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Insight on Ghana’s drone for health project

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My approach is to give a general information devoid of buzz technical words. Will try to make it as simple as possible. My presentation will keep many nagging questions in mind and hope that after everything many questions would have been answered.

I will first like to give a brief background to how Ghana Health Service is organised. ( This is necessary so one can understand the operations of the project and possibly to appreciate why GMA were not initially involved in the discussion of the concept, even though I don’t agree with their non involvement). Will then talk about the various stakeholders in the project and their roles and will end with a step by step description of the process. Hope you will not be bored.

Functionally, Ghana Health Service (GHS) is organised at 5 levels: National through the Teaching or Tertiary hospitals. Example , Korle Bu Teaching hospital, Regional through the regional hospitals like the Greater Accra regional hospital at Ridge, District level through the Polyclinics, Sub-District level through the Health Centers, and, Community level through the Community-based Health Planning and Services centers (CHPS compound or zones).

The CHPS are the smallest units in the structure and can be found in the rural communities. The CHPS have their limitation as to what they can do as a health facility ( HF) and thus they have the appropriate personnel to man these facilities usually headed by a Community Nurse and sometimes supported by a Traditional Birth Attendant (TBAs).

The Health Centers do slightly more complicated job than the CHPS and thus have a higher qualified personnel manning its facilities. Again, the Polyclinics are higher in the rank than the HCs . Next in rank are the hospitals, then the Regional hospitals ( which are referral centers in the regions) and ultimately the Ogboro itself Korle Bu which is a national hospital. Resource ( drugs etc) allocation are made to these HFs depending on its capacity.

If a facility does not have the capacity to undertake a specific job, it will simply refer the patient to the appropriate facility in the hierarchy. I will want you to keep this particular stuff in mind because I will be referring to it again when I come to explain the step by step process in the Drone operation.

THE GHANA HEALTH SERVICE

Ghana Health Service (GHS) is an autonomous EXECUTIVE agency responsible for IMPLEMENTING national policies under the control of the Ministry of Health. ( Not the Ghana Medical Association) . It is one of the agencies under the Ministry of Health (MoH). Some of the agencies are National Blood Service, National Ambulance Service and National Health Insurance Authority. Their mandate is to provide and prudently manage comprehensive and accessible health service with special emphasis on primary health care at regional, district and sub-district levels in accordance with approved national policies.

WHAT AT ALL IS A DRONE

The Supplies, Stores and Drug Management Division is one of the divisions of GHS and one of their objectives is to ” ensure optimum drugs and equipment AVAILABILITY throughout the FACILITIES (HF) of the GHS”. Drones simply put are ” flying computers with a camera or sensor attached to it”. They are equipped with different state of the art technology such as infrared cameras, GPS and laser. They are controlled by remote control systems also sometimes referred to as a ground cockpit. It is unmanned. All unmanned aerial vehicle system has 2 parts; the drone and the control system.

Many drones are equipped with obstacle detection sensors and collision avoidance systems. This project will be designed, installed and operated by the US based Zipline International Inc in partnership with the GHS. It will leverage on technology to improve the SUPPLY CHAIN of critical medical supplies, reduce waste and save lives. This is in line with the government policy of exploring innovative ways, including the use of drone technology to make UNIVERSAL health care available to every Ghanaian in a TIMELY manner irrespective of LOCATION.

STAKEHOLDERS OF THE PROJECT

Ghana Civil Aviation Authority who will create an air corridor for the drones to prevent collisions with airplanes and other larger aircrafts. They will do this through the provision of Flight Control Centers ( FCC). Having given a general description of the structure of GHS and a definition of a drone, let’s now address what I have termed “Ghana’s Drone for Health” project.

Any time I mention project subsequently, I am referring to the Ghana’s Drone for Health project. This project seeks to offer a drone – enabled supply chain solution in Ghana that will ensure secure, reliable and TIMELY deliveries of essential health care products( resources) to hospitals and other health facilities. The Drone facility plus satellite technology using GPS and GIS ( Geographic Information System), all HFs will be mapped and their GPS imputed into the Drone Navigation system.

DISTRIBUTION CENTRES (DCs)

These are the nerve centers for the project. Each DC will have at least 20 drones, launch and recovery equipment, state of the art medical refrigeration equipment and Computerized Order Management systems. Other agencies under MoH like the Supplies, Stores and Drug Management Division of GHS ( you remember? ) and National Blood Service will also be linked to this system. The final stakeholder is the National Security.

