Ghana International Rotation

Posted by BJ Opong at Saturday, November 13, 2010

I have traveled to Ghana several times in the past with my family, and this experience was vastly different from the others. The first and most notable difference was that this was not a vacation and that I would be working at Komfo Anokye Teaching Hospital (KATH). Although I had traveled to Ghana several times prior, I had my first ride on a Trotro. This was by far the new experience outside of KATH that I will remember the most. I had always wondered how the Trotro system works and how you would know where each Trotro was headed, now I know. It was a bit of an adventure the first time I had to wait at Tech Junction with close to 50 other people waiting to head into town. The moment the Trotro pulled up and the doors opened there was a mad dash to the doors to be one of the 12 fortunate people who had a seat, and avoid having to wait another 20-30 minutes for the next one. Although we ended up taking a droppin the rest of our time in Ghana, the Trotro experience is one that I will always remember due to its authenticity to Ghana.

My experience at KATH was just as memorable. KATH on appearance seemed very different from the hospitals I had experienced in the past. As the saying goes “appearances are only skin deep”. As we began to round with the pharmacists and the clinicians, I realized that a lot of the same types of patient and administration issues were present. KATH services a lot of patients in a very resource-constrained facility. Although the budgets may be different hospitals everywhere are faced with the burden of trying to deliver the patient the best care possible, while keeping their costs down. The issue of medications that are too expensive for the patient to afford arise often in the US and similar to here it is up to the pharmacist to determine an alternative medication that has similar efficacy that the patient can afford. Some similar patient issues that I encountered were patients who were non-compliant when it comes to regularly taking their insulin or other medications. It was up to the pharmacist and other health personnel to try to convince the patient of the importance of compliance and how properly taking the medication would lead to less hospital visits.

Another similarity that I was surprised to find is that both Hypertension and Diabetes are very common disease states. I believe that the diet plays a large part in the prevalence of diabetes in Ghana. The diet is filled with dishes heavy on carbohydrates and low on green leafy vegetables. These posse a large problem when attempting to counsel patients on their diabetes and lifestyle changes that needed to be made to improve or slow the progression of the disease. Patients with Hypertension often came to the hospital with very high initial blood pressures. The pharmacists attributed this to patients’ unwillingness to receive frequent check ups. By the time the patients come to the hospital the condition had worsened and would take longer to stabilize. Both of these conditions and issues often occur in the US as well.

Some of the differences that I noticed immediately while on the wards were the prevalence of different infectious diseases. Disease states such as malaria, enteric fever, tuberculosis and schistosomiasis are things we read about but only if we are lucky would we ever encounter it in the hospital. Another disease state that I had never even heard about but is endemic to the area was Buruli Ulcers. I was very surprised to learn of how common it was, so much that the World Health Organization sends a lot of resources and support to help prevent the spread.

I have truly enjoyed this trip to Ghana and getting to experience the country from a new perspective. Being a Ghanaian-American this trip has opened my eyes to some of the woes of the health care system and limited access to resources, be it health based literature or actual medications.