Winter 2012 Newsletter

International Healthcare volunteers went on their eleventh medical mission to Ghana West Africa from September 28th to October 13th.  Approximately twenty eight volunteers from the areas of Anesthesia, Emergency Medicine, General surgery, Plastic surgery, colorectal surgery, surgical oncology, Pediatrics, obstetrics & Gynecology, gynecologic Oncology Nursing and Medical Students form the team for the 2012 mission.

The mission was based in three cities with a total of four clinic sites.  Approximately  200 Patients were attended to and  90 surgeries were performed and 150 of healthcare providers were trained in basic life support.

Since its formation in 2001 IHCV has taken care of over  9700 patients and performed over 600 major surgical procedures.  In collaborations with the hospitals we serve (Central Regional and LA General) we continue to provide CME programs for the resident physicians, staff physicians and nurses.

Our HIV and cervical cancer screening programs continues while we plan to expand the minimally invasive surgical programs to central Regional hospital while building up the program at KNUST hospital.

In 2013 we will be participating in the annual continued medical education program with the Ghana college of Physicians and surgeons for all the clinicians in Ghana in September during our 12th mission. During these missions both teams do gain experience from each other, some of these are expressed by some of our junior volunteers.

ICHV Reflection 2012 - By:Hannah Harper

 Before going on the IHCV mission trip, I had spent hours poring over the IHCV website to learn everything about the group that I could before departing for Ghana.  Although I had previously participated in a similar medical mission in Ghana, nothing really could have prepared me for the experience. Coming from Oregon, I had never previously met any of the other group members and had little idea what to expect from my first trip with IHCV. 

Beyond all, I was blown away by the other people on the trip and their passion both for medicine and service.  As an Anthropologist, I am always interested in learning about what drives people to participate in these missions, what assumptions of their home culture they carry with them, and what they expect to get out of an experience like this.  As I got to know those in my group, I became increasingly inspired by their dedication to each patient and by their efforts to tackle some of the larger challenges the hospital faced. I both witnessed and experienced many of the frustrations that other volunteers faced, and I also had the opportunity to see how the group pulled together to problem-solve through such sticky situations.  Often, we drew strongly from the knowledge of experienced members who had participated in the medical mission several times before—the continued participation of many doctors and nurses is one of the IHCV’s strongest assets and stood out to me as one marker of IHCV’s vitality and success.

During my time at the Cape Coast Regional Hospital, one of the things that became apparent to me was the group’s united interested in helping to facilitate the transfer of knowledge and skills.  When I asked the volunteers what was the most fulfilling aspect of their involvement, most people described the educational emphasis of the medical mission and how this has a more long-term impact than simply treating individuals.  For example, one of the IHCV surgical oncologists is helping to establish the country’s first breast cancer program by closely collaborating with local surgeons and surgical residents.  Also helping to transfer skills, two Emergency Room doctors on the team conducted hands on workshops throughout the two weeks geared at equipping residents, nurses, and medical students with resuscitation skills and other practical ER skills.  As part of the surgical department’s grand rounds, two of the IHCV members presented lectures on shock, esophageal perforations, and a current research collaboration to a room full of residents, surgeons, and medical students.  Throughout the week, local Ghanaian residents also eagerly scrubbed in on most of the IHCV surgical cases to learn new surgical techniques and strategies from the visiting surgeons.  It was also interesting to see how this exchange of knowledge happened in both directions as many of the IHCV doctors and nurses discovered how local teams use new or innovative methods to overcoming existing challenges in their resource-restricted settings. In general, I think the IHCV team also went back to the US with a renewed appreciation for the abundance of resources that fill our hospitals and homes. And I also went back home with a journal filled with amazing experiences, a whole new group of close friends, and excitement about participating in another IHCV medical mission trip sometime in the future!

My IHCV 2012 Experience by:Nabeth Asaama Midley

Just a couple of months ago, I returned from my third trip to Ghana with the IHCV mission.   Having been to Cape Coast in the past, I generally knew what to expect in terms of conditions, accommodations, cuisine, and culture.  I even knew exactly what souvenirs I would bring back for friends and co-workers and where I could find them.  However, reflecting on this experience, part of what made it so meaningful is that even though much of the expectations and infrastructure of the mission remain unchanged from year-to-year, I still manage to feel refreshed and renewed when I return to the U.S. 

