The Law on First Aid and Its Compliance in Ghana: The Case of Drivers in Madina Bus Terminal, Accra

Introduction
There is no doubt that the compliance to the laws of first aid has been the subject of most global discussions in recent times (Adamu, 2011; Lloyd, Byars & Leslie, 2016). This is because health and safety of individuals play a vital role in human existence which in turn helps organizations and national economies as a whole. Thus, compliance to first aid is as necessary as the air we breathe. First aid has been defined as the immediate treatment or care given to a person suffering from an injury or illness until more advanced or definite care is provided or the person recovers (First Aid Manual, 10th Edition, 2014) [1]. Basic first aid includes Cardiopulmonary resuscitation (CPR), how to stop bleeding, treatment for burns, spine injuries and choking among others (First Aid Manual, 10th Edition, 2014).

The laws of Ghana prescribe First Aid as essential to every organization. Section 28 of the Factory, Offices and Shops Act, (Act 328) of 1970 [2], states among others that, every institution in Ghana is supposed to have a first aider and a first aid box. The provision in the Act, is to ensure workers are equipped with first aid skills to help a friend during medical emergency. The health and safety duties require duty holders to consider all risks associated with work, not only those for which regulations and laws exist.

The Ministry of Health also prescribes first aid education in all 1st and 2nd cycle schools to enable school children, acquire the necessary skills to help each other during medical emergency in schools, at homes and public places. First aid requirements will vary from one workplace to another, depending on the nature of the work, the type of hazards, the workplace size and location, as well as the number of people at the workplace. These factors must be taken into account when deciding what first aid arrangements need to be provided. In Ghana, Institution that offer first aid training are the Ghana Red Cross Society, St John Ambulance, National Ambulance Service and other health institutions. This first aid compliance study is part of a cluster analysis of industries that their staff or members have gone through some level of first aid education.

Problem Statement

While many lives are already being saved through first aid, a great many other opportunities are lost. Bystanders who are closer to people having health crises or injuries often do not react at all or they react incorrectly. These bystanders will be first respondents if they step forward to help people with health crises. Some reasons why bystanders do not step forward to help people in health crisis include lack of knowledge and skills, social norms and expectations, and environmental factors. Among the specific reasons cited in the research for the hesitation of bystanders to act are simply not knowing how to help, fear of disease transfer or lack of protective barrier, shock (by seeing blood, abnormal fractures, bad odours, burned flesh, or pain expressed by victims), fear of doing more harm, and fear of legal liability among others. But the universal Good Samaritan Law operates to protect any first respondent, who steps forward to help a person in health crisis without any reward. This indicate that, first respondents should not be afraid of any legal liability, according to Emergency First Aid Response group. (https://www.emergencyfirstresponse.com/good-samaritanlaws- and-cpr/) [3].

Union leaders at the Madina Bus Terminal indicate that, they know first aid procedures, so they do not have time for any other health education on first aid. They claim that their members go through mandatory first education when they are go through processes to renew their driving licences as a requirement by the Vehicle and Driver Licenses Authority (DVLA). But records by the Motor Transport and Traffic Department (MTTD) of the Ghana Police Service, indicates that, there are series of minor accidents involving drivers from the Madina Bus Terminal where without proper application of first aid procedures. This study therefore focuses on drivers at the Madina Bus Terminal, Accra, to ascertain their level of knowledge and compliance with first aid practices and the laws of first aid in Ghana.

Objective of the Study

To evaluate the level of first aid knowledge and practices of the drivers at the Madina Bus Terminal, Accra to inform policy

Theoretical Review

This study is underpinned by the Theory of Safety Culture. According to Lee and Harrison (2000) [4] safety culture construct simply reflect a proactive stance to improve safety at workplaces. Cooper (2016) [5] recommends a partnership between members of staff and management or leadership to work together in minimising the possibility of accidents, thus promoting a good safety culture for all. He asserts the fact that safety culture means different things to people from different background, but all attention should be focus on being proactive for safety at work places for all workers.

