Tuesday, September 27, 2011

TAMALE TEACHING HOSPITAL PURSUES RECOVERY AGENDA (DG, SEPT 26, 2011, PAGE 19


ABOUT five years ago, the Northern Regional Hospital, now Tamale Teaching Hospital (TTH), was plunged into a crisis as several years of neglect left the hospital in a precarious state requiring ‘intensive care’.
With some of the wards being reduced to death traps coupled with the lack of staff and equipment, the centre could simply not hold.
From then till now, however, a lot of things have changed at the hospital and one would be rightly placed to conclude that the hospital is on the path of a major revival.
This renewed hope is driven by notable improvements in various sectors of the hospital’s operations, ranging from infrastructure to service delivery.

Expansion and rehabilitation project
When the hospital was commissioned in 1974, it was meant to function as a regional hospital for the Northern Region and also as a referral point for the Upper East and West regions.
It served as such for several years until 2007 when it became necessary to convert it into a tertiary facility to support the training of medical students of the School of Medicine and Health Sciences of the University for Development Studies (UDS).
However, the change in status posed serious difficulties to the hospital as it had overnight taken on a status that, realistically, was then beyond its capabilities.
Many of the existing structures at the hospital were in a very deplorable state, especially the tower block. This compelled the workers to abandon some of the floors.
It became pretty obvious that the hospital became overwhelmed by the rise in patient numbers as a result of population growth over the years.
As a result, the consulting rooms became inadequate and there were not enough rooms to provide offices for many doctors and administrative staff.
Many wards, such as the maternity and casualty wards, became crowded and patients were compelled to use the floor as there was not enough space for more beds.
In the past, various political administrations had made pledges to rehabilitate the TTH, but these pledges never materialised, until May 2010, when the long-awaited rehabilitation and expansion of the TTH finally took off.
The President, Prof John Evans Atta Mills, cut the sod for the project, following a financing arrangement the government had entered into with the government of the Netherlands.
The first phase of the project, which is in progress, involves the construction of a new four-storey block at the eastern side of the hospital and an innovative link building, which would link the new block to the existing blocks.
The new block is expected to house critical areas such as an Accident and Emergency Centre, Diagnostic Imaging Unit, Labour and Delivery Suite, Operating Theatres and Intensive and Coronary Care units.
The innovative link building provides easy access to all levels of the new and existing buildings for ambulant, wheelchair or stretchered patients and visitors alike, whiles internal lifts in the new building are reserved for medical use.
According to the Chief Executive Officer (CEO) of the TTH, Dr Ken Sagoe, as at August, this year, the contractor for the project – Simed International – indicated that the construction of this block was 90 per cent complete.
“We are expecting that by October, this year, they would have finished with the rehabilitation of the old children’s ward and old medical ward. They would then proceed to tackle the tower block,” he mentioned during an interaction with the press.
Dr Sagoe noted that when the construction of the four-storey was completed, the hospital would have over 600 beds, adding that this would be a significant development.
Although many changes have gone on in the TTH over the past three years, this project appears to be the most glaring and gratifying to the people of the north.

Boosting staff strength
One of the key challenges that faced the TTH during its transition period was the shortage of critical staffs.
It required a number of professionals, including medical officers, specialists, consultants, general and specialised nurses and laboratory technicians.
As at the end of December 2007, the TTH could only boast of 21 doctors and a handful of pharmacists, laboratory technicians and other staffs. However, having followed progress at the hospital since that period, it is pretty obvious that the hospital has made consistent progress in increasing both the quality and quantity of its workforce.
In 2008, the number of doctors increased to 36 and further increased to 58 and 102 in 2009 and 2010, respectively. As at the middle of this year, the hospital now had 112 doctors and there are indications that the number would increase further by the end of the year.
Checks also revealed that nursing levels have seen a sustained increase from 309 in December 2009 to 450 in 2010 and 706 in mid-2011, with 70 of them being midwives.
In the laboratory section, the number of technicians has increased from a figure of nine in 2008 to 59 in 2011. There are now 25 pharmacy staffs as against six in 2008.
The creation of new sections such as audit, public relations and human resource, has equally led to the employment of more professionals for these areas.

