Experts highlight growing Parkinson’s burden and emergency care gaps in Ghana

A growing neurological burden and a push to strengthen emergency trauma training in Ghana formed the twin focus of a health discussion on the Asaase Breakfast Show, featuring clinicians and medical students examining Parkinson’s disease and capacity gaps in trauma care.

Neurosurgeon Dr Teddy Totimeh described Parkinson’s disease as a rapidly growing neurological condition globally, noting that while it is commonly associated with tremors and slowed movement, its clinical picture is significantly broader and more complex.

He explained that Parkinson’s affects the central and peripheral nervous systems, particularly brain regions responsible for movement regulation. Central to the condition is the degeneration of dopamine-producing neurons in the brain stem, which disrupts the brain’s ability to fine-tune motor control.

According to him, this degeneration is linked to the accumulation of abnormal proteins that gradually destroy affected neurons.

The resulting symptoms include difficulty initiating and sustaining movement, involuntary tremors due to reduced motor control, and postural instability that affects a patient’s ability to stand upright. He added that patients may also experience “freezing” episodes, where movement suddenly stops.

Beyond motor symptoms, Dr. Totimeh stressed that Parkinson’s also has significant cognitive and psychological effects. Dementia, he noted, is common among patients, and depression often emerges both as a neurological consequence and as a response to progressive disability.

While Parkinson’s is typically diagnosed after age 50, he highlighted that about 1% of cases are early-onset, occurring in people under 50, and these cases often progress more aggressively and may reduce life expectancy.

Diagnosis challenges and late detection in Ghana

Dr. Totimeh explained that Parkinson’s disease is primarily diagnosed clinically through observation of symptoms, as advanced diagnostic tools remain limited or costly in many settings.

“In our environment, we do not really have the objective lab-based ways of diagnosing Parkinson’s,” he noted, adding that this often contributes to delayed diagnosis, especially in younger patients whose early symptoms may be mistaken for fatigue, recovery from infection, or general weakness.

However, he indicated that awareness among physicians in Ghana is improving as global prevalence rises. Over the past two decades, he said, Parkinson’s cases have more than doubled worldwide, making it an increasingly important public health concern.

He also distinguished Parkinson’s disease from Parkinsonism, a broader category of symptoms that mimic Parkinson’s but may be caused by other conditions such as hypertension-related complications, head trauma, or exposure to pesticides.

He noted emerging evidence suggesting higher rates of Parkinsonism in rural populations, potentially linked to pesticide exposure.

On treatment, Dr. Totimeh explained that early-stage Parkinson’s is typically managed with medication that replaces or mimics dopamine, particularly levodopa-based therapies. These drugs can significantly improve symptoms.

However, he raised concerns about access, noting that in Ghana, only about 30% of patients who need these medications are able to obtain them due to cost and availability constraints.

He also highlighted advances in neurosurgical treatment, including deep brain stimulation, where electrodes are implanted into specific brain regions to regulate abnormal neuronal activity. This intervention can reduce tremors and improve mobility, although it does not address cognitive decline or all motor complications such as freezing.

Despite its promise, he emphasised that surgery does not replace medication, and both approaches remain necessary for comprehensive care.

He called for improved inclusion of neurological medications within the National Health Insurance Scheme to reduce financial barriers for patients.

Stigma and social misunderstanding

The discussion also addressed stigma associated with Parkinson’s disease. Dr. Totimeh pointed to what he described as “stigma depression,” where social misunderstanding and negative attitudes toward the condition worsen the psychological burden on patients.

He referenced public reactions to a recent high-profile diagnosis in Ghana, noting that online commentary revealed widespread misunderstanding of neurological conditions.

He argued that stigma not only affects mental health but also discourages early diagnosis and treatment seeking, calling for stronger public education and scientific communication.

Trauma care training: addressing critical skills gaps

The second part of the discussion shifted to trauma care training, led by Dr. Olivia Boutell, a British medical doctor and lead of Trauma STAR.

She explained that trauma remains one of the leading causes of death globally, particularly among people under 45, yet it is often underemphasised in medical training curricula.

Her programme aims to equip Ghanaian medical students with practical, life-saving skills in primary trauma care—focusing on stabilising patients in the critical minutes after injury.

Dr. Boutell noted that Ghana’s pre-hospital emergency system remains limited, particularly in ambulance response and structured emergency medical services, making hospital-based early intervention even more important.

Medical student engagement and training demand

Martin Banzie, a health officer with the University of Ghana Medical Students Association, said demand for trauma training among students has been extremely high, with previous sessions oversubscribed.

He explained that while students are taught theoretical aspects of emergency medicine, practical trauma management skills are often limited in the standard curriculum.

“This is essential. We may have the theory, but not always the hands-on skills needed to save lives,” he said, adding that many students are eager to bridge this gap before entering clinical practice.

Strengthening trauma systems in Ghana

Local organiser Dr Ulrick Sidney Kanmounye emphasised the urgency of improving trauma response systems in Ghana.

He noted recent public discussions around patient outcomes in emergency care settings, highlighting concerns that delays in treatment and limited pre-hospital care can negatively affect survival rates.

He described the trauma training initiative as timely and important, particularly as medical students increasingly take proactive steps to acquire additional competencies beyond the formal curriculum.

The discussion underscored two converging health priorities: the rising global and local burden of Parkinson’s disease, and the urgent need to strengthen trauma care capacity in Ghana’s health system.

From neurological degeneration requiring long-term multidisciplinary management to emergency trauma cases requiring rapid, practical intervention, the experts agreed on one central theme—improved training, access to treatment, and public understanding are critical to better health outcomes.