Thomas Yaw Berko sets off on his old bicycle towards Akyaakrom village, cutting 30km across the red road of the Ahafo Ano North district, in southern Ghana. He needs to get there before noon so he can get back to the Tepa health centre before nightfall.
He has made this journey twice a week for the past 6 months since he joined the Tepa center as a volunteer health worker. There are just two volunteer health workers assigned to the Ahafo Ano North district, and together they are responsible for more than 7000 households. The work they do is critical.
Patients presenting with early lesions have good treatment outcomes. Hence, village health volunteers are crucial in the early detection of Buruli ulcer.
Berko met Shaibu, a 16-year-old boy, four months ago. Shaibu’s mother had noticed swelling with an open spot on his left leg. In the beginning, the spot looked more like a mosquito bite. But over the next 2 weeks, the spot grew bigger, to the point where Shaibu could no longer manage the daily 5-mile walk to school.
Berko happened to be in Shaibu’s community doing his house visits and he noticed the crusty scab on Shaibu’s leg right away. “I took a close look, and I knew that Shaibu had Buruli ulcer,” says Berko. “We had to take action fast to avoid infections to the bone which can lead to gross deformities or even the amputation of limbs.”
In Ghana, patients with advanced Buruli ulcer are hospitalized for more than three months, which means they cannot go to work, to school or take care of household chores and the family.
Thanks to Berko’s early diagnosis, Shaibu was referred to the Tepa health centre for more specialized care which includes antibiotic treatment under direct observation of a healthcare professional.
"Patients presenting with early lesions have good treatment outcomes,” says Dr Richard Phillips, the doctor who treated Shaibu in the Tepa health centre. “Hence, village health volunteers are crucial in the early detection of Buruli ulcer.”
Sometimes, I find it very difficult to cycle several kilometers just to reach one patient, but it makes me feel happy to be useful, to even one person at a time.
Since 2005, Ghana and other countries where Buruli ulcer occurs have adopted the World Health Organization’s policy for early detection and treatment. Under Ghana’s National Health Insurance scheme, the government introduced an insurance programme in 2003 which provides financial protection to make access to quality health services affordable for Ghanaians. Children under 18 are exempted from paying a premium; health services are completely free of charge. Since 2003, over 6000 patients have received treatment while being financially protected.
Buruli ulcer is no more a neglected disease in Ghana. The government of Ghana, through different community initiatives, is educating the population about the disease and the importance of early reporting and treatment. It thereby helps to eliminate the stigma attached to the disease.
Today, Berko is teaching Shaibu an exercise to slowly move his legs upwards and downwards in order to prevent disability in the future.
“Shaibu will soon be able to return to school,” says Berko enthusiastically. Community work isn't always easy, he admits. "Sometimes, I find it very difficult to cycle several kilometers just to reach one patient,” he concludes, “but it makes me feel happy to be useful, to even one person at a time."
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