As I write this, it’s hard to believe that just a couple weeks ago we took our four volunteers to the airport to fly back to the US. It was an intense 13 days, and along with our Ghana based staff, we all became a team that worked together like a well-oiled machine. Over six clinic days (two days each in three different remote villages) we evaluated and treated 1065 patients.
Some medical conditions are very common in this tropical country but unheard of in the U.S., so our three RNs and one NP learned a few things – likewise, they could share their training and expertise with our Ghanaian medical staff during the mission.
One of the main illnesses in this area is malaria. Malaria is a mosquito-borne disease endemic to the tropical regions of the world. One of the problems in impoverished villages like the ones we work in, is that people cannot afford to go to the clinic if they get sick. In the beginning stages, malaria can be treated successfully with artemisinin-based drugs taken orally. However, if the illness progresses without treatment, the patient will often die of high fever and dehydration if not hospitalized. We were fortunate that it’s been dry and so there were fewer mosquitos than usual. Yet there were a significant number of malaria cases in two of the three communities we visited.
Another significant health problem is type-2 diabetes. We intended to test every adult’s blood sugar level and we had medication available to treat them if necessary. Unfortunately, our glucometers all malfunctioned and our borrowed glucometer ran out of test strips! The tropical heat causes strange things to happen to equipment. Next time we’ll have a more heavy-duty glucometer available with plenty of test strips. Diabetes is such a widespread issue in this population that to be able to give a patient enough medication to at least get them through until they’re able to get to a clinic for follow up care would make a difference in the communities.
Hypertension is another major problem. Many patients with impossibly high blood pressures have no symptoms and continue on with their daily lives until they literally drop dead. We were able to supply hypertensive patients with a short-term dose of blood pressure medication with the directive to follow up at the regional hospital for ongoing care. Whether they will be able to do so is another question, but at least we will have made some intervention. We had one gentleman come to our outreach clinic who’d been seen last October by our nursing volunteers. He was diagnosed with hypertension and referred to the hospital clinic. He wanted to let us know that he followed up with our recommendations, and has been taking his medication as prescribed ever since. His BP is now within the normal range and he looks and feels so much better.
We saw quite a few skin conditions also. The humid heat can lead to fungal skin infections and a tropical skin disease called “yaws”. Yaws can be treated with antibiotics (see below). One girl of around ten years old possibly also had yaws which she’d had for four or five years. Our team treated her last October and according to her mom, the treatment helped her for a while and then the condition returned. We sent her off with another round of antibiotics and we hope she will be cured of what must be terrible suffering.
A man of around 40 years of age came to us with a huge open wound that started as a small abscess. The wound had progressed over some months while he attempted to self-treat the problem and was near the bone. He looked quite ill, and the wound was obviously infected and painful. The first time the wound was packed, it took about a foot of gauze strips to fully pack the tunnels that had formed. We sent him home with a round of antibiotics and told him to come have the wound re-dressed in three days. In three days, he looked so much better – generally healthier, smiling, and in less pain. Three days after that, the wound was significantly smaller – it only took about six inches of gauze to pack it – and was no longer infected. The local community health nurse will follow up with the patient to make sure he is fully recovered.
Another young man we saw in October for a burned leg returned to us for a check-up. The burn covered most of one leg and was a gaping wound when we treated him in October – after following our instructions and taking his medications, six months later the burn was nearly healed! Without access to surgery, skin grafts, or even regular wound dressing, it’s incredible that this man survived, let alone be using his leg normally with just a very small area left to heal.
We are often asked about HIV/AIDS rates in Ghana. Unfortunately, the rate of HIV/AIDS is rising. The good news is that treatment is available at the regional hospital HIV clinic and is free. So, if we can identify HIV positive patients, we can provide counseling and hope they will follow up. Sadly, there is so much misinformation about HIV that many patients will commit suicide if they’re told they have it, or might have it. When we identify a possible HIV positive patient, based on their presentation, we walk a thin line about how to manage the situation. There were several possible HIV positive patients and we tested them without telling them what the test was for. We then told them it was very important that they go to the hospital for additional testing to determine the reason for their illness and to get care. The patients were identified by the Ghana Health Service physician on our trip who will follow up with them to make sure they are seen at the HIV clinic.
If you’ve seen pictures of Africa, you will likely know that head-carrying is the norm here. Even small children carry heavy loads, balanced on their heads! By the time they’re adults, they’re coming to us complaining of body pains – neck, lower back, and knees. Lower back pain is referred to as “waist pain” here. These body aches and pains are directly related to the heavy work that poor villagers do daily – not only head-carrying, but farming by hand, construction work, and fishing. We distributed a lot of ibuprofen and acetaminophen!
One example of serious conditions that poor villagers just live with because they can’t afford care – this woman has had this tumor on her leg for many years. She needs surgery to remove it, but most likely cannot afford it. The tumor was infected and we cleaned and dressed it and prescribed antibiotics.
Besides that, we had a range of coughs, colds, upper respiratory infections, vaginal infections, and a few STIs. Our nurses were amazing at triaging patients and directing them for further testing or consultation with our NP and our Ghana-based physician. Once the patient received a diagnosis and prescription, they came to the pharmacy for free meds and then went on their way. Our team worked like clockwork, and patients hardly had to wait once their turn came to be seen. The staff of the three clinics we visited did a superb job of setting up tents and providing benches in the shade for the huge number of people who came to be treated.
As mentioned previously, pulling off a successful mission is a real team effort. Start to finish, here’s the anatomy of a medical mission:
It’s a huge undertaking! Knowing that with our intervention, over 1000 poor villagers have better health today makes it worthwhile!
We greatly thank the US foundations who provided us with free medications and supplies:
We also thank the many private individuals who made in-kind and monetary donations. All told, we received about $100,000 worth of donated supplies and medications, and purchased an additional $2000 worth of medications in Ghana.
Any products we were not able to use to treat the patients who came to our mission clinics were donated to clinics in the communities we served.
Our next mission will be in early August, and will be focused on children. We expect to do well-child checks and dental check-ups on around 1000 children, and provide vitamins, de-wormer, care for sick children, clothing and shoes, and general health education. We need to raise $2000 for the purchase of needed medications for this mission.
Your donations make it possible for us to continue this important work with some of the world’s poorest people. We thank you for your generous support!