In order to understand the issue of workplace safety among drivers and workers in the informal small-scale enterprises, there is the need to explore the theory of safety culture. In addition, attitude and behaviour towards workplace safety can be linked to people’s culture; that is their shared beliefs, customs, arts and knowledge. There is, therefore, the need to discuss how the concept of culture can be applied to provide greater understanding of safety culture and as a means by which to approach safety in the workplace. In order to examine first aid compliance among the drivers, this study adopted the safety culture theory which aligns with organizational policies and procedures. The study sought drivers’ views on policies and structures they (especially union leaders) have put in place to reduce accidents as a preventive measure and first aid procedures they apply when there are minor accidents.

Methodology

The orientation of this study and the character of the study site as well as the socio-demographic characteristics of the respondents called for quantitative approaches in data collection. The choice of this approach was justified on the premise that, it allows a closer contact between the researcher and the participants being studied. In this case, studying first aid practices among the drivers meant that, the researcher needed to get closer to them in their daily activities and at their workplace, in order to get more insight into their operations. The drivers stated that they have gone through mandatory first aid training before their licenses is renewed. Therefore, the study used in-depth, semi-structured interview guide and observations which served the purpose of obtaining individual perceptions of the work conditions and of the workrelated accidents and the way they are treated. Thirty-seven drivers and three union leaders were interviewed. Data analysis was carried out through thematic analysis.

Data Analysis

From the study, it was revealed that members are not aware that there is a law that make first aid mandatory i.e. section 28 of Factory, Shops and Offices Act (Act 328), of 1970. This may account for the low interest in first aid compliance although they had opportunity to go through health education when they were renewing their driving licenses. “I don’t have any first aid box in my car because I don’t know there is a law to that effect”. This also leads to the poor attention to safety culture and compliance to first aid among drivers in Madina. Again, it came out that, there are many minor accidents among the drivers and passengers, where drivers do not know what to do. And this has still not prompted many to comply fully with safety issues especially first aid skills. The drivers do not have any knowledge of organizations offering first aid education in Ghana. First Aid training has not caught attention of leaders of trade unions in transport business to enable them impress upon drivers to be trained [6,7].

“There are frequent accidents and minor injuries but there is no money to cater for such due to the demands from car owners”. In addition, it also came up that, some drivers do not have First Aid Boxes at home and in their cars and those who even have them, do not have anything that will be useful during medical emergencies. This accounts for the low compliance to the laws on first aid.

Further, the study revealed that, the health education that drivers are made to go through before their diving licenses are renewed does not influence their behaviour to take first aid seriously. They just go through as a requirement to get their licenses renewed. A separate study to ascertain the effectiveness of the health education drivers go through as a requirement to renew their license is needed to ascertain the effectiveness of the prerequisite health education. Finally, the study discovered that there has been many lawsuits against drivers and their car owners on accidents. The unions and car owners handle such cases, the drivers emphasized.

Conclusion and Recommendations
The capacity, preparedness and willingness of ordinary people to provide first aid in situations of health crisis are a critical for protecting human lives. There are already many first aiders courageously meeting these needs today, but there are also a number of lingering barriers to a wider application of first aid that lawmakers can help to address in Ghana. Voluntary first aid education remains extremely important. Governments should consider sanctions to the mandatory first aid requirement pursuant to section 28 of Act 328 of 1970. From the study, it is clear that, there is low compliance to first aid laws. The researcher suggests the recommendations:

a) First aid education should be supported with official guidelines and standards to ensure enforcement.

b) Sanction should be attached to non-compliance of first aid law.

c) There is the need to strengthen the Inspectorate Division of the Labour office, Ministry of Employment and Labour Relation for their monitoring purposes.

d) There must be continuous advocacy by the Ministry of Employment and Labour Relations on health and safety issues.

e) Trade Unions should play active roles in advocating for first aid education for their member.

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