The North Journals
Mahmud Mohammed-Nurudeen
February 16, 2025, marked exactly one year since the tragic passing of 18-year-old Justin Nindor. Justin had been diagnosed with Cerebrospinal Meningitis (CSM) just three days before his death at St. Joseph Hospital in Jirapa, located in the Upper West Region.
Justin’s father, Nindor Yelwie, a 60-year-old farmer, recalled the heartbreaking moments leading up to his son’s illness. “When Justin first complained of a headache, I didn’t immediately suspect it was CSM. I told him to visit the clinic, but he refused to go,” Yelwie explained.
The parents had left for the farm that day, and when they returned, Justin’s headache had worsened. His condition became more concerning, so he was finally taken to the clinic, where he was treated with anti-malaria medication.
However, as the night went on, Justin’s condition worsened significantly. “At dawn, his situation became severe, and we rushed him to St. Joseph Hospital,” Yelwie said, recounting the desperate three-day period before they could get proper medical attention for their son. “It took us three days before he was finally sent to the hospital. I never expected this could happen to my son. I am still deeply traumatized by his loss.”
Yelwie, who has seven children, expressed the ongoing grief of losing his youngest son, Justin, the last of his children. Justin’s younger sister, who was just a baby at the time, passed away five years ago, adding to the family’s heavy burden of loss. The family lives in Ul-vozu, a community near Jirapa, where the sorrow of losing another child continues to weigh heavily on them.
“I have been to the hospital so many times, but nothing could prepare me for losing Justin,” Yelwie said, his voice filled with deep sorrow. “The pain is still fresh, and the trauma of losing him lingers with me every day.”
Justin was sent to the hospital late
According to Evans Nindor, Justin’s paternal uncle who works at St. Joseph Hospital in Jirapa, Justin’s condition took a severe turn before being brought to the hospital. “When Justin was first brought in, he couldn’t eat properly, and his headache was intense,” Evans recalled. “His parents, Justin’s father and mother, had left for the farm that day. When they returned, his condition had worsened, so they took him to the Ullo Clinic in Jirapa.”
On February 13, 2024, Justin was referred to St. Joseph Hospital in Jirapa. At the hospital’s emergency ward, doctors immediately began interventions. “A lot of medical interventions were administered to stabilize his condition. Once things were under control, he was transferred to the ward,” Evans explained. Testing was done to confirm whether Justin had contracted CSM, and it was later confirmed that he indeed had the disease.
Justin’s condition rapidly deteriorated. “He was vomiting, had diarrhea, and complained of a persistent headache. He was very restless and aggressive, and his eyes were unable to open,” Evans said. “He was isolated in the ward as a precaution.” Unfortunately, despite the medical team’s efforts, Justin passed away on February 16, 2024.
Evans explained the severity of his nephew’s condition before he was brought to the hospital. “His condition had worsened significantly by the time he arrived at the hospital. He was so strong that he could struggle with over five people and overpower them, which was alarming,” Evans said, acknowledging that it was “too late” when Justin finally received medical attention.
“It was a heartbreaking situation. Justin was a young guy, and we never expected something like this to happen to him. It was really difficult for all of us,” Evans said, visibly shaken by the loss. He added that the parents initially thought it was just a regular headache and didn’t realize the seriousness of the situation. “If they had brought him in on the first day, we might have been able to save him.”
Evans also noted the challenges they faced during the treatment process. “Because I work at the hospital, I was able to secure the necessary medicines for Justin. It was a privilege I had, which others may not have had access to in a similar situation,” he shared, emphasizing how critical timely medical intervention can be in cases like Justin’s.
A source at St. Joseph Hospital revealed that the outbreak places significant pressure on health workers, as they face challenges in treating cases that arrive in critical conditions due to delays in seeking care.
“The doctor-patient ratio is a major issue. Right now, two doctors are managing about 500 general cases each day. There are times when we suspect a case, but there are no doctors available to test and confirm it.”
129 suspected cases, 29 confirmed, 16 deaths with Nadowli-Kaleo and Nandom as epicenters
In the early months of 2024, the Upper West Region was hit with a sudden and deadly meningitis outbreak. Within a matter of weeks, the disease spread rapidly across the region, affecting dozens of people and claiming the lives of more than 20 individuals. The outbreak disproportionately affected children and the elderly, who are particularly vulnerable to the disease.
