A lot of talks and noise has been made across the 16 regions of Ghana regarding the COVID-19 pandemic as to measures and strategies to put in place to contain the disease in case the number of infected people escalates. A lot of reassurances and good speeches has being made in our attempt as a nation to fight this pandemic. The politicians, religious leaders, the media, and varied union groups have added their voice in our bid to prevent the spread of the disease as a nation. The COVID-19 has indeed brought a shock to the entire world from Wuhan (China) where it began claiming 3000+ lives, 5000+ lives in Italy, Germany, the United States of America could also not escape the blow of the COVID-19, South Korea, Germany, UK, Togo, Rwanda and Ghana has also confirmed 24 cases which has tested positive for COVID-19. The above statistics are worrying and calls for global concern as to the best strategies and policies that governments and institutions must put in place to address the pandemic. This calls for strategic leadership and thinking.
In a pandemic case scenario such as the COVID-19, there are two main entry points into a nation:
• Vertical Transmission Route – Imported cases
• Horizontal Transmission Route – Community Transmission
For the vertical transmission, the client and all possible contacts can be traced by the Emergency Response Team and quarantine for 14 days. If within this period, these contacts starts exhibiting signs of COVID-19, their blood samples are taken for testing and if the results proves positive, they are managed at an isolation centre. However, if the transmission moves from the vertical to the horizontal, that is, Community Transmission, then Ghana must prepare itself for the worst case scenario like other nations. This is because the transmission pattern gets expanded and we can only expect exponential infection rate except for Divine intervention. When we start getting over two hundred cases a day, our fragile and weak health system will collapse. Mortality and fatalities will increase especially for clients with underlining medical conditions such as diabetes mellitus, hypertension, coronary heart diseases and worst among all, people living with HIV (PLHIV). Hospital Acquired Infections (Nosocomial Infections) also take a toll on the infected person, accounting for the death rate. This is what happen in most of the European countries, on the 13th of February, Wuhan in China recorded 14, 000 new infection but now the infection rate is 39. People who get infected can recover if managed by competent and motivated health staff. What we can do is to break the chain and line of transmission by adhering to the safety guidelines being offered by the Ministry of Health, Ghana Health Service and World Health Organization (WHO) so that we do not spread the infection. This reason underpins why Government of Ghana gave the executive order on the ban on social gathering such as churches, mosques, schools, universities, the social distancing is of importance in breaking the horizontal transmission route.
There is an undeniable fact that pressure on our health staff is going to be very high, to say the least. The provision of adequate information from the Chinese Centre for Disease Control and Prevention shows more than 3000 healthcare workers infected with the COVID-19. Howard Catton, the CEO of the International Council of Nurses in Geneva remarked that it is crucial to gather information on the group of health workers affected, to further identify modes of transmission, and when and how they are being diagnosed, in order to manage and protect them, thereby preventing further infection of the virus. Mr. Catton said: “This is a serious and ongoing situation and we know that the Chinese Government is pouring massive resources into treating people who have the virus and aimed at containing it. Working on COVID-19 patients takes an immense physical and emotional toll on the healthcare staff, and sadly, as has happened before, health care staff working in the frontline with patients who have the virus are at risk of contracting it themselves”. According to the International Council of Nurses in Italy, Italy’s health workers are sacrificing their health in the battle to combat COVID-19 but lack sufficient protective equipment to keep them safe. The International Nursing Council and the Italian Nurse Association are warning us of the dire consequences of not supplying adequate Personal Protective Equipment (PPEs) for health workers working with COVID-19 patients. Latest statistics shows that healthcare workers make up 9% of Italy’s COVID-19 infected patients. The high rate of infection among healthcare workers is a serious concern because health workers who are infected must stay away from work for at least 14 days, depleting the already exhausted workforce. Simple arithmetic calculation of the 9% out of the number infected in Italy can give us an idea of the larger number of people infected in Italy alone, we can use this as a baseline to make our analysis of the number of health staff infected across the globe.
The current Ghana situation from our research conducted through phone calls, personal interviews with health staff, our own visit to most of the health facilities in Ghana from Regional Hospital facilities across the regions, Christian Health Association of Ghana across the regions and private health facilities reveals and gives credence to the unprepared nature of our health system in Ghana. We were looking at the psychological preparation of the health workers in Ghana whether or not they are adequately prepared for the COVID19? The answer from the Doctors, Nurses, Pharmacists, Midwives, Medical Laboratory scientists, Anesthetists, and the paramedical community will shock you! They answered with an emphatic NO, that how can they be ready when they do not have enough personal protective equipment like face masks, gloves, to say the least. According to our research, most Doctors and Nurses are forced to wear mask which are far past their effective use (using one face mask for over a week), some facilities do not have mask at all and gloves for staff protection. We found out that some health staff in some government selected facilities as a holding point for COVID -19 took to their heels leaving helpless suspected COVID-19 patients at the mercy of God to die, some we witnessed ourselves. These are the realities in Ghana now and we cannot pretend we are not aware of it. The staff are taking cover in Act 651 of the labour law which says if your employer do not provide a safe environment for your work, then you can flee. The environment is indeed not safe for the health workers in Ghana and the earlier we admit and look for remedy, the better it is for us all. Health workers are not angels and superheroes, they are stepping up and answering the call to duty to serve humanity. Health workers are men and women who have families and friends and responsibilities, and they must be protected from the risk that caring for patients with COVID-19 poses. There must be adequate test kits to test all health workers for the virus, health workers must have adequate PPEs they need so that they can carry out their duties without fear for their own safety and that of their families. It is highly unacceptable for health workers across the country to work without sufficient protection and Government must put a robust supply chain in place now. The whole world is watching the commitment of central government, duty bearers to demonstrate leadership and commitment towards the protection of the health care workers in Ghana. It is also a moral and a legal obligation of government, duty bearers and managers of various health facilities across the country to ensure that health care workers do not work in an environment that is injurious to their own health.

