KBTH 90th Anniversary Lecture

Korle Bu Teaching Hospital’s 90th Anniversary Lecture was given by Rev. Prof. Seth Ayettey on September 18th, 2013. The title of the lecture was “NINETY YEARS OF EXCELLENCE IN HEALTH CARE: OUR FUTURE ASPIRATIONS AND CHALLENGES” and it is our pleasure to share it with you on our website.



I thank God for the privilege to deliver the 90th Anniversary lecture for an institution of monumental significance in the life and history of our nation. Korle Bu has been instrumental first in the health of millions of Ghanaians and foreign nationals. It has served to train health workers and specialists who have served in all parts of the country. A good number of products of this institution are also working in health institutions around the world. Korle Bu has and continues to be a site for medical research with results that have benefitted medical science significantly. Additionally, this hospital has contributed greatly to the establishment of medical schools and of regional and district hospitals in the country.

Korle Bu has its place in medical history too. Research work at this hospital led to the discovery of yellow fever. This resulted in the development of a vaccine against that disease. As some of you know, the viral strain used to develop the vaccine named the Asibi strain, was isolated from a Ghanaian called Asibi in 1927. Dr. Hideyo Noguchi, a Japanese Scientist at the Rockefeller Institute for Medical Research, USA and Dr. William A. Young of Great Britain who were part of the research team both died from this disease in 1928. Ghana also takes its place in medical history through Dr. Cicely Williams, a Jamaican-born Oxford scholar who reported protein-calorie malnutrition from her work at the Princess- Marie Louis hospital, at Korle Bu and at other locations from 1929-1936. She named the disease Kwashiorkor (originating from the Ga language). This name is known in medical literature.
Our own Professor Felix Konotey Ahulu worked at Korle Bu to contribute to advances in the knowledge of sickle cell disease.
It should be a source of pride to the nation that the reputation of Korle Bu is captured in its recognition as a referral center for WHO in West Africa. Ghana and Korle Bu’s very own Dr. Anarfi Asamoah Baah, is the Deputy Director General of WHO.

The contribution this hospital has made to health and to socio-economic development in Ghana, West Africa and the world is truly significant.

On the occasion of the 90th anniversary, we all must give thanks first to Almighty God for the vital role Korle Bu has played in our development. And second, we must recognize and salute those who have dedicated themselves to make Korle Bu what it is today. We must thank God for generations of doctors, nurses, anesthetists, dentists, pharmacists, dieticians, physiotherapists, record managers, radiologists, oncologists, teachers, ward assistants, orderlies, cleaners, drivers, catering staff, administrators, security personnel, horticulturists, laborers and all others who have served this hospital.

May God bless all those who have devoted their lives and their resources to make Korle Bu what it is today. And may God provide more abundantly for this hospital to become one of the very best in the world.


The Theme for the 90th Anniversary Celebration and for this address is, “Ninety Years of Excellence in Health Care: Our Future Aspirations and Challenges”. This theme recognizes that over the past 90 years, Korle Bu has rendered a good degree of quality services that have benefitted many. As a direct beneficiary of care at Korle Bu, I would confirm that this hospital has, on many occasions, been indeed a blessing to many, notwithstanding the enormous challenges with equipment supply and maintenance and with manpower resources and compassionate care.

The emphasis of the theme, however, is not on what has been achieved or on what is behind us. It is on what lies ahead. It is where Korle Bu will be in 50 and more years from today. How do we envision Korle Bu in the 21st Century? What role will it be playing in the health service of Ghana 50 years from today? The theme is therefore apt and visionary: We learn from the Scriptures that “where there is no vision, the people perish” (Proverbs 29 vs. 18).

To see clearly where we want to position Korle Bu, we must remind ourselves of the journey we have travelled, recognizing the foundations laid over the years. An overview of the history of Korle Bu is therefore important for us to appreciate the valuable lessons that should guide our vision and mission for the next 50 or so years.

In this lecture, I shall show how Korle Bu has progressively developed to the present state. I shall then address the subject of what our future aspirations should be – that is, where Korle Bu we should be positioned in the scheme of the health services in Ghana. After that, I shall address some of the major challenges that we must confront, if we shall succeed in moving the hospital to new and greater heights.


