TOR’S PROBLEMS

By Ekow Mensah,

For six long months, the Tema Oil Refinery has been losing an average of US $300,000 ( three hundred thousand dollars) a day.

In total the Refinery has lost up to US$54 million over the period.

These losses have come about simply because the Refinery is not doing what it was set up to do.

Sources close to the Refinery told “The Insight” that is only manages to pay its workers by renting out is facilities to private oil companies.

As a result of the poor performance of the Refinery as many as 15 highly skilled workers have abandoned their posts and are believed to have secured employment in the Gulf and the Middle East.

This exodus has occurred in the last 12 months and there are serious worries that continued exodus of skilled personnel could affect the efficient running of the Refinery.

Until Ghana started exploiting its oil resources, the Refinery which s the single largest industry in Ghana accounted for 12 per cent of the Gross Domestic Product.

It is expected that rehabilitation work on the Refinery would be completed by the first week in March.

The Refinery was shut down because of a break down resulting from the supply of negative power.

EDITORIAL

LET’S SAVE TOR!

Since 1998, the revamping of the Tema Oil Refinery has continued to pop up as a major election issue and yet the Refinery is still saddled with numerous problems.

The report that the Refinery has not been able to process even a tea spoon full of crude oil for more than six months must be worrying.

For an economy which faces major challenges the loss of US $300,000 on a daily basis by the state owned refinery must be a huge shock.

The Insight calls attention to the many problems faced by TOR including the exodus of its skilled personnel and demands that immediate action is taken to deal with them.

 TOR  needs to be saved to help improve the overall health of the Ghanaian economy.

 This is an urgent task which must be done .

You Have Advanced Cancer! –

Need for nationwide early detection and screening now

You have disseminated cancer of the colon!

As bad as that sounded, it was hardly enough to convince Kodwo to accept the chemo-radiotherapy that had been prescribed for its management by his doctors! This was primarily because he did not feel particularly ill at the time of the diagnosis.

“I don’t want to lose my hair,” he reasoned.

 After almost two years of keeping his hair, the cancer spread further and hair loss became the least of his worries. In time, the cancer caused an obstruction of his intestines, which obstruction then led to surgery followed by even more expensive treatment regimes, leaving family and friends wondering what difference early detection and aggressive management would not have made. Could Kodwo have been the beneficiary of a health system that started routine personal reminders every year after the age of 35 to routinely screenfor colorectal cancer using occult blood in the stool? The disease would be diagnosed earlier, treatment would be prompt and life would be significantly prolonged. 

Will young Adzo, diagnosed with obvious advanced breast cancer, but totally refusing any referral for tertiary specialist care on account of morbid fear of surgically losing her precious breasts have benefited from regular habitual self-examination? Will the old lady, reporting only because of back pain and paralysis, but attributing her cancer-eaten breasts to witchcraft have benefited from routine early mammography?

Morbid though the above may sound but true nevertheless, and possibly, our inevitable fate if the current absence of an active nationwide cancer control programme is allowed to persist.  The system appears perfectly designed to diagnose only late stage cancers. That is attested to by many clinicians who are constantly distressed about late stage presentation even as Dr. Kofi Nyarko, Program manager for Non Communicable Diseases and focal person for cancer control within the Ghana Health Service laments current “over focusing on treatment to the detriment of primary prevention and a national screening programme.” Thankfully, according to Prof. E.K. Wiredu, Chairman of Trustees of the Cancer Society of Ghana,“Advances in understanding risk and prevention, early detection and treatment, have revolutionized the management of cancer leading to improved outcome for patients.”

According to the World Health Organization, every year “more than two-thirds of the13 millionnew cancer cases and deaths occur in developing countries where cancer incidence continues to increase at alarming rates.” A national cancer registry is fundamental to any such national cancer control programme. Fortunately, Ghana has developed these registries very well in Komfo Anokye Teaching Hospital and less so in Korle Bu Teaching Hospital. Also quite clearly outlined is a national strategy for cancer control in Ghana (2012 -2016) which appears to be have been bogged down by the lack of resources and/or leadership will in a phenomenon described by the WHO as “struggling to move from commitment to action.”This firmly puts Ghana outside the “17% of the African countries and 27% of the low-income countries that have cancer control plans with a budget to support implementation.”

