MEDICAL IMAGING- THE GHANA SITUATION

Diagnostic Medical imaging is the technique and process of creating visual representations of the interior of a body (Anatomical) for clinical analysis and medical intervention, as well as visual representation of the function of organs or tissues (Physiological). All these procedures are handled by the imaging team to advance a better understanding of the complex practices and protocols behind each image.

The team comprises; Radiologists, Medical Physicists, Biomedical Engineers, Radiation Technologists and other supporting staff, who collaborate to advance the course of the imaging process to the benefit of patients. Interestingly, there have been an increased use of medical imaging in Ghana, mainly for staging and localizing tumors and cancer diagnoses, as well as detecting anatomical and physiological problems. The success of this increase will depend on an effective medical imaging team, with well-trained clinical Medical Physicists and Biomedical Engineers, who are key members of a well-defined imaging team.

The absence of this imaging team hinder the expansion and the development of precision medicine through integrated decision support application software and effective use of medical imaging equipment and devices in Ghana. This is because, the absence has affected the realization and transformation of medical imaging, which would have made medical equipment smarter, imaging results faster and examinations more precise, to obtain effective diagnoses outcomes and above all prevent the constant break down of these equipment.

In Ghana, there are about 500 imaging equipment country-wide, of which 62% are in Greater Accra region, 11% in Ashanti region and the rest of the 27% are dotted across the country. This in balance is a major challenge to health care delivery in the country. According to internationally accepted standards, this is really inadequate to serve the population of about 30 million and use for proper diagnoses of diseases. Unfortunately, this is the stuck reality and we currently have no option but to accept it. Apart from the inadequate imaging equipment, there is also an issue of frequent break down of these equipment. This may be attributed to several factors, among them being the lack of expertise in these centers. This I found as unacceptable since these experts are available in the country and the International Atomic Energy Agency’s Basic Safety Standards, of which Ghana is a signatory, says they must be employed by the authorities and owners of these facilities, unfortunately, not much has been done in this regard.

Annually, an average of 250 imaging experts are trained in Ghana, which are made up of Medical Physicists, Radiologists, Radiographers, and Biomedical Engineers. Of this number, just about 50% are employed, who are mostly Radiologists Radiographers. This is because the Radiographers take the images and the Radiologist report and interprets those images. The absence of these professionals will mean no imaging process, hence the system is forced to employ them. However, the other core members of this team namely the Medical Physicists and the Biomedical Engineers, whose jobs are very essential not only for the quality assurance and optimization of the processes and protocols but for the safety of both patients and users of these facilities. In other words, the risks associated with the use of these machines are extremely high in Ghana to both patients, users and the general public when these additional professionals are not involved. As to why this persists it’s only the authorities and owners of these facilities who can explain. It is of interest to note that several attempts by the Ghana Society for Medical Physics and other related health professionals to resolve these issues fell on deaf ears. The politicians are not interested and to make matters worse the technocrats in the field who should know better turn a blind eye, exposing citizens to extreme risk and danger. I intend to leave this aspect for another discussion, however, what the general public should know is that all is not well with the diagnostic imaging processes in Ghana and the earlier something is done about it the better, for the safety of the patients, users, and the general public.

The rapid progress of medical imaging and the invention of various medical imaging equipment have benefited mankind in the developed world. However, this seems to be the reverse in the developing world, including Ghana. I have visited a number of facilities in Europe and had the opportunity of seeing the wonders in using this equipment in the proper and correct diagnosis of diseases as a necessity before treatment. The more sophisticated these bio-instruments are, the better the diagnosis. Unfortunately, I weep for mother Ghana any time I visit these facilities across the country. It is time the general public realized that we are all at high risk for lack of action by our leaders in ensuring that Medical Physicist and Biomedical engineers are employed in all imaging facilities in the country.

Even though medical images play an important role in clinical diagnosis and therapy of various diseases. It is often thought of as a way to represent anatomical structures of the body with the help of X-ray, Sound waves and electromagnetic wave. But often it is more useful for physiologic function in addition to the determination of anatomical structures. With the growth of computers and image technologies, medical imaging has greatly influenced the medical field. As the quality of medical imaging affects diagnosis, medical image processing has become a hotspot and the clinical applications wanting to store and retrieve images for future purposes need some convenient process to store those images in detail.