Korle Bu Hospital, originally known as the Gold Coast Hospital, came about as a result of a policy of the British colonial government to extend health services to the indigenes. Prior to that and before the 20th Century, health care focused on slave traders, colonial workers, and on Africans employed by the colonial government.

With growth of the British administration and its penetration to the interior of the Gold Coast; with increased missionary activity; with expansion of military services within the Gold Coast and with high mortality rates among Europeans, the need to expand the health services became evident.

Under Governor Hugh Clifford a new policy was established to extend health services to the indigenes. There was increasing burden for health care and therefore the need for training of health auxiliary staff. Until then, the indigenes had relied solely on traditional medical care.

When Governor Gordon Guggisberg took over in 1919 he extended the colonial policies to include economic development of the Gold Coast.

Canadian-born Guggisberg, served first as Director of Surveys in the Gold Coast in 1905, and then as Governor from 1919 to 1927. The vision and passion of this man, for Africa, must inspire all good leaders who seek to be part of the crusade to rebuild the continent.
Sir Frederick Gordon Guggisberg was providentially assigned to Ghana to be, in his own words, “an Engineer, sent out to superintend the construction of a broad Highway of Progress along which the races of the Gold Coast may advance —– to those far Cities of Promise, the Cities of Final Development, Wealth and Happiness.”
In pursuing this vision, Sir Gordon Guggisberg invested his life fully to lay a solid foundation upon which the Gold Coast was to ‘progressively’ develop. His contribution to the economic development of our country has, indeed, been monumental and invaluable.
From a biographical sketch documented by Professor Robert Addo-Fening of the Department of History of the University of Ghana, his grandfather, a Polish Jew, went into exile in a village in Switzerland called Guggisberg. He did this “in order to escape possible conscription into the Russian army.” Apparently, to hide his identity, the grandfather adopted the name of this village as their family name. Two of his children, John and Frederick Guggisberg, migrated to Preston Ontario, Canada. In Galt, Ontario, Sir Guggisberg was born to Frederick Guggisburg in 1869. Four years later, his father died. His mother later married an English Admiral called Ramsey Dennis who took the family to Britain. Here, Sir Guggisberg was educated and served in the colonial administration where he rose from the rank of Second Lieutenant of the Royal Engineers to Brigadier General.
Sir Guggisberg, a committed Christian, served in several countries in his career including Singapore, India, the Gold Coast, France, Nigeria and in Guyana, his last post before he died in 1930.
His achievements of historic importance and international relevance were in the period he worked in the Gold Coast, first at the Survey Department from 1902 to 1908, and then as Governor, from 1919 to 1927.
As a surveyor, Guggisberg helped to establish the map of the Gold Coast. This difficult assignment that required extensive travel through the length and breadth of the country was at great risk to his life. But it served an extremely useful purpose: It brought him in touch with the chiefs and people of the Gold Coast and to our culture. Through this, he recognized the economic potential of the country. More importantly, he recognized the capabilities of the African.
As Governor, he focused on the building of an infrastructure that would promote growth of the economy and therefore give the Gold Coast a competitive advantage in the world market. Trade in cocoa was foremost on his mind. He, therefore, invested resources at his disposal to build a seaport at Takoradi in 1928 and to construct extensive network of roads (260 miles) and of railways (230 miles). He also strengthened education and improved health care to advance our nation through a 10-year development plan.
In improving public health, Guggisberg focused on sanitation and on pipe-borne water supply for Accra, Sekondi, Winneba and Kumasi. He also pursued the plan for a government hospital for the Gold Coast. Communicable diseases were rife at the time, with malaria, tuberculosis, yellow fever, leprosy, yaws, dysentery, syphilis and others, but Guggisberg recognized the critical need to provide for hospital-based care also.
A major outcome of his vision in health was the building in 1923 of the Gold Coast Hospital, now the Korle Bu Teaching Hospital.
Guggisberg also anticipated the building of a Medical School and other health training institutions. He therefore acquired from the chiefs and people of Sempe, Accra, 160 acres of land to accommodate that vision.
Under Guggisberg, a Medical Research Institute was also established at Korle Bu. It was in this laboratory that Dr. Noguchi and Dr. Young and others worked on infectious diseases.
