CSM, COVID-19: Investigate Dr. Osei Kuffuor Afreh – Youth Group

Regional Director of Health Service, UWR, Dr Osei Kufuor Afreh.

A youth group by Name Coalition of Concerned Citizens in Upper West have called for Authorities to investigate the Upper West Regional Director of Health for several stated reasons.

According to the Coalition, the Director has performed below expectations prompting for the call.

They stated the Issues the Director should have addressed in his capacity yet failed.


Investigate Dr. Osei Kuffour Afreh, Upper West Regional Director of Health Service for
CSM outbreak, bad Leadership and Misappropriation of Funds
The Upper West Regional Health Service in the recent past was adjudged and touted as one of
the best in the country that had a very robust and effective system. These outcomes have been
captured in various monitoring and holistic assessment reports as well as the Ghana Health
Service Annual Reports. However, when Dr. Osei Kuffour Afreh assumed the reigns as the
Regional Director of Health Service these gains started fizzling out. The current trends in the
region have rather taken a nosedive. The parochial interest, immaturity, arrogance and amateur
leadership styles of the Regional Director of Health Service can largely account for the current
developments. The following are but a few of them:

1. Poor and Amateur Leadership Style

a. Dr. Afreh since assuming duty has demonstrated that he is not a team player. He adopted the
divide and rule tactics in the management of the region. Based on this, he has sidelined the
core management team of the Regional Health Directorate except the few that are prepared
to play along and do deals with him. The situation is so bad that the Chief Pharmacist who
formally proceeded on compulsory and mandatory retirement last year (i.e. August 2019)
is still at post for them to continue to do their deals. Meanwhile, there are equally competent
and well-qualified Pharmacists in the region that can take over and effectively play the role
of a Chief Pharmacist.
b. Dr. Afreh keeps on giving instructions to staff in the districts without recourse to their District
Directors of Health Service. This is in clear violation of the formal laid down channels of
communication of the Ghana Health Service. Such acts breed indiscipline in the system. It is
therefore not surprising that discipline has broken down in the region and this has adversely
affected the performance of the region. As a consequence, the people in the region are at the
receiving end. It is therefore not surprising that this has brought untold pain and suffering to
the poor innocent patients in the region.
c. Dr. Afreh as the Regional Director of Health Service is not providing the needed leadership
for the region to engender the required quality healthcare delivery. He does not care about
whatever is happening in the hospitals, health centers and CHPS compounds. He is never
available and does not provide the needed support for the Medical Superintendents and
District Directors of Health Service in the discharge of their duties. This was evident and
came to play when the Upper West Region reported its first COVID-19 positive case. The
District Director of Health Service made frantic efforts to reach him on phone to no avail and
followed up with messages. Though he read the WhatsApp messages, he could not be
bordered. It is sad to state that he refused to give the District Director of Health Service the needed logistics and support to undertake the said contact tracing as required by the GHS
d. It is very sad and unfortunate that the national leadership of the Ghana Health Service is not
taking any concrete step to address the leadership crisis in the region which has brought and
continues to bring suffering and pain to the people of the region. It is a fact that last year the
Director-General together with the Ghana Health Service Council Chairman embarked on a
fact-finding mission when another pressure group organized a press conference on Dr. Afreh.
All the different groups they met lamented the negative attitude, disrespect, arrogance and
incompetent leadership style of Dr. Afreh. The different personalities and groups they met
included: The Honourable Regional Minister, Regional Health Committee, District Directors
of Health Service and Medical Superintendent. Could the lack of action from the national
leadership of the GHS lent credence to his claim that he has bought all those who matter in
GHS and that he is untouchable and no one can reprimand him for his behaviour?
e. The arrogant and abusive nature of Dr. Osei Kuffour Afreh caused two (2) Medical Doctors
(i.e. one in Lawra Municipal Hospital and the other in Nadowli Hospital) to resign within a
year. This is unprecedented in the history of the health service in the Upper West Region.
Meanwhile, for close to two (2) years he has been in office as Regional Director of Health
Service, he has not been able to attract one (1) single Medical Doctor to the region.
f. He has also kept all the strong official vehicles in his bungalow. Meanwhile, the Regional
Office has a big fenced yard to accommodate these vehicles. He does not normally release
these vehicles for service delivery when the need arises. As a result, Regional Officers are
deprived of the use of these vehicles to undertake monitoring activities including CSM and

