Beatrice Tetteh, M.D, is currently in the last few months of her Pediatric Residency Training at Harbor-U.C.L.A. Medical Center in Torrence, California. She recently traveled to Ghana for a month as part of an elective rotation that was a partnership between the UCLA Department of Pediatrics and the Ghana Health and Education Initiative (GHEI).
I was in the Sefwi Bekwai region of Southwestern Ghana. Specifically, I lived in the village of Humjibre, but did work throughout the Sefwi Bekwai district. Districts in Ghana are synonymous with the County system used in the United States. Living in the village was obviously very different from Southern California. Cocoa farming is the main source of work for the area’s inhabitants, but people are very entrepreneurial, with multiple roadside shops and other businesses [in the village].
The GHEI grounds in Humjibre are located at a cross point between an elementary school and high school. So every morning I could hear school children in the yard playing before the start of classes and reciting lesson plans during the school day. People worked hard during the day, but you still saw people out on the street or at the local drink spots in the evening.
What was the goal of your rotation in Ghana?
One of the objectives was to gain an understanding of the Ghana Health System and to be able to compare/contrast with medical management in the States. It was also to work toward the advocacy side of health care by performing the newborn resuscitation courses and further investigating the congenital heart disease referral process.
One of my other roles was teaching midwives and nurses present at deliveries newborn resuscitation management. Helping Babies Breathe is a curriculum generated from a partnership between the AAP and the World Health Organization. In order to address the Millenium Goal of decreasing infant mortality rates, this curriculum was made specifically for areas with limited resources. I trained midwives, nurses, and other staff present at newborn deliveries in clinics and at the District hospital. Topics covered included recognizing signs of respiratory distress, standard newborn management, and bag mask ventilation. Each participant had hands-on practice with performing bag-mask ventilation.
They were held at Bibiani District Hospital, where we had two training sessions, and both sessions had about 12 attendees.
We also held one at Chirano Health Center, where we hosted one training course, with about 10 attendees, and we used the same curriculum that we presented at Bibiani.
We also held a refresher course at Bekwai Health Centre for those that had participated in the training the year prior and those that had not received the training previously.
During your visit, what children’s health issues were being tackled?
Malaria was by far the most common condition that was diagnosed or suspected in the clinic and health center during my clinical work. Often times this was diagnosed according to the patient’s history or by a rapid screening test, much like what we use for RSV/Influenza.
Other health issues included inguinal hernias, tachypnea and poor oral intake. When treating patients we also had to be aware that there were health alternatives that the parents may attempt to utilize instead. For example, we diagnosed an inguinal hernia in an 8-month-old male and informed his mother that he would require at minimum a surgical consult in case it became worst in the future. She stated that she was planning on going to an herbalist to see if he would have any medicine to make the hernia go away. Allopathic medical management is often times in competition with other alternative medical practices and caregivers.
I had the opportunity to observe a delivery at the clinic in Humjibre. The mid-wife performed the delivery, went to clean up, then proceeded to see the patients that were waiting to be seen. Physicians are only found in hospitals and the local clinics/health centers are staffed by midwives/medical assistants, respectively. My main clinical role was seeing patients at the Bekwai Health Center with the medical assistant.
What was the biggest challenge of your work here?
The language barrier! While seeing patients at the health center, I had an interpreter. When I was out an about in the city, I used some of the Twi phrases that I picked up or was able to speak English when that was an option.
GHEI is an NGO founded by a past UCLA Pediatrics resident with the objective of helping the people of Ghana build a sustainable future through community-based health and education projects. Visit http://www.ghei.org for more information and volunteer opportunities.
Photos courtesy of Beatrice Tetteh, M.D.
Photos courtesy of Beatrice Tetteh, M.D.