Governor Ransford Slater (remembered by Slater Avenue), took over from Guggisberg in 1927. He slowed the pace of development in the health services initiated by Guggisberg and postponed the plan for a Medical School. Instead, he favored the training of nurses, medical assistants, sanitary workers and midwives. He also retrenched the health staff for economic reasons.
Between 1932 and 1957 when Ghana gained Independence, 12 governors of the British Administration served in succession. A major policy shift in health in that period was in the decision to train doctors and dental staff overseas.
Between 1900 and 1953, a number of health training institutions emerged.
From 1962, Dr. Kwame Nkrumah led major advances in the development of health care in Ghana, beginning with the establishment of the Ghana Medical School at Korle Bu.
Dr. Nkrumah added significantly to the work of Sir Guggisberg at Korle Bu by building the four tower blocks between 1962 and 1964 – the departments of Medicine and Therapeutics, Child Health, Surgery and Obstetrics and Gynecology.
With these developments, Korle Bu gained the status of a Teaching Hospital.
Dr. Kwame Nkrumah focused on an industrialized economy with significant investments in energy to support his plans. To this end, he built the Akosombo Dam and established the Atomic Energy Commission. He also built the largest seaport in West Africa, the Tema Harbor and expanded road and railway networks to facilitate the movement of people and goods.
Further, Dr. Nkrumah expanded primary, secondary and tertiary education. The Kwame Nkrumah University of Science and Technology and the University of Cape Coast are monuments of his contribution to education and to advance the development of the human resource base towards economic independence.
This vast infrastructure development facilitated growth in all sectors of the economy including health, with significant impact on localizing training of health personnel.
At Korle Bu alone, there had been rapid growth in health training institutions at the tertiary level.
There had also been rapid development of specialist centers. Among these are the center for Clinical Genetics, initiated by Professor Felix Konotey Ahulu in 1975; the National Cardiothoracic Center, established in 1989 by Professor Kwabena Frimpong-Boateng; the Reconstructive Plastic and Burns Center, commissioned in May 1997 with huge investment through Dr. Jack Mustarde, a British philanthropist. Other centers are the National Center for Radiotherapy, commissioned in May 1998 under President John Jerry Rawlings. Under Rawlings, the Dental School, the School of Public Health and the School of Allied Health Sciences were also established.
Under President Kufuor several developments occurred. These included the building of a new Administrative Center, Physiotherapy Department, a new Central Laboratory, renovation of the Gynecology theatre, the building of an oxygen plant and the provision of stand-by generators. During the term of Kufuor, kidney dialysis was expanded and kidney transplants began with a joint team of specialists from Ghana and the United Kingdom.
President John Evans Atta Mills added significantly to growth at Korle Bu. Projects initiated in his term included the National Blood Bank Center, the new Eye Center, the new Imaging Center (CT Scan and MRI), and the Reproductive Center. In his term, the Children’s Block Surgical Theatre was renovated and the fiber optic network connection of the entire hospital was established to join the e-Government project. This has laid a strong IT foundation for e-Hospital and Telemedicine at Korle Bu.
More importantly, President Mills initiated plans for the building of an ultra-modern 650-bed Korle Bu Emergency and Clinical Subspecialties Hospital based on a new Master Plan prepared in December 2009 for the Hospital. The Consultants for this project were Canadian Planning Architects led by Mr. Don Jenion, under the auspices of a Canadian NGO known as the Korle Bu Neuroscience Foundation led by a neuroscience nurse, Marjorie Ratel.
Funding for the first phase of this project is available from the Saudi, Kuwaiti, Badea and OFID funds.
When the new hospital is built, the capacity of Korle Bu to offer highly specialized services will be significantly enhanced. This will position Korle Bu to become a quaternary referral center in Ghana, in West Africa and in the continent of Africa. Korle Bu will become a highly specialized health institution, comparable to any in the developed world, offering advanced clinical services. This will also make Ghana quite independent in health services delivery, having capacity to manage all complex health issues. At this level, Korle Bu shall become a center that will attract patients requiring specialized care from the global community.
President John Dramani Mahama, our current President, has the special privilege of implementing the plans for this innovative Korle Bu Hospital project. When built, President Mahama will take a monumental place in African history as the one responsible for the new birth or renaissance of Korle Bu.