By mid-February 2025, the region has experienced a troubling outbreak of Meningitis, with 129 suspected cases reported across eight districts and municipalities. Of these, 29 cases have been confirmed, and unfortunately, 16 lives have been lost to the disease.
The outbreak has been particularly severe in the Nadowli-Kaleo District and the Nandom Municipality, which have emerged as the epicenters of the disease, contributing significantly to the rising number of cases and fatalities in the region.
In 2024, St. Joseph Hospital in Jirapa recorded 35 suspected cases of CSM, with 7 confirmed cases and 2 deaths. Many patients delayed seeking medical care, either opting for self-medication or arriving late due to expired insurance or financial constraints. “Some only report to the facility when their condition has already worsened,” said a hospital source.
In 2025, the facility has already recorded 10 suspected cases, with 1 confirmed case and 2 deaths, highlighting the continued challenges in timely diagnosis and treatment of the disease. The hospital urges the public to seek prompt medical attention to prevent further loss of life.
How is Ghana responding to outbreaks?
Over the past four years, health workers across the country have faced significant challenges, as the capacity of the health system to handle emergencies has been repeatedly tested. During this period, it has become clear that the country still struggles with insufficient funding to effectively address public health issues such as CSM.
Although the scale of the CSM outbreak is severe and the worst in a decade, the national response has been slow, primarily because the health system is stretched thin due to ongoing management of other crises. This delay in responding to the CSM epidemic is concerning.
The World Health Organization (WHO) states that about 10-15% of CSM patients will die without proper treatment. The current death toll indicates that not enough has been done to tackle the outbreak. Ghana’s high mortality rate from CSM can be attributed to the lack of focused attention and resources dedicated to this epidemic. Additionally, environmental factors—such as poor living conditions, inadequate housing, and rising temperatures—have played a significant role in the frequent occurrence of CSM outbreaks in the country over the years.
In April 2020, Ghanaian lawmaker Rashid Pelpuo, representing Wa Central, criticized the slow response to the CSM outbreak, calling it a “loud silence and lack of expeditious action.” His remarks came as public outcry grew for more resources to be allocated to contain the outbreak.
The former Sports Minister called for the same level of attention and urgency given to the fight against COVID-19 to be extended to the CSM crisis, emphasizing that more lives had been lost to CSM than to the virus. “It remains a fact that 5 lives have been lost from COVID-19 and though these are precious lives, and one life is too many to be lost, this number is slight compared to the 33 deaths caused by CSM in the last few weeks. These are Ghanaians and loved ones of people of the Upper West region.”
Dr Pelpuo accused certain political figures of using the crisis for personal gain, alleging that drugs for CSM treatment were being managed with political motives. While he refrained from naming anyone, he claimed that instead of distributing the drugs through the Regional Central Medical Store for fair use, the government allegedly handed them over to an individual to present as their personal effort in combating the outbreak. “Not only is this alleged act dishonest, it is also cheap and inhumane as it portrays elements in your government as heartless people who will stop at nothing, including using disease and death, to reap political gains,” Pelpuo said.
But does the country give priority to CSM like it has done with other outbreaks such as cholera, COVID, malaria and HIV/AIDS in terms of mass public education? Aside St Joseph hospital where education is provided at OPD, and all waiting points, many facilities are unable to carryout education and sensitization exercise due to lack of both human and material resource.
Some residents claim that TV and radio programs focused on educating the public about the disease and the importance of sending suspected cases to health facilities are not being effectively carried out.
One resident stated, ‘Compared to other outbreaks, the education is insufficient. I believe there should be regular radio and TV programs to ensure people are informed about the disease.’ He also suggested that an information van be sent around rural communities, as some lack access to radios and TVs, as well as to markets on market days, to educate and raise awareness.
Parliament orders for immediate action on outbreak
First Deputy Speaker of Parliament, Bernard Ahiafor, has instructed the Ghana Health Service (GHS) to take immediate action to contain the ongoing Cerebrospinal Meningitis (CSM) outbreak. The directive came after a statement was delivered by Dr. Sebastian Sandaare, the MP for Daffiama Bussie Issa, on the floor of Parliament on Thursday, February 6. Dr. Sandare emphasized the need for swift intervention to address the crisis and prevent further loss of life.
“This calls for urgent, enhanced disease control measures. Mr Speaker, I appeal to the government, the Ministry of Health, the World Health Organisation, UNICEF, and other stakeholders to mobilize technical, financial, and logistical support immediately to help control and prevent the outbreak,” he urged.
