ARE YOU TRULY GETTING VALUE FOR MONEY?

Parenting is not an easy job and I’m yet to meet anyone who thinks the contrary. As if juggling work, day care and arranging for a nanny to watch your children in your absence are not enough, there comes the hunt for the right school which would facilitate the educational needs of your children so they become properly educated and someday contribute meaningfully to society.

I was recently engaged in a conversation with a friend where amongst the host of things we talked about, the issue of education came up. Her daughter had gained admission into kindergarten and her admission letter stated she was to pay a non-refundable fee of acceptance which included ‘building development fee’ of one hundred cedis. Her school fees, books and school uniforms were to be purchased separately.

I was just flabbergasted but before I could get over that rude shock she told me this was even ‘cheaper’ because other schools charged far more than what she had to pay. Further inquiries from other friends with children in preschool revealed a similar trend and I could no longer hide my growing disgust. I must admit, some of us will need a lot of patience someday when we become parents.

Africa’s population is currently one billion which translates into a growing population needing education and health services. Unfortunately, these are not adequately provided for by our governments, hence the opportunity for individuals to invest in such areas. You only have to compare the success rate of private schools on one hand and public schools at he basic level to see why most parents would prefer the private route. Which of course means that providers see the opportunity to charge increasingly ridiculous prices. Parents are being held at a ransom as they are forced to pay exorbitant fees to access basic education for their children.
 Of course, it’s not a must for your child to attend a school that charges exorbitant fees but when your options are limited you have no choice but to cough up the money. Parents who protest about these fees which seem to do a pole vault every term or school year are “politely” told to withdraw their children if they feel they cannot afford.

For some of these schools where Parent-Teacher Associations (PTA) exist, they are just a mere façade as parents are not really consulted on issues concerning their children and the school; they are only summoned to be informed about the increment of fees or any other levies. End of discussion. No room for negotiations or airing of views. Just pay up. Others prefer not to have such an association anyway; they send the bill so you pay up. At least they are being straight forward.

On the flip side, the school buildings of some of these private schools are nicely designed, classrooms are air conditioned, class sizes are reasonably small, have spacious playgrounds, computer labs, etc and an ‘assurance’ that your child will pass their examinations to gain admission into ‘first class’ second cycle schools and universities in and outside the country.

The only questions that run through my mind whenever I see so called ‘International’ and ‘Montessori ‘ schools springing in every corner are whether they are accredited with their activities monitored by any formal body. Are the children truly getting the right kind of education whereby the schools are adhering to the prescribed national syllabuses to justify the huge sums of money being paid? Are they being taught to be analytical and creative or simply taught to pass examinations? Also, do some of these schools have counselors? Certified nurses in their sick bays in case of health emergencies? If a child has an allergy does the teacher know what to do? Who foots the medical bill when a child gets injured on the school premises especially when it’s a clear case of the school being negligent; the parents or the school? I know of cases where children who have had nasty medical emergencies have had their parents called to come for them without the administration of very simple and basic first aid needs.

These and many other questions plague my mind when I hear of the exorbitant fees that are charged in these private schools. Yes, education is expensive and more so quality education. However there must be real value for the money you pay. So, are you getting your money’s worth?

TO CUT OR NOT TO CUT?

 Apart from the genitals, the chests of women bear these fatty tissues of different shapes and sizes that distinguish females from their male counterparts. They are at once symbolic of both femininity and of fertility. However, these same assets that any woman is proud to possess; that gets men all tongue tied and babies babbling with joy seems to be the very thing that brings grief, pain and possible loss of life to many.

Cancer of the breast accounts for about twenty-two percent of all cancers in women. It has existed for hundreds of years and has claimed the lives of many. Though the advancements in medicine have improved the survival rates, it is still one of the top ten causes of deaths in women.

Treatment options for breast cancer include chemotherapy, hormonal therapy, radiation therapy and surgical intervention. Surgical intervention includes mastectomy – which is the total or partial removal of the diseased breast tissue, and lumpectomy – the removal of the breast tumor, a procedure which conserves more breast tissues.