If Korle Bu will be a world-class hospital delivering superb clinical services equal to the best in the world, what must we begin to do to achieve that? What role must Korle Bu play in the overall development plan of the Ministry of Health to make Ghana independent in health services delivery? What role do we expect Ghana to play as a key partner in the global world of health? What kind of leadership is needed to move Korle Bu to greater heights? And what challenges must we recognize and contend with to ensure that the new vision and mission are followed?
The new Master Plan, developed by our Canadian partners, seek to establish a health institution that would serve Ghana well over the next 50 or so years.
Underpinnings in it are the availability of land, a compact hospital concept for efficient and effective health services delivery, quality health-care assurance and sustainability of health services.


When Guggisberg acquired 160 acres of land for the Gold Coast Hospital, he had the economy of land use in mind. He therefore built a compact hospital with inter-connected wards and health delivery facilities, leaving the rest of the land for future development.
Over the years, however, there was a shift from Guggisberg’s concept of a hospital. The tower blocks, for example, were widely separated, with attendant problems of maintenance and of effective and efficient interdepartmental care of patients.
Several other buildings had also been sited without consideration of facility adjacencies to permit efficient functioning of the hospital.
Fortunately, the hospital still has 24 acres of land un-encumbered to use for building the new hospital center. There are also pockets of undeveloped plots within the hospital boundaries, as well as plots that can be redeveloped to maximize staff housing.
Managers of the hospital must use this available land wisely and not repeat mistakes of the past. We must appreciate Professor Frimpong-Boateng for securing the remaining property of the hospital (including the 24 acre plot). We should also acknowledge Professor Nii Otu Nartey for requesting a new Master Plan and for insisting developments at the hospital are based on that plan.
What all of us must keep in mind is that Korle Bu will be here in the next 50, 100, 200 years and longer. Land use must, therefore, be carefully planned to allow for 50-year cycles of development.
As we begin building the new hospital, plans must be in place now for how the current site of the hospital (old site) will be wisely used when the life span of the new hospital is reached.
What I am advocating for is a land-use policy at Korle Bu. And this policy must be rigidly adhered to, just as Governor Guggisberg originally intended.

It is fortunate and timely that a new hospital is being planned within Korle Bu at this time. With this, Government must carefully think through what role Korle Bu should now be playing in its development plans for the health services over the next 50 years. This is critically important and must instruct revisions in the various ACTS covering the health services including ACT 525 for the Teaching Hospitals.

Korle Bu has operated more like a general hospital than a specialized one for many years. Especially in Accra, medical and surgical emergencies and obstetrical emergencies that could be effectively managed at general hospitals and even at polyclinic levels are brought to Korle Bu. The result is that the specialized staff at Korle Bu is over-burdened. The hospital is therefore unable to function effectively as a tertiary referral center.

With current population of Accra at about 4 million (4 times what it was at the 1990 census), plans must be made to decongest this hospital and allow it to offer more critical services. The Ridge Hospital, the Police Hospital, 37 Military, Legon Hospital and other hospitals established in the capital including those at Teshie and La are still inadequate to cope with the burden of health care in Greater Accra and to decongest Korle Bu. More hospitals are needed especially at the western and northern corridors of Accra. In this regard, the new University of Ghana Hospital has come at the right time.
As a Teaching Hospital with responsibility for producing high grade specialists in all disciplines, government must seriously consider upgrading Korle Bu to the quaternary level. Korle Bu should be resourced to be able to function at such a level.
If this proposal is accepted, Korle Bu could now be mandated to play a major role in producing super-specialists for Ghana, additional to its current role as a site for basic training of doctors, dental surgeons, pharmacists, nurses and technologists.

In collaboration with the new University of Ghana Hospital, Korle Bu will also become a site for advancing medical research.

To position Korle Bu as a quaternary health institution, I would recommend the following:

I would like to propose that the current Korle Bu Teaching Hospital Polyclinic that has been in existence since 1964 be upgraded to a General Hospital, equivalent to a Regional Hospital. Such a facility would take over much of the current load of the main hospital. It will also serve as an additional site for undergraduate training of doctors, nurses, technologists and other health professionals.

