HomeBusinessThe Graduation Ceremony: A Time-Honored Tradition of Prestige, gradually losing its relevance

The Graduation Ceremony: A Time-Honored Tradition of Prestige, gradually losing its relevance

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BEYOND EARLY DETECTION: WHAT HAPPENS AFTER A BREAST CANCER DIAGNOSIS? 

  Breast cancer awareness must go beyond pink ribbons, screening campaigns and calls for early detection. Ghana must also confront whether its health system is adequately prepared to care for those who receive a diagnosis. Every October, pink ribbons, awareness campaigns and screening activities remind us of the importance of early detection in the fight against breast cancer. Across workplaces, churches, communities and health facilities, women are encouraged to examine their breasts, attend screening programmes and seek medical attention when they notice unusual changes. These messages are important. Early detection can improve treatment outcomes and save lives. But after losing someone I cared deeply about to breast cancer, I have found myself reflecting on a question that deserves equal attention: What happens after early detection? Let me call her Abena. Abena was a woman in her late thirties, a working professional who had spent more than a decade advocating for breast cancer awareness. She organised screening activities within her church and workplace and encouraged other women to take their breast health seriously. She understood the importance of early detection and actively promoted it. In August 2023, she discovered a lump in her armpit. An initial ultrasound examination reportedly indicated that the finding was benign. However, the swelling persisted, and a month later she noticed changes in her left breast. Further investigations, including biopsy, eventually confirmed breast cancer in November 2023. What followed was a difficult journey through the healthcare system. The physician who requested the investigations had travelled outside the country by the time the results became available. Abena was asked to wait until the physician returned before a referral could be made to the next level of care. Eventually, a colleague facilitated the referral. At the oncology unit, she was informed that the workload was high and that an arrangement described to her as "intramural" payment could secure an earlier appointment. Without this payment, her first appointment would have been in February 2024. She paid and was seen that same day. Subsequent review visits also involved additional payments.   The financial demands did not end with securing appointments. Each chemotherapy session cost approximately GH¢2,000, while a supportive injection administered after each session cost about GH¢900 at the time. The medication was provided for administration by health workers at a nearby facility. Abena completed eight cycles of chemotherapy and was preparing for a total mastectomy. Throughout this period, her health deteriorated. She experienced significant complications, including loss of sight and speech, and eventually died in June 2024. Yet, even while battling the illness, she managed to complete her Master of Laws programme. Her determination to keep going remains one of the things I remember most about her. I share Abena's story not to suggest that every aspect of her care was inappropriate or that one experience represents the entire health system. Neither can I establish that the challenges she encountered alone determined the outcome of her illness. However, her experience raises difficult questions about access, affordability, referral coordination and the support available to patients navigating serious illnesses in Ghana. A diagnosis should mark the beginning of a coordinated response, not the beginning of another struggle to find care. BEYOND AWARENESS: EXAMINING THE HEALTH SYSTEM  Early detection is only one part of the cancer care pathway. Following a suspicious finding, patients need timely diagnostic investigations, clear communication of results, appropriate referral, specialist consultation, treatment and continuous follow-up. These services must work together. Delays at any point can create additional anxiety, financial pressure and uncertainty for patients. This is particularly important when viewed against Ghana's commitment to achieving Universal Health Coverage (UHC) by 2030. The Sustainable Development Goals, especially SDG 3, call on countries to ensure healthy lives and promote well-being for all ages. Target 3.8 specifically commits countries to universal health coverage, including access to quality essential healthcare services, affordable medicines and financial risk protection. These commitments must translate into meaningful experiences for people who seek care. Universal health coverage cannot be measured simply by the number of people who enter a health facility or the availability of screening services. It must also be reflected in whether patients receive the right diagnosis at the right time, whether referrals lead to actual access to care, whether treatment is affordable and whether continuity of care is assured. The question is not only whether we can detect diseases early, but whether our health system is prepared to respond effectively when we do. Patient navigation is one area that deserves greater attention in strengthening cancer care. Nurse navigators play an important role in helping patients move through what can be a complex and overwhelming healthcare pathway. They support coordination of