Availability of specialist care
One significant development closely linked to the increase in staff numbers is the availability of specialists.
Some few years back, all manner of cases, ranging from complex to less complicated, were being referred to other tertiary facilities in the south. This is no more the case, since the TTH now has a number of specialists, including an ophthalmologist, neurosurgeon, obstetric gynaecologists, radiologists, psychiatrists, orthopaedic surgeons, paediatricians and urologists, who offer services not only to people in the Northern Region, but those in the Upper East and Upper West regions and beyond.
The pile of work that greets these specialists each day is overwhelming and they deserve commendation for remaining committed to the north.
These specialists have helped the hospital to improve and expand its clinical services and have performed lifesaving surgeries.
In November, 2009, the hospital saved the life of a teenager, Iddrisu Rukaya, who was at the point of death when she was found lying in a pool of blood in a gutter at Kakpayili, a suburb of Tamale,
“When they brought her, the skull had crushed open and a significant chunk of her brain matter had protruded and stuck to the skin. In fact, she was between life and death,” the Head of the Neurosurgical Unit of the TTH, Dr Adam Abass told the Daily Graphic when he was interviewed.
“The whole bone fragment on that segment was off and sinking into the brain and there was also some debris in the brain,” he further mentioned.
Rukaya underwent surgery, successfully, and recovered subsequently through a combination of intensive care and physiotherapy.
In that same year, the TTH performed, successfully, its first renal dialysis, a procedure that is performed for people whose kidneys are not functioning well or are damaged either permanently or temporarily.
Similar operations have been performed at the eye, gynaecology, urology and other sections.
According to the Public Relations Officer of the TTH, Nii-Otu Ankrah, the setting up of an endoscopic surgical unit has enabled the hospital to do endoscopic surgeries and interventional endoscopy.
He also mentioned the Intensive Care Unit (ICU) and the neonatal ICU as two other critical units that were set up and “they have played critical roles in helping save the lives of patients.”

Replacing obsolete equipment
In the absence of modern equipment, however, the work of these specialists is limited.
For instance, the consultant urologists, Dr Akis Afoko is left with no option than to use out-dated methods to repair urological conditions, such as open surgeries.
He told the Daily Graphic that he could perform more surgeries in shorter periods with an endoscopic machine, as well as other equipment.
At the eye unit, the ophthalmologist, Dr Seth Wanye has been compelled to use outmoded slit lamps, tonometers, microscopes and surgical instruments.
Dr Wanye said the eye clinic would not have to refer patients with conditions that require laser treatment or cornea transplant to other hospitals if the TTH had a modern laser machine and other equipment.
However, in the estimation of Dr Sagoe, these challenges could soon become a thing of the past because the hospital was expecting over 80 containers full of medical equipment which would be used to furnish the various sections of the new block when construction is completed.
He also mentioned that the government had awarded on contract the establishment of an MRI facility, which is expected to enhance medical imaging at the hospital.
Already, the hospital has been a beneficiary of large quantities of donations of medical equipment from various philanthropic institutions and partners.
In fact, the hospital management is hopeful it would soon have a modern eye care centre with the support of the Lions Eye Centre and the University of Louisville, both in Louisville, Kentucky, in the United States.
The head of the eye clinic, Dr Seth Wanye mentioned that these partners have pledged to donate state of the art equipment to the eye clinic, which would enable the hospital to perform major eye surgical operations that include cornea transplant and laser treatment for diabetic patients with severe retinal diseases.
He said in addition, a tissue bank and an optical laboratory would also be established at the eye unit to enable the unit produce eye glasses and make them available to patients at affordable prices.


Way forward
One thing remains clear, with consistent effective leadership, government support and partnership, the TTH is on the path to realising its vision of becoming a “centre of excellence for quality tertiary healthcare and medical education and research.”

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