Community Outreach

February 24th, 2017 by Shormeh Yeboah
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Community outreach is an important function of the hospital here. Teams from the public health and psychiatry units travel out routinely to remote and hard to reach communities to counsel, educate and provide services like vaccinations and basic health assessments. There is also an outreach team that does individual home visits to look in on a few of the elderly and disabled in the village. I had the opportunity to accompany some of the teams on two different outreach missions so far, each very enlightening.

 

The public health unit conducts outreach visits to each of the surrounding communities once a month to check in on new moms, monitor their baby’s weights, give vaccinations and counsel on nutrition and family planning. See pictures below. This requires the permission and corporation of community leaders who help to inform the community and encourage people to attend. It is impressive how such simple interventions makes such an important impact on people’s lives. Each woman and her baby had a unique story – yet as they gathered together under that tree, I felt a true  sense of community within the group, that they were all involved in raising their children together and were appreciative of the health worker’s presence.

All pictures were taken and used with permission.

 

The psychiatry department organized what is a called a Durbar last week, or a mental health education outreach program similar to a town hall meeting in another one of the more remote communities in the district. The purpose was to increase awareness of mental illnesses, dispel some of the cultural misconceptions often associated with this and educate on the availability of treatments for these conditions. Again, it required permission and buy in from the village chief and community leaders to facilitate the gathering. As a sign of respect, we were  invited to greet and sit with the chief in his compound. The psychiatric nurse spoke for about an hour  in Twi – with the help of interpretation, I appreciated how skillfully he was able to explain mental illnesses making it relevant to the cultural setting and beliefs.

Culture and Identity 

February 17th, 2017 by Shormeh Yeboah
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“You are Ghanaian?”  “Your name is Yeboah and you can’t speak Twi?”

It’s been interesting to see the conflicting emotions and reactions that I’ve experienced here regarding my nationality and cultural identity. Having not grown up here I’m considered “not really Ghanaian.” Another curiosity is that Yeboah is originally an Ashanti name, and it is so common especially here being in the heart of the Ashanti region. I hear it around me all the time.  It’s almost like Smith or Johnson.  My family however, are not Ashanti, but Ga, a smaller tribe that live in Accra. So I have an Ashanti name but I’m Ga, and I don’t speak Twi and didn’t grow up here. My family lived in UK, Nigeria, Botswana and now the US where I have now naturalized. The struggle third culture kids face when asked the question “where are you from?” This is often difficult to answer. The author Taiye Selasi offers us a solution. Proposing the concept of “locality” instead of “nationality.” See her TED talk here:

I agree and do identify with some aspects of her assertions. I am a multi-local and perhaps do have multiple identities from the different “localities” I have lived in, but I also feel though an innate need to identify with one nationality and with one culture that I can claim as my own. Experiencing the Ghanaian culture now first-hand on this trip I feel is just the beginning of this journey for me…

 

Catching up: Week 1 and 2

February 15th, 2017 by Shormeh Yeboah
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Hi all, I’ve had some difficulty posting on the blog so I’ve been documenting on Word. I’ll post everything here now and will try to keep it in chronological order as much as possible.

 

When every single moment is a new experience, the passage of time feels quite different.

 

On my arrival in Accra, I was met by my uncle and aunt at the airport and spent the first couple of days at my uncle’s house. I am so fortunate to have all my extended family here in Accra – I don’t get to see them enough so it was nice catching up.

 

I made the journey from Accra up to Ankaase accompanied by my aunt in her work car.  It is a 4 – 5 hour journey up north from Accra to Kumasi (the second largest city in Ghana). Ankaase is located a few miles north of Kumasi. Unfortunately, the town is not charted on google maps (at least not yet, a request has been made to rectify that!)

 

 

Arriving in Ankaase, I hadn’t known what to expect. I had no idea quite how rural it would be!  First thing you notice is the dust. It is currently the dry Harmattan season which cakes everything with dust. Here it is a reddish clay like color that sticks to everything. (Harmattan are the trade winds that blow in from the Sahara Desert over West Africa into the Gulf of Guinea from November to March)

Ankaase is a small rural village of I think of about 15,000 people or so. People here are very poor and subsist on petty trade and small scale farming.  The hospital – Methodist Faith Healing Hospital (MFHH) is owned by the Methodist church and partially government sponsored. The hospital was founded by Dr Cameron Gongwer, an American family medicine physician who lived in Ghana with his family for 12 years. He planted a seed as a small hole in the wall clinic that has since sprouted into a bustling multi-functional hospital.