2. Cerebrospinal Meningitis (CSM)

a. For the first time in the history of the Upper West Region, the region has recorded 42 deaths
(as of 18th April, 2020) from CSM. This figure is more than the recorded total number of
deaths from COVID-19 for the whole country.
b. The geographical features of the Upper West Region are similar to that of Northern, North
East, Savannah and Upper East Regions. Meanwhile, they are not recording this high number
of deaths. The difference between what is happening in our region and the other 4 regions of
the north is the caliber of the leadership.
c. One cannot separate the high CSM death incidence and the associated happenings from the
leadership crisis stated above. In light of these happenings, one shudder to ask the Director￾General of the Ghana Health Service why he decided to take away Dr. Winfred Ofosu, a very
matured and experienced Regional Director only to replace him with an incompetent,
amateur and arrogant Regional Director, Dr. Afreh?
d. Everyone knows that CSM always occurs in the hot seasons starting January to April and
later in the year between October to December every year. As a result, health workers
normally intensify health education and related interventions before the onset of the period.
Unfortunately, this year we have not seen many activities or actions in this regard and our
understanding is that the Regional Director did not release the needed resources to the
districts to facilitate their work.
e. Also, medicine for the meningitis epidemic that was airlifted and received on 31st
March 2020, were left to sit in the Regional Medical Stores until the evening of 17th
April, 2020 when pressure was brought to bear on Dr. Afreh before he sent out letters in the
evening informing hospitals to come for the medicines. Unfortunately, 17th April was a Friday which means the hospitals will receive these letters on Monday (i.e. 20th April). Could it be that the Regional Director and the retired Chief Pharmacist were hoarding the medicines
so that they could divert them to private Pharmacy Shops? Between 31st March when the
consignment was airlifted and 20th April when facilities started receiving them, the people
who died because of lack of medicine during this period, one can imagine the number of
them who could have been saved if the medicines were distributed to the hospitals early
enough? If we were in a serious country where leaders are held accountable, some people
would have lost their job. We, therefore, call on the Upper West Parliamentary Caucus to
file an urgent question on this immediately parliament resumes. For heaven’s sake, these are
human beings dying and not animals because of the parochial interest of someone.

3. Management of COVID-19 Cases

a. As part of the strategy of managing the COVID-19, the Ghana Health Service has formed
and trained Response Teams for all the levels (i.e. national, regional, district and health
facility). These teams are to handle issues such as sample taking, testing and management of
patients. However, Dr. Afreh has sidelined the Regional Response Team and because he was
not part of the training, he is mismanaging the COVID-19 cases including the unprofessional
release of results to patients without providing the required counseling. It was Dr. Afreh who
dealt with the Nigerian who tested positive to COVID-19 and later bolted. It is strongly
suspected that the Nigerian went into hiding because of the unprofessional manner in which
the case was handled. Such unprofessional conduct is endangering the people of the region
and makes people who have tested positive to spread the disease to innocent persons. We,
therefore, wonder why Dr. Afreh because of money will sideline officers who have been duly
trained to manage the pandemic and rather engage in unprofessional conduct that is exposing
all of us in the region to the virus.
b. Besides, Dr. Osei Kuffuor Afreh personally sent the lady nurse who had contact with the first
COVID-19 positive person to Jang after her first sample was tested negative without waiting
for the second test in two weeks, he hurriedly wanted this lady back in Jang without adhering
to the national protocols. It took the timely intervention of the Chief of Jang to reject the
reintegration of the staff and insisting that the protocol should be strictly followed.