“Ghana has everything in terms of policy and strategy in place to move. The only thing left is the resources, both human and material. They are no funds for primary prevention and screening. Most of the Ministry of Health’s programs are funded by donors but because no donor is currently into cancer care, we are handicapped”, said Dr. Nyarko. This in his view is further complicated by what he also calls an over focusing on treatment.

“A loan of $ 13.5 M was approved by the Parliament of Ghana but it all went into clinical care; rehabilitation of radiotherapy centres in the Teaching Hospitals because people equate cancer control to the building of such centres.” Acknowledging Ghana’s current reputation as having the best cancer management center in West Africa (with two Teaching Hospitals and a third primary facility in East Legon attracting many patients in the sub region), Dr. Nyarko sounded frustrated that sufficient attention did not appear to be accorded the establishment of a national screening programme to aid early detection and better treatment outcomes.

Further, although Ghana has declared smoking in public places illegal, it has taken no practical steps, current considerations notwithstanding,to drastically raise taxes on tobacco and alcohol as other countries have done to properly establish and fund its national cancer program.

However, with the introduction of the Human Papillovirus (HPV) Vaccination Exercise in 13 pilot districts in Ghana’s Northern and Central regions, there appears to be some hope for cervical cancer, believed to afflict 3038 women every year, 66% of whom die. Further, it is gratifying to note the announcement by the Chief Director of the Ministry of Health about a government commitment to broaden the minimum benefit package of the NHIS to include more comprehensive management of cancers. This is in addition to health education messages put out by authorities calling on women to screen for cervical cancer while reporting any vaginal discharge and/or bleeding after having sex. For years, Battor Catholic Hospital in the Volta Region, under Dr. Kofi Effah’s current leadership has been at the forefront of screening thousands of women for cervical cancer.

Korle Bu Teaching Hospital

To quote Dr. Clement Adusa, Managing Director at the Radiation Oncology, Department of Radiotherapy at Korle-Bu Teaching Hospital, “prevention is the most cost-effective and sustainable way of reducing the global cancer burden in the long-term.”  And for the general population, this should immediately translate into the same old things, much talked about, much ignored and yet which if practiced, could make a ton of difference: avoidance of excessive alcohol, smoking, unhealthy diets and physical inactivity. 

Further, people are encouraged to take personal responsibility for health screening, learningfrom the UK’s NHS advise to women to start screening for cervical cancer from the age of 25 and subsequently to be “screened every three years till the age of 49 and subsequently every five years till 64 years.” Similarly, women are invited for their first mammogram at the age of 50 – 53. In addition, women with a family history of breast cancer are encouraged to do earlier tests coupled with regular breast   examination for early identification and subsequent investigation of any breast lumps. 

Also, given that prostate cancer could well remain symptomless till a very advanced stage, men in their forties would benefit from annual tests for prostate specific antigens (PSA) and digital rectal examinations.  PSA is a chemical produced by the prostate and may be raised in cases of benign/ non-cancerous enlargement, infection or cancer. Indeed, “The American Cancer Society recommends regular screenings for prostate cancer for all men over the age of 40. Your doctor may determine that you need testing even earlier, especially if you are a member of a high-risk group (including African-American men and men with a family history of prostate cancer).”

Cancer appears to be such a distant concept till it comes sufficiently close. With urgent coordinated action at both the national and individual levels through the establishment of a rigorous Ghana Cancer Control Programme, it need no longer retain the tag of a death sentence.

Sodzi Sodzi-Tettey

www.sodzisodzi.com

Sodzi_tettey@hotmail.com

“People are fed up of senseless politics”

President John Mahama

Against a backdrop of angry political rhetoric, President Mahama insists that the state must ensure election security, help to improve agricultural production and develop institutions with the authority to investigate corruption.

Pedalling furiously and revellingin the thrill, a youthful John Mahama piloted a bicycle without brakes down a hill towards a busy traffic junction in Accra in the 1960s. It was only when his companions screamed “Dramani, slow down,” Mahama recalls in his just published memoir, that he made the split-second decision to turn the bike at speed into a side street. He flew over the handlebars and landed in a hedge but escaped with a few cuts and bruises.

Mahama laughed when I suggested that a political career could be likened to riding a bicycle downhill without brakes. Making split-second decisions does not trouble him, he assured me. Yet Mahama comes across as a considered politician with clear goals for the government of which he took charge on 24 July. Forty days later, in a speech at Accra’s conference centre, he set out an ambitious programme.