Dr. Sandare emphasized the importance of cross-border collaboration to prevent the further spread of Cerebrospinal Meningitis (CSM). He also proposed the creation of a Public Health Emergency Fund to ensure that there is sustained financial support for both current and future health crises.
During the debate, Minority Chief Whip Frank Annoh-Dompreh sharply criticized the Ghana Health Service (GHS) for its slow response to the outbreak. He called for the GHS to be summoned to Parliament to provide clear answers on the situation. Annoh-Dompreh raised questions about the cause of the outbreak, wondering whether it was due to a vaccine shortage or negligence on the part of health authorities. He warned that failure to act swiftly could exacerbate the crisis, putting more lives at risk.
“There must be a way that the Ghana Health Service should come and explain to us, is it the case that we are lacking vaccines. Is it the case that they never knew about this? They are sleeping on the job. What is happening? They must come and give us some reasons,” he said.
He added, “We can’t be allowing such basic ailment to be taking lives so necessarily the Ghana Health Service must go to the aid of the poor people in the Upper West, otherwise the matter will get out of hand.”
In response to the concerns raised, the First Deputy Speaker, presiding in the Speaker’s absence, directed the Ministry of Health to take immediate remedial action to address the ongoing Cerebrospinal Meningitis (CSM) outbreak.
“The Ministry of Health must create awareness, conduct contact tracing, intensify medical care for affected victims, and consider establishing a Public Health Emergency Fund to handle outbreaks. I so direct,” he ordered.
Health Minister highlights financial barriers in meningitis treatment
The Minister of Health, Kwabena Mintah Akandoh, noted that financial challenges were a significant factor in the delay of individuals seeking medical help when experiencing Meningitis symptoms such as neck stiffness, coughing, and sneezing.
In response to this issue, the government has introduced free treatment for residents in the affected districts who present with these symptoms and possess active health insurance cards. Additionally, the minister provided boxes of antibiotics to the Nadowli-Kaleo Health Directorate to aid in the treatment and management of the disease.
The Minister recognized the dedicated efforts of the health staff and urged them to fully commit to the battle against Meningitis, emphasizing, “If we all put our heads together we can create a strong health system in the country.”
“We will continue to do our best to encourage you (health staff) to have a smooth running of the facilities to be able to contain the situation. What is very important is that the number of deaths is drastically reducing,” he explained.
Mr. Akandoh warned the health staff to refrain from displaying negative attitudes toward patients at the facilities. He urged those responsible to stop such behavior, emphasizing that failure to do so could result in disciplinary action.
He assured the public that the Meningitis situation in the Upper West Region is currently under control. He emphasized the importance of concerted efforts from all stakeholders to effectively combat the outbreak.
He also stated that while the government and health-sector stakeholders are working diligently to contain the situation, it is equally important for community members to play their part.
He urged individuals to report early to health facilities if they experience symptoms of Meningitis, as early detection, management, and treatment are crucial to preventing further spread and saving lives.
Why PHEF is a must?
In several parts of the region, there has been significant delay in seeking medical care at health facilities. Many patients resort to self-medication before eventually visiting the hospital, and some face financial barriers due to expired insurance or the inability to afford transport costs. “They only seek help when their condition has already worsened,” a source stated.
Additionally, some patients struggle to afford the required medication if it’s not available at the healthcare facility, and others are unable to settle their hospital bills. “Relatives of the victims sometimes withhold critical information, such as when the condition was first noticed, the measures taken, or which drugs were given before arrival. This makes it difficult for healthcare providers to determine whether the previous treatment was effective or possibly an overdose,” a health official explained.
The hospital currently does not have vaccines for the specific strains of meningitis seen in the outbreak. While they do have the necessary medications to manage the cases, late arrival of patients severely complicates treatment, often making recovery much harder. “If we had the vaccines, the situation would be different. Vaccines would speed up recovery even when patients come in late,” said a medical officer.
In the case of Evans, who lost his nephew, he had to purchase the necessary medications and cover the costs himself after his nephew’s burial. “It was a privilege,” he said. “If they had been asked to pay, like others, they might not have been able to afford it.” This highlights the critical need for measures to be implemented that ensure patients are treated immediately upon arrival at the hospital, as timely intervention could save many lives.
The Upper West Regional Hospital is the only facility in the region capable of confirming suspected Meningitis cases, while other laboratories can only perform basic tests such as Gram staining, glucose and protein tests, and globulin tests, leading to delayed diagnoses and treatment.