appointments and referrals, facilitate communication between patients and healthcare providers, help identify financial and psychosocial barriers and promote continuity throughout treatment. Ghana has made efforts to introduce and strengthen patient navigation services. However, we must look beyond the existence of individual initiatives and ask questions about their reach and sustainability. How many breast cancer nurse navigators are available across the country? How many have undergone structured, competency-based training in patient navigation? Are these services accessible to patients outside the major tertiary hospitals? Do we have adequate systems for their deployment, supervision and continued professional development? A patient navigator should not merely direct a patient from one department to another. The role requires the knowledge and skills to coordinate care, anticipate barriers and help ensure that patients are not lost along the treatment pathway. Strengthening this service should therefore form part of our broader investment in cancer care. The challenges highlighted by Abena's experience are also not exclusive to cancer. Patients living with hypertension, diabetes, stroke, kidney disease and other chronic conditions face similar needs for timely diagnosis, appropriate referral, affordable medicines, regular monitoring and continuity of care. As the burden of non-communicable diseases continues to increase, the demands on our health system will become even greater. This is therefore a broader health-system concern. We need to examine how effectively our services are organised to support patients from the point of first contact through diagnosis, treatment, rehabilitation and follow-up. The ability to provide continuous, coordinated and person-centered care must become a central measure of the quality of our healthcare delivery. TURNING POLICY COMMITMENTS INTO PATIENT EXPERIENCES  Ghana's Free Primary Healthcare initiative presents an opportunity to strengthen access to essential services, improve early identification of health conditions and reduce barriers at the primary healthcare level. Similarly, the Ghana Medical Trust Fund offers an opportunity to address some of the financial challenges associated with serious and chronic illnesses. These are important interventions, but their impact will depend on how effectively they connect with the wider health system. Expanding access to primary healthcare must be accompanied by adequate diagnostic capacity, functional referral systems, specialist services, essential medicines and a health workforce equipped to provide quality care. Financial support must also translate into access to the actual services patients need and when they need them. We must be careful not to create a situation where patients are encouraged to seek early care but encounter delays, prohibitive costs or limited treatment options once a serious diagnosis is confirmed. Access to healthcare should not end at the point of screening or diagnosis. It must extend throughout the patient's journey. This also calls for deliberate investment in the health workforce. Nurses and midwives are central to patient education, early identification, care coordination, treatment support and follow-up. Their capacity must be strengthened through appropriate training, adequate staffing, supportive working environments and the resources required to deliver quality care. Patient navigation, for instance, should not depend solely on isolated projects or the commitment of a few individuals. It should be deliberately integrated into the organisation of cancer services. BEYOND OCTOBER: A CALL FOR NATIONAL REFLECTION  Breast cancer awareness should not end when October ends. Screening campaigns and public education remain essential, but they must be matched by a health system that can respond to the needs of those who receive a diagnosis. Abena's story is a reminder that behind every diagnosis is a mother, a family and a future that may depend on how effectively the health system responds. It is also a reminder that the success of our health policies should ultimately be judged by the experiences and outcomes of the people they are intended to serve. As a country working towards UHC by 2030, we must move beyond counting the number of people screened, educated or reached through awareness campaigns. We must also ask whether those who need further investigations can access them promptly, whether referrals are completed, whether treatment is affordable and whether patients receive the support required to complete their care. This reflection is in honour of Abena and the souls our health system might have failed. Their stories should challenge us to look beyond awareness and confront the gaps that patients encounter when they need care the most. Early detection is important. But what happens afterwards is equally important. And so, beyond the pink ribbons, the screening campaigns and the annual calls for early detection, I leave us with one question: WHAT'S NEXT AFTER EARLY DETECTION?  I hope this question will spark a much-needed national conversation among policymakers, healthcare professionals, health institutions, civil society, communities and every Ghanaian who depends on the health system. We must collectively examine whether our healthcare delivery system is adequately prepared not only to detect illnesses, but also to provide timely, affordable, quality and continuous care to those who need it. Maame Akosua Serwaa Gyening Email: masagg30@gmail.com  