Generally, there are three forms of medical imaging; first by the use of X-ray as in Conventional X-ray, popularly referred to as X-ray, Computed Tomography referred to as CT, Mammography, and Fluoroscopy. Secondly, the use of waves (electromagnetic and sound) as in Magnetic resonance Imaging, referred to as MRI and Ultrasound, referred to as scan (in Ghana) and thirdly by Nuclear Medicine Techniques, where a radioactive substance is inhaled or injected into a patient and a camera is made to detect the radiation from the tissues of the patient. The difference between the first two imaging processes (X-ray and electromagnetic and sound wave) and the third process (Nuclear Medicine Techniques) is that in the case of the first two cases, the X-ray and the electromagnetic and sound waves are generated from a source and made to pass through the human tissues and a picture of the internal tissues or organs are drawn. However, in the third case (Nuclear Medicine Technique), the source of the radiation is the radioactive substance inhaled or injected into the patient and the camera is made to detect the source of the radiation which is defined by the metabolic activities of the patient’s tissues based on their health state.

Though the final images obtained from many techniques have similarities, the technologies used and the parameters represented in the images are very different in characteristics as well as in medical usefulness, even different mathematical and statistical models are used. Several techniques have been developed to enable CT, MRI and ultrasound scanning software to produce 3D images for interpretation and diagnoses. Traditionally, CT and MRI scans produced 2D static output on film. Therefore to produce 3D images, many scans were made and then used to produce a 3D model which can then be manipulated for the purpose it was taken to answer clinical questions.

Despite all these benefits, medical imaging also poses danger to the users, patients and the general public, based on the use of radiation in acquiring these images if the right care is not taken by the experts in the field. Radiation is energy that comes from a source and travels through space and may be able to penetrate various materials including human tissues. Light, radio waves, and microwaves are types of radiation that are called nonionizing radiation. The kind of radiation discussed in most of these imaging equipment is called ionizing radiation because it can produce charged particles (ions) in matter which can cause serious irreparable damage to tissues. However, experts in the field like Medical Physicists are trained with taxpayers’ monies to offer services in this regard, in order to ensure the safe use of these equipment. Unfortunately, those who matter have refused to employ these professionals despite Ghana signing on to the International Atomic Energy Agency’s Basic Safety Standard (BSS) documents which demands that these professionals are employed to offer services for the well-being of all Ghanaians.

I have the following questions for the authorities and owners of imaging facilities;

  1. What will it take to ensure that all hospitals in Ghana are made to employ at least one Medical Physicist and a Biomedical engineer each, to ensure the safety and proper functioning of this equipment?
  1. Why are you ignoring the danger posed to the citizens by ignoring your responsibility of protecting the general public and the sick as enshrined in article 30 of the 1992 constitution of the Republic of Ghana.

I leave these questions to the conscience of those responsible to do the right thing and I will be back if nothing is done.

Shiraz Issahaku (Ph.D.)

Imaging Expert/Consultant

BNARI Gets New Director

The Ghana Atomic Energy Commission (GAEC) appointed Dr. Micheal Yao Osae as the new Director of the Biotechnology and Nuclear Agriculture Research Institute (BNARI) in a short ceremony organized in Accra.

In his opening remarks, the Director-General (DG) of GAEC, Prof. B.J.B Nyarko, commended Prof. Kenneth Danso (the outgoing Director) for his consistency in keeping the Institute actively running even in times of difficulty. He also congratulated Dr. Osae for his new role and called on all staff of the Institute to offer him the needed unconditional support.

Prof. Danso in a short address expressed gratitude for the opportunity offered him by the DG and Management of the Commission to serve for two terms (8years).

Prof. Danso has been credited with significant successes during his tenure in the areas of research, development, and commercialization. One such success under his leadership was the Institute’s collaboration with the University of Cape Coast to release a high starch content, beta carotene fortified and Vitamin A enriched cassava varieties.

The Institute also received a grant from the Council for Technical and Vocational Education and Training (COTVET) to expand the production of protein bait for the control of mango fruit flies in Ghana. Additionally, Prof Danso’s stewardship also led to the recognition and elevation of BNARI by the International Atomic Energy Agency (IAEA), resulting in the training of more scientific staff from Ghana in the area of mutation breeding.

He has played key roles in ensuring capacity building of staff through the acquisition of a flow cytometer – a sophisticated equipment used to detect and measure the physical and chemical characteristics of a population of cells or particles. He also initiated the processes for the procurement of a Near Infrared (NIR) spectrometer for the Institute.

