Well, not really and no this is not a Game of Thrones review. More accurately the harmattan has arrived. If you live in West Africa though, this is all the winter you get.

The harmattan, which begins from November and ends in March is a dry dusty wind which blows from the Northeast and West of the Sahara Desert, over West Africa into the Gulf of Guinea carrying sand particles (Wikipedia). This period is also characterised by extreme temperature variations during the day and night.
According to the American Heritage Dictionary, the word Harmattan originates from the Arabic Word, “haram” which means “evil thing”, probably in relation to the unpleasant conditions experienced during the period.

The cold, dust and dryness during the period generally tend to cause discomfort for everyone but are more pronounced in persons living with Sickle Cell Disease in whom the unpleasant conditions may precipitate crises, and people living with chronic respiratory tract conditions such as asthma who may have acute asthmatic attacks.

If you have Sickle Cell Disease and live in Ghana, you probably felt it in your bones, sometime in December last year. Admittedly, the harmattan seems to have waned but it is still necessary to take precautions to maintain good health.

For persons living with Sickle Cell Disease and their relations, these are truly difficult times.
The dry harmattan conditions predispose to dehydration which is a known precipitant of crises in Sickle Cell Disease. Further the extreme temperature variations resulting in very warm days further increase the risk of dehydration and extremely cold night and dawn which may also precipitate crises. In addition to these, upper respiratory tract infections are quite common during the period. Usually of viral origin, these colds and flu usually resolve in a few days with adequate rest and hydration but may sometimes be worsened by a superimposed bacterial infection which cause general ill health and may result in a crisis. Finally, as a result of the dusty condition, fresh fruits and vegetables may be contaminated. To prevent gastrointestinal infections, it is essential that all such produce are properly washed before consumption.

The signs and symptoms of crises include pain, in any part of the body such as the arms, legs, chest, etc., anaemia, symptoms of which include easy tiredness, palpitations, dizziness and headache, and Jaundice (yellowing of eyes), dark urine etc.
Symptoms are usually specific to the cause and type of crisis, however in the presence of any of the symptoms mentioned above, a fever, malaise etc. one should consider going to a health facility to receive medical attention.

Preventing crises during the harmattan involves maintaining the general principles that one follows daily to prevent ill health.
These include continued routine follow-ups and daily medications such as hydroxyurea and folic acid, continuing vaccination schedule such as pneumococcal vaccine for children living with Sickle Cell Disease, staying hydrated always, staying warm using scarves, socks, sweaters etc, eating clean healthy food, avoiding other known precipitants of crises such as strenuous physical activity, frequent hand washing to prevent flu, notifying employers/school authorities about specific requirements early so they can be arranged and finally stay informed about what you can do to stay healthy.

These activities require active participation of everyone involved in the care and management of the person living with Sickle Cell disease. The patient, parents, friends, colleagues, school authorities, employers etc.
Patients need to stay compliant on medication, avoid precipitants etc, while caregivers monitor them and support them through this period to ensure they are compliant and notice any changes that may occur. Employers and school authorities need to make concessions for patients as they may for example need time off work to receive medical attention or require warm water for bathing if in boarding school. Warm water which may be life saving giving the circumstances.

On the whole we all have specific roles to play in this effort. Let’s perform to the best of our capabilities and keep our loved-ones healthy during the harmattan.

Winter has come. Stay warm, stay hydrated, stay safe.

Winter Has Come. 
Dr. Sefakor Enam Bankas. 

(The writer is a person living with Sickle Cell Disease and a Sickle Cell Disease Advocate. All views expressed are personal, please contact your doctor/counsellor for further information.)

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