The emphasis of most of my work, in collaboration with the local staff (Ester) consisted of trying to optimise child health in the surrounding areas. We conducted several clinics in the nearby villages, providing vaccines against polio, hepatitis B, yellow fever, and diptheria. The vaccination schedules and content were based on the international guidelines of UNICEF. Regular clinics also meant that the growth of infants could be monitored. While children often maintained average weight and length parameters for the first year of life, the majority of two and three year olds were observed falling below the 25th percentile. This malnourishment was attributed to insufficient energy intake following the cessation of exclusive breastfeeding, which UNICEF recommends for the first six months only. These clinics were extremely busy, with over 200 mothers and babies in attendance on each occasion! I really enjoyed these clinics, though I was certainly soaked in sweat by the end – I had never seen so many babies!.....Overall, my time in Elmina was an enjoyable and eye-opening experience and gave me a good insight into health issues in the region. The planning on the ground was a little difficult at times, but I feel I am capable of self-directing myself to the activities I was most interested in – and was able to do this most of the time. It would have been nice to be accompanied by another student while on this placement, but there was more than enough to do to keep me busy most of the time and I would recommend it to other medical or health professionals/students with similar interests.Vince Anderson, M3 Student, University of Sydney, Australia - Dec 2009 to Jan 2010
I am in fact safely back in the US, reacclimating to life in a First World country. I had an amazing time and I don't think I can ever practice medicine the same way again. I'll try and get on these documents over the weekend. I wish I could have stayed longer but I don't have the luxury of more than 2 weeks at a time like the residents who join the program do. Thank you for everything, Dr. Ulzen, none of this would have been possible without you. I loved every minute and would do it again if the opportunity arises. Heshy Zaback,Physician Assistant, NY, February 2009
"During my elective in Ghana, I gained greater self-confidence in my clinical decision making and increased my cultural awareness and sensitivity. It was a great way to learn about communicable diseases and social determinants of health in a developing country. I was exposed to the challenges (successes and frustrations) of providing healthcare in a resource poor environment. I would strongly recommend this program." ...."My only complaint was that I felt too well taken care of!" Erin Reich MSIV, University of Western Ontario, London ON Canada - Nov. - Dec. 2008
...Due to the limited availability of supplies and hospital beds, most of the surgical procedures I was involved with were general surgery, orthopaedics and obstetrics/gynecology. As emergencies came in, we dealt with them, though surgically this presented a problem due to resources. From an anesthetic perspective, monitoring equipment was frequently unavailable due to power outages or simply being unavaible. ECG monitoring was occasionally available as was pulse oximetry, though blood pressure was often performed using a manual cuff and in at least one instance, this was unavailable. I was called to the emergency department (Accident and emergency - or A&E - as it is known) one afternoon to help assess a female patient requiring an urgent c-section. The hospital, at that time, had no running water available for sterilization of equipment, no piped-in oxygen and no electricity due to the intentional black-outs. As such, the decision was made to transport the patient to the nearby District hospital where the essential services would be available. I was loaded into a waiting ambulance along with a case of IV fluids and we set off down the highway with lights and sirens blaring, headed for the nearest hospital. When we arrived, we had few to no drugs available and Harry, the nurse anesthetist, induced the patient while I attempted to repair the anesthetic machine and obtain some vitals. The patient survived, as did her child, though it was an eventful delivery!...As for the EAUMF, I can't say enough of the hospitality that was shown to me by all members of your staff. All of the transportation worked out, seamlessly, and Francis and Lucy (And Lucy's mother and sister) were some of the nicest and most helpful people that I have ever met. All of them truly went out of their way to ensure our safety and comfort and made sure that we not only worked hard, but enjoyed ourselves while we were there. It has been nothing but a pleasure to keep contact with them and I hope that this continues...I truly enjoyed my time spent in Elmina and Cape Coast and would recommend it to anyone thinking of traveling to experience the medical system in a developing country. The Foundation provided us with everything we needed and went out of their way to ensure our comfort while in Ghana. Thank you very much for your hard work!Jason Nickerson,BHSc, RRT(A),Department of Anesthesia,Capital District Health Authority,Halifax, NS - April 2007
