As I write this epistle, you are just about to be sworn in as Ghana’s first real president. You see Kwame Nkrumah started as Prime Minister (in 1957), and took the title of President in 1960 when he declared Ghana a Republic. Since then we had one real Prime Minister (Busia), and a host of self declared Heads of State. Some of the others (like Limmam and the fellow you are replacing) were also Presidents but we Amanfoo like to believe that we have the real president, others may think otherwise.
First of all senior Kuffour, I am proud to welcome you to the helm of Ghana politics. Not only are you a great Amanfoo but you were also in the great Butler house! We Amanfoo, as you know like to help each other (We play Kokofu ball). In my capacity as Former Health Prefect I think the least I can do is to guide in the minefield of our health system. So now listen:
I just have a short advice for you on how to tackle the problem of health care in our beloved Ghana. I am very much aware of the enormous number of problems you will face on day one of your new office, so I will be brief.
You see if you can solve half of the health problems in Ghana you will have achieved a lot. In doing so, you will keep more people alive, and more importantly you will also have more able-bodied people who will work, earn money, pay taxes and also buy consumer goods which will then improve the economy. You will also see more healthy children growing up and attending the schools which you are going to fix (remember, your predecessors have messed up big in the Educational System). People will live longer, there will be fewer funerals and therefore fewer handshakes and hence less infections transmitted from person to person.
By the way Mr President, did you know that in Ghana today, funerals are the most frequent social events? I bet you also didn’t know that at funerals the average person shakes the hands of 100 people each day. If we assume that a quarter of these people have used public latrines in the last hour or so before shaking hands and that half of the rest have had a sneeze or wiped their tears (or nose), just before shaking hands, then we can assume that at least a billion bacteria (germs) will change hands with every 100 handshakes. So even if you are able to reduce funerals by 10%, then you will mathematically reduce infections by 25% through handshakes alone. You can ask the Department of Statistics to check on my maths! This 25% reduction in infections will translate into a further reduction in our mortality rate which will of course reduce the number of funerals again.
Now let’s see how you can make people live longer. First I suggest that you " clean" the cedi. You see, not only is the cedi valueless but more importantly, there are so many of them and they change hands so frequently that a lot of them are very unsightly even to look at let alone to touch. Most of the "smaller" denominations like the 200, 500 and 1000 seem to lose the ink in them every 2 weeks or so. When I was a child 1000 cedis was a fortune but today it is pocket change!
You see Mr. President, most countries now have something called "credit cards". These are plastic cards that keep longer and are usually clean unless the owner uses them too often! But of course, I almost forgot, before we can use these cards properly, the people must be able to read and write, so you will have to ensure that kids coming out of the senior secondary schools and the Universities can read and write again! That may take a while so you can probably just improve the value of the cedi and thereby decrease the rate of circulation. You see what I mean is this: When the cedi is dirty, or when the chemicals in them seethe out then the Makola women get the dirt and the chemicals into their stomachs when they eat kenkey with their fingers whilst on the job! When this happens they get sick, they go to the hospital where they have to pay "cash and carry" otherwise no nurse or doctor will attend to them.. Just by cleaning the cedi, you will break this chain reaction and the doctors will get more time on the picket lines on strikes either for themselves or in sympathy with the University students. You see when that happens you don’t have to pay them so you save all that money.
The next thing you should do is to pave all the roads. You see, the dust on the roads is a major source of catarrh and headaches. If you pave half the roads in Ghana, you will reduce headaches by 75% (check my Maths again).This will translate into 50% reduction in purchases of APC and paracetamol (we call it Tylenol in Canada and US) so again people can save more money because they are more healthy and can work better and pay more taxes to give your government more money to build more roads and further reduce dust as well as hospital visits.
Now let’s see how you can improve the health of farmers. Just give them machines to work instead of cutlasses and hoes. You see Mr President, when old people bend all day to weed, they develop chronic back pain so their life span on the farm decreases. As you know, the younger generation hates farming so unless you give them tractors and combine harvesters they are all going to continue to hang around the airport, the licensing office and the harbours trying to get a "catch" from people arriving from overseas. If you improve conditions on th e farm, more young people will stay in the villages and help to increase farm produce. By increasing farm output, food will be cheaper, people can afford good staple food, live healthier and longer lives and of course pay taxes longer which again is music to your revenue coffers.
The next thing you can do is to forbid all commercial drivers from drinking alcohol on the job. As you will learn a few days after you assume office, the leading cause of death Ghana now is not malaria or cancer. It is in fact accidents on our roads. Most of these accidents can be attributed to the poor state of our roads which you have already promised to fix. So the next thing you should do is to reduce the number of accidents due to drunk driving (the police call it " DUI" or driving under influence). You can get some advice from the incoming United States president. Sources indicate that he has some personal experience about DUI. Whilst you are doing that you may also wish to ban a type of vehicle called "ALL VAN". I have it from a very reliable source that this vehicle is a killer especially the ones that travel on the Accra-Kumasi road.
Of course you will need to do something about those police men who sit there on the roads all day to collect cedis from the drivers. Sometime ago these police men were supposed to check drivers and also to act as customs agents. Now their function is a bit fuzzy aside from collecting money from the commercial drivers. I wonder if you will consider deploying some of these able bodied men and women to build more roads or help with the tractors and combines that you have promised to buy for our young farmers.
Last but not the least, will you remember to fix our water system. You have to remind the Managing Director of the Ghana Water and Sewerage System that his job description includes areas outside Accra and Akosombo. You recall the funerals and hand shakes and the infections that I mentioned earlier. The reason for all that chain of events is that we do not have running pipe-borne water in most of our towns and villages. So when people go out to ease themselves and use old "Graphic" as toilet paper, they don’t have access to water to wash their hands. That’s how all these problems from funerals arise and in the end generate more funerals. Of course we will prefer our water to be clean and free from E. coli, so remind the Managing Director that the water has to be chlorinated if only he can get it past the environmentalists ( I don’t know if they are in Ghana too.)
Well Mr President , I know that you are going to be busy in these coming days so I will end here for now .If you need more advise do not hesitate to write back and I will be happy to help you out. I can persuade a few police men to leave their posts on the Nsawam road and join my brother on his farm. Thank you and may God bless you in your new job.
Sincerely yours.
Yaw Twum-Barima. MD, MSc, FRCPC
Note: This article was first published in the Ghanaian News in Dec 2000. It was modified for the Amanfoo web site on Jan 5, 2001.
