War Memorial Hospital Female Ward Upgrade: Complete

Before Shot

After Shot

Can you believe that's the same room in both of those photos?!

MedPLUS has helped upgrade the female ward at War Memorial Hospital in Navrongo, Upper East, Ghana!

The before shot was taken in December, 2011, before the MedPLUS shipment to Ghana's Upper East Region was distributed to the various beneficiary hospitals and health centres, and the after shot was taken last week, in March 2012. All of the medical equipment and ward furnishings you see in the after shot were sourced by MedWish International and delivered to the Regional Health Directorate of Ghana's Upper East Region by MedPLUS Connect.

The staff of War Memorial Hospital, as well as the leadership of the Regional Health Directorate, are very happy with the MedPLUS Connect supplies. The Region's leadership has been working to upgrade War Memorial Hospital to become the second referral centre in the Region, and the MedPLUS Connect shipment has helped them towards achieving this goal. By filling an empty ward with recovered and donated medical equipment and supplies from the U.S., MedPLUS Connect has provided War Memorial Hospital with high quality supplies that will last for many years, and the best part is that everything was free for the hospital!

Thankfully, the day I took the after shot was a quiet day for the hospital, so you don't see many patients in the photo. However, the Region is currently battling an outbreak of meningitis, and I was told that three days before my visit the ward was unfortunately full with meningitis patients. Without this new ward, the old (and crumbling) ward would have been overcrowded and infectious meningitis patients would have been mixed in with all of the hospital's other patients.

MedPLUS Connect is happy to have helped upgrade this ward , and we look forward to working on other worthwhile projects with the excellent leadership of the Upper East Region.

Upper West Regional Health Performance Review

Many of the meeting's participants arrived at the "conference center" each day by motorbike

I recently had the pleasure of attending the Upper West Region Health Performance Review in Wa. This is an annual meeting of the doctors, healthcare administrators, healthcare training school officials and healthcare delivery partners, such as UNICEF and MedPLUS Connect. This meeting provides a forum for discussion on the region's overarching concerns and developments. Each hospital and healthcare training school in the region made a presentation about its recent and ongoing projects as well as its challenges, and we also heard presentations from regional administrators, such as Dr. Chris Fofie, the Regional President of the Ghana Medical Association. Some of the topics discussed were the high rate of labor and delivery taking place outside of healthcare facilities and in the absence of trained healthcare professionals, the region's very low ratio of 1 doctor per 25,000 people (the region has 28 doctors, half of whom are Cubans on 2-year contract with the Ghanaian government), and the high rate of hospital usage as a result of insufficient prevention and poor contintuity of care (last year, the region's hospitals recorded close to 800,000 outpatient visits, while the region's population is only 700,000).

It was overwhelming to listen to the presentations and discussions that took place over the course of this 3-day meeting, both because of the magnitude of the problems and because organizations such as MedPLUS Connect are working on the ground to provide such valuable assistance.

The records that were presented, assuming they were reliable, were surprisingly good. When a presenter talked about an outbreak of an infectious disease, such as yellow fever, he/she knew the index case (the first case of an outbreak), how many people were infected, and how and where the outbreak spread. One presenter discussed the increasing number of hypertension and diabetes cases in the region as a result of longer life expectancies, and another presenter discussed the prevalence of mental health, a topic that has only recently gained attention in Africa.

Attending this meeting also gave me the opportunity to meet with some of our current partners, such as doctors who have received shipments from us, and to form new relationships with doctors or district administrators who may receive future shipments from us. By and large, the people attending this meeting were motivated, capable and hopeful, and they were so happy and thankful that MedPLUS Connect continues to provide them and their colleagues with much needed support.

Different Technology for Developing Countries

Bicycle Ambulance: an Example of Technology Specific to Conditions of Developing Countries

A recent article published by the BBC discusses the issue of donated medical supplies going to waste in the developing world (full text available at: http://www.bbc.co.uk/news/mobile/health-14902877). For example, voltage regulators, infrared sensor technology and ultrasound scanners may lie around unused if there isn't a local technician to maintain such equipment. To avoid these issues, MedPLUS Connect conducts site visits to recipient hospitals before a shipment is ordered, and after it is received. On these site visits, we ensure that the hospitals' requests are compatible with their current infrastructure. If a hospital receives a piece of equipment they can't use, we make arrangements to have it sent to a facility that can use it.

The issue of technology synchronization raises another very interesting question: should developing countries strive to catch up to the technology of developed countries, or should they seek different technology altogether? The BBC article focuses on the latter. The article states that appropriate technology is not low tech, but different tech. Technology designed specifically for environmental conditions of the developing world can yield tremendous benefit - and it would make sense to invest in this kind of technology. Prototypes of "different technology" that were recently displayed at a conference of the Institution of Mechanical Engineers include a solar-powered hearing aid that overcomes the need for expensive batteries, a stethoscope that can connect to mobile phones allowing doctors to monitor hard-to-reach patients remotely, and a nipple shield for breastfeeding mothers who are HIV positive which blocks the transmission of the virus to their babies. The onus is now on the engineering and development communities to get this sort of technology, specific to local environments, into the field.

Ghana Time

Life in Ghana follows a different timeline. Maybe there's a formula for anticipating how late somebody will be for a meeting, or how delayed a flight will be, but I haven't been able to figure it out yet. When somebody tells me he'll get the job done by Friday, I wonder which Friday he refers to.

Ghana Time can occasionally be frustrating, but at the end of the day, that's how life works in most of the world. Few things in the world are as reliable as an Austrian train schedule or a FedEx delivery window. I've learned to change my expectations when working in Ghana. It's not a matter of lowering expectations, because people in Ghana are responsible and always keep their word on important matters, but I've learned to expect the unexpected, especially when it comes to timelines.

Recently we played a game of "Find the bill of lading at the Ghana Ministry of Health." FedEx delivered the document to the Ministry of Health on time, but it took a while to find its way to our Ministry of Health customs representative, who needed it to clear our container from the port. We knew that the document was somewhere at the Ministry, and that it would eventually find its way to our representative, but we tried to speed up the process to get our container cleared and on the way to its destination hospital at Jirapa, in the Upper West Region. This was a great learning adventure, and despite the administrative issues that we perceived, the Ministry of Health solved the problem as they always do, and as should have been expected, their timeline followed Ghana Time. Some things in this world are a given, like the sun rising every morning and the pattern of ocean tides. Maybe Ghana Time is just another impossible-to-change natural phenomenon.