The key to fighting breast cancer lies in early detection so as to have the right treatment administered. Most women in developing countries however are diagnosed in the very late stages of the disease due mainly to lack of awareness about it (thus inability to self-examine breast for lumps) and certain barriers to health services.

“I will not have my breast cut off!” is an all too familiar phrase usually uttered by most women in the doctor’s consulting room that have had the misfortune of being told they have breast cancer. Surgical intervention with a combination of other non-surgical treatment is the protocol for dealing with breast cancer. The earlier the tumour is detected, and smaller the extent of spread, the less radical the surgical intervention.

A diagnosis of breast cancer just like any other cancer can be like handing a death sentence to these patients. It is a traumatic period in their lives where most women are caught in the dilemma of either having the breast cut off to save their lives or keep it so as not to feel “maimed” or “deformed” in the eyes of society, which option almost invariably leads to a painful and agonizing death. Somehow it is expected that these affected women should not even think twice about this decision, neither should it be up for discussion as a person’s life is more important than a pair of tissues on their chest.



Most women in almost every society on the other hand consider their breasts as what makes them “whole”. Having to undergo a mastectomy plagues them with myriads of questions such as – how would she look after surgery? Would her partner still find her attractive? For a single woman would she still be desirable to men? And if she ever gets married would she be able to have children? There is the option of reconstructive surgery (to minimize the emotional distress of losing a breast) but that is limited and very expensive in our part of the world.

There are some women who in the face of an overwhelming presence of the disease have persisted and “kept” their diseased breast “intact,” leading to agonisingly predictable results. Whilst others may have judged them as being stupid or reckless I would rather say they made a choice they thought best, owing to the emotional and psychological trauma they would have to deal with and the fear of being ridiculed by people. No matter how “unwise” their decision might appear, you would have to live through their situation to make any meaningful assessment of the issue.

It’s about time we educated ourselves more about the disease so as to meaningfully support those living with it. Family members and spouses need to understand and know that having breast cancer doesn’t change who your wife, mother, daughter or aunt used to be.

Angela Jolie, a Hollywood actress recently revealed that she has had a prophylactic double mastectomy performed on her owing to the fact that she had a genetic predisposition to having breast cancer. This decision of hers was highly discussed in the media with BBC’s popular World Have Your Say inviting breast cancer survivors to also share their stories. Central to most of the stories of these survivors was the fact that they had their cancer detected early; genetic testing made a difference and the decision to have a mastectomy to either deal with their cancer aggressively or reduce their chances of getting the disease.

Having such a prominent figure, more so an actress, whose physical appearance is a big deal in her line of work come out publicly with regard to her decision to have her breasts cut off so as to reduce her chances of getting the disease was more than an endorsement of the fact that there is still more to live for after being diagnosed with breast cancer and the decision to have a mastectomy performed.

It’s also about time as a nation we invested in centers to have people genetically tested for the disease to ensure early detection especially if there exists a family history of it. We need to step up our educational campaign and most importantly increase our National Health Insurance coverage for the treatment options for these patients.

To women out there battling breast cancer, I salute you. And to those who have survived it, you are heroes and an inspiration to others still fighting this disease.

FULL DISCLOSURE IN THE CONSULTING ROOM

A trip to the hospital is not something anyone relishes. Even a periodic checkup could be quite a chore and some would rather wish they were somewhere else than inside a consulting room.

Aside the long winding queues and clerical challenges that one faces ranging from having our names butchered, to having our dates of birth inaccurately recorded, we now have to come face to face with the person some people dread – the doctor with his assisting nurse who sometimes ask very sensitive personal questions; questions that leave one wondering whether these health professionals are not prying too much under the guise of conducting a thorough medical history.

