’s view, “it must be remembered that there is nothing more difficult to plan, more doubtful of success, nor more dangerous to manage than a new system. For the initiator has the enmity of all who would profit by the preservation of the old institution and merely lukewarm defenders in those who gain by the new ones.”

    • As a first step, I believe we must accept that all that happens to us as a people or as individuals is our fault and not a result of chance, bad luck or an accident. Our lawlessness and tendency ...

    “Repression is not the way to virtue. When people restrain themselves out of fear, their lives are by necessity diminished. Only through freely chosen discipline can life be enjoyed and still kept within the bounds of reason.”

    • That documents like the Ghana Health Service Facts and Figures are released annually with little fanfare but the inauguration of boreholes and other similar projects attract our attention and receive significant press coverage is indicative of this reality.

    In typical style, Ralph Waldo Emerson once said, “valour consists in the power of self-recovery so that a man cannot have his flank turned, cannot be out-generalled, but put him where you will, he stands. This can only be by his preferring truth to his past apprehension of truth; and his alert acceptance of it, from whatever quarter; the intrepid conviction that his laws, his relations to society, his Christianity, his world may at any time be superseded and decease.”

    • Like St. Francis’s, I speak up because I believe, I have a responsibility to be involved in dialogue around health innovation that would change the face of our healthcare delivery and improve quality of life.

    According to Mihaly Csikszentmihalyi, “of the many causes that shaped St. Francis’s actions, a primary one was the belief that his actions mattered, and that he had a responsibility to change the world around him. This belief, in itself, is a “cause.” The idea of free will is a self-fulfilling prophecy; those who abide by it are liberated from the absolute determinism of external forces. Chance”

    • In the last ten years, the face of chronic disease management across the world has been changing. These changes have been focused on increasing the role of the patient in staying healthy whilst living with a long-term ailment.

    Cameron C. Taylor argues in Eight Attributes of Great Achievers that “we have within us the power to choose how we respond to a hurtful situation. We cannot control the actions of others, but we can control how we will respond. As we understand our power to choose, we see that we are in control. Our life is not a result of our environment or upbringing, but a result of our choices. We have the ability to determine the kind of life we want to live and the type of person we wish to be.”

    • It is under these clouds that Ghana... will be approaching the general elections in December. We have for a while ...

    Carl Sagan in his book The Demon argues that “at the heart of science is an essential balance between two seemingly contradictory attitudes, an openness to new ideas, no matter how bizarre or counterintuitive they may be, and the most ruthless sceptical scrutiny of all ideas, old and new. This is how deep truths are winnowed from deep nonsense.”

    • The truth, however, is none of the two political colours is being entirely honest with us. A simple review of our national budget spend for the last ten years can point all of us citizens to this reality. Fact is...

    We should resolve now that the health of this nation is a national concern; that financial barriers in the way of attaining health shall be removed; that the health of all its citizens deserves the help of all the nation.” Harry Truman

    • “A complete stranger has the capacity to alter the life of another irrevocably. This domino effect has the capacity to change the course of an entire world. That is what life is; a chain reaction of individuals colliding with others and influencing their lives without realizing it. A decision that seems minuscule to you, may be monumental to the fate of the world.”

    Ghana currently has approximately 3,200 doctors and a doctor to patient ratio of 1: 9043. For us to half our current doctor to patient ratio and bring the figure to 1 doctor to 5000 patients in five years will require a lot of policy planning and strategic thinking. Using the current population of 29 million, this will mean we will need a doctor population of 5,800 in 5 years assuming none of the current stock is lost through, migration, ill health, death or career change. If attrition is factored in at 10% it implies our current stock of doctors will shrink to 2,880 leaving a training requirement 2,920 over five years or 584 doctors yearly assuming none of the newly trained doctors is lost to attrition yearly.

    • Even more worrying is the view of the Minority Leader Haruna Iddrisu who argues that the status quo be maintained. Hear him, “I disagree that ..."

    Tiffanie DeBartolo in How to Kill a Rock Star had this to say. “Did you really want to die? No one commits suicide because they want to die. Then why do they do it? Because they want to stop the pain.”

  • Most early medicines originated from plants. Stephen Harrod Buhner ones wrote, “Fifteen years ago I had an odd dream. In it, a medicinal plant that I was interested in, an Usnea lichen that is ubiquitous on trees throughout the world, told me that while it was good for healing human lungs it was primarily a medicine for the lungs of the planet, the trees. When I awoke, I was amazed. It had never occurred to me in quite that way that plants have some life and purpose outside their use to human beings.”

    • Some have even averred that in times of crisis they will rather be treated on the floor than be turned away due to, “a lack of beds.” Forgetting that, just finding a place in emergency care is one thing but without oxygen, defibrillators, nebulisers and other basic critical care equipment, any health facility that just gave you a furniture space may actually be doing more harm than good...

    “For the most part, people strenuously resist any redefinition of morality, because it shakes them to the very core of their being to think that in pursuing virtue they may have been feeding vice, or in fighting vice they may have in fact been fighting virtue.” - Stefan Molyneux

    • These bootlicking zombies go out guns blazing attacking anyone in their wake, stopping at nothing to even countenance reason and think that others should quiver.

    “There are two kinds of idiots - those who don't take action because they have received a threat, and those who think they are taking action because they have issued a threat.” Paulo Coelho in “The Devil and Miss Prym”

    • What surprised me though was the passiveness of the observers and their lack of compliance with the present social protocols. To start with, these observers were clearly breaking the law by not practising social distancing or wearing facemasks or shields. Yet, ...

