THE INCESSANT ban on motorbike riding in the Bawku Municipality of the Upper East Region has been identified as a major threat to healthcare delivery and quality healthcare accessibility in the Municipality. The ban has equally placed unfavorable effects on the declining standards of education.
It will be recalled that in 2011, the National Security Council in consultation with the Upper East Regional Security Council, placed a ban on motorbike riding in Bawku. This according to the council, was to bring under control, the then increasing cases of killings as a result of the protracted Chieftaincy conflict between the Mamprusi and Kumasi ethnic groups in the area.
Even though the ban initially was generally enforced without giving special attention to any group of persons or individuals, it was later reviewed and paved way for women and security officers to ride. Even with that, there are strings attached. Women who ride cannot pick men and must always ride in crash helmets. Security officers on the other hand must also be in their uniforms and crash helmets as well. They all can only ride after 6:00am and must pack their bikes before or at exactly 6:00pm.
This report is put into two parts. This fist part examines health-related consequences of the ban. The second and final part which is expected to be published on Friday this week, will also examine crime-related consequences, educational consequences and economic consequences of the ban.
Having given an overview of this report which has the support and collaboration of Media Foundation for West Africa and STAR-Ghana, it is hoped that you will enjoy reading it.
Health-related Consequences
Unarguably, motorbikes are the most affordable, readily available and economically manageable means of transport for the people of the Upper East Region. It is therefore an unquestionable fact that an economically viable town like Bawku, many people especially men, relied mainly on motorbikes as their means of transport until the ban came into force a little over three years ago.
Before the ban, many families in accessing healthcare solely relied on motorbikes to transport their ailing relations to health centres or hospitals for that matter. For instance, men transported their pregnant wives on motorbikes to hospitals for Ante-natal care. Surrounded by so many communities which are out-of-the-way roads especially in the rainy season, coupled with poverty which does not allow people to purchase cars for private use, motorbikes served about 95% means of transport to hospitals. In actual fact, motorbikes were used as ‘ambulances’ in emergencies.
The alternative for civilians – men for that matter is that, they are allowed to rid tri-cycles otherwise referred to as ‘Motor Kings’. They use them for commercial and private purposes. Unfortunately however, this alternative is just too costly for the ordinary man to come by. One commercial motorbike rider who gave his name as Salam at the lorry station in Bawku says prices of the machines are now between Ghc 3,500 and Ghc 4, 250 depending on the brand/make and the engine capacity.
Obviously, this cannot be said to be ‘small money’ for an ordinary man who perhaps is a peasant farmer. Azimbe Amadu was spotted by this reporter at Quality Health Centre in Bawku. He had brought his wife in a ‘motor king’ to the hospital. He explained that it was easy, fast and economical to use motorbike to pick a relation to the hospital with motorbike than it is today with ‘motor king’.
This is about accessing healthcare in the wake of the ban. What about delivering healthcare? Madam Agbanwu Gabiora Abeyeri, is the in-charge at the Urban East Health Centre in Bawku. She says due to the ban, the official Pick-Up of the centre is used to perform most of the activities motorbikes would have been used for. For instance, it is sometimes used to convey staff to communities for outreaches and National Immunization campaigns which previously motorbikes were used.
Again, the vehicle is used to transport victims of emergencies especially labour. As a result, there is always heavy financial toll on the centre as it frequently has to service or repair the vehicle to keep it on the road. With the National Health Insurance Scheme covering almost 100% of the centre’s clients, the scheme’s inability to settle its bills has often aggravated the situation.
Again, nursing mothers who were not sent for outreaches are now being used for such programmes. This she laments greatly affects the health of their babies as they travel on dusty and bumpy roads to undertake those exercises in far away communities. These babies according to her, inhale dust and as a result, often fall ill. This will have short and long term effects on them because they may develop diseases like asthma or respiratory tract infections. As if that is not enough, such babies, she says do not even get exclusive breastfeeding as their lactating mothers do not get sufficient time to feed them.
Madam Abeyeri says Community volunteers who also play significant roles in healthcare delivery can no long bring their reports to the centre but rather, the centre’s staff have to go for such reports.
Per the operational geographic division of the Ghana Health Service, Bawku Municipality has seven sub-municipalities. With a total number of 16 motorbikes, each of these sub-municipalities is assigned a number of motorbikes for official use. They are: Kuka East, 2, Kuka West, 3, Bardor-Barribari, 2, Urban West, 2, Mognori, 3, Natinga-North, 2 and Natinga-South, 2.
The Bawku Municipal Health Director, Madam Rosemond Azure, in an interview, reveals only a limited number of female workers are now using the motorbikes. She says unlike in the past when male and female workers were paired to use the bikes for outreaches, only female workers are now assigned. This she admits is not very effective.
The Director says posting of staff has also become a big problem because sending male workers to faraway communities requires that they are given accommodation in those communities. Unfortunately, there are no accommodation facilities. As a result, male staff must be posted within town such that they can foot to work or ride bicycles. But again, workforce at every facility requires a balance of males and females with their specialty areas. However, this cannot be met because the ban has put her in a dilemma when it comes to issues of posting staff.
Madam Azure corroborated the financial burden the ban has placed on her Municipality as narrated by Madam Abeyeri. The situation has become more serious due to the lack of ambulance in the entire municipality.
According to her, all her efforts to convince the Municipal Security Council to allow her staff to also use motorbikes has proved fruitless as she has been told the matter was above them.
The story is not different at the Quality Medical Centre and Presbyterain Hospital respectively. The Chief Executive Officer of Quality Group of Companies, operators of Quality Medical Centre in Bawku, Dr. Francis Adams Asaanah, admits the ban continues to drain the treasury of the centre as its senior medical officers are conveyed to and from work daily with the official cars.
Though he explains that other workers who stay nearer to the centre ride bicycles, 12 senior officers who stay a bit far away from the centre are transported to and from work at the expense of the centre.
On the effects this could have on productivity, Dr. Asaanah, explains that for those staff who rely on the centre’s vehicles for transport, they have no problems. However, those who ride mostly report to work late with tiredness. During rainy season, some may even not be able to come on the days it rains heavily.
With a workforce of 166, the CEO says 70% are males and the remaining 30% females. Quality Medical Centre provides services such as 24 hour Out-Patient and In-patient services, general consultation in internal medicine, general surgery, pediatric surgery, antenatal, delivery, general obstetrics and gynecology, post-natal, Electrocardiogram (ECG) services, blood transfusion, scan and laboratory services. This is the only health centre with an ambulance.
On his part, Mr. John Alaale Abugri, General Manager of Bawku Presbyterian Hospital, also recounts how the ban has adversely affected service delivery and the heavy financial burden it is having on the hospital. He mentions late reporting to work and hospital conveying staff to and from work as serious challenges confronting the hospital.
Dr. Asaanah of Quality Medical Centre reveals six of his staff resigned due to the conflict. Madam Azure, the Municipal Health Director, also says a Public Health Nurse sought transfer and was released because she said her life was been threatened due to the conflict. However, Mr. Abugri of Presbyterian Hospital though admits some of his staff resigned; they did not link their reason with conflict.
None of them can however establish on record the number of people who might have died as a result of the effects of the ban and explain there are multiple factors that may lead to death which the ban could be included.
By: William N-lanjerborr JALULAH
