A Lesson Called Muamba! – Nana Kwaku Agyemang

The collapse on Saturday of Fabrice Muamba during the FA Cup sixth round clash between Tottenham Hotspurs and Bolton Wanderers sent shock waves throughout the football fraternity world wide. As I looked on at the unfolding events I too couldn’t believe my eyes. It seemed as if the paramedics were taking far too long to recover the boy and as the minutes ticked on the severity of the situation began to dawn on the 36,000 people in the stadium and the millions people that were watching via their television sets, like me

41 minutes had elapsed in what was a terrific encounter of pacey efficient, effective and a physically challenging game of football that up until that point had honors even with a score draw of 1 goal a piece. No one could have foreseen or even predicted that a young and very athletic Fabrice Muamba would suffer from what has been reported as a heart attack and struggle to regain consciousness with the support of a fully equipped paramedics team.

In the UK players undergo rigorous examinations to monitor and keep tabs on their health status as a matter of course. These take place at recommended periods by the clubs doctor. But even before the player signs a contract for his new club the issue of the players health is deemed to be the most important determining factor of whether the transfer will be completed or not. Previously the pre-signing medical was usually a formality and would normally be over over in less than a couple of hours. But in today’s environment of multi-million pound transfer fees and astronomical salaries, it has become a far more rigorously intense procedure.

The first part of the medical is usually undertaken by the club doctor, who will ascertain the player’s medical history during the examination. The club doctor will check for any previous significant illnesses and ask if the player has had any operations in the past. In addition, the doctor will check the family history of the player, which may be indicative of hereditary conditions.

Apart from major illnesses or operations, the doctor will check for past sporting injuries, which should have been recorded in the player’s medical file, made available by the selling club. This will give a picture of how often the player has missed training or matches and if the player has had any recurrent injuries such as hamstring strains or ankle sprains.

The medical examination is followed by a thorough physical examination of all muscles and joints. The doctor and physiotherapist will assess the range of motion in each joint and compare it with the normal values. Some football clubs use isokinetic devices which give an indication of muscle strength. Some conditions can reveal themselves due to characteristic readouts from this machine.

Once the musculoskeletal system has been checked a more routine examination is undertaken, including checking height, weight, body fat, lung capacity, pulse rate and blood pressure. In addition vision, hearing and dental health are checked. An electrocardiogram (ECG) and echo cardiogram are usually undertaken to rule out cardiac abnormalities.

The findings of the examinations may lead the doctor to order more specific diagnostic tests if required. For example, if the player has had a previous surgical reconstruction of an anterior cruciate ligament rupture, and there is laxity in the joint when it is examined, it may be necessary to have a repeat MRI scan of the affected knee to check its integrity.

Or, if the player has complained of not feeling well in the past, the doctor may order blood tests. If a problem arises, it may be necessary to refer the player on to a consultant, who can assess the player and advise the buying club on his medical status and prognosis. These supposedly routine examinations take three days, since the buying club must arrange for the player to see the consultant and have diagnostic tests at very short notice.

But in taking health issues a step further there is an initiative which began in 2010 called Premier League Health this program was sponsored by the The Football Pools at a cost of over 1.6 million pounds and is set to run for three years. It was designed to bring awareness about the unhealthy lifestyles that men lead especially those on low income leading to lower life expectancy rates which is a major concern for the British population and should be for us to in the “third world” as our life expectancy ratios are even lower than what has caused concern in the UK!

So far they have succeeded in collaborating with 16 Premier League clubs to raise awareness about men’s health issues as well as encouraging people to commit to long term changes in their lifestyles. So far over 3000 men have Participated in the program. In attempting to meet the health needs of these vulnerable groups of men, especially those from poorer backgrounds, is a huge challenge.

Premier League Health is helping and has tackled issues as diverse as depression, obesity and alcohol and substance abuse. Premier League Health targets men aged 18 and over, with clubs offering help in a community setting with initiatives including weekly classes and group sessions with National Health Service (NHS) health trainers in and around iconic football grounds local to the men not to mention high profiled celebrity professional players too.

The Ghanaian comparison to all of this couldn’t be any further than the distance from earth to the moon! The investment in football is at an historic high but is ironically very low and the same is true of the transfer fees and the salaries that are normally paid in 3 month arrears! The medical examination of a player being transferred from one club to the other in truth doesn’t even exist despite the new regulations issued by the Ghana Football Association (GFA) to the contrary.

Clubs have already began complaining about how expensive the routine tests are and as a result most clubs find a way around such medical examinations to the detriment of the players concerned. There are probably only two MRI machines in the whole country one of which is in Korle Bu Teaching Hospital and has broken down and the other in the 37 Millitary Hospital and which costs an arm and a leg to use! I think It wouldn’t be far from the truth for me to assume that none of the clubs especially in the Glo Premeir League really know and understand the health status of their players and I challenge any club to come forward and demonstrate to me otherwise.

What makes it worse is the fact that very little confidence can be placed in the First Aid services that are available at the Premier League Centres should a situation arise like the one the world witnessed on Saturday involving Fabrice Muamba. Would they be in a position to respond appropriately to the set of circumstances that confronted their colleagues in the UK? Do they even have a defibrillator at hand or even know when and how it should be used? I stand to be corrected but I doubt it!

As we sit out the tension in awaiting positive developments from the intensive care unit in London our prayers go out for the recovery of the life of Fabrice Muamba and our thoughts remain with the family too. Muamba’s set of circumstances go to show that where the English Premier League have endeavoured to ensure the safety of every player and match officials we are still not able to legislate against the hand of fate.

I guess in Ghana we are surviving on the grace of the Almighty alone as we push our footballers into life threatening scenarios on a daily basis with the minimum of fuss or indeed concern. Breaking all the rules and being oblivious to the need of promoting healthy lifestyles amongst the playing body it is only a matter of time before we are struck with the inevitable once again.

Last season several players died on the field of play including our own beloved Alhaji Sly Ibrahim Tetteh the Founder of Liberty Professional Football Club. His death shocked the football fraternity for a while and the issue of health and safety at League Centres was heavily debated at the time, but some 5 months later it all seems to have been forgotten and the fact that everyone who died playing football could have been saved had the appropriate personnel and equipment been available at the time has been lost in the cacophony of sounds about who will win the Glo Premier League this season.

It does not appear that we are prepared for such an eventuality and what makes it worse is the lifestyle of the players is not at all conducive to increasing life expectancy ratios anyway and with no one conscious enough to encourage healthy long term changes especially in relation to the consumption of food and drink its just a matter of time before we are faced with a tragedy or two of our own!

The tragedy of Fabrice Muamba has important lessons for us to learn from whether or not we chose to learn is another matter. So in the meantime as we continue our favourite past time “procrastination” let’s all at least say a prayer for Fabrice Muamba…….

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