OPERATION OF THE PROJECT

The drones will operate 24 hours a day from 4 DCs that will be implemented under the project. 1 D.C. has been decided and that is the Suhum DC. It will service some 500 HFs. The DC will be stock with some 148 life saving and essential medical supplies including emergency blood and oxytocin. Others include emergency medicines for surgeries, severe infections, anti venins and anti rabbies, diabetic emergencies and extremely high blood pressure emergencies.

In all, the will be 2,500 HFs under this project spread across the country. Each DC will manage a number of HFs. Zipline will employ 200 Ghanaians including Pharmacists, Engineers, Flight operators and many more essential and allied support staff. Again, it will not replace the existing supply chain but will only handle EMERGENCY STOCK OUT situations. The total service cost is $12.5 million dollars for the 4 year period covering all the 4 DCs that will service some 2,500 HFs across the country. At full throttle, the cost will be $88,000 per month.

THE DEMAND AND SUPPLY PROCESS

When a HF RUNS OUT of a resource ( or a product) , it will order an emergency delivery by a drone that will arrive within 40 minutes. There MUST be a request from the HF to a DC for a service before that service can be delivered via a drone. Note, it is expected that the HF MUST have the capacity to administer the product or resource before it makes the request.

This is thus, a Request and supply system. ” You ask, we deliver”. So the question of, do we have the requisite personal to administer the product will not arrive.

I painfully took you through the structure of GHS, so you can appreciate this. After the request, the DC will verify the request with higher Authority. Once cleared, the DC will alert the FCC, the drone center and its internal stores/ Logistics unit. The resource or product will then be packaged and the drone mounted and placed on its launching pad .

With GPS of the facility activated, the drone will be launched and it is expected to reach its destination within 40 minutes. Remember all the GPS of the HFs have been mapped and inputted into the drone’s navigation system.

10 minutes before arrival, the requesting HF will be notified about the impending arrival of the drone. At a predetermined location in the facility, the designated official will go and pick the resource (s). On arrival, the package will be ejected off the drone via a parachute and drop off at the destination. The drone will then return to its DC and will be plucked off the skies onto a bouncy pad and decommissioned.

