10 Facts about Glaucoma

1. Glaucoma is the second leading cause of blindness globally according to the WHO.

2. Glaucoma causes an irreversible damage to the optic nerve.

3. There is no cure (yet) for Glaucoma

4. There may be no symptoms to warn you

5. Elevated eye pressure is a major risk factor for Glaucoma

6.Glaucoma is a hereditary disease

7.Glaucoma results in a peripheral or side vision loss initially , which affects your ability to move safely.

8. Early detection and treatment for glaucoma can slow down the progression of the disease

9. Glaucoma can be managed with medications and surgery

10. The best way to prevent vision loss in Glaucoma is to be regular with scheduled eye examinations as advised by your eye care professional.

Dr Prince Opuni Quarcoo (OD)



“Why Bother Doctor; she’s going to Die Anyway?”

The case of Mansa: A true story

We (clinicians) had just confirmed that the underlying cause of sweet 4 year old Mansa’s (not her real name unsettling fever and bone pain) was actually a type of childhood cancer of the blood called Leukemia. This was after about 6 weeks of hospital admission, blood transfusions, several near miss situations and an antibiotics bill in excess of GH₵3,000 (US$750). While Mansa battled to stay alive, her mother died in the same hospital from what dad informed me her doctors said was a kidney problem. The entire extended family spent fortunes and sold property to keep mum through dialysis (a procedure of ‘cleansing‘ the blood of impurities with machines in the event of kidney failure, which function in the living being is performed by the kidneys).

So, we broke the news of Mansa’s diagnosis including the foreseeable cost of treatment (GH₵20,000 for the 3 years of treatment) to dad first and then, to the rest of the family (on dad’s request). One member of the family made this remark during the counseling session: “Cancer? In this child, then why bother doctor; she’s going to die anyway?” They missed their first clinic appointment after this; Mansa died at home less than a month later. She is now part of a growing statistic of childhood deaths from cancer in Ghana.

Stark reality

Childhood cancers are very rare but when it happens to your child, it is way too common. 80% of all children with cancer are in resource limited countries of Africa and South America. In the advanced, developed world, 85% of childhood cancers are curable! That is, 8 to 9 out of 10 kids diagnosed with cancer as in Mansa’s case, will be cured of their cancer and be alive 5 years or more after completing treatment.

Here in Ghana, the two biggest teaching hospitals attend to combined, about 400 (out of an expected 1000) kids with newly diagnosed cancer per year. About a third of these kids will die; another third will not complete their treatment (abandon treatment) and eventually die; and the final third will survive.

Figure 1: Childhood Cancer Statistics 1998 – 2013, KATH


Figure 2: Cost of Treatment of Burkitt Lymphoma and Leukaemia, 2014, KATH


Let’s put this in context: in advanced countries, 4 year old Mansa would have been diagnosed within 3 days of admission; she would most likely be alive now no matter the cost and we (clinicians) would not have discussed cost of treatment. 

What does it take to cure a child of cancer? Are Ghanaian doctors not well vexed in the art?

About 50 years ago in these same advanced countries, there were a lot of ‘Mansas’. A diagnosis of blood cancer or leukemia meant certain death; it was a matter of how long. This is our situation in most cases in Ghana now. So, how did they do it, and continue to do it in the advanced countries?

  • Research: National and international collaborations between various childhood cancer treatment centers to improve diagnostic and treatment strategies; including training and retraining of experts in the field of childhood cancer management
  • Advocacy: Largely led by private individuals and non-government, non for profit organizations that run effective campaigns to create awareness and raise funds to support the treatment of childhood cancers. No single organization, government or private, can bear the huge financial burden of curing childhood cancers alone
  • Health Infrastructure: Curing a child of cancer requires in addition to highly trained health personnel, effective healthcare systems (data systems; allied health systems; diagnostic systems) including infrastructure and constant updating of existing knowledge
  • Political Will: Resources (human and financial) required to be invested in childhood cancer care needs commitment from various governments in sustainable, long term policies such as establishment of centres of excellence dedicated to childhood cancer care, specialists’ training and international collaborations at the level of governments 

 I will end this short expose’ by asking readers to think about these (may be controversial) questions:

  • When will Ghana’s National Health Insurance Scheme recognize the need for supporting at least part of the cost of the treatment of even the commonest childhood cancer in Ghana?
  • Tell me, will you rather your taxes of GH₵20,000 (US$5,000) be spent in curing (with all certainty) 20 kids with even the deadliest form of (cerebral) malaria; or in providing free school uniforms for 200 pupils, instead of using it to provide treatment for Mansa who has only a 30% (realistically, currently) chance of surviving in Ghana?
  • Will another Mansa, born to parents of low socioeconomic class, be able to beat leukaemia in the next 50 years in Ghana?

