A Typical Trip
The Overall Schedule
Day One: Leave U.S.
Day Two: Arrive Accra at night, stay in a hotel
Day Three: travel by van to Sekondi settle into rooms, unpack personal items, unload supplies, set up clinic, introduction to community and orientation
Day Four through Nine: conduct clinics
Day Ten: rest and relaxation at a local resort area
Day Eleven: tours of hospitals and clinics
Day Twelve: return to Accra by van, night in a hotel
Day Thirteen: tour Accra
fly home to U.S.
A Typical Daily Schedule
7:00 am Breakfast and announcements
7:30 am Triage and clinic begins
1:30 pm Clinic ends
2:00 pm Lunch and announcements
Free time **
6:00 pm Dinner and announcements
Free time **
*Free time can be spent with with community members in informal settings or used to conduct formal or informal training for community health workers or providing health information to community members.
Living Conditions
The weather in Ghana is hot regardless of the time of year but the humidity is the most striking aspect. During the dry season, from October through April temperatures stay above 90 degrees and water for bathing is often scarce. Electricity is water-powered, so occasional blackouts occur in times of drought. The rainy season, May through September, is slightly cooler, with nighttime temperatures in the 70s. The pace of life in Ghana is much slower than in the West, and simple things can take more time than visitors sometimes think they should. Among the many lessons that Ghana teaches is patience.
GHM team members live in church housing, which is clean but sparse. Two large dormitory rooms, each holding up to a dozen people, have only one bathroom apiece. The only personal space is the individual's bed. There is no privacy. Some people find this lack of privacy difficult; some have found that books or tapes of music can be helpful in providing some respite from day's activities and provide a “sense of privacy.”
The community is welcoming and appreciative of the hard work displayed by GHM team members, and they are eager to take good care of everyone. Indeed, they provide exceptional care. Laundry is done by hand by women in the church community every day. The dormitory rooms and bathrooms are cleaned daily. We are served three meals a day. The food choices are limited but plentiful, with a mix of African and American dishes. The staff will accommodate all reasonable dietary restrictions if given sufficient notice. Many participants bring food items that are important to their daily diets either for health reasons, personal preference, or as snacks such as soy items, peanut butter, raisins or nuts.
Ghana Health Mission Clinic
GHM offers at least two free clinic sessions per year on the site of the Pentecostal Revival Church in Sekondi. Groups led by Dr. McKenry go to Sekondi in March and August of each year. Another group led by Dr. Anita Hunter has gone in March and July. Nurses, nursing students, nurse practitioners, and nurse practitioner students, medical residents and attending physicians work together to provide medical care with the essential assistance of many from the church community who provide translation and other needs of the clinic.
The primary goal of the clinic is to diagnose and, if possible, treat acute conditions. GHM maintains a small fund in case patients require urgent treatment at one of the local hospitals. Although acute problems are the main focus, GHM has established an ongoing blood pressure clinic. If a patient is admitted into the program, GHM provides sufficient medication (hydrochlorothiazide) to last until the following clinic session. In between clinic sessions, the patients have blood pressure checks on the first Saturday of each month by an experienced Community Health Educator and Advisory Board member who can refer patients to local physicians if the need arises.
There are a variety of medical problems encountered. Many resemble the problems we see at home such as asthma, upper respiratory infections, urinary tract infections, musculoskeletal problems. The unique problems in this community are related to nutrition, sanitation, crowding, farming and fishing techniques, sand and sun exposure, heat, and parasitic infestations. Children often have malnutrition, developmental delays, physical development anomalies, anemia, skin infections, diarrhea and dehydration, tinea capitus, intestinal parasites, malaria, upper and lower respiratory infections, asthma, urinary tract infections. Adults have symptoms of dehydration (dizziness, headaches, weakness), waist pains (low back pain, arthritis), malaria, typhoid fever, filariasis, intestinal parasites, tuberculosis, tinea skin infections, hypertension, vaginitis, PID. You also may see leprosy, guinea worm, and other tropical diseases
Clinic Routine
Regardless of the site, each clinic is administered along the same routine so that providers can see patients efficiently and provide quality care. The number of patients that will be seen is determined by the number of providers available. Patients cannot be admitted to the clinic area unless a Community Health Educator has distributed a card indicating that the person can be seen. Thus, the community, not GHM, controls access to clinic health care. Patients pay a small admission fee that goes into a fund available for urgently needed medical care and administered by Rev. Andoh and the Advisory Board.
Once admitted, patients are triaged, demographic information, vital signs (including height, weight and blood pressure) and the three most important presenting complaints are recorded.
Each provider has a separate area. In Sekondi, these areas are small stations within a very large room. There is a small curtained area to be used for examinations that require the patient to disrobe, but the vast majority of patients can be seen at the provider's station. In other clinic sites, there may be individual rooms, some with beds and desks.
Each station or room is maintained with basic supplies for examination and treatment as well as commonly prescribed medications (e.g., ibuprofen, multivitamins).
Each provider and triage personnel is assisted by a Community Health Educator, whose primary job is to provide translation services. Several have been with GHM for most of its trips and are very experienced in how the clinics are run.
An average clinic day begins with breakfast at 7:30 am. Triage begins to admit patients at 8 am. Providers remain at the clinic until all patients are seen, usually ending by 2 pm when the team goes to lunch. While that may seem like a short day, the intensity of the work makes it a very full and productive time.
Free Time
There is a sufficient amount of free time built into the schedule so that GHM team members can explore the many opportunities Sekondi and Takoradi have to offer. With the help of community people this free time can be the most memorable part of the trip.
Some of the most rewarding times have been spent sitting and talking with members of the church in the courtyard in the early evening at the end of their day. Going to the local market is an adventure in itself. Listening to the choir rehearse for the upcoming Sunday service is inspiring. There is not a moment that is not full of potential.
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