Foreward

The Methodist Church Ghana believes that the Church is the agent of
God in human history to spread the good news of the Kingdom of God
to the world. The good news is a call to a life of freedom, as Jesus said
you shall know the truth and the truth will set you free.
It is in the pursuit of spreading the good news of the Kingdom that the
Church as part of its annual calendar dedicates a week to celebrate Gods
gift of good health and relief to mankind in the midst of suffering, inequity,
and pain. During the week the Church engages the Society on issues of
public health concern. These activities fulfill Gods will concerning the
health of mankind, which is that in all respects you may prosper and be
in good health, just as your soul prospers".
This year the public health issue focused on is Sickle Cell Condition. This
is an inherited condition that can bring suffering and trauma to many
families. It is surrounded by many misconceptions, which leads to choices
that aggravate the suffering and pain resulting from the condition.
In this booklet we have tried to provide the facts about the sickle cell
condition, with the hope that the knowledge gained from it will help
individuals living with it, those with the trait, and the entire populace to
live healthier and longer.
May the abundant grace of God be with you as you read this booklet.

The Presiding Bishop

The Methodist Church Ghana

The Methodist Church Ghana

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1. What is sickle cell condition?

It is an inherited condition that affects haemoglobin (Hb), the substance found in
red blood cells. Normal haemoglobin is called A. Each individual inherits one type
of haemoglobin from the mother and another from the father. If both parents
have haemoglobin A then the individual has haemoglobin AA. In individuals with
the sickle cell condition the haemoglobin they have
inherited from the parents have no A but rather S
and may be together with another abnormal
haemoglobin. Red blood cells containing the 'normal'
haemoglobin remain round as they carry out their
function of oxygen and carbon dioxide transport
around the body through the blood vessels. Red
blood cells containing S change their shape to a
'sickle' (an implement used in weeding) shape under
certain conditions that would normally not affect red
blood cells with Hb A.
These sickle red blood cells are stiff, sticky and do not
move easily through the blood vessels.
Normal red blood cells can live up to 120 days on
the average. For sickled cells it can be as low as 14
days, because the abnormally shaped cells are picked
up by the body's protective mechanisms and
destroyed. This rapid destruction leads to anaemia or blood shortage as the body
is unable to cope with the speed needed to build up enough red cells to maintain
the normal blood level.
Sickle red blood cells also tend to form clumps and get stuck in the blood vessels.
The clumps block blood flow in the blood vessels that supply the bones and all
other organs. The blocked vessels thus lead to shortage of blood supply and thus
nutrients and oxygen to the bones and other organs leading to pain, organ
damage and infection.
2. Is there any difference between Sickle cell trait, Sickle cell disease and
Sickle Cell Anemia?
Yes.
i. A person with sickle cell trait is one whose red blood cells contain normal
haemoglobin (Hb A) and Sickle haemoglobin (Hb S) combined to form Hb AS.

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Acknowledgement
The Methodist Church Ghana acknowledges the immense contribution the
of following persons who worked as members of the health week
planning committee.
They are:
1. Dr. Ivy Ekem of Korle Bu Teaching Hospital and the Ghana Institute
of Clinical Genetics for all the technical input and advice
2. Mr. Gideon Akuamoah-Boateng and Nana Kwasi Opoku Darko of
the Sickle Cell Association of Ghana for putting together the draft
script for the docu drama and the booklet respectively.

This means that individual inherited normal haemoglobin from one parent and
Haemoglobin S from the other parent. A person with sickle cell trait does not have sickle
cell disease but she / he can pass on the S to his / her child.
ii. Sickle cell disease is a term given to a group of inherited disorders caused by
the absence of normal haemoglobin (Hb A) in their red blood cells. Other
common haemoglobin types apart from S are Hb C, Hb E and beta thalassaemia
(Hb Bth). These can combine with each other in couples during conception and
lead to different forms of sickle cell disease e.g. Hb SC, Hb SE, , Hb S/beta
thalassemia)
iii. Sickle cell anemia (Hb SS) is a type of sickle cell disease but it is so called
because anaemia (low hemoglobin level) is most severe in this type.