    Charles Darwin in “The Descent of Man” argued that “ignorance more frequently begets confidence than does knowledge. It is those who know little, not those who know much, who so positively assert that this or that problem will never be solved by science.”

    • The situation is even worse when it comes to health. In a world where advances in science and medicine have been accepted as one of the main drivers of increased life expectancy; we have neglected the obvious, resorting rather to prayer camps and faith healers.

     Shannon L. Alder argues, “The more you talk about it, rehash it, rethink it, cross analyse it, debate it, respond to it, get paranoid about it, compete with it, complain about it, immortalize it, cry over it, kick it, defame it, stalk it, gossip about it, pray over it, put it down or dissect its motives it continues to rot in your brain. It is dead. It is over. It is gone. It is done. It is time to bury it because it is smelling up your life and no one wants to be near your rotted corpse of memories and decaying attitude. Be the funeral director of your life and bury that thing!”

    • Thirty-two years on, in many parts of Ghana, only the insane still drive straight. From Accra to the hinterlands, I have seen much footage of roads that can be best described as paddy fields. Many of these roads which not too long ago were commissioned with pomp and pageantry as achievements by one previous leader...

    "The pessimist resembles a man who observes with fear and sadness that his wall calendar, from which he daily tears a sheet, grows thinner with each passing day. On the other hand, the person who attacks the problems of life actively is like a man who removes each successive leaf from his calendar and files it neatly and carefully away with its predecessors, after first having jotted down a few diary notes on the back. He can reflect with pride and joy on all the richness set down in these notes, on all the life he has already lived to the fullest. What will it matter to him if he notices that he is growing old? Has he any reason to envy the young people whom he sees, or wax nostalgic over his own lost youth? What reasons has he to envy a young person? For the possibilities that a young person has, the future which is in store for him? No, thank you,' he will think. 'Instead of possibilities, I have realities in my past, not only the reality of work done and of love loved but of sufferings bravely suffered. These sufferings are even the things of which I am most proud, although these are things which cannot inspire envy."

    • In all these instances, we fail to pause and ask ourselves simple questions that may prevent future occurrences of the same situation. In the early part of 2017, there was a report that ...

    “Anything human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone.”

    • For me, two interconnected paradigms stand out; the lack of political will and threats by the citizenry of electoral consequences should the status quo be disturbed.

     “We’re kidding ourselves if we think we can opt out of these decisions. Every policy the government adopts, and every individual choice you make, implies that a valuation has been made, even if no one has been honest enough to own up to it or even admit it to themselves.”  Tim Harford in “The Undercover Economist.”

    • However, in my view, the story must be told. According to the Dialysis Service Foundation (DSF), on average 12,000 kidney failure cases are detected among Ghanaian patients annually.

    In Alan Watts’s words, “we seldom realize, for example, that our most private thoughts and emotions are not actually our own. For we think in terms of languages and images which we did not invent, but which were given to us by our society.”

  • “All governments, even these precious “democracies,” derive all their power by force. Do something the government doesn’t want, like, say, cross the street against the light, refuse to submit to its authority, and it won’t be long before they’ll use some form of force, usually a weapon and the threat of death or injury, to compel you to comply.”  S. Evan Townsend in Hammer of Thor

    • For months, we have been in a place where many assume that this virus has disappeared from our shores. A look at pictures from parties, funerals, weddings and other social events posted on social media indicates that many are also living in this false illusion that ...

    Katie McGarry argues in her book, “Pushing the Limits” that “the worst type of crying wasn’t the kind everyone could see, the wailing on street corners, the tearing at clothes. No, the worst kind happened when your soul wept and no matter what you did, there was no way to comfort it. A section withered and became a scar on the part of your soul that survived. For people like me and Echo, our souls contained more scar tissue than life.”

    • Our view is that the police should have probed this route further in an attempt to achieve a middle ground. We hold this view because the police ignored the violations of all Executive Instruments before, during and after the 7th December General Election; ...

    In the past week, there has been significant agitation by a section of Ghanaians regarding the need for the government to fix the country. For these people, there is so much to be said for the aspirational future of the Ghanaian youth. Members of Parliament who are deemed to have let their constituents down are being named and shamed by the pressure group that has emerged from this social media agitation. Consequentially, the group informed the Ghana Police Service of their intention to invoke their democratic rights to mass protest to show their disdain towards the despondency they find themselves in.

    • I find it appalling that you have the audacity to shout yourselves hoarse, blaming politicians, civil and public servants for all the mess we find in this country, when in reality your actions are indicative that you are conduits to the sleaze you shout about.

     Marcus Tullius Cicero’s view on the law is succinct. Hear him, “For there is but one essential justice which cements society, and one law which establishes this justice. This law is “right reason”, which is the true rule of all commandments and prohibitions. Whoever neglects this law, whether written or unwritten, is necessarily unjust and wicked.”

  • The concept of succession planning and legacy has been part of many a successful organization, family or country. That none is immortal is an unfortunate part of human existence, we are all born, go through life and eventually die.

    • The significance of the disparities in the quality of healthcare provision in Ghana cannot be disputed. Health disparity can be defined as...

    “Years ago, I recognized my kinship with all living things, and I made up my mind that I was not one bit better than the meanest on the earth. I said then and I say now, that while there is a lower class, I am in it; while there is a criminal element, I am of it; while there is a soul in prison, I am not free.”

    • If we are not ready to accept these realities and continue talking in the language we have used for sixty plus years and back it with the same behaviours where experimentation is frowned upon but gimmicks that benefit a few financially are the name of the game, ...