By: Wilberforce Asare

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  105. L’UFCM a constaté depuis quelques mois l’accroissement des tromperies à la « roqya ». Les témoignages de personnes victimes de ces pratiques se multiplient et présentent les mêmes caractéristiques : « Une personne vous appelle et vous propose une séance de « roqya » gratuite. Cette personne vous propose de rappeler un numéro prétendu gratuit, souvent un numéro commençant par 0 800… » Mais, dans les faits, cette prestation est loin d’être gratuite, puisque la conversation est facturée à vos frais et à votre insu. Au-delà de l’aspect juridique qui est traité à ce jour par le pôle juridique de l’UFCM[1], ce procédé soulève la problématique de sa conformité au Coran et à la Sunna. En effet, la « roqya » peut se définir comme une thérapie qui permet de soigner les actes de sorcellerie, de mauvais œil et également de se protéger contre ces derniers. Par conséquent, est-il possible de la pratiquer par téléphone et quelles sont les exigences édictées par le Coran et la Sunna ? Nous présenterons ainsi successivement les conditions liées au soignant (I), les exigences relatives à l’environnement où est réalisée la « roqya » (II). Nous aborderons ensuite la question de la gratuité de la prestation ou de sa contrepartie financière et enfin les conditions dans laquelle elle est réalisée (III). I- Les conditions liées au soignant Souvent la « roqya » est perçue comme une pratique dispensée par un tiers. Or, il est essentiel de rappeler et de souligner un fait important : la meilleure des « roqya » est celle que nous dispensons nous-mêmes à travers le « dhikr » et la récitation du Coran. Ainsi, pour se prémunir des maux liés au mauvais œil ou à la sorcellerie, il convient régulièrement de lire le Coran et faire des invocations notamment celles du matin et du coucher, de réciter régulièrement la sourate « La vache », de renouveler son intention, de placer la certitude dans son cœur, d’effectuer ses prières etc., et surtout de demander à Allah la meilleure des protections. Toutefois, dans certaines conditions, il est nécessaire de recourir à un soignant. C’est à ce stade qu’il convient d’être vigilant. Il ne suffit pas de se rendre auprès d’une personne qui se présente avec la qualité de cheikh ou d’imam pour accepter de lui confier cette pratique. Comme pour tout procédé et encore plus lorsque cela relève de considérations religieuses, il est important de bien choisir son soignant car ce dernier est tenu de posséder des qualités bien affirmées. La maîtrise du Coran et des traditions prophétiques en la matière est une condition sine qua none, mais insuffisante. La personne doit également avoir des notions de psychologie afin de déterminer la part de sorcellerie et celle de troubles psychologiques fréquents chez les patients. La personne doit posséder une bonne hygiène de vie, notamment spirituelle puisqu’il n’est pas inutile de rappeler que le succès de la « roqya » dépend de Dieu. Ces critères sont difficilement évaluables, surtout par une personne qui est affectée par un mal-être, quelle que soit sa source. C’est pourquoi les proches doivent accompagner la personne dans la recherche d’un soignant qualifié et reconnu comme tel par des référents religieux de la localité (imam, responsables associatifs, etc.). De manière générale, le soignant doit posséder des qualités déterminées que nous pouvons synthétiser de la manière suivante. Il doit : être en capacité de lire le Coran, croire avec certitude au Coran, être empreint de piété, connaître les pièges et les caractéristiques du diable et des djinns, connaître la méthode prophétique de la « roqya », disposer de connaissances de base en psychologie, avoir la conviction que le succès de sa thérapie dépend de Dieu. A l’exception de la première exigence, il semble difficile de vérifier les autres conditions dans le cadre d’un entretien téléphonique avec une personne que nous n’avons jamais rencontrée, même si elle se présente sous le titre de « cheikh » ou d’un imam. Par conséquent, ces conditions soulignent une première limite quant au recours à la « roqya » par téléphone. Par ailleurs, à l’instar de tout médecin, le soignant doit, avant de prodiguer des conseils ou une médication, procéder à une consultation. Ainsi, un environnement adéquat est indispensable pour la réalisation d’une « roqya ». Il est enfin inconcevable qu’un médecin puisse vous affirmer par téléphone connaître votre maladie et attester pouvoir vous guérir. Vous auriez plus que des doutes sur ce prétendu médecin. II- Un environnement propice et la réalisation d’une consultation préalable à la réalisation d’une « roqya » Il est intéressant de noter que, dans son ouvrage « Comment se protéger des djinns & satan », Wahîd ‘Abdussalâm Bâli évoque l’importance du climat pour réaliser une roqya[2]. Ainsi, il expose les points suivants : « 1. Préparer le climat adéquat en faisant par exemple sortir les images et les statues de la pièce où on va soigner le malade, pour permettre aux anges d’y entrer. 2. Débarrasser le sujet de tout ce qu’il peut porter sur lui comme talismans ou amulettes et les brûler. 3. Éteindre tout ce qui peut émettre le son de la musique et des chants. 4. Vider le lieu de tout ce qui comporte une infraction à la shari‘a à savoir, par exemple, la présence d’un homme qui porte de l’or ou une femme qui ne porte pas le voile légal – al-hijab. 5. Donner au malade et à sa famille une leçon de dogme de façon à ce que leurs cœurs ne soient pas attachés à un autre qu’Allah. 6. Leur faire savoir que la façon de soigner est différente de celle des sorciers et des charlatans et que le Coran recèle guérison et miséricorde, comme l’a informé Allah le Puissant et le Majestueux. 