4. Lack of Respect and Undermining of Authority

a. The Honourable Regional Minister held a press briefing session on 14th April, 2020 to update
the press on the CSM and other related conditions. This was done with inputs from the
Regional Director of Health Service. Unfortunately, and out of malice, 2 days after this press
briefing, Dr. Afreh also organized another press briefing on the same subject matter. We find
this as a clear demonstration of disrespect geared at undermining the authority and High
Office of the Honourable Regional Minister.
b. Apart from the above, in a letter dated 28th October, 2019, Dr. Afreh openly flouted the
directives of the Honourable Regional Minister for him to organize a meeting with aggrieved
nurses to settle their differences to ensure industrial harmony in the region.

He has subsequently failed or refused to apologize to the Regional Minister for such ill-mannered
and discourteous behavior.
c. We find these developments as unfortunate and despicable which should not be entertained
in any way. We respect and uphold the High Office of the Regional Minister as a sacred one
which must not be desecrated and we expect anyone with proper upbringing to accord the
same level of respect to the office.

As if the above is not enough, on 28th March, 2020, in a Facebook post, Dr. Afreh out of
disrespect for the people of the Upper West Region, posted that the people of the Upper West
Region do not value ourselves. We do not blame him because the people of the Upper West
Region have been kind to him, accommodated as well as entertained him all this while and
that gave him the gut to spew out this rot. As people who are well cultured and mannered,
we will not follow him into the gutter.
e. The people of the Upper West Region are peace-loving and kind-hearted. We love ourselves
and outsiders but that should not give the right to any empty-headed who is full of himself
and thinks he is a superhuman being to insult us. Please Director-General, can you give us a
Regional Director of Health Service who is well cultured, matured, competent and will
accept and love us for who we are?

5. Recruitment for New Upper West Regional Hospital

a. The Ministry of Finance granted financial clearance to the Ghana Health Service to recruit
staff for the new Upper West Regional Hospital. Due to the decentralization of recruitment
in the Ghana Health Service, the clearance was sent to the Regional Director of Health
Service to conduct the recruitment.
b. It is rather unfortunate that 3 months after the approval was given for Dr. Afreh to conduct
the recruitment, he is yet to complete the process. The hospital is therefore compelled to
engage casual staff to provide the cleaning and security services. These people will have to
be paid from the hospital’s scarce resources. Meanwhile, the hospital was started without
any seed money and basic supplies. This means that before the hospital started operation, it
had already started accumulating debt.
c. It was until headquarters brought pressure to bear on him that he started the recruitment
interview in the early part of April 2020 and the people are yet to start work.
d. Information filtering in from very credible sources shows that Dr. Afreh brought people from
the south to be employed as junior staff.

These are people who came to the region for the
first time and were in the region because of the interview. Meanwhile, the region has a lot of
unemployed persons with the required qualifications. It is rather very sad that we have
equally qualified people in the former Regional Hospital, who have worked there for the past
10 years and are still not made permanent staff but unfortunately, were not considered. Our
checks also show that the cleaners and security people currently working at the new Regional
Hospital were also not considered meanwhile, people were brought from outside the region
to be employed.

e. We are not saying that only indigenes should be the ones to be employed for the hospital.
Our point is that for the junior staff, irrespective of ones’ tribe that person should have been
resident in the region. This is because we want to avoid the situation where people will come
for the appointment after a short time and request for transfer back to the south. In that case,
the region becomes the loser.
6. Financial Mismanagement
a. Notwithstanding the fleet of official vehicles (five) in his bungalow that he has been using,
he still uses the scarce money meant for service delivery to maintain and service his private
infinity SUV.
b. We are also worried about how funds meant for service delivery in the region are managed.