    “Few things are sadder than encountering a person who knows exactly what he should do, yet cannot muster enough energy to do it. “He who desires but acts not,” wrote Blake with his accustomed vigour, “Breeds pestilence.”

    • Anyone who has insight into Ghana’s pharmaceutical supply chain will know that in the late 1990s ...

    Ha-Joon Chang in 23 Things They Don’t Tell You about Capitalism argues that “recognizing that the boundaries of the market are ambiguous and cannot be determined in an objective way lets us realize that economics is not a science like physics or chemistry, but a political exercise. If the boundaries of what you are studying cannot be scientifically determined, what you are doing is not a science.”

    • Whilst at it, he solicited the help of other drivers, all of whom drove past. Amongst them was one in a shirt marked with the inscription, “Greater Works,” he drove past too, and so did a police vehicle.

    “A man was going down from Jerusalem to Jericho when he was attacked by robbers. They stripped him of his clothes, beat him and went away, leaving him half dead.  A priest happened to be going down the same road, and when he saw the man, he passed by on the other side.  So too, a Levite, when he came to the place and saw him, passed by on the other side.  But a Samaritan, as he travelled, came where the man was; and when he saw him, he took pity on him. He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, brought him to an inn and took care of him. The next day he took out two denarii and gave them to the innkeeper. ‘Look after him,’ he said, ‘and when I return, I will reimburse you for any extra expense you may have.”

    • Reading the article again this morning, I could feel the anguish in her words and roundly understood why she opted to undergo testing for these mutant genes ....

    “Perhaps this is what the stories meant when they called somebody heartsick. Your heart and your stomach and your whole insides felt empty and hollow and aching.” Gabriel García Márquez

  • Nine persons, including the chairman of the Trobu Constituency of the New Patriotic Party (NPP), Mr Kwame Ofosu Adjei, have been arrested by the police for allegedly taking over toll collection in some state facilities in Accra.

    • A lot has been said about who to blame and who should take overall responsibility for this failure to utilize a key component of our labour force. On many occasions, ...

    “Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan Press On! has solved and always will solve the problems of the human race.”

    • The opposition often sit and wait for a change of government to reverse entirely or even abandon what the predecessor government has started.

    “Do not go where the path may lead, go instead where there is no path and leave a trail.” Ralph Waldo Emerson.

    My penchant for following down the dusty fields in the middle of nowhere to seek understanding of why for sixty years we fail to have a system befitting of what one will call world-class healthcare, providing dignity and efficiency is what keeps me awake.

    • I find it surprising that a government claiming to have done so much in the area of health will not deem it necessary to put the statistics out to buttress its arguments.

    Given enough time, you could convince yourself that loneliness was something better, that it was solitude, the ideal condition for reflection, even a kind of freedom.”

    • In our view therefore, unless the patient is willing to put their information out or permits same, it will be an unacceptable breach of confidentiality if they were coerced or the information was released without their consent.

    “In the middle of the journey of our life, I came to myself within a dark wood where the straightway was lost. Ah, how hard a thing it is to tell what a wild, and rough, and stubborn wood this was, which in my thought renews the fear!” –Dante Alighieri in The Divine Comedy

    • We cannot continue to observe these mediocre trends in our health outcomes whilst listening to political actors self-congratulate and squabble over issues that have done little to reverse the tide.

    “Let us not get scooped up by gaslighting manipulators stealing our emotions and taking possession of our inner child to carry out their dark agenda. Let the light of our intuition guide us subtly and wisely along the path of trust and suspicion.”

    • Unsurprisingly, the citizenry has in characteristic fashion started the usual shouting chorus without any of us asking the relevant questions of why we got here in the first place.

    According to Sun Tzu, “If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”

    • Without that, we will continue to apportion blame for our shortcomings and feed off the crumbs of those who prioritise their taxpayers. Sad as this may sound, we must allow these ...

    Frank Herbert in the “Dune Chronicles” states, “deep in the human unconscious is a pervasive need for a logical universe that makes sense. But the real universe is always one step beyond logic.”

    • It is untenable to say we cannot have an appointments system that will decongest waiting areas. It is unacceptable to argue that this is the design we inherited from a generation that had at best the manual typewriter ...

    “Life is a series of natural and spontaneous changes. Don’t resist them; that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they like.” Lao Tzu

    • Checks indicate that majority of the illicit supplies (strengths of tramadol higher than 100mg) are trafficked into our country through porous land borders and originates mainly from the port city of Cotonou in Benin

    Tom Robbins in Even Cowgirls Get the Blues argues, “I believe in political solutions to political problems. But man's primary problems aren't political; they're philosophical. Until humans can solve their philosophical problems, they're condemned to solve their political problems over and over and over again. It's a cruel, repetitious bore.”

    • Having citizens at the decision-making table also affords policymakers the opportunity to have conversations around what is feasible and what is not. It provides the citizens with the option of challenging the rationale...

    “We define our identity always in dialogue with, sometimes in the struggle against, the things our significant others want to see in us. Even after we outgrow some of these others—our parents, for instance—and they disappear from our lives, the conversation with them continues within us as long as we live.”

    • Our other concern is the risk of fuelling vaccine hesitancy across the continent if the message around these expired vaccines is not communicated properly. This could be driven mainly by anti-vaccination groups and individuals who could question why other medicines are not used after their expiry date but we are being made to disregard this norm and make exceptions.

