Based on an example request list that we provided (with categories for diagnostic equipment, wound care, etc, etc), Dr. Twumasi will develop a request list of supplies and equipment that best reflects the needs of the Northern Region. Since much of the supplies will be distributed to the region’s five new polyclinics, it was important for us to get a better feel for their specific needs, priorities and challenges. Just days before our meetings in Accra, a young doctor from Karaga Polyclinic had sent a list of needed supplies and equipment to the MOH, along with a heartfelt request letter. After hearing more about him in our regional meeting AND learning from a contact that he did an away rotation at the University of Michigan, we knew we had to meet him. A few phone calls later, we had a site visit scheduled and a vehicle arranged and were ready to visit Karaga. Just outside of Tamale, the paved road is replaced by bumpy red dirt, and banks and hotels give way to flat expanses of farmland and thatched-roof family compounds.
In the tro-tros and pickups passing by, there seem to be an equal number of people sitting on roofs and perched atop bags of rice as there are actually occupying seats. The landscape is dotted with women hanging brightly colored laundry over bushes and uniformed school children clustered around homemade soccer goals. I felt ready to get out into the communities where MedPLUS Connect shipments make the most impact, and eager to meet Dr. Abraham.
While completing his internship at the Tamale Teaching Hospital, Dr. Abraham was inspired by a talk on the need for doctors in the health facilities surrounding Tamale. He took a position as the sole doctor in Karaga, a district in Ghana’s Northern Region that previously was without a doctor and is still without a hospital. Since arriving in Karaga this year, Dr. Abraham has petitioned the government and Ghana Health Services for funds and equipment to turn his polyclinic into a fully functioning and comprehensive hospital.
When Dr. Abraham’s polyclinic lacks the training or medical equipment necessary to care for a patient, the patient is refereed to the regional hospital in Tamale. Even in the comfort of a Ghana Health Services SUV, the trip that we took from Karaga to Tamale was a jarring two hours. For many polyclinics and district hospitals in the Northern Region, the trip is three or four times that distance. Because the Karagra Polyclinic lacks an anesthesia machine—and thus has no option to replace an epidural with general anesthesia if complications arise during a c-section—many high-risk delivery cases, and most general surgery cases, have to be referred. Although we talked for almost four hours, Dr. Abraham’s words about referrals stuck out: “…sometimes when I write a referral, it feels like I am writing a death warrant.”
Dr. Abraham’s frustration is evident as he is forced to reconcile his years of training with the constraints that a lack of funding and medical equipment place on the care he can provide. At the top of Dr. Abraham’s request list is an anesthesia machine. I hope that together with our partners in the U.S., we can get an anesthesia machine into Dr Abraham’s very competent hands.