We arrived in Accra, Ghana, late Tuesday night. The airport was crowded and for a moment we were terrified, realizing that we knew not a single person in the entire country. However, as Dr. Ulzen had promised, an incredibly friendly man named Edwin was waiting for us at the arrival terminal...On our first full day in Elmina we met Mariatu, a coordinator at the Elmina Health Clinic. She drove us to all of the sites that we would rotate through, introduced us to the directors at each and took us on tours. Afterwards, she met with us to discuss our goals for the rotation and together we created a schedule, outlining at which sites we would spend each day of the week.....Cape Coast Regional hospital: This site offers the opportunity to learn about many medical specialties (e.g. surgery, general medicine, pediatrics, obstetrics and gynecology, intensive care, HIV and infectious disease, emergency medicine, wound care and others). We spent time in the emergency room, participated in rounds with the gynecologists on the in-patient ob-gyn ward, observed the gynecology out-patient clinic and observed the HIV outpatient clinic. There were always many attending physicians, residents, nurses and nursing students who were eager to answer our questions and encourage our participation and contribution to case discussions...Elmina Clinic: We saw about 25 patients a day, ranging in age from just a few weeks to people in their 80’s and 90’s. We saw a variety of pathologies, including malaria, typhoid, pneumonia, anemia, malnutrition, scabies, thyroid disorders, cirrhosis, elephantitis, worms, mastitis and traumatic injuries...Out-reach Vaccination Program: Every morning a van leaves from the Elmina Clinic at about 6 AM, carrying a scale and vaccination equipment. The van goes to villages that are too far from the clinic for parents to bring their children in for routine weight checks and vaccinations. When we arrived at a village we walked all around, meeting the people and announcing that we had come and that parents should bring their children to a designated place. We then set up, hanging the scale from a tree and preparing the vaccines. The children all come with special shorts that have a strap which allows them to suspend from the scale so that we can weigh them and make sure that they are gaining weight appropriately. We then gave the children vaccines (oral polio, BCG, hepatitis, diptheria, measles, mumps) and vitamins according to their age and vaccine history...Ankaful Leprosarium:We also participated in the clinics where we saw, discussed and learned about various skin diseases including leprosy, pemphigus vulgaris, scabies, eczema, chronic dermatitis, cutaneous manifestations of river blindness, fungi (tinea corporis, tinea capitus, tinea pedis) and serious drug reactions. The attendings allowed us to examine all of the patients and discuss the diagnosis and appropriate treatment for each...We spent our weekends traveling around the country, visiting various places including Tema, Koforidua, Kumasi (which has the largest open market in West Africa), Busua, Nezulezo (a village built on stilts), Kakum National Park (which has a canopy walk through the rain forest) and Hans Cottage (which has alligators that Anthony pet!)...We cannot say enough wonderful things about this program and encourage anyone interested in a health elective in Africa to participate in EAUMF.Melissa Frey & Anthony Rossi Cornell Medical College, May/June 2007
...In Ghana, things don’t happen when you think they should, or in the order you think they should. There is no timetable or itinerary, but everything still gets done, and it happens with
warmth, wit and good-humored charm. As “supervisors,” we had been given the rare privilege of not only being able to learn and observe how important public health efforts are meted out in
Ghana, but also to participate and vaccinate as well. Aaron and I had the opportunity to visit twenty- five of the tiny villages around Elmina. Bouncing through the rugged rainforest
roads that connected one village to the next, we would pass families harvesting palm nuts, yams or pineapples from the bush. We would see people carrying enormous loads of firewood on their
heads, and once in a while, the driver would stop to give a weary worker a lift.... Though we left Ghana, the K.E.E.A. district and the people there have not left us. Our hearts are changed.
They are fuller and perhaps a bit gentler. Thank-you for your support and for the trip of a lifetime. We are forever grateful for this opportunity your kindness afforded us... Drs A.
Krych & E. Rodruigez Interns from The Mayo Clinic, Minnesota, March/April 2005
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