By Efo Small
Think of Ghana as a patient in the intensive care unit; the following is its medical report resulting from the devastating impact of galamsey on its health.
Medical Report on the State of the Nation - Existential Perspective
Patient Name: Republic of Ghana
Date of Examination: Consultant: 23 September 2025
Diagnosis
- Primary Disease: Galamsey - a malignant cancer infiltrating the nation’s vital organs: rivers, forests, and farmlands.
- Immune System Status: Severely weakened. The authorities, entrusted with defense, are failing to mount an adequate response.
- Medical Team: Labour unions and professional bodies, notably the Ghana Medical Association who should act as doctors for the nation, remain largely silent and passive.
- Patient’s Condition: The public, instead of acknowledging the illness, is in denial - pretending “all is well” while the disease spreads unchecked. To the public, once the disease is yet to show its debilitating symptoms “all is well".
Prognosis
If left untreated, the cancer will metastasize beyond repair, threatening food security, public health, economic stability, and the survival of future generations.
Condition: CRITICAL → risks becoming TERMINAL without immediate intervention.
Recommended Treatment
- Radical Surgery → Swift and uncompromising removal of galamsey operations across all affected regions.
- Immune System Therapy → Strengthening institutions to build resilience against corruption, complicity, and sabotage.
- Medical Accountability → Labour unions, civil society, academia, and thought leaders and particularly the GMA must speak and act with courage as guardians of the nation’s health.
- Patient Awakening → The public must abandon denial, rise in collective responsibility, and demand accountability as if survival depends on it - because it truly does.
With the current national mindset, treatment is impossible. Healing requires courage, discipline, and a transformation in leadership and citizen responsibility. Otherwise, the patient, Ghana, faces a terminal outcome.
The blow that galamsey is dealing the country on daily basis requires urgent attention. In fact, if a leader hesitated for 5 mins before initiating the most drastic measures available to him to solve galamsey, that leader is unqualified to take care of my rabbits.
Galamsey is not just an environmental nuisance; it is an existential crisis that strikes at our food, water, health, and the survival of generations unborn. The destruction is visible, the science is settled, and the urgency is undeniable. Any leader who dithers in the face of such clear and present danger proves himself incapable of true stewardship.
In the face of all these, the most visible steps we see about galamsey are press conferences and talk shops. The measure of leadership is not in words spoken at press conferences but in immediate, courageous action when delay means death. If we cannot trust our leaders to defend our rivers, we cannot trust them to defend our future.
POISON coming home
Groundwater (the source of boreholes and wells) is part of a connected hydrological cycle. Pollutants from surface activities like galamsey seep into soils and riverbeds, and through infiltration and leaching, they contaminate aquifers. Once heavy metals such as mercury, lead, and cyanide compounds reach groundwater, they persist for decades or even centuries because they do not degrade.
The frightening reality is that groundwater contamination is often silent: boreholes may appear clean and tasteless while carrying toxic loads invisible to the naked eye. Communities in mining zones of Ghana - especially in Ashanti, Eastern, Western, and Central Regions - have already reported unsafe borehole water due to elevated heavy metal concentrations.
Mercury and lead exposure cause kidney failure, neurological damage, and developmental defects, while cyanide poisoning affects the cardiovascular and nervous systems. If galamsey continues unchecked, borehole water, which many rural communities see as a last refuge for “safe” drinking water, will no longer be safe. When that happens, Ghana faces a total water security collapse.
The deafening silence of Ghana Medical Association
Politicians have been playing a came of equalization and finger pointing with galamsey for decades, while a few greedy people, including the elite of society keep causing damage to the greater majority through galamsey. But why a critical institution like the Ghana Medical Association (GMA) - in whose hands the pulse of the nation beats - is also silent, beats my mind. To the GMA, I search for a prayer, but words escape me. For I am no poet in prayer. With a heart heavy full of hope however, I script the following appeal to GMA.
Dear GMA,
In life, we all stumble, but sometimes we are fortunate enough to be given a second chance. I believe this is ours. Ghana invested in us, trained us, and entrusted us with the health of the Motherland. Doctors and health professionals are not merely healers of individual patients; we are custodians of public health. Galamsey is poisoning rivers, destroying forests, and endangering the very foundations of life and survival in Ghana. If GMA takes a bold stance - louder, clearer, and firmer - history will remember us as more than clinicians. We will be remembered as defenders of the nation's veins, lungs, and lifeblood.
If we remain silent, history will judge us as complicit. It is our moral obligation to act boldly, speak out, and demand that this environmental cancer be stopped once and for all, even if it means threatening a strike action.
We can hardly be faulted by our current leaders as they led the charge for the previous government to end galamsey. They are in charge now. Those of us who never believe in democracy and never voted did so primarily because of galamsey.
When leaders fail, the people must lead the leaders. Societies run to ruin if both the leaders and the people fail. Please, let's not all fail.
Let's remember this: Your greatness lies not in what you have achieved individually, but in what your country has become through our collective sacrifice.
Let me end here with a prayer: "May God deliver us from the venom of the cobra, teeth of the tiger", and the catastrophic collapse of thought from Ghanaian politicians."
The author, Efo Small, is a health professional and a passionate steward of the environment
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