3. Madam Charlotte Owusu of the Sickle Cell Condition Associates for

her untiring effort to see that all that can be done for people with
the condition is carried out
4. The team at the Methodist Church Headquarters, Mrs Araba Ata
Sam, Very Reverend Philip Norgbordzi, Enoch Osafo and Kwasi
Botwe among others for all the work they did behind the scenes to
make sure that this booklet comes out.
We are also grateful to Sickle Cell Trust of Jamaica and NVIDIA for
permission to use their images for educational purposes.
May all your effort be a blessing to many as the Lord rewards you in due
season.

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7 Myths concerning Sickle Cell Condition and the facts.

Those without sickle cell trait or disease

Myth 1:
Sickle cell is from familial and ancestral spirits, or from witchcraft or a curse on
your family.

i. Accept who you are

Facts:
i. Sickle red blood cells arise from haemoglobin type which is inherited
from parents just like the color of one's eyes. It is present for life.

iii. Enroll to be a regular blood donor in order to give life to

another

ii.

It is not an infection that you can catch from someone else or pass it
to another person like common cold.

Myth 2:
A negative sickling test means I have normal haemoglobin and thus normal
red blood cells
Facts:
i. Four tests are needed to confirm whether one has inherited abnormal
red blood cells or not. The tests are (a). Sickling test, (b). Hb
electrophoresis, (c). Full blood count, and (d) blood film comment
ii. Sickling test and Hb Electrophoresis in a reputable laboratory will
show the type of haemoglobin one has inherited for the majority of
people. For the rest only the additional FBC and film comment may
show that the haemoglobin is not an A.
iii. Never do only the Sickling test. And a positive test does not
automatically mean you have sickle cell disease.

ii. Do not discriminate, treat with contempt and stigmatize

others whom Christ has died for and Accepts.

iv. Know the truth about the sickle cell condition so that you can
help free people from ignorance and disease. The Bible says
knowledge of the truth shall set you free
The Church
i. Ordained ministers and preachers within the church should avoid
telling people with sickle cell condition that through prayer and
fasting, they can be delivered from the condition. Rather they
should encourage the congregation to seek Medical Advice, as
they continue to pray with them. Remember Gods Message to
Paul in the time of illness, My Grace is Sufficient for you.
ii. Use your meetings to provide information to the congregation
especially the youth
iii. Encourage the members of the Church to enroll as regular blood
donors.
iv. Preach against stigmatization of people with Sickle Cell Condition
and provide an avenue to reach such persons with love and care.
v. Let your congregation become a support group to continuously
provide care and love to people with Sickle Cell Condition.

Sickle Cell Condition: Individual and Church Responsibilities

What can individuals and Church do to support people with sickle cell
disease (Hb SS or Hb SC etc)
Individuals: Generally
i. Inform yourself correctly about the Sickle Cell Condition Find
out your haemoglobin type by taking the Four Tests.
ii. For those with Sickle cell disease
i.

The first thing is to accept who you are, beautifully and

wonderfully made in the image of God and a unique individual.
You are not a sick-ler, you only have abnormal red blood cells.

ii. The second important thing you must never forget is the
adage prevention is better than cure
iii. Keep a diary and note all the circumstances that bring about
crisis and avoid them.
iv. Learn the common symptoms of anaemia: Fatigue, Shortness
of breath, Dizziness, Headache, Coldness in the hands and feet,
Pale skin, Chest pain
v. Seek Regular Medical Advice and trust in God for GRACE and
Courage to manage your life according to the medical advice
vi. Seek professional counsel when you are thinking about marriage
and becoming a parent one day
Those with sickle cell trait
i. Accept yourself for who you are.

