Well, I finally made myself sit down and go through those 1000+ intake forms that have been sitting on my table since I got back from Ghana a month ago! Now all the data is entered, nice and neat, on spreadsheets and I've put together some thoughts on the mission, based on what we recorded. Please note that this is not a scientific study, nor should it be taken as such. But, I think it will give the readers a better idea of what sort of work we do, and the impact we make on the poor villages we work in.
We conducted outreach clinics in three different communities in Southeastern Ghana (Volta Region) - two remote villages, and one small town. In all cases, the patients we saw had come from the numerous villages surrounding the clinic locale. People who can't afford medical care get excited when the "American doctors" come to town and will walk miles to be seen. So although the clinics were held in specific places, our patients didn't necessarily come from that village/town.
In total, we saw and treated 1065 patients, ranging in age from one month, to 108 years old! Our nurse practitioner and three RNs worked alongside our Ghana Health Service team of a physician's assistants, nurses, and a pharmacist, to diagnose and treat these patients.
Above, see a chart that shows the age breakdown of our patients for each location. The total number seen for each age group was:
Under 5 - 107
5 to12 - 118
13 to19 - 63
20 to 29 - 96
30 to 39 - 129
40 to 49 - 127
50 to 59 - 131
60 to 69 - 124
70 to 79 - 120
80 to 89 - 35
90 to 99 - 10
100+ - 1
There were 776 adults (age 20 and over), and of these, 632 reported being engaged in some sort of occupation. The types of work people do to support themselves and their families has a bearing on the physical complaints and medical issues they have. See the chart below:
Each community was different in terms of the types of work available to people. Yama Lente is a farming community, many miles inland from the sea. Hence, farming is the primary occupation in this village and its environs. All three communities had many people (mostly women) who reported being "traders." These folks set up at the local markets and sell a variety of goods - foods, cloth, handicrafts, etc.
In fact, the vast majority of the patients we saw were either farmers or traders. Both of these occupations are extremely physically taxing - farming is done by hand for the most part, most people being too poor to own a tractor, or even a pickup truck for that matter. It's a far cry from the highly mechanized farming done in the U.S. Selling at the market usually involves the market ladies carrying loads of merchandise on their heads, sometimes even walking long distances to get to the market with their wares.
So it comes as no great surprise that most adults complained of bodily pain - "waist pain" (lower back pain), knee and neck pain, being primary. All of our volunteers to date, at least those who've never been to Africa before, are amazed and even shocked at the incredible loads people carry on their heads. As a side note, I tried it once! I carried a carton of bottled water on my head for about a block. It's actually surprisingly easy to balance a heavy load on one's head, but carrying loads day in and day out, starting at a very young age, takes a toll on one's spine. Note: after a short distance I was like "get this box of water off me!" Our patients in Ghana are strong, but they ache!
Chronic headaches also seemed to be a common complaint - again, this could relate to heavy physical work in the hot sun. I have a suspicion that dehydration plays a part in numerous health problems, too. In future missions, I'd like to record how much water the person drinks, and their access to clean drinking water. I'm wondering if having to buy purified water causes people to drink less than they should.
Another major health issue afflicting adults is hypertension. Our practitioners diagnosed 184 people with hypertension - or referred them to be monitored for the early stages of this problem. Some folks had been diagnosed in the past but had run out of their medications. We were able to provide 169 people with high blood pressure meds, enough to last them until they could get to the hospital for further care. The highest blood pressure we observed was 260/118. 354 people had a systolic BP of 140 or over. 176 had a diastolic BP of 90 or over.
Below is a pie chart showing the overall diagnoses for all three communities:
Malaria is a mosquito-borne disease endemic in Ghana (and throughout all tropical regions of the world). In April, the rainy season hasn't started in earnest yet, so there are fewer mosquitoes, hence less malaria. Despite that, we suspected malaria based on the patient's symptoms and administered 187 rapid diagnostic tests for malaria - while only 29 were positive, 81 patients were diagnosed with malaria and treated with medication. Our Ghana Health Service staff, familiar with malaria, told us that the tests can show 'negative' if the illness is in the beginning stages. In that case, the patient is treated if they are obviously ill and have the typical presentation.
Vaginal infections were another fairly common issue with our female patients, sometimes part of a complex of urinary tract infections and reproductive tract complaints that indicated possible STIs. The patients were treated with antibiotics and antifungal cream and/or oral medication, as appropriate. Men also presented with symptoms of urinary and/or sexually transmitted infections and were treated appropriately.
Two patients were tested for HIV based on their symptoms. The Ghana Health Service is making a great effort to educate people about HIV prevention and treatment, but it's still a touchy subject amongst the villagers. A diagnosis of HIV is still feared as a death sentence, even though medication is available for free. Also, the stigma of being HIV positive and concerns about being ostracized in the village lead some people to avoid being tested, even if they know they're at risk. In the case of our two patients, the tests were done surreptitiously and the patients asked to return to the hospital for additional testing at no expense. Our GHS personnel kept contact information for these patients so they could follow up.
You can read my previous blog post for additional information about diagnoses and treatments from this mission.
Overall, we made 1265 diagnoses, and provided 2732 doses of medication. See the chart below for the medications we prescribed:
Another successful medical mission under our belts, we would like to thank all of our supporters, without whom we could not make such a large impact in poor communities in Ghana:
Show Me Your Stethoscope, our partner organization
Our medical volunteers
Our Ghana Health Service staff and Director of the Ketu South Municipal District, Joseph Degle
Brother's Brother Foundation
Henry Schein Cares Foundation
And private donors like you!
COMING UP SOON! PEDIATRIC MISSION IN AUGUST! On this mission, we'll be focusing on the children, with well-child checks; distributing vitamins, dewormer, clothing, etc.; and caring for sick children.
WE DEPEND ON MONETARY DONATIONS TO BE ABLE TO BUY THE MEDS WE NEED FOR THESE MISSIONS - PLEASE CONSIDER DONATING ANY AMOUNT OF MONEY - EVERY LITTLE BIT HELPS SO MUCH!