As you would no doubt be aware, patients are encouraged to provide accurate information when seeking medical treatments so as to assist the medical professionals in making right diagnosis and consequently have the appropriate treatment administered. However, chances are that you are not too keen to let the doctor or nurse to know you drink six bottles of beer a day, that your last sexual intercourse was unprotected, that you secretly take Viagra or occasionally engage in recreational drug use. There is the fear of being judged and we would rather have our ‘sinful’ lifestyle remain a secret than tell a total stranger, even a doctor about them.

Some weeks ago, I was experiencing a terrible back pain and general weakness. I however thought it would blow away until I woke up on a Tuesday morning extremely warm to touch, with a blinding headache and a catarrh, at which point I didn’t need a soothsayer to tell me I needed to go to the hospital.

An agonizing two hours later I found myself in the doctor’s office. The doctor went through the routine drill: I presented my complaints, she did an examination and begun to ask questions. To one of these questions, “do you have a stomach ulcer?’’ I answered in the negative. In fact, I once developed an ulcer about five years ago (that earned me a visit to the emergency room at an ungodly hour of 1am). Fortunately for me, it healed up as quickly as it came and had never developed since then. Therefore, I felt it was insignificant enough to omit from my record.

After a series of tests including an x-ray she concluded I had malaria whereas the x-rays showed there was nothing wrong with my spine; instead, the terrible back pain I was experiencing could be as a result of my sitting posture or the type of chair I used at work. She therefore gave me a prescription for antimalarial drugs, some antihistamine for the catarrh which seemed to be an allergic reaction, some multivitamins and Flotac for my back pain.

I went home and religiously took my medication. Four days into taking them, I started having some severe stomach aches but dismissed them for hunger pangs since I wasn’t eating as much as I used to due to my illness. The stomach pain however persisted but I just ignored it, thinking it would go away after I was done with my medications. On the eighth day I realized it was no longer an ‘ordinary’ stomach ache but was now experiencing more severe pains which were only relieved by eating (a classic sign of an ulcer). The temporal relief would last for about two hours and I would be forced to eat as quickly as I could to ease the pain. I was now at my wits-end and was wondering what exactly was going on till it dawned on me that my ulcer was back.

This was however puzzling because I couldn’t recall avoiding food totally whilst being sick so where from this harsh intense stomach pain? Everything became clearer after deciding to recheck the leaflet that came with the medication. Flotac is a combination anti-inflammatory drug classified as a non-steroidal anti-inflammatory drug (NSAID) which is used to treat gout, rheumatoid arthritis, dysmenorrhea, osteoarthritis, ankylosing spondylitis, rheumatic inflammation of the spine and pain syndromes of the spine. The doctor had prescribed it to help my back pain. Flotac however is contraindicated in people with stomach ulcer.

A horrible, empty feeling in the pit of my stomach greeted this realisation – I had caused another ulcer due to my failure to mention to the doctor that I had previously had it (no matter how brief it was). If I had made her aware of that fact, she would have prescribed an alternative and I wouldn’t have had to go through this needless pain. My medication was switched and after a week I finally felt well.

Lesson learned. My experience made me realize just how foolhardy it was not to take into consideration even the most insignificant previous medical condition. Not many are as lucky as I was though, to quickly come to the realization of the possible cause of their “follow up” illnesses. They either develop something worse from what their initial problem was or worse, die in the process of taking certain medications just because a vital omission was made while providing information to health professionals because they felt such details were insignificant.

Don’t repeat my mistake.

PRESERVING THE DIGNITY AND HUMAN RIGHTS OF WOMEN

Female Genital Mutilation, an acknowledged rite of passage in some societies is a topic some of us seem to prefer to be oblivious of. We know it exists in our country and in other parts of the world, know of its horrors but for some interesting reasons have distanced ourselves from discussing it. I was no exception until somewhere in 2001 when I read Fauziyah Kassindja’s “Do They Hear You When You Cry” co-authored with Layli Miller Bashir which left a lasting impression on me.