Figure 3: A graph of newly diagnosed childhood cancer cases seen in KATH, 1998 – 2013


Dr Lawrence Osei-Tutu (Official Doctor, BISA APP; Paediatrician and Health Advocate)

oseitutlaw@gmail.com; www.facebook.com/ChildhoodCancerAwarenessKATH

Honeymoon, pleasurable or diseased

When burning love become a  medical condition on your honeymoon. Ouch!. It began when she started feeling sick and sexual intercourse become a painful act. Honeymoon Disease (Cystitis ), which is known as Urinary Tract Infection is the cause.  Females are more prone to this disease than males because their urethra are shorter than that of the males. It basically develops, when a woman have sexual intercourse for the first time or have sexual intercourse again after a long period of time ( and also having sex every other day ). Bacteria such as E. Coli which normally lives in the anus get into the urethra via penile thrusting.

The urethra become bruise, irritated and inflamed which makes it easier for the bacteria to invade the urethra and then the bladder, it starts to replicate leading to infection after sexual intercourse. However, aside it occurring after sexual intercourse, Honeymoon Disease can also start when an unclean fingers, or other object is inserted from the anus into the vagina where the bacteria are introduced there and also wiping from back to front instead of front to back ie, from the vulva to the anus after bowel movement or urinating are also at higher risk of the infection.

urinary-tract-infection-cystitis-diseaseIn addition, it presents itself with burning and painful urination, urge to urinate frequently, urine is cloudy or blood tinged and also pains above the pubic bone. Generally, the symptoms start a day or two after the bacterium is introduced into the urethra and then the bladder.
Most importantly, some simple precautions can help ensure that,the disease does not occur such as, urinate immediately after sexual intercourse to flush out the bacteria from the urethra. Drinking at least two liters of water a day is important to help flush out the bacteria and prevent proliferation which occurs when urine is concentrated.
When cleaning after bowel movement, it is recommended that wiping is done from the front to the back.
When ready to resume penis- vagina sex, consider applying a water based lubricant to the vagina area to ease penetration and avoid abrasions from occurring.
Avoid using any deodorant, vagina spray or a strong femine intimate washes that could irritate the delicate lining of the vagina.
The use of condoms is not guaranteed to prevent infection from occurring.
Avoid drinking too much coffee, soda and citrus juice which can tend to irritate the bladder.
Drinking cranberry juice on regular basis may tend to prevent bacteria from sticking on the wall of the bladder. However, cranberry cannot actually cure an existing bladder infection once they are acquired.
Importantly, treatment is based on a proper diagnosis through examination of the urine sample at the laboratory. A specimen of urine is taking midstream ( urinating first, then catch the middle sample of the urine in a specimen bottle ). Where the vulva is wipe clean of secretions, the bacteria is looked out for and its quantified number per high power field. Then the doctor can advised on the proper treatment ( antibiotics ) for the disease.

A gynecologist should be seen for further treatment if the infection recurs. Now the burning love of the luxurious honeymoon is accomplished taking into consideration this health tip.

By Ophelia Kamason

HALITOSIS — A significant health and social concern

Usually referred to as bad breath, halitosis is a common complaint in the adult population and can be a significant social problem. It may however affect people of all ages.

It is characterized by unpleasant breath of air emanating consistently from the mouth. In extreme cases, affected individuals lose self-confidence and become social isolates.

The mouth (oral cavity) is the chief origin (90%) of bad breath and less often the nose, tonsils, sinus, pharynx, lungs, stomach, and metabolic diseases may contribute.

Dental decay, gum disease, oral infections, mouth sores, oral cancer, food impaction between teeth (such as meat), poor oral hygiene, poor denture/prosthesis hygiene, low salivary flow rates are all reasons for intraoral halitosis.

randy-chanceEven in the mouth, we find out that the tongue is the major site of oral malodor production. The mouth is home to many hundreds of microorganisms that have complex interactions with one another. Majority of these organisms hide in small crevices, crypts and pockets where there is less oxygen because oxygen tension can be detrimental to their survival.

These microbes feed on minute proteinaceous debris in the oral cavity, digest them and release certain sulphur by-products and acids. The Sulphur products are volatile and mix with every breath of air before it is exhaled. This accounts for the malodorous smell we know as halitosis.