FOHA is appealing to Government of Ghana to rise to the occasion to make sure that health workers in Ghana are supplied with adequate PPEs as soon as possible in order to fight and contain the COVID-19. Not having the PPEs will be like going to war with paper shields and toy guns, these supplies are needed now, not tomorrow. FOHA is also calling on all the clergy, the house of chiefs, the media, civil society organizations in Ghana, citizens of Ghana abroad and all citizens of Ghana to join the discussion in order to make sure we have a robust, efficient and effective health system in Ghana. Ghana is still in the window period of the COVID-19 and from our facts on the ground, our systems and health workers are ill prepared for this battle in the event that the figures of the new infections escalates, which is highly probable because we have moved from the vertical route of transmission (imported) to the horizontal route of transmission (community).

RECOMMENDATION
1. Government’s $100 million allocated for the fight of COVID-19 should be distributed to all facilities as soon as possible. There should be an update about the status of all monies released to various regions in the COVID-19 battle, this is an emergency and if we do not respond promptly and proactively, we shall pay dearly for it as a nation.
2. Make PPEs available for health workers as soon as possible.
3. Ban on social gatherings should be enforced.
4. Making testing of COVID-19 a protocol for all health institution, mass testing for all.
5. The Minister of Health, Director General of Health, Minister of Information, the media and all stakeholders on board the fight against COVID-19 should be in face mask during press briefing and they must observe the social distancing as well.
6. Wearing of face mask is not negotiable for all.
7. The China success story.
8. Lockdown.
We hope the government, duty bearers, all stakeholders and all citizens will give a hearing to this petition.

Thank You
Yours Faithfully,

Rev. Jefferson Agbotro Kwasi
Founder & CEO, FOHA

FRIENDS OF HEALTH ASSOCIATION (FOHA)

• FOA is a progressive , non-profit, non-governmental organization (NGO), 100% not for profit charity in Ghana that has being on the forefront of health care for 12 years now in the area of :
• Public Health
• Clinical Health
• Nutrition
• HIV/AIDS
• Research, policy and advocacy
• Community Development & capacity Development.
• FOHA has head office in Ghana, Sunyani, UK, USA, Netherlands, Germany, China
• Over 300 medical volunteers across the globe
• Sponsors of the 2018 Bono & Ahafo Regional World Aids Day through UNAIDS
• Member of the Ghana Coalition of Health NGOs
• www.fohaghana.org/ www.founder.fohaghana.org