Retool hospitals for efficiency — Urologists

BY: Emmanuel Bonney
• Prof. J.E. Mensah — President of the Ghana Association of Urological Surgeons
Prof. J.E. Mensah — President of the Ghana Association of Urological Surgeons

The Ghana Association of Urological Surgeons (GAUS) has called on the government to retool all hospitals with modern urological equipment for effective healthcare delivery.

It said apart from the main referral hospitals such as Korle Bu Teaching Hospital, 37 Military Hospital and the Komfo Anokye Teaching Hospital, which were equipped, the smaller regional hospitals had nothing, a situation that was not the best for patients requiring that service.

“We think that if all regional hospitals and some of the big teaching hospitals are given the needed equipment, it would go a long way to improve the care we give to these patients and also improve training as well,” the President of the GAUS, Prof. J.E. Mensah, said in an interview with the Daily Graphic.

Urological diseases

Urologic diseases describe a wide variety of conditions, all related to the filtering and carrying of urine out of the body. These diseases can affect men, women, and children of all ages.

These diseases affect very specific parts of the body. In females, they involve the urinary tract. In males, they affect the urinary tract or the reproductive organs.

Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate or loss of bladder control. Complications can include urinary tract infections, bladder stones and chronic kidney problems.

Communique

This was to throw more light on the communique issued by the GAUS at the end of its Annual General Meeting in Accra recently.

The communique was issued after the GAUS’ AGM and Scientific Session, held on July 17, 2021 in collaboration with the academic staff from Melbourne University, Australia, and a urologist from South Africa, as well as its sponsors.

The day’s event held sessions attended by urologists and urologists in training from teaching, regional and district hospitals across the country. Pharmacists and other urology industry players were also present.

“The scientific session, which was chaired by Prof. G. O. Klufio, the outgoing president of GAUS, was aimed at improving the care of patients with Congenital Genitourinary Disorders.

Rising cases of urological diseases

The communique said from discussions, it was observed that Hypospadias (a birth defect in boys where the opening of the urethra is not located at the tip of the penis) was the most common congenital abnormality seen in Ghana, followed by undescended testis and posterior urethral valves (small leaflets of tissue in the urethra).

Such conditions, according to the communique, result in the valves partly blocking urine flow because not enough urine get through them to leave the body.

“This causes a reverse flow of urine. This can harm the urethra, bladder, ureters and kidneys.

“Adequate treatment requires a thorough neonatal assessment of the baby but there are not many urologists to handle these rising cases.

“As a matter of urgency, therefore, the GAUS is advocating the expansion of a Urology residency training to include paediatric and plastic surgery rotations to increase residents' exposure to these conditions and their management,” the communique said.

National data

The communique further called for the compilation of a comprehensive national data set on those disorders, including follow-ups and outcome information to give a clearer picture of the situation.

Participants recommended that at birth, “all children's genitalia must be carefully examined to detect and document any congenital anomalies. Before consulting with a urologist, parents of babies with abnormal genitalia should be counselled against circumcision.”

Lack of tools

According to Prof. Mensah, who is also the Head of Department of Surgery of the Korle Bu Teaching Hospital, retooling the hospitals with the requisite equipment was critical for adequate care to persons in need of urological services as it also served as an avenue for training.

One of the biggest challenges of urologists, he said, had to do with the lack of the equipment to work with.

“They come for training and you post them to the regional hospitals and they cannot function well. The retooling will definitely help and it is not only in urology; a lot of specialities have the same challenges- the equipment,” he said.

“To manage the congenital anomalies very well you would need equipment. The big hospitals like Korle Bu and 37 have some of these equipment but the small regional hospitals don’t. We don’t want patients to always be referred maybe from Tamale to Korle Bu,” he said.

Prof. Mensah further noted that though some hospitals might have “bits and pieces” of equipment, even those might be old and thus not effectively fit the purpose, thus the need to replace them.

“If you train a urologist and post him to a regional hospital, you must necessarily provide him with the equipment he needs to work with. So, that is what we are saying,” Prof. Mensah said.

Resolved challenge

The issue of inadequate urologists and working tools have been a recurring challenge in the country.

In early 2000, there was a handful of them, a situation that saw specialists from particularly, the Korle Bu Teaching Hospital, frequently travelling to the other regions to deliver specialists consultation.

In 2005, three of them met their untimely death as they returned from an official duty.

The victims, Professor John Kwateboi Marmon Quartey, First Consultant Urologist and Founder of the Anatomy and Urology Departments of the University of Ghana Medical School; Dr Isaac Kofi Bentsi, Consultant Urologist, and Dr Benjamin Osei-Wiafe, Specialist Urologist, died in a fatal accident on the Bunso-Apedwa stretch of the Accra-Kumasi road on August 27, as they were returning to Accra after undertaking an outreach programme at the Sunyani Regional Hospital.