The remainder of our Regional Hospitals are now reasonably well equipped. It should therefore not take much to upgrade them to teaching hospitals, as has been recently done for the Cape Coast and Tamale hospitals. This will enable Ghana to expand its infrastructure for producing health professionals with great benefit to all citizens. With this, we should be able to offer more assistance to the neighboring countries in their efforts to develop adequate numbers of well qualified health professionals.

Government should also begin to plan to strengthen District Hospitals to become training sites for all cadres of health professionals. Indeed, some of the District hospitals are already performing such a role. If we make this a national policy, it will help to bring quality health care closer to every home and, especially, to rural dwellers. We cannot achieve the Millennium Development Goals for Health if we do not bring quality health closer to the doors of every one in our communities. And our goals for health should not be limited to the MDGs that are intended to drive national and global improvements in health care. Our goal must be to develop our health services to the level where no woman should die from pregnancy or complications of it and where every child survives and grows to achieve his or her full potential.

Korle Bu will not achieve a quaternary level of health care and in a sustainable manner without adequate investments in the Ghana College of Physicians and Surgeons and in our Colleges of Health Sciences. At the current levels of producing specialists, it will take a long time to develop adequate manpower to the levels that would be required for Korle Bu and for the new University of Ghana Hospital.

It is to be noted that the Ghana College has since 2007 produced a total of 154 specialists in the division of Physicians and 216 in the division of Surgeons. And this covers only a limited area of sub-specialties.

I have already noted some advantages in moving Korle Bu a notch higher in the scheme of services in the health sector. Other benefits will be the following:

A quaternary hospital sets the highest standards for highly skilled professional care of the patient. This is critical also for sustainability of quality health care of the patient. The standard of care of the patient, including critical care, would cascade from here to all levels in the health care system down to the District Hospitals and to Health Posts.

Quality of medical research will be strengthened when Korle Bu is positioned to offer highly specialized services that should free its consultants and teachers time to prosecute high level clinical research. As the standard of research and of clinical science is raised, the hospital will drive the health research agenda in the country. Results of research in collaboration with health research centers such as Noguchi should position Ghana to attract the best medical researchers and also attract significant research grants. Korle Bu, ultimately, has great research potential, especially in the area of tropical medicine.

Sustainability of our health services is directly related to the quality of academic leaders we have in our institution and those they, in turn, would produce. In the next 20-50 years, we need professors in nursing, pharmacy, allied health, medicine, surgery and dentistry who will be expertly mentoring the next generation of academic leaders.

As noted earlier, this hospital, in conjunction with the Ghana College and with the University of Ghana Hospital, must also be able to produce high-caliber specialists and consultants for all regional and district hospitals.

d. INTERNATIONAL HEALTH TRAINING SITE: Over the next 20-50 years, Korle Bu should position itself to be a preferred center for training for health specialists for other African countries. Indeed, it should be able to attract students from the rest of the world, as we see already happening.

An important requirement for strong institutions that have sustainable programs is the ability to attract and retain high caliber health professionals and managers. To be able to achieve this, the hospital must adequately reward its staff for services they provide. When Korle Bu is functioning as a quaternary hospital, it should be possible to generate significant income from faculty and intra-mural practice, as well as from other services it will offer. Indeed, if government establishes such a policy and implements it, the hospital should be able to generate enough funds to sustain its programs and to reward its staff in ways that will enable them to render quality services and enjoy quality of life. With such a policy, industrial actions should hardly be encountered.

f. TELE-EDUCATION AND TELE-MEDICINE: Korle Bu, together with the University of Ghana Hospital, should be the nerve center in an online referral system where doctors and other health professionals at regional and district hospitals can access professional advice through Tele-medicine. By this, many patients could be managed at regional and district hospitals without need to move them to a higher center. Current medical technology even allows remote surgical procedures. Korle Bu should invest in this.

Major challenges to be addressed for this hospital to move to the next level and to become a major player in global health are the following:

i) Focused and carefully planned and executed National Agenda for Health. Many have called for a National Strategic Plan that will set the agenda for effective and sustained development of the nation over the next several years. This is essential. Developing a nation and its institutions on party manifestos not linked to a national strategic plan is not the best. Manifestos must be based on and derived from a National Strategic Plan for sustained development. A long range (30-50 year) national strategic plan is needed, therefore.

