Wed, Feb

Elizabeth Ohene writes... Pre-existing conditions

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  • I have now come to the conclusion that pre-existing conditions are not necessarily physical, they are more a state of mind. For example, look around our streets and see the number of signposts advertising cures for diabetes, kidney, lung and heart diseases. We believe in cures and have always struggled with the concept of managing a health condition.

There are new terms that have entered our everyday language with the advent of the novel coronavirus (COVID-19).

The very name of the disease has posed problems for many of us because the pronunciation has turned out to be difficult for many, but that is a different story.

There are words such as symptomatic: showing symptoms of COVID-19, which can include a fever, dry cough, shortness of breath and body aches. Asymptomatic: not showing any such signs, but carrying the infection and able to transmit.

Contact tracing, enhanced tracing, flattening the curve, herd immunity, lockdown, pandemic, PPE, nose mask, ventilator, community transmission, vertical transmission, co-morbidity, shelter-in-place and, of course, social distancing.

Up until a few weeks ago, self-isolation and quarantine were concepts that were quite alien to most of us. Today such words have entered everyday usage.

Sometimes, some people use the words or purport to use them just to show they have also heard and not because they necessarily understand the words.

I would put in this category, what former President John Mahama said about the lifting of the partial lockdown in the Greater Accra and Greater Kumasi areas.

He said: “The President might be seeking to rely on what is called herd immunity as a strategy to fight COVID-19, but I dare say this is dangerous.”

The former President does not say that he knows that this is what President Nana Addo Dankwa Akufo-Addo is doing, he does not tell us what herd immunity is either, but he tells us it is dangerous.

What is dangerous, is people taking terms and words they do not understand themselves, and throwing them around, and end up confusing all of us and making the work of the health professionals even more difficult.

Pre-existing conditions

Of all these new terms, the one I like best is pre-existing conditions, because that, I believe, has the most relevance to our situation.

The first time I heard the term pre-existing conditions, it was in relation to American Health Insurance issues and the arguments about Obamacare.

Apparently, the insurance companies are usually reluctant to give you cover if you have what is deemed pre-existing conditions. I worked it out for myself that it meant unless you can prove that you had never had a headache in your life and your parents had both died from old age while climbing Mount Everest, you couldn’t get an insurance cover.

With this COVID-19, the question of pre-existing conditions has come to the fore. It looks like the majority of people being killed are those that are said to have pre-existing conditions.

These have been designated as asthma, obesity, diabetes, high blood pressure, heart disease, chronic lung disease, chronic kidney disease, liver disease and people whose immune systems have been compromised.

It seems to me there aren’t many health conditions which send one to see a doctor, left out of this list, apart from being old. But then it turns out, being 65 years and above, is deemed to constitute a pre-existing condition. I am therefore interpreting this pre-existing condition to mean once you are 65 years old, you are a candidate.

State of mind

But then we all now know that there are non-health issues such as housing that features highly in the pre-existing conditions. If you live in a densely populated area and a densely populated house, you are a candidate for community transmission, and if you get infected by COVID-19, and you die, you will be counted among the “underlying conditions” category.

I have now come to the conclusion that pre-existing conditions are not necessarily physical, they are more a state of mind.

For example, look around our streets and see the number of signposts advertising cures for diabetes, kidney, lung and heart diseases. We believe in cures and have always struggled with the concept of managing a health condition.

We find it difficult to accept the idea that when you are diagnosed with hypertension, you might have to take medication every day for the rest of your life.

It does not take a lot of effort to understand the popularity of all the many potions being canvassed in videos on the Internet in this country.

Or take for example, the sheer number of conspiracy theories that have come up with the advent of the COVID-19. Here is a disease that has brought the world to a grinding halt, a disease that has suddenly turned on its head, everything we all knew about our world.

The normal way we deal with difficult things is to blame the problem on witchcraft. The enormity of COVID-19 appears too much for the capacity of the hapless old ladies that we usually hold responsible for ill-health, death, failing exams, unemployment and poverty.

But offer a mix of Bill Gates and 5G, the fifth-generation technology being introduced by telecommunication networks as the culprits, and it is so much easier to swallow.

The pre-existing condition of when in trouble, to put the blame on a man, richer beyond imagination, scheming to get even richer still has been too tempting for all of us.

I am not quite sure what Bill Gates could possibly do with the extra billions of dollars that we are being told he would make if we all had to be vaccinated against COVID-19.

Some among us are now so certain Bill Gates and vaccines are the problem, they are ready to become full scale anti-vaxxers.

And yet, in my lifetime, I have seen many deadly diseases that used to devastate our lives disappear. Smallpox, diphtheria, mumps, are no more, polio is almost gone and for the past 17 years, no child had died from measles in Ghana, all thanks to vaccines.


Of all the problems that have been thrown up by this pandemic, it is obvious, the most serious, the most dangerous, the most difficult to tackle, are the pre-existing conditions.

The hygiene problems, the bad diet, the overcrowded homes, some people not having enough to eat, the majority of us being too fat, not taking enough exercise, always finding someone to blame, the Europeans and Americans keeping their elderly folks in care homes, the National Democratic Congress (NDC) candidate former President Mahama attributing bad motives to decisions taken by President Akufo-Addo, Kojo Oppong Nkrumah wowing audiences, young men in Ghana drinking alcoholic bitters and endangering their kidneys; they are all underlying causes and pre-existing conditions. COVID-19 has only brought them to the fore.


And on the subject of new terms, I have discovered a new term which I like very much that I would like to introduce to those who don’t know it yet.

The term is “black elephant”, which I hasten to add has nothing to do with my party, the New Patriotic Party aka the elephant party.

The term ‘black elephant’ was coined by the environmentalist Adam Sweidan and is described as a cross between ‘a black swan’, which is what you call, an unlikely, unexpected event with enormous ramifications; and the more popular saying, ‘elephant in the room’, which is what you call, a looming disaster that is visible to everyone, yet no one wants to address.

I am drawing up my list of black elephants.

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