For example, last year i.e. September 2019, funds were released from the GHS Headquarters
for the region to organize a residential workshop on supportive supervision, he rather organized a non-residential program. We are interested in knowing what happened to the
money that was meant for accommodation.
c. We are encouraged by the admonishing of His Excellency the President that we should be
citizens and not spectators. As a result, we are calling on the Director-General of the Ghana
Health Service to immediately commission forensic audit on how funds meant for service
delivery were utilized during the tenure of Dr. Afreh. Our call is borne out of the fact that it
is because of the people of the region that those monies were released. We strongly believe
that the region is currently facing a health crisis because of the way monies meant for service
delivery were managed.
d. In as much as we do not want to interfere in the management of the region, if the Director General should fail to commission the said forensic audit, we will instruct our lawyers to
invoke the powers under the Right to Information Act, Act 989 to obtain the financial
documents from the region. Also, we will petition the various donors who provided the funds
and also publish whatever financial information we have on the region.
e. He has kept a retired pharmacist a loyalist as signatory to the Ghana Health Service Account
and considering the rots we would not be surprised if the medical stores is burn down to
conceal under dealings and evidence.
f. We have also gathered some information that, the Regional Director of Health Services and
the Accountant, are engaging in questionable financial spending’s. on the 17th April, 2020-
Friday about 20 cheques were signed without following administrative or due processes. We
believe it was fishy and in bad faiths- personal gains. We believe it an attempt to delete the
coffers of the regional health directors since his sins a catching up with him.

7. Working Relationship with Staff who are not from Upper West Region

a. The Upper West Region continues to be touted as one of the most peaceful, loving and
hospitable region to non-indigenous. This is a region that has never interfered in the
management of state Institutions or their internal matters. It is as a result of this that the
region has accommodated the despicable attitude and arrogant conduct of Dr. Afreh for all
this while with the hope that he will mature over time and change. Unfortunately, the said
attitude and conduct are engrained in his DNA and change is not insight meanwhile his poor
leadership skills are causing the death of our people.
b. It must be noted that no one has personal issues against Dr. Afreh or dislike him in any way,
it is his negative attitude and conduct that we frown upon. Dr. Afreh has taken the leniency
and hospitality of the people of the region for granted.
c. There is enough empirical evidence to buttress the point that the people of the region love,
respect and support people from other tribes, colours or nonindigenous in the discharge of
their work. It is undeniable fact that this region has been a home to great personalities like
revered Dr. Ebenezer Appiah-Denkyire, former Regional Director and later Director-General
of GHS, Dr. Winfred Ofosu (former Upper West Regional Director), Dr. Joseph Nuertey,
Dr. Felix Ahorsu, Dr. Fofei among others.
d. Although Dr. Appiah-Denkyire left the region about 20 years ago, people of the region still
have fond memories of him and the successes he chalked in the region. It is therefore not
surprising that the region recognized the great achievements and contributions he made by
naming the Children Ward of the then Regional Hospital after him.

It is clear from the foregoing that Dr. Afreh has run down the robust Health System he inherited.
It is also very evident that he is not having the welfare of the people of the Upper West Region
at heart and he has manifestly demonstrated that he is not in the region to improve quality
healthcare delivery. The just ended CSM audit of the region by headquarters team led by Dr.
Kyei-Fared, a world-renowned epidemiologist speaks volumes about the serious lapses in the
region. Sadly, Dr. Patrick Aboagye-Kuma, Director-General is very well aware of all these
developments in the region but is doing nothing about them meanwhile, our kin and kith are
dying. If the people who are put in public offices and paid with our taxes fail to deliver on their
mandate, we the citizenry will not continue to sit unconcern. We will fight for ourselves.
Based on the aforementioned, we have resolved that the people of the Upper West Region have
had more than enough of Dr. Afreh. As a result, he should be transferred out of the region with
immediate effect. We dare say that if he is not moved from the region within 3 days, we will
fight for ourselves using all legal and acceptable democratic avenues within the law. Enough is
enough. COVID-19 has only killed 9 people in the whole country and it has caused the president
to declare a national emergency. In the case of CSM, it has killed 42 people in only the Upper
West Region and we are not getting the needed attention and support. The President in his
addresses has never found space to even mention our predicament in passing.

They say he who  down fears no fall. We are already down and therefore we do not fear fall and nothing can stop
us from fighting for our rights as enshrined in the Constitution.
Forward ever, backward never.
We are poised and charged for action now.
Thanking you.

Yours faithfully,
Issahaque Suleman
Co- Convener
(Tel: 0241124344 / 0244898652)
Tahiru Lukman
Co- Convener
(Tel: 0209154057 / 0551018778)


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