Finally, he championed the development of new products at the Radiation Technology Centre (RTC) of the Institute and the introduction of the floriculture project for GAEC. Among the many achievements, he was also instrumental in the introduction of commercial poultry production at the Institute.

Dr. Michael Osae, in his acceptance speech was thankful for the opportunity given him to serve as the Head of the Institute. “I want to transform BNARI into a world-class research-intensive Institute, one of the foremost centres of excellence in biotechnology and nuclear techniques in agriculture with support from my abled staff”, he added.

He explained that to achieve this vision, his administration will be first, a human resource focused, with the goal of motivating staff to put in their very best.

He also plans to establish the first-ever agriculture-based laboratory with the capacity to perform all laboratory tests required in the agricultural sector to enhance research output as well as create avenues for generating funds through technical and laboratory services. “With regards to research and development, my administration will chart a new course”, he revealed.

Dr. Michael Osae briefly served as the Deputy Director of BNARI after serving as the Manager of the Radiation Entomology and Pest Management Centre (REPMC) for a period of 10 years. He is an accomplished agricultural entomologist and a Principal Research Scientist.

Present at the ceremony were the Deputy Director-General, Prof. Dedeh Shiloh Osae, Director of Administration, Mr. Felix Adeku, Director of Finance Mr. Cyprian Basing and the Director of Radiological and Medical Sciences Research Institute (RAMSRI), Prof. Mary Boadu.

 

Established in 1993, the Biotechnology and Nuclear Agriculture Research Institute (BNARI) is one of the research, development and technology transfer Institutes of GAEC.

 

The Institute currently has six centres namely; the Biotechnology Centre, Radiation Technology Centre, Radiation Entomology and Pest Management Centre, Soil and Environmental Sciences Research Centre, Nuclear Agriculture Research Centre and Socio-Economics and Commercialisation Centre. The main objective of the Institute is to be the leading institution that provides sustainable solutions to challenges in agriculture, health, and industry through the application of biotechnology and nuclear science interventions.

 

By: Office of Cooperate and Public Affairs, GAEC.

People of Wenchi From A Hole – GAEC Scientist

A Senior Scientist at the Accelerator Research Center of GAEC, Dr. Amos Forson has stated that data from his research on the origin of the people of Wenchi buttresses their long-held belief that their ancestors came from a hole.

He made this comment at the maiden edition of the GAEC Seminar Series held on Tuesday, February 25, 2020.

Dr. Forson revealed that contrary to the written history about the origin of his people, scientific evidence proves otherwise. “Their history as was mostly written by the Europeans indicates that they migrated from Middle Niger in the 17th century and settled at Bonoso before relocating to their current location, Wenchi. However, results from radiometric dating from the Bonoso Site suggest that the people inhabited that land long (about 400 years) before then.”, he said.

He specifically stated that the results showed that the Bonoso Archaeological Site was inhabited continuously for about 500 years, 610AD (7th century) to 1160AD (12 century) and therefore rejects the Scholarly assertions that Bonoso was just occupied in the 17th Century. “Western-written documentation on Ghana’s past has superficial time-depth going only as far back as the fifteenth century AD”, he added.

He was giving a presentation on “The Vital Role and Application of Accelerator-Based Techniques in Archaeology and Cultural Heritage Research for the Development of Archaeo-Tourism Industry in Ghana for National Development”

Dr. Forson stated that Ghana has a high number of excellent and very rich cultural heritage and several historic and archaeological sites, as well as valuable assets. These he said have potentials of becoming major educational and Archaeo-tourists attractions in the country when developed and preserved. “But this is not so”, he lamented.

He said that stakeholders have a huge task of correcting our negative image and providing an authentic reconstruction of past heritage for the development of Ghana’s Archaeological tourism (Archaeo-tourism). “This can be achieved through promoting public interest in archaeology and the conservation of historical and archaeological sites, museums, monuments, Palaces, interpretation centers, etc.”, he added.

He urged that there is an urgent need for the application of appropriate scientific technique(s), to investigate Valuable Heritage materials, potential Archaeological sites, and artifacts.

Cultural heritage studies involve the investigation and analyses of cultural heritage materials such as inorganic (eg; Pottery, beads) and Organic materials (eg; Bones, Charcoal paper, etc).

