KUMACA viral outbreak: When preventive healthcare is traded for mischief

My heart bleeds to write this article, in that, sons, daughters, friends, brothers and sisters have lost their dear souls as a result of a mysterious disease we could have prevented if our governments over the years had prioritised preventive healthcare. Allow me to express my heartfelt condolences to the mothers and fathers who have lost a child, the families who have lost a dear one from this mysterious disease we have been battling with over the week or so.

First of all, it is said that it is in preventive medicine that a medical professional will receive his major calling. It is therefore not misplaced at all for countries, states and continents to prioritise preventive medicine as the best approach to a holistic health service. I can say unequivocally that, this KUMACA outbreak is as a result of a healthcare system that has gone haywire - no holistic approach and lacks the basic common sense of health services - thus to prevent diseases.

Notwithstanding, let me throw a little light on the history and epidemiology of this mysterious H1N1. H1N1 is an influenza virus type A that causes diseases in humans, birds, and pigs and other animals. There are three groups of the influenza viruses but only the type A is found to be very important to cause pandemic and epidemics in these species. Their natural reservoir is aquatic birds. The viruses are described with reference to a hemagglutin (H) and a neuroaminadase (N) proteins that project from the viral envelope - and there are about 15H and 9N forms that can assort to form several specific genetic strains of the virus-like H1N1, H2N3, H1N5, etc. The first record of H1N1 was the 1918 pandemic human influenza in the United States. Just after this outbreak, a similar disease (swine flu) was recorded in the same country. It was then generally believed that the swine flu was caused as a result of the adaptation of the human influenza virus in pigs which was indicated that both the human pandemic flu and the classical swine flu strains have a common avian (bird), ancestor.

The pig is known as the “mixing vessel” for the influenza virus because it is scientifically known that different strains of the virus  (avian, human and swine) can reassort or mix in the pig to give a different virulent strain. In the 1980s, there were many genetic mixings between avian-like H1N1 and human-like H3N2 viruses. Mixtures of human and classical swine genes have been isolated over the years in Asia, USA and several other countries. It is suggested that the H1N1 viruses have disappeared from the human population, and the pig population provides a reservoir for the virus. The unfortunate thing is that pigs can be infected with type A human influenza strains during epidemics of human influenza, but show no clinical signs of the infection. The 2009 human pandemic outbreak was found to have a swine (pig) origin. Thus pigs usually have an important role in the ecology and epidemiology of influenza A viruses, so to speak.

We know, anecdotally, through professional discussions that, influenza viruses have been circulating among pigs in the Ashanti region since 2015 and this has not been confirmed by the veterinary services, maybe, as a result of incapacitation and a neglect of the service over the years - the fact being that successive governments do not recognise the need for the veterinary service. It beats my imagination when I try to understand this though. In this 21st century when almost 75% of all emerging diseases like this H1N1, the Ebolas, the Marburg, the zikas, the Nepahs, etc are zoonotic (i.e can be transferred from animals to humans)? The WHO says about 60% of all human diseases are zoonotic. How on earth will one undermine such a profession which has the professional mandate to make sure that these diseases are maintained in the animal population in order not to spill over to the human population? It’s pathetic!

The 1956 joint WHO and FAO symposium on the collaboration between human medicine and veterinary medicine was so decisive: wherever there is the need to place veterinary service in the society, this must never be underestimated. Eric Savereid on the eve to a new era in Africa made it clear to African leaders: “ make room in your social pecking order for veterinarians, you need them badly!” And just recently the White House made it clear that to keep Americans safe they need to have more public veterinarians and even as “special agents.” In accord, the white house appointed a veterinarian as a secretary to Cabinet and most US states have it mandatory by law to have veterinarians on all state boards of health. Today the veterinary service of Ghana has only about 32 government veterinary doctors of which about 20 of them are in administrative positions. A service that needs not less than a thousand (1000) doctors and over 2000 technical staff. Yet, government seems not to be perturbed about the need to employ more public veterinarians and technicians.

There are about 52 jobless young veterinarians who have graduated from the universities and for over 2 years now have not been employed. The second batch of these young veterinarians undertook their mandatory housemanship training and has not been paid. The third batch has been asked to proceed with another housemanship training without offer letters; their fate left to the mercy of nature to take care of. The ministry doesn’t seem to have any better plan to regularise this housemanship training and government is happy about veterinarians being jobless while people like our brothers and sisters at KUMACA die from a mysterious disease which could have been prevented with adequate veterinary workforce and good surveillance of such diseases in our domestic and wildlife animals.

A country who produces only about 8% of the protein it consumes. We have some good news anyway, the Nana Addo Dankwah government plans to build some poultry and meat processing plants for us. Kudos to the president! However, let’s see the sustainability of these poultry processing plants without a strong veterinary service; let’s hope if we will not breed such disease outbreaks with the meat that will be coming out of the plants without a strong veterinary service; let’s see if diseases will spare the very input (the birds) to feed these plants without a strong animal health system.

We do not plan for the worse to happen, but the worse will happen if we do not plan and plan well. Did we say we have eradicated guinea worm from this planet? It is lurking somewhere awaiting a conducive season to attack and it has already begun. Uganda in October had an outbreak of Marburg virus, our friends in Nigeria were combating with Zika virus not long ago. Where is our surveillance system and contingency plan for such diseases? Obviously none!

Anyway, if government thinks we as professionals will resort to picketing before she can wake up to address our grievances, then we are sorry we aren’t going to do that because we know, surely that, if teachings and advice does nothing, experience will one day teach the recalcitrant some lesson to reason, and it has started. Let’s take this as a prophetic token - a true auspice: We don’t preach that the veterinary service is the Messiah to prevent such outbreaks, they happen even in countries with strong veterinary services, yet we will not be safe as a country from such emerging diseases if we do not strengthen and respect the veterinary profession. Because we are at the moment prone to the stings of these diseases; our healthcare system is holistically weak with respect to the preventing these outbreaks.

Until then, let’s continue with the policies that will make us believe in our healthy utopia - thinking that all is well - without recourse to the very institutions that will add value to the country’s total health care. God will save us from the very things that human efforts and wisdom are to be applied. Our faiths save us then.

Read Full Story