Prior to reading her book I had a fair idea what FGM was as a result of reading articles about the issue and watching documentaries on how it’s done – horrifying scenes which took literally months to drive out of my shocked brain. The book looks at the sheltered life Fauziyah Kassindja had in Togo with her parents until her father died. Life becomes very difficult for her and so to avoid being made to go through the circumcision and married off to be the fourth wife of an elderly man, she flees to the United States to seek asylum.

According to World Health Organization, FGM involves the partial or total removal of the external female genitalia for non-medical reasons, a practice that is more often targeted at underage and vulnerable girls. Although there are cases of FGM in Asia, Europe and the Middle East the vast majority of cases happens in twenty eight African countries. One hundred and forty million girls and women worldwide are currently living with the consequences of the practice. Although FGM is thought to be based on religious practices – especially Islam – it must be noted that that is not the case. There is no correlation between FGM and Islam or any other religion for that matter. It is purely a cultural or societal practice.

In Ghana, FGM is practiced among some of the ethnic groups in the northern parts of our country. While some of the girls willingly accept to go through the procedure others are made to do it against their will. Also, due to the fact that the practice is unacceptable in many parts of our country, these girls and women have to do it away from the sanitised areas of hospitals and other controlled spaces as is the case with new-born males who have to undergo similar procedures. Instead, it’s done by older women in the community with unsterile blades and other crude cutting instruments.

The procedure itself is rather abrupt. The young girl to be circumcised is pinned down on a mat or the floor by other women, her external genitalia washed with water and the circumcision carried out. The dangers associated with this procedure include excessive bleeding, urinary problems and infections, complications at child birth and of course the psychological damage it occassions in some girls. Women who have undergone FGM have difficult childbirth sometimes resulting in the death of the baby, mother or both. They bleed excessively during child birth as a result of the point of cut or “wound” (previously healed) erupting from the force of pushing their babies.

You would expect that as a result of the physical pain experienced by these women and the strong advocacy against FGM the practice should be completely eradicated. Unfortunately that is not the case. Most women after having gone through the procedure still insist their daughters and grand-daughters go through same because it is a rite of passage without which they would somehow not be considered “real women”. The rationale behind the practice is to make women less promiscuous and more fertile. Additionally, they consider the external genitalia “ugly” and unfeminine hence circumcising them would make them “clean” and more feminine.

An article I read sometime back in The Mirror tried to justify the practice further by arguing that FGM is no different from what women subject themselves daily to so as to enhance their beauty. By women applying chemicals to their hair, bleaching their skins, tanning them, augmenting their breasts, nose, and all other “beauty” procedures, they are no different from the woman who decides to have FGM performed on her. This was in response to the government trying to implement laws against the practice. To the author of the article it was an infringement of rights of these women. But how can we take this (male) author seriously, when he has very little chance of going through this himself? After all, FGM is performed so as to make these women more acceptable in their communities as some men refuse to marry women who have not been circumcised.

One thing the writer failed to realize is that women who choose to have chemicals applied to their hair, their breasts augmented, or get nose jobs do not do so against their will. FGM on the other hand does not give women in the practicing communities the option to decline. They either have it done or be forever shunned. Some of these girls flee from their homes in the North to seek refuge in Southern parts of our country with others like Fauziyah who are compelled to seek refuge in other parts of the world. For these women to resort to such measures so as to avoid being victims gives one a sense of how serious, terrible and inhumane the practice is.

FGM in my opinion is unequivocally cruel and a painful procedure any girl or woman on this earth can be subjected to. It is an extreme form of discrimination against women and a violation of their human rights. The issue of FGM is a delicate one as it inflames passions in people who are against it (like me) and those who staunchly defend it. Regardless I believe women should ultimately have the right to accept or reject it. They should never be made to do it against their will. In December 2012 the UN General Assembly accepted a resolution to eliminate the practice. Let your voice be heard. Say no to FGM especially to those who must undergo it against their will.