Although he speaks solemnly about building on the legacy of tolerance and social reform left by his predecessor John Atta Mills, Mahama has quickly established his own agenda. Conscious of criticism that his National Democratic (NDC) is anti-business, Mahama insists that the private sector would lead Ghana’s transition to a fully fledged middle-income country. Last year the World Bank said Ghana’s recalibrated national income meant it had graduated from a least developed country (LDC) to lower middle-income status. Mahama will chair the newly launched Private Sector Advisory Council and has pledged it will respond speedily to complaints from business of bureaucratic obstacles.

Late President John Evans Atta Mills

He has also set up a unit in the presidency to monitor public-service delivery. He has called on civil society groups to work with government to propose ways to improve services. “Make no mistake – the way we do business in government must change, ”Mahama told Ghanaians in his 4 September speech, which set out a busy schedule ahead of elections on 7 December. The campaign is intensifying with clear differences emerging between Mahama’s platform and the policies of the New Patriotic Party (NPP) and its presidential

candidate, Nana Akufo-Addo.

Alongside his business initiatives, Mahama explains that he still wants a strong developmental role for the state. That is anathema to Akufo-Addo and the NPP. On the NPP’s flagship policy calling for free secondary education for all, Mahama questions the party’s figures and the practicality of its immediate implementation. Between Mahama’s practised conciliatory posture and Akufo-Addo’s skills as a seasoned courtroom advocate, the campaign offers Ghanaians a choice of political style as well as policy substance.

Much will depend on the campaigns.

The most reliable statistic to emerge from local opinion surveys is that about 25% of Ghanaians are yet to decide on which candidate to support in December.

TAR: You have said your predecessor President John Atta Mills embodied qualities that Ghana’s politics sadly lack – civility, humility, honesty and peace. Do the voters agree with you?

JOHN DRAMANI MAHAMA: Those qualities were why President Mills was elected. Since he entered politics in 1997, he showed patience, tolerance and openly supported peace. Unfortunately, he was quite vilified in his period in office, but Ghanaians admired the tolerance of not responding to the personal insults thrown at him.

Wasn’t it crass hypocrisy for people to vilify President Mills and then say he’s a great statesman after he died?

No, I wouldn’t accuse any Ghanaian of being hypocritical. We were united in our grief at the passing of President Mills. Even people who vilified him suddenly realised that this man stood for something.

We can take consolation in that.

Some people say you are cast in the same mould as Mills – a decent man swimming with sharks. Will your call or tolerance make any difference?

Our people are fed up of the senseless politics and arguments that lead nowhere. A decent and dignified life can only come from debate, not attacks on personalities or insults that lead nowhere.

Politicians should heed what people want or they could get punished for continuing with the old type of politics. I don’t think about sharks, I just swim.

Some politicians say oil revenues have raised the stakes in this election – that  whoever wins could be in power for a generation?

I don’t think it’s about stakes, it’s about Ghana and Ghanaians. Government must balance out the non-oil sector and the oil sector. Ghanaians think beyond brick and mortar. Meeting their needs is important, but what kind of leader they have, issues like corruption, rule of law, and justice are just as important.

Why is it so many young people leaving school and university can’t find jobs?

What can be done?

We have a rapidly growing youth population.

We need to accelerate economic growth to create jobs. We’ve seen an expansion

in the services sector, new jobs being created that can absorb some of the youth. With the new oil and gas industry we expect more jobs, that’s why local content has become important.

President Mills said agriculture was critical to create jobs and prosperity.

What success have you had with the farms?

We’ve brought inflation down from 25% to below 10%, mainly because of lower food prices. We have seen increasing maize and rice production. We are producing 30% of our rice. With irrigation, we’re sure that Ghana should be self-sufficient in the majority of staple

foods that our people consume, and will export food to its neighbours. We’re assisting small-scale farmers to expand farms and increase their productivity per acre. We’re backing commercial farmers who go into agriculture as a business, employ people and mechanise.

Do you agree that the National Democratic Congress wants to promote a developmental state to lead the country economically, whereas the National

Patriotic Party is a more conservative party putting its faith in business?

The NDC and the Convention People’s Party are left of centre, social democratic parties. The NPP declares itself to be a liberal democratic party, right of centre. Our philosophy holds that you can use the market to stimulate economic growth, but we don’t think the market should govern everything.

You must find a way of regulating the market so that it doesn’t create a class of society that loses out because everything is left to market forces. A lot of liberal democratic politicians believe the market must determine those issues.