7. Diagnostiquer son cas : pour cela poser des questions au malade pour s’assurer de la présence de tous les symptômes (…) ». Or, dans les témoignages communiqués, l’interlocuteur qui se présente comme soignant ne pose aucune question aux personnes. Il débute ainsi la « roqya » directement par une récitation du Coran. En outre, il est intéressant de souligner que dans l’un des témoignages communiqués à l’UFCM, l’interlocuteur demandait à la personne de remplir successivement des verres de lait, d’huile, d’eau etc. et de les poser par la suite sur la table de la salle à manger. Au point que la personne s’est retrouvée avec une multitude de verres posés sur la table. Le comble est que la personne ignorait ce qu’elle devait en faire lorsqu’elle a pris conscience de la tromperie. Nous constatons par conséquent qu’une « roqya » ne peut être réalisée dans un environnement quelconque. En effet, une procédure de diagnostic est essentielle. Nous pouvons à titre d’exemple faire le parallèle avec un rendez-vous chez le médecin ; ce dernier ne peut vous prescrire une ordonnance sans au préalable vous avoir ausculté et interrogé sur les différents symptômes que vous ressentez physiquement. A défaut, au lieu de guérir vous allez aggraver vos maux. Cette attitude vigilante du médecin traitant doit se retrouver lorsque nous envisageons le recours à une « roqya ». Pour illustrer ce propos, nous citerons l’exemple de l’anthropologue, spécialiste de l’islam européen, Farid El Asri, chercheur associé au Centre Jacques Berque, qui nous rapporte une situation alarmante suite à une « roqya » : « Une jeune femme en Belgique (…) est morte suite à une tentative d’exorcisme. Pendant les séances, les fkihs (imams) utilisent normalement de l’eau « coranisée ». Pour cette jeune femme, prétendument stérile, les exorcistes ont carrément plongé son visage dans l’eau et quand elle tentait d’en sortir pour respirer, les guérisseurs estimaient qu’il s’agissait du jinn qui l’habitait et ils replongeaient son visage dans l’eau. Pendant le procès, la famille de la défunte s’est présentée comme musulmane et a accusé ces pratiques d’être extérieures à l’islam quand les guérisseurs estimaient qu’ils avaient simplement fait ce qu’ils pouvaient. Le fait de recourir trop systématiquement au fkih risque également de faire passer une crise d’épilepsie, par exemple, pour une crise de possession. »[3] Nous allons aborder enfin la dernière problématique, celle relative aux honoraires du soignant. III- Les honoraires du soignant Le Prophète, bénédictions et salut sur lui, « a agréé les Compagnons qui ont été payés pour la roqya ». Il est dès lors autorisé de rémunérer un soignant en contrepartie d’une prestation. Toutefois, cette rémunération doit être raisonnable et surtout clairement définie avant le traitement. En outre, nous ne pouvons que souligner et rappeler que, si la roqya est réalisée dans un cadre sérieux, il convient de procéder à toutes les déclarations administratives. Comme pour tout contrat, vous devez exiger un document écrit et le praticien doit préciser quels sont ses engagements exacts afin d’éviter tout litige postérieur. Malheureusement, tous les témoignages transmis à l’UFCM soulignent que l’interlocuteur insiste à plusieurs reprises sur la gratuité de la prestation. Or, dans les faits, cette dernière est payante puisque le coût de la communication est surtaxé. Ainsi, l’une des victimes qui nous a contacté, s’est retrouvée avec une facture téléphonique (hors forfait) de 1800 euros. Par conséquent, nous constatons que ces « roqyas » gratuites sont fondées sur la technique dite du « call-back » qui consiste à amener une personne à rappeler un numéro surtaxé, information qui lui est bien évidemment dissimulée. Une « roqya » peut être payante à condition de respecter un cadre prédéterminé, fondé sur l’information et la transparence des honoraires. En conclusion A la lumière des développements susvisés, l’UFCM appelle d’une part à une régulation du métier de la pratique de la « roqya », d’autre part, à la vigilance de chacun à ne pas céder à la tentation d’une « roqya » qui ne serait pas réalisée dans les conditions requises et qui pourrait produire des effets inverses. Au-delà du cadre spirituel ou juridique, les divers témoignages reçus et étudiés par l’UFCM ne peuvent pas nous laisser indifférents à la question suivante : pourquoi des personnes sont-elles amenées à accepter aussi facilement une « roqya » par téléphone ? Est-ce la gratuité qui a déterminé leur choix ? Certes le mal-être produit par cette société est de plus en plus grand. Nous vivons une époque où les êtres sont de plus en plus coupés des signes de Dieu et vivent un rythme de vie effréné. Ces affaires sont révélatrices des maux les plus profonds qui touchent la communauté musulmane. Par ailleurs, comme l’ensemble des rites islamiques (hajj, halal, pompes funèbres) censés nous rappeler les limites qui déterminent la voie vers Dieu, nous constatons que leur marchandisation trahit de plus en plus leur vocation première. Suffit-il qu’un interlocuteur se présente à nous comme un « cheikh » ou un imam et qu’il nous propose une « roqya » gratuite pour l’accepter aussitôt Ne devrions-nous pas tous nous interroger sur le fait qu’il y ait des musulmanes et des musulmans aussi isolés et aussi ignorants de leur propre religion pour être trompés aussi facilement ? Sommes-nous devenus si dépendants des Hommes que nous en oublions de nous adresser directement à Dieu pour solutionner nos malaises ? Autant de questions que chacun d’entre nous a la responsabilité de se poser. En effet, aucun de nous ou de nos proches ne sont à l’abri d’une telle tromperie. Il convient enfin de rappeler que la « roqya » est un remède précis et qu’elle ne peut se faire que sous certaines conditions et surtout qu’elle demeure l’exception à la règle, qui est de toujours s’adresser directement à Dieu. Avant de recourir à une « roqya », il convient de faire une introspection sur ses propres pratiques cultuelles et de revenir.

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