Orthopaedic and rehabilitation services in Ghana in dire state – OAG

The Orthopaedic Association of Ghana (OAG) has issued a dire warning regarding the state of orthopaedic and rehabilitation services in the country’s healthcare sector.

Despite a rising prevalence of musculoskeletal conditions and disabilities, the Association notes that orthopaedics and rehabilitation services are in critical condition due to a shortage of certified orthopaedic surgeons, outdated equipment, and inadequate logistics and facilities.

According to the World Health Organisation (WHO), approximately 1.71 billion people worldwide suffer from musculoskeletal conditions, which are the leading cause of disability globally, with low back pain being the single leading cause of disability in 160 countries.

Musculoskeletal conditions significantly impede mobility and dexterity, leading to early retirement, reduced well-being, and diminished social participation.

At the 2024 Annual General Conference by the Orthopaedic Association of Ghana held in Kwahu, Eastern Region, themed “Combating Musculoskeletal Disability: The Role of the Orthopaedic Surgeon,” President of the Association, Dr. Rapheal Kuma-Ametepe, urged the government to prioritise training and retaining more orthopaedic surgeons and enhance orthopaedic and rehabilitation services to ensure holistic quality healthcare delivery.

Currently, only about 70 certified orthopaedic trauma surgeons are in the country.

“The situation is dire. We don’t have the required numbers to take care of the population. One of the main aims of the association is to help in the training of more orthopaedic surgeons. In the country now, when we started four years ago, the number of orthopaedic surgeons was less than 50 in the whole country, which is woefully inadequate but with collaboration with our partners, we’ve been able to train and now our numbers are somewhere around 70,” Dr.Kuma-Ametepe said.

The WHO’s Rehabilitation 2030 initiative aims to ensure countries meet the rehabilitation needs of individuals with musculoskeletal conditions.

However, Dr. Kuma-Ametepe expressed disappointment at the lack of public rehabilitation centres in Ghana, which undermines the efforts of orthopaedic surgeons.

"Virtually, we don’t have rehabilitation centres in Ghana. The hospitals have physiotherapy departments but for instance, in Germany, you go for surgery two days or three days after you are discharged. For the rest of it, you are sent to a rehab centre where there are specialists who will take care of you until you are able to do things by yourself but here you finish the surgery and the patient is discharged home. Home to do what? That is why we get some complications after we have done a good job.”

Dr. Peter Konadu, a trauma surgeon at Okomfo Anokye Teaching Hospital and senior lecturer at KNUST, emphasised the need for more training centres to address the severe shortage of orthopaedic trauma surgeons in the country.

He also advocated for the inclusion of some orthopaedic services in the National Health Insurance Scheme to encourage individuals to seek professional care rather than resorting to traditional bone setters, which worsen their conditions.

In a speech read on his behalf, the Director-General of the Ghana Health Service, Dr. Patrick Kumah Aboagye, acknowledged that rehabilitation services are a vital component of quality healthcare delivery.

He announced that the Physicians and Surgeons College has developed new programmes to train more trauma surgeons and hinted at plans by the National Health Insurance Authority to include rehabilitation services in the scheme.

For Ghana to meet Universal Health Coverage by 2030, there is a need for more investment in orthopaedic and rehabilitation services to meet the growing demand in the country to reduce musculoskeletal disabilities.