According to the Ghana Association of Medical Laboratory Scientists (GAMLS), there is an urgent need for financial clearance to recruit more medical laboratory scientists to address the current shortage of personnel in the region. This shortage has negatively impacted the turn-around time for cerebrospinal fluid (CSF) investigations, delaying crucial diagnoses.
The Upper West Regional Chairman of GAMLS, Michael Amoah Gyansah, emphasized the need for the retooling of laboratories in district and municipal hospitals, with the introduction of PCR machines to swiftly confirm suspected Meningitis cases. This would also enable hospitals to perform culture and sensitivity testing to identify bacterial agents more efficiently.
“We call on the government, Non-governmental Organisations, philanthropists, and individuals to urgently support the improvement of testing capacities in our district and municipal hospitals, to do culture and sensitivity testing,” he said.
There is also a pressing need for better logistics and supply chain management, including the provision of needles and syringes, and the establishment of an isolation center to prevent further transmission. “Although there have been no recorded cases among health workers, it’s crucial to ensure their protection to avoid any potential risks,” the official from one of the affected health facilities emphasized.
In 2020, the African Development Bank (AfDB) extended significant support to Ghana’s COVID-19 response, approving a substantial grant in July to aid the country’s Emergency Preparedness and Response Plan (EPRP). This followed the World Bank’s contribution in April 2020, which provided approximately $100 million to support Ghana in combating the pandemic. According to reports, this funding was structured as “short, medium, and long-term support.”
While similar financial assistance was likely offered to other countries, many nations have used the pandemic as a turning point to reassess and strengthen their health security systems. These efforts aim to enhance their preparedness for future epidemics, ensuring a more tactical and proactive response.
Although Ghana has faced significant challenges due to COVID-19, it remains unclear whether sufficient structures have been established to manage future outbreaks effectively and safeguard the country’s health security.
Experts and health advocates have proposed the creation of a Public Health Emergency Fund (PHEF) as part of the strategy for handling future public health crises. One key suggestion is to direct the proceeds from the COVID-19 Levy, which has been in effect for the past three years, toward the establishment of this fund.
While some businesses and individuals in the private sector have criticized the COVID-19 tax, arguing that it has become burdensome and has outlived its original purpose, especially now that the World Health Organization has declared COVID-19 is no longer an epidemic, the government has yet to reconsider its continuation.
Despite this, experts believe that if the government were to listen to calls for converting the COVID-19 Levy into a PHEF, it would create a more sustainable mechanism to handle future outbreaks. The fund would help bridge some of the gaps in the health system, addressing emergency needs more swiftly.
While the PHEF is not a cure-all for health challenges, it would be a significant step toward strengthening the country’s epidemic preparedness and response. It would also serve as a practical lesson learned from the COVID-19 outbreak, ensuring the country is better equipped to tackle future health emergencies.
The Public Health Emergency Fund (PHEF), established in 1983 in the United States, serves as a reserve to assist agencies like the Administration for Strategic Preparedness and Response and the Centers for Disease Control and Prevention (CDC) in quickly responding to various public health threats such as diseases, extreme weather, and other emergencies. The Infectious Diseases Rapid Response Reserve Fund, set up in 2018, allows the CDC to swiftly address infectious disease threats. The fund received $800 million between 2019 and 2023, with $600 million allocated in 2020 after the onset of the COVID-19 pandemic.
Experts stated that, while Ghana may not be able to match the funding levels seen in the United States, the country can still establish a similar Public Health Emergency Fund using the existing COVID-19 Levy. This approach could be tailored to Ghana’s context, considering its unique resources and needs, and would help strengthen the country’s capacity to respond to health emergencies.
The governments’ past experiences, such as the shortage of childhood vaccines about three years ago, underscore the need for a dedicated fund to mitigate such challenges. During that time, substantial resources were mobilized to procure vaccines, highlighting the ongoing financial strain the government faces.
A disease control officer in the Upper West Region said PHEF would reduce dependency on external aid, enabling the government to strengthen the national health system and be better equipped to handle future health threats independently.
Experts suggest that the PHEF could help tackle challenges like upgrading laboratories, providing necessary logistics, resolving cash-and-carry issues, offering in-service training for healthcare officers and laboratory technicians, and supporting research centers in vaccine research and production. These measures, along with others, could assist healthcare workers and facilities in preparing for any potential outbreaks.
