When ‘orators’ rule over ‘practical people’

God bless our homeland Ghana.

That is how the Ghana national anthem begins.

Ghana is an amazing country! Good information is going out to the public as the nation observes cervical cancer awareness month this month.

On radio and at public places, people are talking about cervical cancer.

It is amazing how people who have not passed a speculum before to visualise the cervix can rattle how colposcopy is done and how cervical precancer is treated with cryotherapy, thermal coagulation or Loop Electrosurgical Excision Procedure (LEEP).

I have listened in awe.

The general public will respond as they are being told to do. They will go to the hospitals, clinics, health centres and CHPS compounds to be screened or vaccinated. Then they will be hit with the reality: few health institutions in Ghana do these.

I spoke to a pathologist in Accra about 15 years ago. He told me about how they went about a cervical cancer screening awareness creation in the 1980s and realised, to their dismay (when women started coming for pap smears), that the few pathologists in Ghana couldn't handle the workload.

Thankfully these days women have other options than pap smears, including HPV testing with self sampling, where women can take the samples themselves at home.

When I was resident training to become an obstetrician gynaecologist, I remember we were not happy when every time someone had to teach us about operative vaginal delivery (including forceps delivery).

The person who did it himself had never conducted a forceps delivery. My first practical experience with forceps delivery was under a visiting foreign specialist at Battor.

I am not against theoretical knowledge. Real change comes when knowledge is applied to solve problems and to innovate.

We cannot reduce the incidence of cervical cancer if we don't have health workers trained to follow up screen positives and to treat precancerous lesions of the cervix.

Almost everyone is confined to awareness creation and to an extent screening.

Who manages the screen positives? What is the way forward? I remember what one of my teachers (and a friend) told me.

It sounds like a truism: somebody cannot teach you what he himself doesn't know.

For a long time our education system has been more of theoretical knowledge.

To change this, our leaders must concede that in spite of the many certificates and titles, many of them do not have the practical skills to transfer to the next generation.

They must be humble about this and involve those with practical skills to be involved in training.

It does not matter if these people with practical experience are younger, or do not have big titles and certificates.

Where the skill is not available locally, we should bring in people with the skill to teach us or send people out on a special mission to learn skills to come and teach, not just to go for certificates and titles.

A decade ago, I had to learn basic German and spend a year in Germany learning skills in Gynaecologic Oncology that were difficult to acquire in Ghana. Those were difficult times but I am convinced it was worth it.

The Cervical Cancer Prevention and Training Centre at Battor, established in May 2017, has demonstrated that we can solve our problems locally.

We have trained nearly 100 health workers across Ghana (general nurses, midwives, physician assistant, doctors) and there are over 160 health workers across Ghana in line for training in 2020, thanks to sponsorship from the Tema Lions Club and other sponsors.
Let's walk the talk!

The writer is a gynaecologist and head of the Cervical Cancer Prevention and Training Centre at Catholic Hospital, Battor in the North Tongu District of the Volta Region of Ghana.