His work utilized an Accelerator ion Beam Analysis (IBA) and Accelerator Mass Spectrometry Radiocarbon Dating (AMS-14C Dating). Although there are other techniques mostly used for elemental characterization of Archaeological materials, such as Atomic Absorption Spectrometry (AAS), X-Ray Fluorescence (XRF), Inductively Coupled Plasma-Optical Emission (ICP-OES), Inductively Coupled Plasma-Mass Spectrometry (ICP-MS), Instrumental Neutron Activation Analysis (INAA) and Laser Ablation (LA), accelerator-based techniques in recent times have been the most successfully applied technology in the field of Cultural Heritage studies.

The Seminar series is a Ghana Atomic Energy Commission monthly presentation session on scientific findings and innovations and their relation to the socio-economic development of Ghana.

By: Office of Cooperate and Public Affairs, GAEC

Ghana’s Cervical Cancer Prevalence Highest in The Subregion

“Estimates of Age-Standardized ratios of cervical cancer prevalence for Ghana (35.4), are higher than those of Benin (29.0), Burkina Faso (23.3) and Cote d’Ivoire (21.7)”.

A revelation made by Dr. Adolf Kofi Awua, a Senior Research Scientist at the Cellular and Clinical Research Centre of GAEC. He made this statement during his presentation at the February edition of the GAEC monthly Seminar series.

His presentation on the topic, “A tailored within-Community Specimen Collection Strategy Increased Uptake of Cervical Cancer Screening and the Detection of non-Vaccine-type HPV in a Cross-Sectional Study in Ghana”, focused on risk factors, screening, preventive measures and prevalence rates among others.

He indicated that when it comes to cervical cancer prevention, there are three types of Vaccines against the sexually-transmitted Human Papilloma Virus (HPV) – the causative agent. “It also takes a long time (about 15 years) before the severe form of the disease develops”, he added

According to Dr. Awua, pre-cancer lesions are detectable using effective screening tools, and early detection means the disease can be completely cured. He added that cervical cancer is the most preventable of all cancers. “While some countries are working towards Elimination Programmes, Ghana still doesn’t have a Control nor a Prevention Programme”, he lamented.

He opined that Ghana does not have a cancer prevention programme, most probably due to the constant habit of officials acting only when there is an observable large effect of disease among the population.

Again, he indicated that low levels of knowledge and understanding limit the populace from taking appropriate actions until it is too late. “Without a cervical cancer prevention programme, Ghana will continue to see cervical cancer cases at the late stages of the disease at our treatment centres and each death due to cervical cancer in Ghana is a tragedy that should have been prevented”, he cautioned.

In her closing remarks, the chairperson of the programme, Prof. Mary Boadu, who is also the Director of the Radiological and Medical Sciences Research Institute, added that treatment of cervical cancer is very expensive and a better way is to prevent it from developing in the first place. “There is, therefore, the need for increased preventive awareness creation and expansion of facilities to cater to Ghana and the subregion”, she added.

She thanked the organizers and other participants for coming in their numbers and making the programme a success. Present at the seminar were Research Scientists, Technologists, Administrators and other Staff of GAEC.

By: Office of Cooperate and Public Affairs, GAEC

Scientists call for Nuclear Technology in Energy, Health Sectors

The Research Scientists Association (RSA) of the Ghana Atomic Energy Commission (GAEC) has ended its three day celebrations with a call on government and major stakeholders to employ nuclear technology in pursuing reliable electricity supply and production as well as ensuring an agenda to apply nuclear technology to health care, particularly in the treatment of cancer, tuberculosis, malnutrition and a number of others.

    Dr. Francis Hasford

The calls by Dr. Vincent Agbodemegbe, Manager of Localization and Stakeholder Support Center of the Nuclear Power Institute and Dr. Francis Hasford, Head of Medical Physics of the Ghana Atomic Energy Commission respectively formed part of a public lecture at the British Council in Accra on Thursday as part of the Research Scientists Association’s maiden weeklong celebrations.

The RSA with membership at the Ghana Atomic Energy Commission and the Nuclear Regulatory Authority organized the public lecture as part of the RSA week celebration 2019 themed: “Ghana beyond aid: the role of nuclear technology.’

The aim of the lecture was to educate the general public on the peaceful application of nuclear in medicine and for the generation in electricity for the country.

To ensure dependable electricity supply, Dr. Vincent Agbodemegbe called for the pursue of nuclear technology which he said was a proven means of ensuring sustainable electricity which is the key energy component that supports and sustains national growth.