With this in place, governments will be held accountable for and evaluated by how far they advance the national plan within the period of their stewardship. It is within such a national framework for development that Korle Bu can be properly positioned and developed to become a world-class health provider.

ii) Strong Governance structures:
An institution is as strong as its governance system. With competent men and women in governance, the hospital will have a good chance of achieving its ends.

iii) Strong and Effective Leadership:
Perhaps the most important challenge that will face the hospital in its aspiration to the next level of development is leadership. I am not referring only to the top position of the Chief Administrator but also to all leadership positions, managerial and academic. We must endeavor to attract strong, visionary, passionate and compassionate leaders who will follow an approved developmental agenda for the hospital. Such leaders must be skilled in building strong, effective and caring health-delivery teams. They must also have a healthy attitude, with plans to grow the next generation of leaders through a well documented and followed succession plan.
iv) Quality Human Resource for Health:
Another major challenge that will face this hospital in its plans to be a first class health institution is staffing. When the new 650-bed University of Ghana Hospital is completed by early 2015, most of the current health professionals of the Medical School serving Korle Bu will be relocated. A Committee is already in place examining and addressing this critical challenge and I have no doubt they will come with a blue-print solution.

I strongly believe that there is a great blessing in the challenges we face in regard to human resource capacity building. Ghana has suffered brain-drain for several years. Many of our key professionals serving abroad have improved themselves and are highly qualified. They are also at the stage in their lives where they are planning to return. This is a golden opportunity for Ghana to attract and recruit them to serve. This is time for Ghana to transform “Brain-Drain” into “Brain-Gain”.

When well resourced, the Korle Bu hospital should also be able to attract well qualified workers from other nations.

iv) Biomedical Engineering and Equipment Maintenance Culture:
A critical problem that has plagued the health system of this country for decades that must be addressed now is equipment maintenance. Year after year, government invests huge sums of money to procure costly capital equipment for hospitals. Comparatively, little emphasis is placed on maintaining such valuable equipment. Consequently, the equipment suffers rapid break downs, with shortened life-span. This greatly affects delivery of essential health services.

This trend must be reversed if we would make meaningful progress in the health sector. There should be a concerted effort to revamp biomedical engineering and to strengthen our Colleges of Engineering to produce more biomedical professionals. There is also need to standardize equipment procurement and maintenance.

v) Accommodation and other facilities for Staff, Patients and Visitors:
It is important that staff (especially critical care givers) should be comfortably housed close to the hospital. The needs of their children (including education) should also be catered for.

In the Master Plan, provision has been made for a Medical Hotel. This is a modern best practice, in consideration of the needs of patients from overseas and their relatives. It will also serve relatives of patients referred from other parts of the country.

vi) Vehicle Parking: The need for a multi-story car parking facility is long overdue. Any visitor to the hospital is immediately faced with the challenge of parking. The Master Plan addresses this problem. But more has to be done. If this is effectively managed, it could be a good source of income long-term.

In summary, I would say that we are in no doubt at all that Korle Bu has served this nation well and contributed significantly to socio-economic development. It should now be positioned to contribute more effectively as a leader in provision of best quality health care and in medical research. It should provide expert care with best standards in clinical practice with the patient at the center; It should provide super education and training for critical health staff; It should be led by visionary men and women with passion for advancement of Ghana and with skills for innovation and positive change; it should have clinical workers with healthy attitudes and compassionate hearts.

I once again thank God for grace for me to prepare this lecture. I thank the Board for the invitation considering me worthy to speak on the theme. Professor S.K Addae’s book on “History of Modern Western Medicine in Ghana” provided rich resource of information. I take this opportunity to thank the doctors and other staff that expertly saved my life 3 years ago. I thank Cecilia my wife and the rest of my family for support; I acknowledge the expert services rendered by the Canadian Planning Team led by Don Jenion. I also thank Ms Marjorie Ratel and the Korle Bu Neuroscience Foundation Canada group for invaluable help to the hospital and for personal assistance. Professor Nii Otu Nartey helped with preparation of the address and Monica Dzikunu provided secretarial assistance. I am grateful to them.

And now we should all say with E.T Mensah and his Temple’s Band “Korle Bu, Korle Bu, Korle Bu, Oyiwala donn”.

I thank you all.

God bless our homeland Ghana.

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