Studies have shown these microorganisms reside in large amounts on the surface of the tongue closer to the back (or throat area). Many patients I see in the clinic avoid brushing this part of the tongue because of the fear of stimulating the unpleasant gag reflex.

Saliva is a very important bodily fluid responsible for oral self-cleansing among other functions. Aside physically neutralizing any bacterial by-products, it has antimicrobial factors that control the reproduction and balance of the oral microbial population.

During sleep, salivary flow is significantly reduced, the mouth is closed for a considerable length of time (meaning less oxygen entry), and the anaerobic microbes flourish and produce concentrated amounts of these Volatile Sulphur Compounds (VSCs). This explains why everyone experiences some bad breath first thing in the morning. We refer to this as transient halitosis and its worse if you forget to clean the night before.

Other reasons for reduced salivary flow may be; during fasting periods (food stimulates saliva secretion to aid in chewing and digestion), dehydration, cigarette smoking etc.

Some very healthy foods we eat can have a high impact on our breath. Onions, garlic, and fish are notoriously known for causing bad breath. Most of us have had arguments at work or school with people who are chronic garlic eaters. Remember onions and garlic to be Sulphur-containing foods.

Systemic diseases such as diabetes mellitus (fetor diabeticus), chronic kidney disease (uremic fetor), chronic liver disease (fetor hepaticus) and gastric reflux disease are less common reasons for halitosis.

So far we have been discussing what is termed as “Genuine halitosis”, which is halitosis that actually exists and can be confirmed by professional testing. Treatment of genuine halitosis will involve identifying causative factors and eliminating them.

More importantly however, some individuals complain of bad breath yet do not have confirmable halitosis even with objective testing. Such people wrongly interpret other people’s gestures as an indication that their breath is offensive. These individuals become so much aware of themselves that they tend to adopt behaviors to minimize their perceived problem (eg. Mouth covering during conversations or distancing themselves from social interactions).

We term this as “Halitophobia”. Some authors regard this as a form of social phobia where individuals are anxious about another person’s behavior toward them. They are unable to accept their perception of bad breath as unreal. These individuals will require clinical psychological assistance.

Dr Randy Chance, BSc. Med. Sci, BDS

Korle-Bu Teaching Hospital & Official Doctor at Bisa

Accra- Ghana


JA Regezi, JJ Sciubba, RCK Jordan. Oral pathology- Clinical pathologic correlations; 5th Ed 2008, pp 193-194

José Roberto Cortelli, Mônica Dourado Silva Barbosa, Miriam Ardigó Westphal. Halitosis: a review of associated factors and therapeutic approach. Braz. oral res. vol.22  supl.1 São Paulo Aug. 2008

Ken Yaegaki Jeffrey M. Coil Examination, Classification, and Treatment of Halitosis; Clinical Perspectives J Can Dent Assoc 2000; 66:257-61

van den Broek AM, Feenstra L, de Baat C. A review of the current literature on management of halitosis. Oral Dis. 2008; 14(1):30-9. Review

S R Porter, C Scully Oral malodour (halitosis); BMJ. 2006 Sep 23; 333(7569): 632–635.

Five things you should know about HIV and AIDS

  1. What are HIV and AIDS?

HIV—Human Immunodeficiency Virus— a virus that weakens the body’s immune system gradually, ultimately causing AIDS.

AIDS—Acquired Immune-deficiency Syndrome— is the most advanced stage of HIV infection, which can take from 2 to 15 years to develop depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.

  1. How is HIV transmitted?

HIV can be transmitted through direct contact with a HIV positive person’s body fluids, such as blood, breast milk, semen and vaginal secretions. Individuals cannot become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water. Also, a person cannot get HIV by sharing a school bus or classroom or working at the same workplace of with people that are HIV positive

1 22

  1. Is there a treatment for HIV and AIDS?

 There is no cure for HIV infection but there is treatment available, called the antiretroviral treatment (ART). With effective ART, people living with HIV can enjoy healthy and productive lives.

  1. What are the signs and symptoms of HIV infection?

HIV infection goes unnoticed for years as generally there are no exclusive symptoms. The first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash or sore throat.

  1. How do I know if I have an HIV infection?

The only way to know if you have HIV is to take a blood test. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages. Remember, you don’t need to be sick to take an HIV test! It is better to test early.