Myth 3:
Through prayer and fasting and deliverance one may be cured of sickle cell
disease.
Facts:
i. The haemoglobin leading to sickle red blood cells is inherited and it is
present throughout life.
ii. Currently, the only cure is by replacing the bone marrow through a
very serious procedure called stem cell or bone marrow transplant
which Ghana does not have the facilities for at the moment.
What is available is treatment for the symptoms and complications
that result from having sickle red blood cells which if done well can
give good quality of life.
iii. Good medical care from qualified health professionals must be
sought.
Myth 4:
People who have sickle cell disease (Hb SS or Hb SC or Hb S/Bth etc) have all
the red cells flowing in the blood vessels distorted and sickled and therefore
are often in crisis
Fact:

i. Sickle Cell Crisis occurs when a significant number of the red blood
cells of an individual change their shape from the usual round shape
to sickle shape. This happens when some circumstances make the
bodys internal environment lack oxygen or dehydrated or acidic.
Then the red blood cells with hemoglobin S change shape into sickle
shape clogging the tiny vessels and causing severe pain wherever
the clogging occurs: around the joints, in the abdomen, lungs, in the
head, in the male organ (Priapism), in the ribs and other bones etc.
Sometimes shrunken vessels e.g. in the cold may also lead to clogging.
ii. The circumstances that can give rise to sickle cell crisis include, Fever,
fatigue, high altitude, poor hydration e.g. not drinking enough
to replace natural and excessive fluid loss, prolonged squatting,
stress, malaria, cold weather.

ii. Know the truth about the sickle

cell condition so that you can
give appropriate information
iii. When you plan to marry and
become a parent seek professional
counsel

Myth 5:
Persons with sickled red blood cells do not suffer from malaria because they
have immunity and do not need to take Malaria medicines
Facts:
i. Malaria affects all persons with sickle cell condition, and those with Hb
SS are affected even more seriously than others.
ii.

In the persons with Hb SS Malaria parasites invade the red cells,

multiply in them using up the cells oxygen supply, until the cells burst.
More parasites are released causing severe fever. The onset of fever
recipitates sickle cell crises in the person with Hb SS. It is important
for such persons to take malaria medicines promptly when
diagnosed.

iii. It is persons with the trait that have some protection against malaria.
In the person with Hb AS when the malaria parasite multiplies, the Hb
AS cell changes from round to sickle shape and does not reach
bursting point quickly before the spleen mops it up, preventing further
progress of the disease. Thus such individuals often do not suffer from
the severe effects of malaria. They must however be treated when
they get malaria as the body's mechanism may not be able to clear
the parasites.
Myth 6:
If partners intending to marry and one has Sickle Cell Trait (Hb AS) then all
their children will have Hb SS
Facts:
i. A child with sickle cell disease ((Hb SS or Hb SC or Hb S/Bth) has to
inherit it from both parents.
ii.

If one or both parents have normal red blood cells (Hb AA), then they
cannot have a child with sickle cell disease.

iii. If both parents have sickle cell trait (Hb AS or Hb AC or HB A/ Bth),

then there is a 25% chance that at each pregnancy they can have a
child with Sickle red blood cells.
iv.

If both parents have sickle cell disease then all their children may have
sickle cell disease.

v. When thinking about marriage and becoming a parent, you should know
whether you have normal or sickle haemoglobin. Seek professional
counseling to find out the chances that your child will have sickle cell
disease or a carrier of it (sickle cell trait)
Myth 7:
The vast majority of children with sickle red blood cells do not survive
beyond age 20
Facts:
i. It is appointed onto man once to die, however it is impossible to
predict when someone will die even when afflicted with an illness
ii. Many people with Hb SS have lived well over 50 years of age and have
enjoyed abundant life and impacted their generation. There are
individuals with Hb SS in their 70s.
iii. Those who live longer know how to take good care of themselves.
Some of the things they do are:
a. Seeking good medical care from qualified healthcare professionals
b. Getting regular check ups
c. Taking simple steps to prevent infections
d. Learning and cultivating healthy habits like drinking a lot of water
even when they are not thirsty; eating a balanced diet.
e. Getting support from family, community and the Church