Medicine as a weapon in the struggle for Namibian liberation

International Seminar Series: Seminar On Southern African Responses To Imperialism, Harare 22-24 April 1987Ford Foundatio

Medicine in the struggle for Namibian liberation

Seminar paper - Seminar on Southern African Responses to Imperialism,Ford Foundatio

SOCIAL CLASS, THE STATE, AND MEDICAL DECOLONIZATION IN GHANA: A STUDY IN THE POLITICAL ECONOMY OF HEALTH CARE

This dissertation examines the persistence of the colonial legacy of medical maldistribution (that is, uneven distribution of medical personnel, facilities, and budgetary allocations against the background of demographic, morbidity, and mortality patterns) in post-colonial Ghana. It focuses on Ghana\u27s role and status in the capitalist world-system, the ideological and political nature of the Ghanaian state, and internal class structure/relations as the contextual elements of a political economy perspective for analyzing the problem. The central questions posed are: What does the post-colonial period have in common with the colonial period that continues to reproduce the uneven distribution patterns in health care? What happened after independence that apparently aborted the popular expectation of decolonization? What is the best way to conceptualize the continuity between the colonial and post-colonial situations? And what, above all, are the pre-conditions for decolonization in contemporary Ghana?^ Interviews with government and health officials in Ghana, and analysis of secondary data constituted the main methods of study. The case-study approach was combined with a cross-national, comparative perspective (focusing on The People\u27s Republic of China, Cuba, and Mozambique) to address the problem.^ The study found that throughout the post-colonial period in Ghana, medicine and health care generally have been subordinated to the accumulation needs of capital and the legitimation concerns of the state. The maintenance and consolidation of the colonial health care legacy are found to be directly related to the structural weaknesses of the local ruling classes vis-a-vis foreign capital. It is concluded, from cross-national experiences and from developments in Ghana itself, that the possibilities and prospects for medical decolonization in Ghana are inextricably linked to the evolution of a political culture and a sustained process of economic transformation in which the laboring classes and their interests will acquire a predominant place.

Respiratory failure requiring mechanical ventilation in critically ill adults in Ghana: A prospective observational study

Introduction: Respiratory failure is commonly seen in African emergency centres and intensive care units, but little is known about the need for intubation and mechanical ventilation. Methods: From April to October 2017, we recorded the number of patients intubated and ventilated in the emergency centre and intensive care unit at Komfo Anokye Teaching Hospital in Kumasi, Ghana on a daily basis. We assessed patients for presence of acute respiratory distress syndrome (ARDS) using the Kigali Modification of the Berlin ARDS criteria. ARDS patients were re-assessed daily. Results: During the study period, 102 patients were intubated, of which 82 were assessed by the study team. The remaining 20 patients died before they could be assessed. Two (2.4%) patients were identified as having ARDS, and both died. Neither was treated with prone positioning or chemical paralysis. It is possible that many of the patients who died before an assessment suffered from ARDS, considering its associated high mortality, and thus the true incidence of ARDS may have been higher. Conclusion: Respiratory failure requiring intubation and mechanical ventilation is common in patients presenting to the emergency centre or intensive care unit at an academic tertiary care centre in Ghana. The true incidence of ARDS was likely underestimated by our study. Keywords: Respiratory failure, Respiratory insufficiency, Low-resource setting, Intubation, Mechanical ventilation, Ghan