    Adam Smith in “The Theory of Moral Sentiments” argues that, “the prudent man is always sincere, and feels horror at the very thought of exposing himself to the disgrace which attends upon the detection of falsehood. But though always sincere, he is not always frank and open; and though he never tells anything but the truth, he does not always think himself bound, when not properly called upon, to tell the whole truth. As he is cautious in his actions, so he is reserved in his speech; and never rashly or unnecessarily obtrudes his opinion concerning either things or persons.”

  • Pema Chödrön in The Places that Scare You states, “A further sign of health is that we don't become undone by fear and trembling, but we take it as a message that it's time to stop struggling and look directly at what's threatening us.”

  • In his book The Once and Future King, T.H. White opined, “The best thing for being sad," replied Merlin, beginning to puff and blow, "is to learn something. That's the only thing that never fails. You may grow old and trembling in your anatomies, you may lie awake at night listening to the disorder of your veins, you may miss your only love, and you may see the world about you devastated by evil lunatics, or know your honour trampled in the sewers of baser minds. There is only one thing for it then — to learn. Learn why the world wags and what wags it. That is the only thing which the mind can never exhaust, never alienate, never be tortured by, never fear or distrust, and never dream of regretting. Learning is the only thing for you. Look what a lot of things there are to learn.”

    • To start with, public nursing training is reliant solely on government funding and thus numbers are determined by budgetary allocation ...

    “All successful people men and women are big dreamers. They imagine what their future could be, ideal in every respect, and then they work every day toward their distant vision, that goal or purpose.”

    • This cannot be right and is why I believe our government should take a good look at our pharmaceutical supply chain with the view of driving the prices of medicines down.

    According to Henry David Thoreau, “the cost of a thing is the amount of what I will call life which is required to be exchanged for it, immediately or in the long run.”

    • We cannot continue to sit on the fence when many of the diagnostic parameters being taught and practiced are riddled with these diagnostic biases, and expect others to address the discrepancies. Neither can we shout ...

    “It takes humility to reconsider our past commitments, doubts to question our present decisions, and curiosity to reimagine our future plans. What we discover along the way can free us from the shackles of our familiar surroundings and our former selves. Rethinking liberates us to do more than update our knowledge and opinions — it’s a tool for leading a more fulfilling life.”- Adam Grant

  • “Invariably, knowledge dictates life, liberty, and death, but those who have historically occupied the seats of power not only dictate what is defined as knowledge but also dictate what’s included, what’s excluded, and how it is filtered to society vis-à-vis America’s major institutions. Particularly the educational system; ultimately, shaping the very essence of life.” Martin Guevara Urbina.

    • In recent times, however, I have come to believe that there are ways to bridging this gap in a manner that will enhance efficiency.

    “I want to create a system that provides for all members of society, but one that also uses the wealth generated by Artificial Intelligence (AI) to build a society that is more compassionate, loving, and ultimately human.” – Kai-Fu Lee

  • Theodore Roosevelt in Strenuous Life opines, “Far better it is to dare mighty things, to win glorious triumphs, even though checkered by failure, than to take rank with those poor spirits who neither enjoy much nor suffer much, because they live in the grey twilight that knows neither victory nor defeat.”

    • The case of residents of Madina is a classic example of our societies definition of man’s cruelty to man. As I write, ...

    Marcus Aurelius in Meditations opined, “If someone is able to show me that what I think or do is not right, I will happily change, for I seek the truth, by which no one was ever truly harmed. It is the person who continues in his self-deception and ignorance who is harmed.”

    • Things like these are why I have been intimating that there is a huge potential for an entire service industry around healthcare. One that would decrease risk, ...

    According to Lao Tzu, “life is a series of natural and spontaneous changes. Don’t resist them; that only creates sorrow. Let reality be the reality. Let things flow naturally forward in whatever way they like.”

    • Anytime I see political players discuss healthcare policy, I have the distinct feeling that they see Ghanaians as consumers of whatever healthcare they are provided with.

    “All over the place, from the popular culture to the propaganda system, there is constant pressure to make people feel that they are helpless, that the only role they can have is to ratify decisions and to consume.”

    • We cannot continue to lose valuable human resources to the scourge of mental health and be taken seriously as a country interested in transformational development

    Adam Grant in Originals argues, “overall, the evidence suggests that liking continues to increase as people are exposed to an idea between ten and twenty times, with additional exposure still useful for more complex ideas.”

    • Then he decided to go even a step further, ... “ Mr Speaker, Government under the leadership of the Office of the Vice-President and Office of the Senior Minister, and in consultation with the relevant professional institutions, has produced standardised designs and costs of various public infrastructure projects in Health, (such as CHPS, Polyclinics, District Hospitals and Regional Hospitals).”

    “To improve is to change; to be perfect is to change often. We shape our buildings, and afterwards, our buildings shape us.”

    • How can it be that infant deaths have been cut by over 70% and the population growth rate is 2.2% but our population profile has virtually stagnated? The answer lies in a critical look at ...

    “Without realizing that the past is constantly determining their present actions, they avoid learning anything about their history. They continue to live in their repressed childhood situation, ignoring the fact that this no longer exists, continuing to fear and avoid dangers that, although once real, have not been real for a long time.” - Alice Miller

    • Sadly, we seem to be accepting of our situation in a manner that the user of the public toilet becomes accustomed to the fragrance of its surroundings. This for me is the sequence that needs to be broken ...

    “When an incidental colour or a random fragrance takes possession of our imagination, we can unexpectedly blossom into a new entity as it gives us wings and enlightens our horizon, just like canary birds that feel stimulated and start singing as soon as they sense the radiance of the sun through the reflection of the skylight.”

    • It is therefore disingenuous if the picture is painted as though Africans will be exclusively selected in a grand scheme by some conspirators in dark suits. It is actually unfair to ...