For more information, please visit: http://www.who.int/mediacentre/factsheets/fs360/en/


Pollution Kills As Many People As Cancer Does, UN’s New Environment Chief Warns

The new head of the United Nations environment agency today laid out key issues facing the international community on environmental issues, including pollution as well as the linkages among the environment, wars and conflicts, and migration.

“The World Health Organisation has estimated that seven million people on the planet are dying from pollution – that is more or less the same number of people dying from cancer,” the Executive Director of the UN Environment Programme (UNEP), Erik Solheim, told reporters in Geneva.

In his remarks, the former Norwegian politician and diplomat flagged the role that partnerships could play in UNEP’s mission, noting that “at the very minimum we will be ready to go into partnerships with companies who either behave well or are ready to change,” and citing a recent agreement in Addis Ababa to look into a partnership with Ethiopian Airlines to find ways to assist the company in achieving the maximum fuel efficiency.

The second issue is “to look into the crossroads between environment and wars and conflicts and migration,” said Mr. Solheim.

To bring greater focus to these priorities, he said, it is necessary to reach out to more people and change narratives to get closer to people’s hearts. As a first step, he is considering changing the organisation’s name from “UNEP” to “UN Environment.”

Mr. Solheim also highlighted how his past experience would help inform him in his new role. As a negotiator of the peace process in Sri Lanka between 1998 to 2005, Mr. Solheim said he had gained valuable lessons, including the importance of dialogue and compromise.

“In my view you should always try to talk even with political leaders as well as guerrilla leaders or terrorists leaders who do not seem to be amendable to compromise – let’s try talking,” he said.

Mr. Solheim was elected to the UNEP position for a four-year term by the General Assembly on 13 May this year, succeeding Achim Steiner of Germany, who led the agency for the past 10 years.



“I don’t eat meat anymore”, “I am on a fruit diet”, “eggs are not good for my healthy”, “I don’t drink milk anymore, am on a weight loss journey” these are among some common health conscious phrases we hear in Ghana. It is very commendable that individuals are becoming aware of the toll unhealthy diets have on their health and they try making conscious efforts each day towards healthy eating. Unfortunately many of us do not understand the concept of healthy eating; we are either using logic to approach healthy eating or reenacting what we read on the internet which is shrouded with myths and exaggerated truths. It is very important we finally grasp the concept of healthy eating and its true importance.

Healthy eating can be likened to fueling an automobile. You would need the right type of fuel in the right quantity for the car to work at its optimal best. If the automobile is fueled with the wrong type of fuel, the engine might breakdown, in a similar manner if automobile is fueled with less amount of fuel the car might function for a while but breakdown due to fuel shortage. Same happens in the human body. Food is fuel for the body, so the right type of food and adequate amounts should be eaten at all times. This is referred to as the concept of healthy eating.

This highlights the need to know the right type of meals you need to eat and the recommended amounts your body needs, this is because every individual has different needs and body composition. What may have worked for your friend, relative or favorite fitness blogger may not work for you simply because you are two different individuals with different requirements. It is therefore essential to seek advice from the right professionals for a comprehensive assessment of your needs and professional advice on how to resolve your dietary concerns.



a childInfant feeding can be a real daunting task. The struggle of finding the right healthy meal options for optimal growth coupled with fussy eating habits of children, mums of today are most likely to continuously stick to the one recipe or food brand their infant tolerates most and this act may result in certain unforeseen nutrient deficiencies in the child. Healthy eating should always adapt the principles of variety, balance and moderation.
Below are a few healthy modification, moms can try when cooking staples for their infants, to increase nutrient content of meals.

– Blend cooked vegetables (beet root, carrot, turkey berry, fresh Moringa leaves) and use as base for cooking rice.
– Cooked Vegetables can be diced or grated into rice (beet root, carrot).
– Coconut flesh and water can be blended and used as base.

– Coconut pulp and water can be blended and used as base for preparing porridges. Especially corn, oats & wheat based porridges.

– Boiled yam/potatoes can be mashed with grated carrot or beet roots.
– Vegetables can be steamed and mixed with mashed yam/potato.

– Fruits (washed and cleaned) can be mashed and mixed with milk. Fruits like pawpaw, banana, mango or soursop.
[Fruit – one portion, Milk – 3 teaspoons, or yoghurt – 240mls]


Healthy Recipes: Whole Wheat Stir fry

stirFryTired of plain and boring white rice, let discover new ways to infuse some health into your daily meal choices. Whole wheat grains have been described to expose the body to a broader spectrum of nutrients. The bran and endosperm of the grain are packed with proteins, fiber, iron, B Vitamins       and antioxidants. Whole wheat has been linked with positive outcomes in the management of diabetes, blood cholesterol and weight control. This is just one of the reasons why you should include more wheat grains in your meals.