Everybody here is so welcoming! Akwaaba is Twi for “you are welcome” this is a phrase you will hear whenever being introduced to anybody. The accommodations are quite decent. I literally have a whole suite to myself. It is the old guest house behind the main house where Dr Gongwer used to live. About a 10 minute walk to the hospital. Another team from Virginia Commonwealth University arrived about a week after I did and are staying in the main house with Emmanuel “Manny” Otsin.  Manny has been the one primarily corrdinating the activities of us visiting phycisians and students has been invaluable to this experience here so far. He trained in the US as an ED nurse and has been volunteering at the hospital for the past year. He has many incredible stories about his experiences so far. You can follow his adventures at: anidasowoha.blogspot.com

 

Pictures of Ankaase Methodist Faith Healing Hospital:

The main market is directly across the street

 

Healthcare is drastically different here. I am learning so much! Challenges abound with the resource limitations here, it is disheartening at times. However, people make the most of what they have. The hospital sees upwards of 300 patients a day in the outpatient department alone. There is an 81 bed inpatient facility including maternity, surgical, medical and pediatric units and a small but very busy emergency/casualty unit. There’s a lab (for basics like bmp, cbc, malaria parasite screens, CD4 counts) an ancient analogue xray machine (but it works!), ultrasonography, psychiatry, physiotherapy, pharmacy, ENT, optometry, and a public health department. For this being a rural district hospital, there is an impressive diverse array of services provided for the patients and it is deeply entrenched in the community.

 

The language barrier is a challenge for me so I’m working closely with the medical officers here.

 

The outpatient department (OPD) works on a first come first serve basis. There are no appointments. No schedules. Patients arrive early in the morning and sit and wait for however long it takes until they are seen by the doctor. There are about 4 consulting rooms – some have 2 providers in one room. Patients come in continuously one after another after another until they’re all seen…

 

Malaria is endemic here and is one of the most common diagnoses I’ve come across. It’s on the differential for almost every presenting complaint – sometimes treated empirically, regardless of whether malaria parasites are found on blood smear.  There’s also infectious gastroenteritis, enteric fever (typhoid fever) – these are treated with broad spectrum antibiotics to cover all possible etiologies. Peptic ulcer disease and gastritis have also been common (Interesting. I’ve learned this has to do with certain aspects of the diet and habits such as fasting for long periods of time…)  Chronic Hepatitis B and HIV are also quite common.  Most surprising to me though is the chronic conditions that are so prevalent here – hypertension, diabetes, asthma – my bread and butter in clinic in the US!  Here, patients present in extremis sometimes. They present to the ED in hypertensive emergencies with stroke, paralysis, heart attacks… uncontrolled diabetes presenting in DKA. Medication compliance , financial/poverty issues, cultural beliefs all combine to make controlling these conditions a challenge. Patients needing specialty or tertiary care are referred to the main teaching hospital in the city of Kumasi about 45 minutes away. Patients may often refuse to go because they would not be able to afford the treatment provided. Refusal of treatment due to lack of funds is frustratingly common. Poverty as the main determinant of health is very evident here…

Introducing Myself

February 4th, 2017 by INMED
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Hello! My name is Shormeh Yeboah and I’m a family medicine physician practicing in Philadelphia, PA. I am completing my INMED international medicine service learning experience at the Ankaase Methodist Faith Healing Hospital (MFHH) in Ankaase, Ghana, during the month of February 2017. This has been a long time coming! I have had an interest in global health and a desire to experience and learn about healthcare delivery in low resource settings for quite some time. But it was always just that – a desire, I never really knew quite how it would manifest  – until I was introduced to INMED. I am originally from Ghana and I was thrilled when I learned that INMED has affiliations with 3 different sites in the country! For me, this is also a chance to live in and connect with the country of my birth. Excited!