    Elizabeth Bear argues in her book Ancestral Night that “conspiracy theories are really attractive. Figuring out patterns is one of the things that get your brain to give you a nice dose of chemical reward, the little ping of dopamine and whatever else that keeps you smiling. As a result, your brain is pretty good at finding patterns and at disregarding information that doesn’t fit. Which means it’s also pretty good at finding false patterns, and at confirmation bias, and a bunch of other things that can be fatal. Our brains are also really good at making us the centre of a narrative because it’s what we evolved for.”

    • Research indicates that over 97% of all patients with COVID-19 will go through this type of disease progression. Therefore, like HIV, in the strictest sense, the classical asymptomatic COVID-19 patient does not exist. Unfortunately, ...

    William H. McNeill wrote in Plagues and Peoples sometime in 1976 that “It is obvious that human (and non-human) diseases are evolving with an unusual rapidity simply because changes in our behaviour facilitate cross-fertilization of different strains of germs as never before, while an unending flow of new medicines (and pesticides) also present infectious organisms with rigorous, changing challenges to their survival.”

    • Once again, we are bystanders at the table of health.

    Ha-Joon Chang in “23 Things They Don’t Tell You About Capitalism” argues “equality of opportunity is not enough. Unless we create an environment where everyone is guaranteed some minimum capabilities through some guarantee of minimum income, education, and healthcare, we cannot say that we have fair competition. When some people have to run a 100-metre race with sandbags on their legs, the fact that no one is allowed to have a head start does not make the race fair. Equality of opportunity is absolutely necessary but not sufficient in building a genuinely fair and efficient society.”

  • I listened to the Minister of Health this morning on the current position of government regarding the Central Medical Store (CMS) arson. I must first start by acknowledging the tenacity he has demonstrated in getting this far. Having said that, I want to put certain information into prospective.

    • This situation cannot continue. This is because as our country’s disease burden becomes dominated by chronic diseases, many of us could be falsely blinded ...

    Prolific British street artist Banksy, in Banging Your Head Against a Brick Wall argues that “your mind is working at its best when you’re being paranoid. You explore every avenue and possibility of your situation at high speed with total clarity.”

    • In Ghana, this fatigue is obvious too; for example people find the need to wear face masks a strain. There have been cases also where it is claimed Veronica buckets have been left empty, ...

    “But then we get exhausted and we wonder if we can accomplish any of the things we hope for, without destroying ourselves in the process. We ask ourselves if it’s time to quit.”

    • On the surface this statement is laudable; but an in-depth look raises serious concerns. To start with, ...

    In Marvin Simkin’s view “democracy is not freedom. Democracy is two wolves and a lamb voting on what to eat for lunch. Freedom comes from the recognition of certain rights which may not be taken, not even by a 99% vote.”

    • Truth is, healthcare now is heavily reliant on data. Unfortunately, many countries in sub-Saharan Africa have had very little interest in this new raw material.

    Eric Topol in his book, The Patient Will See You Now, painted this picture about the future of healthcare delivery; “It may just mean that the best way to cut the ever-increasing costs of health care around the world will be to provide cheap smartphones with Internet service to those who otherwise could not afford to buy them.”

    • Four years on and with the 7th December election fast approaching, health is again on the campaign trail with the opposition National Democratic Congress promising the provision of free primary health care for all citizens.

    “The task of the leaders must be to provide or create for them a strong framework within which they can learn, work hard, be productive and be rewarded accordingly. And this is not easy to achieve.” Lee Kuan Yew, The Singapore Story

    • Considering that many complain about the cost of medicines locally, I have been trying to understand why ...

    “The refusal to take sides on great moral issues is itself a decision. It is a silent acquiescence to evil. The tragedy of our time is that those who still believe in honesty lack fire and conviction, while those who believe in dishonesty are full of passionate conviction.”

  •  Rob Siltanen in a passionate rant blurted, “Here's to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They're not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can't do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do.”

    • Some have said a clean mind resides in a clean body. Though this may be true, a few things I have observed around outpatient health facilities in Ghana make me wonder what sort of minds we leave health facilities with.

    “In times of stress and danger such as come about as the result of an epidemic, many tragic and cruel phases of human nature are brought out, as well as many brave and unselfish ones.”

    • Another example can be seen in the restoration of nurses’ allowances which dominated the 2016 election campaign. At the time of that debate ...

    According to Patrick Rothfuss “It’s like everyone tells a story about themselves inside their head. Always. All the time. That story makes you what you are. We build ourselves out of that story.”

  • Jostein Gaarder in The Solitaire Mystery opines "A joker is a little fool who is different from everyone else. He's not a club, diamond, heart, or spade. He's not an eight or a nine, a king or a jack. He is an outsider. He is placed in the same pack as the other cards, but he doesn't belong there.

    • Simply put we have conspired to turn the official definition of an ambulance (a vehicle equipped for taking sick or injured people to and from the hospital, especially in emergencies) upside down.

    James Baldwin in Tell Me How Long the Train’s Been Gone states, “I remembered my mother’s insistence that I always wear clean underwear because I might get knocked down by a car on the way to or from school and I and the family would be disgraced even beyond the grave, presumably, if my underwear was dirty. And I began to worry as the doctor sniffed and prodded, about the state of the shorts I was wearing. This made me want to laugh. But I could not breathe.”

    • When the Ghana Government plays “pilolo” with us.

    In George Bernard Shaw’s view, “the reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man.”