When we talk of wheat based meals, try thinking beyond wheat bread. There is a vast array of recipes which includes wheat as its main staple. Below is a simple wheat based recipe you can try


  • Whole wheat grains, 3/4 cup
  • Salt, 1/2 teaspoon
  • Vegetable oil ,1 tablespoon
  • Carrot , 3 small grated
  • Red/green bell pepper , 2 medium bulbs chopped
  • Onions, 2 medium bulbs chopped
  • Ginger, 2 teaspoons grated
  • Garlic, 1 clove minced
  • White pepper, ¼  teaspoon
  • Black pepper, ¼ teaspoon
  • Egg, 2 egg whites beaten
  • grilled chicken breast, 4 ounces shredded


    1. Cook wheat in a small saucepan with 1 cup water and 1/4 teaspoon salt.
    2. Cover and cook, undisturbed, until wheat absorbs water, about 1 hour. Remove from heat, fluff with a fork and leave uncovered.
    3. Heat oil in a large skillet or wok over medium-high heat. Add black pepper and white and stir for 10seconds
    4. Add egg whites. Stir gently until egg is evenly distributed.
    5. Add onions, ginger, garlic, if desired; cook, stirring frequently for about 2 minutes.
    6. Add cooked quinoa and stir gently
    7. Sprinkle chopped pepper and grated carrots into mixture. Stir gently until it is evenly distributed.
    8. Allow to cook for 2 minutes and add shredded grilled chicken. Stir until it is evenly distributed.
    9.  Serve with some side salad (optional) and enjoy.


Healthy Recipes: Banana Pancake

pancakeThis recipe is for pancake lovers who are cutting back on a few calories. A typical pancake recipe comprises of some ounces of calorie; dense flour, milk, eggs and butter totaling 160kcal for one six inches (6’) pancake without toppings. With a few healthy modifications you can enjoy this low calorie banana pancake (90kcal) which does not include FLOUR. This delicious recipe is also loaded with nutrients; potassium, vitamin B6, magnesium, fiber to mention a few.

I must also add, this a great meal or snack for children, especially fussy eaters. It is delicious and very easy to make.


  • 1 medium ripe banana
  • 2 egg whites
  • 1/8 teaspoon baking powder, for fluffier pancakes
  • 1/8 teaspoon salt
  • 1/4 teaspoon vanilla or ½ teaspoon of cinnamon
  • 1/2 teaspoon coconut oil, for the pan.


  • Maple syrup or jam.
  • 1 cup fresh fruit, like mango, pawpaw or apples.


  • Small mixing bowls
  • Fork
  • Nonstick griddle or frying pan.
  • Spatula


  1. Mash the banana: Peel the banana and break it up and mash until the banana has a pudding-like consistency and no large lumps remain.
  2. Add any extra ingredients: Add 1/8 teaspoon of baking powder for fluffier, lighter pancakes, and whisk in salt, cinnamon or vanilla to add flavor to the pancakes.
  3. Stir in the eggs: Whisk the eggs together until the yolk and whites are completely combined. Pour the eggs over the banana and stir until the eggs are completely combined.
  4. Heat a pan over medium heat: Melt a little butter or warm a little vegetable oil in the pan to prevent sticking, if you like.
  5. Drop the batter on hot pan: Drop roughly 2 tablespoons of batter onto the hot pan. It should sizzle immediately — if not, turn up the heat slightly.
  6. Cook for about 1 minute: Cook the pancakes until the bottoms look browned and golden when you lift a corner.
  7. Sprinkle with toppings: Sprinkle any loose toppings, like nuts or fruits, over the top of the pancakes. Serve and enjoy.

Macronutrient Comparison

Regular pancake (white flour, egg, milk, oil)

 Calorie: 323kcal, carbohydrate: 41g protein: 12g fat: 11g fiber: 1.3g

Banana pancake (banana, egg, oil)

 Calorie: 147kcal, carbohydrate: 23g protein: 4.7g fat: 0.39g fiber: 2.6g

Banana has a relatively low calorie as compared to regular pancake thus it is highly recommended for weight management. Not only is it a low calorie meal option, it is also loaded with nutrients namely potassium, B vitamins and vitamin C which are beneficial in warding off many diseases.