I have long harbored an interest in psychiatric health and management within different medical systems and organizations, particularly on an international level.  So, as both a medical anthropologist and a volunteer, I was intent on assisting the medical team as much as possible as well as learning everything I could about the psychiatric health care system in the Central Region in less than two weeks.  With a very accommodating team of both IHCV and Ghanaian health professionals and administrators, I was able to satisfy both of these goals.  Shadowing pediatricians in both the outpatient and inpatient wards involved a lot of half-crazed runs to the supply closet and unyielding pharmacy for medications, searching for disappearing hospital staff and instruments, and frantic hunts for distractions to calm fussy patients.  I was also fortunate enough to meet a few obliging psychiatric and community health nurses who spoke openly about their experiences working in a psychiatric hospital and on a local level.  Ultimately, I was able to observe thought-provoking interactions between parents and their children, hospital staff and parents/patients, and hospital management and hospital staff that have truly informed my own perceptions of well-being and psychiatric health in Ghana.

There is still so much for me to learn and understand about psychiatric health and management in Ghana.  No matter how many times I go, I feel like I’ll walk away with a more intense experience than the last.  On my last trip to Ghana with IHCV, I helped teach CPR, sexual health, and nutrition to students and parents in both classroom and clinical settings.  As empowering and exciting as that was, I’ve found that navigating some of the unknown and unexpected nooks and crannies of the psychiatric health system in Cape Coast through informal interviews, conversations, and basic observation has made this experience with IHCV 2012 my most rewarding experience yet.  I am extremely grateful for the opportunities afforded to me by my involvement with IHCV and look forward to remaining engaged with the mission in the future.

Reflictions of Ghana by Jasmine Aly

I was a first year at Robert wood Johnson medical school and we had just completed a long day of classes. My classmate asked me to go with her to a club meeting that her preceptor was speaking at and I reluctantly agreed. As I walked into the small group room I saw her preceptor ,Dr.Charletta Ayers, standing at the front of the room showing slides of her medical mission trip to Ghana. This was my first exposure to IHCV. I listened as Dr. Ayers explained the pathology of fibroids and the emotional and physical distress it caused women in Ghana where she served as the health ambassador of a village. She then showed images chronicling a mission during which surgical procedures were done to treat these women. Listening to her describe a population so ailed by a treatable disease inspired me to want to be part of that treatment. I listened patiently as she finished her lecture waiting for information about how to get involved only to discover that they don’t take first year medical students and in fact I would have to wait until my fourth year to become involved. This lecture stayed in my mind every year until fourth year. And when fourth year came I applied at the first opportunity.

My experience in Ghana was truly unparalleled. I gained medical and non medical knowledge that I was never exposed to during my medical education in the United States. As the only fourth year medical student I had the unique opportunity to scrub in on all surgical cases. We participated in cases including hernia repairs, hysterectomies, myomectomies, cholecystectomies, and anal fistula repairs. In between cases I would see patients at the OBGYN and General Surgery clinics, and round on pre and post op patients on the wards. The patients were extremely grateful and kind. It was amazing how we were able to build connections with patients given the language barrier. Learning the universal language of nonverbal communication is a crucial skill that I was able to learn in Ghana and one that I will undoubtedly continue to apply throughout my career in medicine. I learned a great deal from watching my attendings operate as well. In addition to surgical technique, suturing, and knot tying, I learned many practical things that can be directly applied to my career in the future. From Dr. Aikins, I learned how to remain composed during surgery when power and electricity were lost. From Dr. Suarez, I learned how to gain knowledge about a patient from just history taking and the physical exam without relying on the novelty of expensive tests and imaging.

Exploring Kumasi and Cape Coast on the weekends was the most awe-inspiring experience. On the first weekend we visited the Cape Coast Castle, a historical landmark which was used to hold and trade slaves during the trans- Atlantic slave trade. I stepped into the dungeons where slaves were held in confinement for months. This was by far the highlight of my trip as I was truly humbled and moved by the atrocity of this historical event. We also visited the rainforest where was walked along rope canopies thousands of feet above the rainforest. On the second weekend we visited different markets, the Ashanti museum in Kumasi, and the Bonwire Kente wool factory. We also had the opportunity to visit a children's orphanage in Kumasi where we spent time playing with the children, meeting staff, and handing out gifts and supplies.

This experience was not only a great forum for learning medical and surgical skills but also an opportunity to study nonverbal communication. In addition, I was able to experience a novel culture. It was in Ghana that I closed by first abdominal incision, performed my first circumcision under guidance of an attending, but also my first time eating banku, balancing plantain chips on my head, walking on a canopy in the middle of a rainforest, standing in a slave dungeon, and riding in a trotro. It will surely not be the last time I visit this amazing country. I am very grateful to have had this opportunity and highly recommend it to medical and non medical professionals.