    • I would conclude by saying the arguments that the export of nurses as proposed by Mr President is a silver bullet that could help fix the problem of unemployed nurses is a huge smoke screen.

    “If someone is able to show me that what I think or do is not right, I will happily change, for I seek the truth, by which no one was ever truly harmed. It is the person who continues in his self-deception and ignorance who is harmed.” Marcus Aurelius.

    • “the government only does the private nurses favour by employing them, so they should desist from giving unnecessary pressure.”

    In “Life and Letters”, Thomas Henry Huxley held this view; “sit down before fact as a little child, be prepared to give up every preconceived notion, follow humbly wherever and to whatever abysses nature leads, or you shall learn nothing. I have only begun to learn content and peace of mind since I have resolved at all risks to do this.”

  • “Staying silent is like a slow growing cancer to the soul and a trait of a true coward. There is nothing intelligent about not standing up for yourself. You may not win every battle. However, everyone will at least know what you stood for—YOU.” Shannon L. Alder

    • Another area of concern is the percentage of public hospitals with a functional emergency team which is said to be high performing at a figure of 25.5%. That our Health Ministry will be bold enough ...

    “Be honest. This applies to every area of your life. Sketchiness is not an attractive trait. No more trying to cover up your baggage, sweeping things under the rug, withholding the truth, blatant lying, or even telling seemingly ‘harmless’ white lies or half-truths – release the need to lie completely! Start NOW.” Alaric Hutchinson

    • Though very versatile, some have had concerns about their reliability and application in the fight against this novel coronavirus. These concerns primarily relate to the sensitivity of these tests.

    “To each, there comes in their lifetime a special moment when they are figuratively tapped on the shoulder and offered the chance to do a very special thing, unique to them and fitted to their talents. What a tragedy if that moment finds them unprepared or unqualified for that which could have been their finest hour.” -Winston Churchill

    • Therefore, we cannot allow a few conspirators amongst our population to destroy the contribution some amongst our citizenry have made towards putting a cap on the world’s malaria death toll, through well-crafted scientific research.

    The late Alvin Toffler American writer and futurist is noted to have stated, “the illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.” No time have I found this quote more poignant than in the last few days when I have experienced the height of intellectual and scientific blasphemy that any society may care to inflict on themselves.

    • In defence of our current strong link approach, some keep saying health care professionals are unwilling to go out of Accra or Kumasi but fail to realise we skew the law of natural selection towards attracting them to the centre by taking a strong link approach towards healthcare policy.

    In 23 Things They Don't Tell You about Capitalism, this favourite quote caught my attention, “Equality of opportunity is not enough. Unless we create an environment where everyone is guaranteed some minimum capabilities through some guarantee of minimum income, education, and healthcare, we cannot say that we have fair competition. When some people have to run a 100 metre race with sandbags on their legs, the fact that no one is allowed to have a head start does not make the race fair. Equality of opportunity is absolutely necessary but not sufficient in building a genuinely fair and efficient society.” Ha-Joon Chang

  • Roy T. Bennett in The Light in the Heart argued that "attitude is a choice. Happiness is a choice. Optimism is a choice. Kindness is a choice. Giving is a choice. Respect is a choice. Whatever choice you make makes you. Choose wisely."

    • Their warped logic is further entrenched by many faith practitioners who advertise their ability to cure diseases, many of which medical science and research can only manage. Even more intriguing is the fact that, some of these men and women of faith are middle-aged adults too and are often afflicted by chronic diseases.

     “As my sufferings mounted I soon realized that there were two ways in which I could respond to my situation -- either to react with bitterness or seek to transform the suffering into a creative force. I decided to follow the latter course.” Martin Luther King Jr.

    • It will be diabolical that the wake of purchasing new ambulances and equipping the Ghana Ambulance Service with pickup vehicles, we fail to ensure that the use of these infrastructures is optimized.

    In Laura Ingalls Wilder’s view “the real things haven’t changed. It is still best, to be honest, and truthful; to make the most of what we have; to be happy with simple pleasures, and have courage when things go wrong.”

    • Compounding this further is the fact that over 60% of our health funding envelope is spent on staff remuneration, with another 15% going into health system running cost. This leaves just around 25% available for ...

    Charles Taylor in Multiculturalism argues that “we define our identity always in dialogue with, sometimes in struggle against, the things our significant others want to see in us. Even after we outgrow some of these others—our parents, for instance—and they disappear from our lives, the conversation with them continues within us as long as we live.”

    • A visit to any health facility in Ghana exposes how such a space is not a priority of our healthcare. To start with, basic information is obtained from new patients without any explanation given or consent sought, often in a crowded environment and within an earshot of many; ...

    In Umberto Eco’s view, “a book is a fragile creature, it suffers the wear of time, it fears rodents, the elements and clumsy hands. So the librarian protects the books not only against mankind but also against nature and devotes his life to this war with the forces of oblivion.”

    • There are times that my belief wavers and often it is not because of what the outsider says but what we do internally. I see more working against us that is self-inflicted than...

    I am no fan of Donald Trump. In fact, I was baffled when he was elected. As I was going through the motions with his electoral success, I came across this quote by H.L. Mencken, "As democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day, the plain folks of the land will reach their heart's desire at last and the White House will be adorned by a downright moron."

  • "We do not grow absolutely, chronologically. We grow sometimes in one dimension, and not in another; unevenly. We grow partially. We are relative. We are mature in one realm, childish in another. The past, present, and future mingle and pull us backwards, forward, or fix us in the present. We are made up of layers, cells, constellations."