Cross-section of the public

 

To ensure the dependence on electricity as a key energy component that supports and sustains national growth, Dr. Vincent Agbodemegbe said nuclear technology was the way to go as it remained a proven means of ensuring dependable electricity supply.

Speaking on the topic, “Sustainable Power Generation, the Nuclear Position,” the Manager Of Localization And Stakeholder Support Center of the Nuclear Power Institute argued that Ghana stood a good chance of creating wealth for its citizens and growing its economy if it could deliver affordable and dependable electricity power to its citizens, adding that most countries grew their economies and became prosperous with the provision of cheap and reliable electric power to their citizens.

He urged the Research Scientists’ Association to engage the public on the benefits of Ghana going nuclear especially with nuclear opportunities providing the needed energy for development and job creation.

Dr. Agbodemegbe described nuclear technology as presenting a comprehensive resolution to ensuring the effectiveness of Ghana’s economy, especially as key sectors that facilitated economic growth relied on electricity.

Dr. Vincent Agbodemegbe

Dr. Francis Hasford who spoke on the theme, “Ghana Beyond Aid: Nuclear Technology for Better Health” recounted Ghana’s history of its agenda to resort to the use of nuclear technology in treating various health conditions including cancer.

According to him, there was the need for the full coverage of cancer care in the National Health Insurance Scheme, and the full implementation of the National Cancer Control Program.

With the active working age group usually affected with cancer, Dr. Francis Hasford said the technology was an effective option in detecting and curing the disease.

He called for adequate education on and screening to detect cancer in its early stages to back efforts at achieving the Ghana Beyond Aid Agenda in the health sector, adding that there should be satisfactory numbers of medical imaging and radiotherapy centers, as well as trained professionals.

Chairman for the occasion and a Board Member of GAEC, Professor Alexander Kwadwo while acknowledging the RSA’s proximity to the Agriculture, Energy, Education and Health Ministries noted that the association’s work was critical to the development of the nation.

He described the theme as very apt as it underscored the peaceful use of nuclear technology as its works had the potential of pushing the country’s economic development.

Representing the Director General Of The Ghana Atomic Energy Commission, Director Of The Radiological And Medical Sciences Research Institute of the Ghana Atomic Energy Commission, Prof Mary Boadu said the RSA’s weeklong celebration was in response to the need for research scientists to make the findings of their work known to the public and clearly reveal their role in the development of Ghana.

According to her, research output should no longer be on the shelves of libraries nor in the laboratories.

Chief Director of the Ministry of Energy, Ing. Seth Manu who underscored the vital role energy played in every economy said one cannot talk about the economy without first talking about energy. “Energy we say is the economy and the economy is energy,” he said, adding that the development was the reason the Ministry of Energy saw the importance of nuclear and other sustainable energy.

He said the Ministry of Energy through its affiliated institution and agencies, was progressively making the required efforts at improving Ghana’s energy situation as it was closely working with all stakeholders to achieve an efficient energy mix that will power the development of our dear nation Ghana, arguing that the need for sustainable, reliable, resilient and renewable energy as base-load is critical for the country’s development.

While acknowledging that the role of nuclear energy cannot be over emphasized, the Chief Director said what Ghana needed was adequate education of the public in this regard with the assurance that the Ministry of Energy as the parent ministry driving the nuclear energy development agenda, would continue to play a leadership role by contributing to the efforts of the RSA towards achieving the necessary education and awareness through strategically planning and mobilizing resources for the attainment of the country’s collective goal.

Ghana’s nuclear journey which began in the 1960s with the construction of the nuclear reactor was designed for experimental work in the field of nuclear and atomic physics. In addition to provision of nuclear power, it was to serve as a focal point for research works involving nuclear techniques in biology, agriculture, medicine, physics and chemistry.

In health, non-communicable diseases like cancers can be managed using the nuclear technology for both diagnosis (using CT, mammography, x-rays) for treatment.

There is currently a Cancer Control Strategy which comprises prevention, early detection (diagnosis and screening) treatment and palliative care. Currently, Ghana needs to increase the number of cancer treatment centers in Ghana.

The nuclear deal is the real green deal which would provide the needed energy for industrialization, job creation which would provide the needed energy for industrialization, job creation and dealing with the climate change.

The way forward therefore is for the research scientists association to also engage the public on the benefits of Ghana going nuclear.

Source:ghanaweb.com