We also believe in a strong social protection programme. We try to ensure the fruits of growth are not monopolized by one class.

There was pretty serious violence at the recent by-elections. Are you prepared to call other party leaders to demand an end to violence?

Before every election, civil society organisations and think tanks get political leaders to pledge to conduct a peaceful and fair election. Sometimes tempers get frayed, something happens at the polling station, and it must be doused as quickly as possible. That is where the alertness of the security agencies comes in.

Biometric Verification was employed in the most credible election in Ghana's history

Ghanaian elections have been largely violence free because everybody’s attention is focused, and there is a lot of public awareness for peace. A few of those by-elections that you refer to fell through the cracks.

Are you prepared to make that call for peace?

I myself have pledged that we’ll conduct peaceful elections that are transparent, fair, successful. I pledge myself to non-violence in the election.

What if people on your side are found to have started violence?

The security agencies will deal with them. The security agencies owe their loyalty to the state. They must do what they must do, no matter what political party is in power.

What are the key policy issues you’ll be talking about in this campaign?

Jobs and employment, then unity, stability and peace. Education is important to the youth, and health, too.

Oil production has fallen to 60,000 barrels per day against a forecast of 120,000. By now, this has hit foreign exchange receipts. Do you worry that you’re going into an election with those kind of pressures?

In terms of revenues, one must feel worried. The oil industry is unpredictable: the price tends to yo-yo. Because of the speed at which the Jubilee field was developed, there might have been some problems with some of the wells, but the companies are resolving this. Recently production is up again to 80,000 to 90,000 barrels a day. We must ensure that other sectors are contributing. We’ve pushed up cocoa production – we made 1m to last year. This year we are expecting between 850,000 and 900,000tn. We can see more money coming in from cocoa production, from the financial services sector and other sectors.

You say corruption is a big election issue. Critics accuse successive governments

of failing to give the mainanti- corruption agency , the Commission for Human Rights and Administrative Justice (CHRAJ), sufficient resources and authority. Do you intend to change this?

CHRAJ is an important organisation that we need to function as the ombudsman.

As we grow the economy, we should look at expanding CHRAJ’s capacity to carry out its mandate. We should review the laws governing CHRAJ to enable it to investigate cases.

CHRAJ can see corruption taking place somewhere, but until somebody makes a complaint it doesn’t have the authority to investigate.

Do you favour full disclosure of the oil contracts that the government signs, and will you insist on international competitive bidding for procurement contracts?

The more transparency we can bring to the oil industry, the better. In Ghana, whatever the process of awarding contracts, eventually they go through cabinet and parliament for scrutiny and debate. That process opens those contracts out to accountability.

What can the political parties learn from the Alfred Woyome saga, in which a political financier claimed $40m for what turned out to be a bogus contract?

The lesson Woyome brings to bear is that we must look at the manner in which we enter into public agreements. I think government should get a small body to look at that whole process of debts and what is creating these debts. A government enters into a contract, a new government comes and says we don’t agree with this contract and so we abrogate it.

That leads to a legal suit and eventually to debt. We have to resolve these issues and reduce these debts.   

  

Interview by Patrick Smith in Accra

THE MAHAMA MEMOIR

John Mahama wrote this closely observed account of growing up amidst the turbulent politics of Ghana from the 1960s until the late 1980s while he was juggling his duties as vice president. It has an added poignancy after Mahama’s accession to the presidency following the death of John Atta Mills on 24 July.

In a series of evocative vignettes from northern Ghana, Accra, Nigeria and the Soviet Union, Mahama’s memoir sketches out the personal and political. Its title, My First Coup d’Etat, refers to the Anglo-American backed overthrow of President Kwame Nkrumah in 1966 and the subsequent arrest of Mahama’s father, who had been a minister in that government. “I don’t have any misgivings. The book was written with honesty – what’s the use of a memoir if it isn’t based on the truth?” Mahama told The Africa Report.

Some have compared the book to US President Barack Obama’s Dreams of My Father, which introduced the Illinois senator to millions. But for Mahama, his book is more social history than political memoir: “My life was the same as that of thousands of other young people who grew up in the same era …I thought it was worth putting that out, how we lived then. I hope it will encourage other people to write about that interesting period.”

Mahama’s well-crafted stories of Ghanaian lives as the country moved from coups and economic crises to stability and growing prosperity hold some wider truths about Africa. Doubtless, it will also be pored over by the more inquisitive voters in this year’s election.