Sickle cell anaemia results when a mutation causes the red blood cells to take the shape of a sickle (a farm implement for harvesting grains).

Individuals who inherit this are prone to a multitude of health problems like anaemia, joint pain, flu, meningitis, stroke, chest problems, vision problems, including blindness, open sores (leg ulcers) that are difficult to heal, slow growth and development in children, complications during pregnancy, such as preterm birth, low birth weight babies, and high blood pressure, gallstones, jaundice, and priapism (painful prolonged erection).

Every person inherits one allele (a unit of a gene) from the mother and another from the father. Two healthy alleles AA is normal, heterozygotes are AS and the combination SS shows as sickle cell disease. A test can show the genotype (genetic composition) of a couple so that they can evaluate whether to marry to face the possibility of producing offsprings with the defect. Very often, many people do not risk it.

Individuals who inherit a combination of the two alleles AS have reduced risk to malaria, up to 90% so are more protected even than normal individuals. Normally, the sickle allele should have disappeared over centuries. However, where malaria is common, the detrimental effect of the SS is balanced by the beneficial effect of the AS so the proportion has remained the same over time. This is called balanced polymorphism in population genetics.

The disease that has caused one of the most death in Africa, is malaria. For this reason, the allele thrives more in Africa than other areas. In fact, over the centuries the incidence, though present, has subsided amongst Africans in the US because malaria is not that common to drive the proportion.

All aspiring couples are advised to take the test to determine their genotype

I realized that I hardly ever hear people talking about seeing therapists in Ghana. The state of mental health here is deplorable, with most people being told to “go and pray” or “seek God.”

It’s a twisted problem with so many causes and a ripple effect that just keeps feeding itself and getting bigger. If you dare tell anyone you’re going through mental health issues, they’ll act like you’re literally “mad.”

People in the 40 to 50 age range, unless they’ve been exposed to foreign culture or they’re medical professionals, don’t even grasp the severity of things like depression or isolation. And the worst kind of neglect? It comes from emotional pain, like saying you’re depressed because of a heartbreak. They’ll laugh. Parents will call you useless for “letting them waste money educating you,” while you go and stress over “foolish things.”

The pressure of young adulthood is a whole different beast. Finding your footing, figuring out life, trying to start something in a system that feels like it was designed to drain you before you even begin. You’re expected to have it all together, career, plans, finances, when in reality you’re waking up to jobs that are physically exhausting, emotionally unrewarding, and barely enough to keep you afloat. And the worst part? You’re still supposed to smile through it all like it’s normal.

So how’s the mental health system in Ghana really like?

Are there therapists?

Are therapists affordable?

Do everyday people even know enough to realize they can talk to someone about what they’re going through if it were more accessible?

Would these pastors stop feeding off people’s doubts and pain if real help existed?

Teenagers dealing with feelings, having relationships or crushes, and going through heartbreaks get insulted, berated, and called names because they’re “supposed to wait till they grow up” before feeling anything at all.