    • One of the biggest challenges of humankind is decision making. Often, most of us have opinions but never a firm view of what action to take. Incidentally, it is common for us to want to hoist these opinions on others as though they were grounded in fact, backed by evidence and a conclusion we have come to.

    “It felt like waiting for something to happen. Which has to be the worth part of being young. So many of your decisions aren’t yours; they’re made by other people. Sometimes they’re made badly by other people. Sometimes they’re made by other people who have no idea what the consequences of those decisions might be.”

    • The laissez-faire attitude with which herbal medicines are advertised on electronic media with claims of one product treating multiple diseases states some chronic and others infectious is known to us all.

    “My love affair with nature is so deep that I am not satisfied with being a mere onlooker, or nature tourist. I crave a more real and meaningful relationship. The spicy teas and tasty delicacies I prepare from wild ingredients are the bread and wine in which I have communion and fellowship with nature, and with the Author of that nature.” Euell Gibbons

  • As a people we have become too accommodating of failure, to us the taste of failure is no longer bitter, to us the sweet honey suckle taste of success must come without pain and strife, to us God and God alone will solve our development problems.

  • “I feel like I'm way down this deep, deep hole and I'm looking up and all there is, is this little dot of light and I have to shout at the top of my lungs for anyone to hear me and even when I do, I say the wrong thing or they don't really listen or they're just humouring me.” Patrick Ness - The Rest of Us Just Live Here.

    • The truth is since its inception, the NHIS, as a social intervention, has been politicised. At each election, ...

    According to Jonathan Swift, “falsehood flies, and truth comes limping after it so that when men come to be undeceived, it is too late; the jest is over, and the tale hath had its effect: like a man, who hath thought of a good repartee when the discourse is changed, or the company parted; or like a physician, who hath found out an infallible medicine, after the patient is dead.”

  •  “Above all, don't lie to yourself. The man who lies to himself and listens to his own lie comes to a point that he cannot distinguish the truth within him, or around him, and so loses all respect for himself and for others. And having no respect he ceases to love.” Fyodor Dostoyevsky in The Brothers Karamazov.

    • It is not surprising that some passengers who test positive are challenging the test outcomes. This is because there is a period between when one is infected with the virus and when even the most sensitive COVID-19 test can detect the presence of an infection.

    Walt Whitman in Walt Whitman’s Camden Conversations argues “I like the scientific spirit, the holding off, the being sure but not too sure, the willingness to surrender ideas when the evidence is against them. This is ultimately fine, it always keeps the way beyond open, always gives life, thought, affection, the whole man, a chance to try over again after a mistake, after a wrong guess.”

    • Currently, three regions Greater Accra (57.3%), Ashanti (19.9%) and Western (8.1%) account for the majority (85.3%) of all reported cases. However, the regional CMR based on Ghana Health Service data indicates that Greater Accra has a CMR of 0.58%, Ashanti 1.2% and Western 0.078%. One can deduce that Ashanti has approximately twice the CMR of both Greater Accra and the national average.

    “Accepting death doesn’t mean you won’t be devastated when someone you love dies. It means you will be able to focus on your grief, unburdened by bigger existential questions like, “Why do people die?” and “Why is this happening to me?” Death isn’t happening to you. Death is happening to us all.”

    • As it is said, countries don’t attract what they want but what they are. Therefore, though we claim to want quality health care, we as a people have failed to invest our thinking into how to convert this wish into a need.

     According to A.A. Milne, “The third-rate mind is only happy when it is thinking with the majority. A second-rate mind is only happy when it is thinking with the minority. A first-rate mind is only happy when it is thinking.” Throughout history, it has been known that thoughts and not our wishes, build a nation. In “As a man thinketh” James Allen argues, “A man is literally what he thinks, plans and acts upon.” In essence, outcomes are indicative of plans, actions and or inactions of yesteryear.

    • In recent times, I have been concerned about our approach as a country to conversations around data. At a minimum, it comes across as though many have not exorcised their school days demons that showed their faces anytime the math tutor entered the class.

    “Objectivity of truth, reality, facts, data – they matter; otherwise, you have the ‘good guys’, the moral persons, in the name of what they call justice, in a fight against what they call injustice, unwittingly adopting the roles of oppressors by persecuting the innocent.”

    • Much as lower and lower-middle-income countries are caught in the middle of these squabbles, their governments need to study the factors that have contributed to the current predicament. It will be unfortunate ...

    “We are sometimes astounded by the behaviour of emotional outlaws, as they act in line with their own standards, but proceed like bulls-in-a-china-shop, create one heck of a mess in their living environment and bring about shocking disturbing dissensions, ever since their inner construction clashes with our emotional architecture.”

    • Turning Adversity Into Opportunity

    “The Chinese use two brush strokes to write the word ‘crisis.’ One brush stroke stands for danger; the other for opportunity. In a crisis, be aware of the danger, but recognize the opportunity.” John F. Kennedy

  • “Remember: It’s not your fault that things are the way they are, but it is your responsibility to do something about them.” Elena Aguilar

  • Anaïs Nin in The Diary of Anaïs Nin, Vol. 1: 1931-1934 argues, “What we call our destiny is truly our character and that character can be altered. The knowledge that we are responsible for our actions and attitudes does not need to be discouraging, because it also means that we are free to change this destiny. One is not in bondage to the past, which has shaped our feelings, to race, inheritance, background. All this can be altered if we have the courage to examine how it formed us. We can alter the chemistry provided we have the courage to dissect the elements.”

    • In the past week, we have been having conversations around viruses and how this new pathogen SARS-CoV-2 has managed to hold humankind at bay and is exacting such a toll on our very survival.