 

Graduation ceremonies are significant occasions in the academic journey of students, earmarking the culmination of years of thorough academic work and dedication. Graduation ceremonies have a strong historical yardstick, well rooted in the traditions of medieval European universities such as the University of Oxford, the University of Bologna and the University of Cambridge, who began holding formal ceremonies to confer degrees on students in the 12th Century, these ceremonies were sacred in nature, marking the transition of students into a professional and learned community. The use of gowns can be traced back to the same period when scholars began to wear robes as a symbol of their academic achievements and to signify their status as members of the intellectual elite. Graduation ceremonies’ significance goes beyond the mere act of being conferred a degree or diploma. They serve as a rite of passage, celebrating the climax of years of rigorous study and personal growth. Graduation ceremonies are rich in tradition and splendor, where students and faculty don ornate robes and gowns. Beneath these elegant garments, they showcase their finest attire, an array of suits, and stunning formal dresses, representing the best from their wardrobes, an occasion of sheer pageantry. Graduates have since time immemorial clothed themselves in their finest attire, honoring the significance and status of the occasion. The attire that graduates choose to wear beneath their gowns is crucial, as it should personify the significance of the convocation and the gown itself. Formal clothing not only augments the overall appearance but also signifies respect for the occasion. Wearing formal clothing demonstrates a commitment to the event and acknowledges the presence of esteemed guests, such as university officials and dignitaries. Ultimately, the clothes worn under the gowns should resonate with the honor and prestige associated with graduation, making the occasion truly grand and memorable. Habits of wearing athletic shoes or casual sandals do not align with the formal nature of the event, while jeans can be stylish, they are generally too informal for such a significant occasion, khakis are woefully inappropriate, draping clothing is also dishonorable, lightweight summer dresses that are too casual do not reflect the solemnity of the ceremony, overly revealing attire, outfits that are too short, low-cut, or revealing do not convey the respect due the occasion, heavy accessorizing is unnecessary. This shift in dress code reflects a broader cultural trend where traditional values are sometimes eclipsed by modern attitudes. While it is essential to embrace individuality, it is equally important to recognize the historical and cultural significance of graduation ceremonies. As society evolves, it is vital to find an equilibrium between personal expression and the respect that graduation ceremonies deserve, ensuring that the worth of these gatherings is sustainably upheld. They should aim to dress appropriately and in a manner that reflects the esteemed status of the convocation. The prestige and honor associated with this occasion seem to be waning. The dressing of graduates in semi-formal and informal attire raises concerns about the respect and significance attributed to the ceremony. This casual approach to dressing for the occasion undermines the gravity and importance of the ceremony, reducing it to a mere formality. It also echoes a lack of respect for the academic tradition and the institution conferring the degrees. Moreover, in recent times, there seems to be a decline in respect and participation from graduates, evident in the increasing number of graduates who fail to attend the ceremony. This trend is often accredited to the rising costs of attending the ceremony, as well as the perceived lack of relevance of the occasion. THE DECLINE OF STATUS AND ATTENDANCE OF GRADUATION CEREMONY Graduation ceremonies in early years were ceremonies for the few elites in society, hence the ceremony came with the highest prestige. The more accessible education became, the wider the graduation door opened. Education is indisputably very essential to every society, and as the common saying reiterates, education is a right, not a privilege. As with multiple facets of civilization, the more people can access what was once a rarity, the more the thing, concept or event loses its essence and becomes very trivial. It is therefore understanding that most young people treat graduation ceremonies as casual events in recent times. The high cost associated with graduation ceremonies has also contributed to the decline in attendance. Nearing the end of their tertiary education, young people are forced to come to terms with and take full responsibility for their lives. That aside, in most schools, all debts have to be settled before students are allowed to graduate. Add all that to the mandatory graduation fees to be paid and interest decreases. As stated earlier, graduation ceremonies mark a significant milestone in the lives of young people and usher them into the next levels of their lives. It is a way to blow the horn and let the world know, that people have subjected themselves to years of training, shown remarkable resilience, commitment, and dedication, and have been successful. Graduation ushers students into the world, “the real world” as it is often referred to. It is the introduction of students into the workforce. However, as has unfortunately been the case in recent times, people come to a halt after their graduation ceremonies. The job sector in Ghana has become very dense over the years, with tens of thousands of graduates competing for the few available slots. With the glaring possibility of unemployment, graduation ceremonies are rendered irrelevant to some people. Regardless of all these, every milestone has to be celebrated. It helps to measure how far one has gotten in their journey. Graduation ceremonies do more than just that, they serve as a reminder of the results, resilience and commitment can bring. In conclusion, the graduation ceremony is a time-honored tradition that deserves to be treated with prestige and honor. Wearing appropriate and formal clothing helps graduates present themselves as professionals, underscoring the gravity of the ceremony. An appropriate attire compliments the gravity of the occasion. As such, it is imperative that graduates, institutions, and society as a whole work assiduously to preserve the dignity and importance of the graduation ceremony, and to ensure that it continues to be a meaningful and celebratory occasion for all stakeholders. By; Saeed M.D Nazir & Janice Opoku-Agyemang

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