From August 5 through 17, 2017, Healthy Villages, Inc. (in conjunction with Show Me Your Stethoscope – SMYS) carried out a healthcare mission in the lower Volta Region of Ghana, devoted to the care and treatment of children. We had four healthcare practitioners from the U.S. on this mission – three registered nurses, and one dental hygienist. Our Ghana-based staff consisted of seven people – a pharmacist, a physician’s assistant, and five community health specialists, who were partnered with our volunteers for language interpreting and mutual education and learning.
We did outreach in six different remote communities during this mission, seeing and treating a total of 1259 children. The youngest child we saw was a newborn of one-week old, and the eldest was 15 years old. This was the largest number of patients who have come to us during the six clinic days of our missions. We were surprised and gratified at the number of children to whom we offered care. It was also surprising how many children were quite ill, received multiple diagnoses, and went home with several different medications to treat those illnesses. We expected about half the number of children, and expected to be focusing more on well-child exams and distribution of vitamins and de-wormer. Part of the reason for this is that during general health missions, caregivers bring very few children to be seen. We felt we had performed a great service to the young by focusing solely on age 15 and under, because we now realize that children’s healthcare needs may go unaddressed.
We had donations of children’s chewable multivitamins from many private individuals in the U.S., and were able to give children between two weeks and one month’s worth of multivitamins. However, due to the large number of patients, we ran out of the donated vitamins after four villages. We then continued to prescribe multivitamins purchased locally (tablet or liquid form, as appropriate) to children who appeared to need them most.
We also received a grant from Vitamin Angels, a U.S. based non-profit organization whose mission is to improve the nutritional status of children up to 59 months of age and pregnant and lactating women. The grant consisted of 2000 doses of de-wormer, intended for children from 24 months to 59 months. Our pharmacist was very cooperative in making sure only children in this age group received the granted de-wormer. Other children requiring this medication received that which we purchased locally. We treated 381 children with the Vitamin Angels medication. A follow up dose for six months after the mission was either given to the caregiver with instructions when it should be administered, or when possible, left with the nearest healthcare clinic and the caregiver told to return to the clinic for follow up treatment. The remaining de-wormer was left with the Ghana Health Service community health nurse who leads our team of Ghana-based practitioners, for distribution to children of the appropriate age group in the community, with instructions to keep a record of how many children were served with this medication for reporting to Vitamin Angels.
Here is some data from the mission:
Total children seen and treated: 1259
Malaria tests administered: 301
Malaria positive: 73
Malaria negative: 228
tested negative but treated for malaria, based on presentation: 68
total treated for malaria: 141
TOP DIAGNOSES TREATED ON-SITE
Intestinal worms: 793
Respiratory illness: 457
Ringworm or skin fungus: 111
Well child exam only: 106
Skin infection or rash: 93
DENTAL (oral pain, cavities): 71
GI illness: 70
Eye problem (conjunctivitis, etc): 39
Headache or body pain: 24
Ear infection: 9
Urinary tract infection: 8
TOP DIAGNOSES REQUIRING REFERRAL TO A SPECIALIST
Umbilical hernia: 7
Undescended testicle: 4
Impacted ear wax: 3
Vision problem (need eyeglasses): 3
Tumor or cyst: 3
Seizure disorder: 2
TOTAL DIAGNOSES GIVEN: 1,793
There were several extremely serious cases brought to us. One was a newborn with neonatal sepsis. The teenage mother of the baby had no support from older, experienced mothers after the birth of the child. According to the baby’s mother, she brought the baby to the hospital for examination, but she and the baby were sent home. Our practitioners had a feeling that the baby’s mother (and the baby) were HIV positive but she didn’t want to share that information. The infant was in such critical condition that its death was imminent.
There were two cases of severe malnutrition, where the children were about half the normal weight for a child their age and showed severe developmental delays. In one case, the mother of the baby had died and the grandmother was raising the baby. The grandmother may have been mentally ill, and did not seem to understand the nutritional needs of the child. The other child may have had a congenital condition.
A teenage boy was brought to us with tumors covering one of his arms. This child’s parents brought him to our October 2016 healthcare mission as well, and we remembered him and his condition. Unfortunately, they had not followed up with our referral, and the boy’s condition had worsened. Two other cases of children with tumors or cysts were also noted.
A little boy of 2 years old came to us with an extremely enlarged eyeball, large enough that the lid would not close over it. The eye was infected and draining. At first the mother would not tell us what had happened to cause this child’s condition; eventually it came out that due to her negligence, a foreign object had entered the child’s eye and the child had never been taken to the hospital for treatment. It was evident that the eyeball would need to be removed and at this point was untreatable.
The caregivers of all these children received education about their child’s condition and the importance of them following up on our referral was made clear. Our Ghana-based physician’s assistant works out of the municipal hospital in Aflao, Ghana, and could refer these patients to himself. Hopefully, knowing their attending physician will encourage these families to seek treatment for their children.
Cough and cold liquid: 363
Antifungal ointment: 94
Vitamin C: 64
Antihistamine ointment: 60
Oral rehydration salts: 58
Antibiotic ointment: 33
Many of the children received multiple diagnoses and multiple prescriptions to treat these conditions. Our organization spent approximately $1600 USD to buy medications in Ghana for the mission. As described earlier, we were fortunate to have received in-kind donations of vitamins and de-wormer, which helped our medication budget considerably.
All in all, this was a very successful mission. The inclusion of a dental hygienist was a real bonus, because children with oral pain could be seen immediately and treated with silver nitrate solution to stop decay. They also received fluoride treatment. We would love to include a dental hygienist and an optometrist on future missions; we are also planning a mission specifically for dentistry and optometry from March 24 to April 5, 2018.
Our pediatric mission in 2018 will take place from June 30 – July 12. A listing of all our 2018 healthcare missions is available on our website – the direct link is here. We look forward to welcoming you to Ghana in 2018!