    Sun Tzu in The Art of War argues that “all warfare is based on deception. Hence, when we can attack, we must seem unable; when using our forces, we must appear inactive; when we are near, we must make the enemy believe we are far away; when far away, we must make him believe we are near.”

  • "Staying silent is like a slow growing cancer to the soul and a trait of a true coward. There is nothing intelligent about not standing up for yourself. You may not win every battle. However, everyone will at least know what you stood for—YOU." Shannon L. Alder

    • For society to thrive and keep its human resource out of harm’s way, health and safety must be prioritised. Health and safety have many facets which need to work in tandem to be effective. To rely on just one aspect, ...

    “Ladies and gentleman,” he said over the speakers, “welcome aboard this recently liberated Gulfstream V. If I could have your attention for just a few moments, I’d like to go over the safety features of this aircraft. It has an engine, to make us go, and wings, to keep us in the air. There are seatbelts, which won’t do you an awful lot of good if we fly into the side of a mountain.”

    • This for me is where less-resourced countries like Ghana, should be looking for options. We need to believe in ourselves that we have what it takes to slow down this pandemic by limiting community spread. We need to

    “If you believe you can accomplish everything by “cramming” at the eleventh hour, by all means, don’t lift a finger now. But you may think twice about beginning to build your ark once it has already started raining”

    • Transparency is not part of our culture and would not be anytime soon. Therefore our society obfuscates on conjecture, gossip and innuendo.

    According to Joseph Pulitzer, “there is not a crime, there is not a dodge, there is not a trick, there is not a swindle, there is not a vice which does not live by secrecy.” I strongly agree.

  • Bruna Martinuzzi argues, “A brief, well-crafted story that is relevant to your topic is one of the most potent ways to maintain the attention of your audience. But the story must be kind.” Benjamin Disraeli goes further, "Never tell unkind stories." Inconsiderate and insensitive stories do not bring grace to those who hear them, and may actually leave the audience dispirited.”

    • This is because in our prime we fail to realise that when our health begins to fail, irrespective of our wealth, our life fortunes ...

    Ernest Hemingway in his book, A Farewell to Arms argues “If people bring so much courage to this world the world has to kill them to break them, so of course it kills them. The world breaks everyone and afterwards many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.”

    • However, it will also be disingenuous if we threw our hands in the air and allowed the problem to fester like we have done for the last sixty plus years. The fact is, drug peddling is a killer and a curse rather than a lifeline to many in our society, ...

    Malcolm Gladwell in Blink argues, “The key to good decision making is not knowledge. It is understanding. We are swimming in the former. We are desperately lacking in the latter.”

    • Over the years we have been made to believe that the reasons for poor healthcare delivery in Ghana are a result of inadequate health professional numbers, lack of infrastructure and the availability of money. In this piece, ...

    Philip José Farmer in The Dark Design argues “You had to make your choice between survival and efficiency, though in the long run survival was optimum efficiency, no matter how much time and effort it took.”

  • “A human being is a part of the whole called by us universe, a part limited in time and space. He experiences himself, his thoughts and feeling as something separated from the rest, a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty.” Albert Einstein.

  •  “When we get out of the glass bottles of our ego, and when we escape like squirrels turning in the cages of our personality and get into the forests again, we shall shiver with cold and fright but things will happen to us so that we don't know ourselves. Cool, un-lying life will rush in, and passion will make our bodies taut with power, we shall stamp our feet with new power and old things will fall down, we shall laugh, and institutions will curl up like burnt paper.” D.H. Lawrence

    • I understand the political ramifications of any conversations around trainee nursing allowances. However, I struggle to make sense ...

    Simple can be harder than complex: You have to work hard to get your thinking clean to make it simple. But it’s worth it in the end because once you get there, you can move mountains.” Steve Jobs

    • That double payments have been a feature of all three changes of government with the public being blinded to it gives me an indication that the only way this self-inflicted anomaly will be corrected is if as citizens we express our displeasure unequivocally and push for a root and branch investigation into all ex-gratia payments since 1996.

    C.S. Lewis argues, "Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated, but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience."

    • Having been shown to reduce cases of malaria by up to 50 per cent when used in combination with other malaria control measures, the potential benefits of Mosquirix to the Ghanaian economy kept me positive.

    “I have come to accept the feeling of not knowing where I am going. And I have trained myself to love it. Because it is only when we are suspended in mid-air with no landing in sight, that we force our wings to unravel and alas begin our flight. And as we fly, we still may not know where we are going to. But the miracle is in the unfolding of the wings. You may not know where you’re going, but you know that so long as you spread your wings, the winds will carry you.”  C. JoyBell C.

    • Estimates from the World Health Organisation (WHO) suggest that if this trend is maintained, the continent’s population will more than double from the current 1.3 billion to 3 billion inhabitants by 2100.

    The majority of people don’t want to plan. They want to be free of the responsibility of planning. What they ask for is merely some assurance that they will be decently provided for. The rest is a day-to-day enjoyment of life. That’s the explanation for your Father Divines; people naturally flock to anyone they can trust for the necessities of life. They are the backbone of a community–solid, trustworthy, essential.”

    • Many seem to confuse healthcare cost with the amount of money they need to pay out when they have an episode of ill-health and fail to have an idea of what the true cost of ill health is.

    “In order to get a holistic explanation, anthropology often has to upend common sense and question what gets taken for granted. Anthropology prompts us to reconsider not only what we think we know – what it means to be affluent, why blood matters, what constitutes reason – but also the terms by which we know it.” -Matthew Engelke

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