Exchange In Ghana

IFMSA SCOPE Exchange in Accra, Ghana ~Akito’s Diary 2007 Spring~ 1.Standing Committee on Professional Exchange (SCOPE) 2.The aim of SCOPE

3.General information about Ghana 4.Exchange in Ghana 5.Junior Clerkship in Kore-Bu Teaching Hospital, UGMS 6.Duty night!! 7.Community Health Training 8.Public Health Department in VRA 9.Doctors in Ghana 10.Health System in Ghana 11.Why Ghana is stable for 50Years? 12.Independence Day!!! 13.FGMSA Annual Congress 14. Hostel in Ghana University 15.Mass in Ghana 16.Flea market

1.Standing Committee on Professional Exchange (SCOPE) The Standing Committee On Professional Exchange (SCOPE) is the first created IFMSA Standing Committee. It constitutes the largest exchange program within IFMSA and it has been running since the organisation's foundation in 1951. 2.The aim of SCOPE The aim of SCOPE is to promote international understanding and co-operation amongst medical students and all health professionals through international exchange of students. The exchange program offers students unique educational and cultural experience in addition to the regular medical curriculum. It also helps to broaden the students understanding of medical and social conditions in different countries. Currently over 6 600 international exchanges are made every year, and 78 countries

throughout the world are taking part in SCOPE. The Professional Exchange is defined and regulated in the Standing Orders of SCOPE. A professional means an exchange of a medical student who undergo a medical practice in a hospital abroad. This practice, named clerkship, is purely educational for the student and he/she will not receive a salary for it.

3.General information about Ghana The Republic of Ghana is a country in West Africa. It borders Côte d'Ivoire to the west, Burkina Faso to the north, To go to the east, and the Gulf of Guinea to the south. The word "Ghana" means "Warrior King",[3] and was the source of the name "Guinea" (via French Guinoye) used to refer to the West African coast (as in Gulf of Guinea). It was inhabited in pre-colonial times by a number of ancient kingdoms, including the Ga Adangbes on the eastern coast, inland Empire of Ashanti and various Fante states along the coast and

inland.

Trade

with

European

states

flourished after contact with the Portuguese in the 15th century, and the British established a crown colony, Gold Coast, in 1874.[4] Upon achieving independence from the United Kingdom in 1957,[5] the name Ghana was chosen for the new nation to reflect the ancient Empire of Ghana that once extended throughout much of western Africa.

4.Exchange in Ghana Expenses: about 300EURO/month (exchange office covered accommodation and lunch) Facilities: Room-share, Shower-cold and sometimes no water, Student’s Lunch-no vegetables except for local food but fine, Computer- available, Internet-LAN and WiFi available(I could use Skype!), TV-Cable TV available Water: mineral water needed Food: some good and reasonable restaurants near by hostel(You can eat vegetable there!) Shopping: Small shops are in the university for your daily needed Anti Mosquito: You can buy anything here except for Anti-Malaria Medicine Security: Inside the university is very safe and outside also safe except for night Weather: Basically hot in March but sometimes cold after raining Clinical Training over view (Obstetrics and Gynecology ):

Monday: Clark and Physical Examination in Gyne Clinic Tuesday: Observe operations in Theater Wednesday: Clark and Physical Examination in Antenatal Clinic Thursday: Ward round in Gyne Dep. Friday: Ward round in Obst Dep. Time line: 8:00~9:00: Morning Lecture all together 9:00~13:00: Clinical Training Afternoon: Clark your own patients in Wards +A duty in Delivery Theater / week +Some Tutorials Type to training: You will join a group of Local medical students (6th year) Events (My case in March 2007 ) 1-Arrival 2-See Drama in Main University 4-Beach!! 5-Independence eve fireworks 6-Independence Day (50th anniversary in 2007) 12~16-Community Health Activity 17~18-FGMSA Annual Congress 22~23-Visited Private Clinic 24~25-Travel to Cape Coast and National Park 27-Visited Noguchi Memorial Institute and WACIPAC Office 30~31-UGMSA Annual Congress 31-Departure

5.Junior Clerkship in Kore-Bu Teaching Hospital, UGMS We had clinical training in Kore-Bu Teaching Hospital which was located next to UGMS. They have medical school for 7 years and 1st year, they studied basic science and before 2nd year they have exam to be selected as Medical Students or other College students. 2nd, 3rd and 4th year they study medicine in lecture room and 5th, 6th and 7th year are clinical training finally (Junior clerkship training). They rotate 8 months/department and divided

to 8-9 students / group. They have morning lecture with all and then spread out. My department was Obstetrics & Gynecology department and I jointed with the 6th years medical students’ group. At first I applied Family

medicine

and

Community

health

department, but the department was small and they suggested me to be the department. In addition, I were also in part of Fever Unit(HIV/AIDS,

and

other

serious

fever

patients there) , HIV Child Clinic( Unit for Children who are infected HIV through mother), and Community Heath department. The training we received were similar as Japan; physical exam, see and talk with patients, present it to cuter or chief of the unit, lecture, and see delivery. The funny thing was that the students’ behavior was also the similar as Japan!! For example; doctors asked us a lot of questions very fast and we answer

but

sometime

no

try to

idea….and

doctors complain about that. They had exam next week and really didn’t want to go to the round and chief of the Unit disappointed so much and say” I had never be impressed with the group!!! And students also complained that they didn’t understand

how

exam

was

difficult…something like that. Medical students are the same all over the world.

6.Duty night!! Our group had duty, “Toucyoku”in Japanese in Obsti & Gyne Department. We stayed in Gyne Emergency room and Delivery Theater whole the night to assist delivery. The room was more realistic atmosphere than my teaching hospital in Japan. Pregnant women were screaming, praying, some babies are miscarriage or abnormality, horrible bloody smell, and only one operation room for Cesarean Section (Teiou Sekkai)……here was the place that human live starts. The biggest different here was that they didn’t use anesthesia, and because of the pain they were screaming very seriously. The funny thing was that midwife gets mad and

beating pregnant women during the delivery but still pregnant women gratitude her and gave some gifts. Berth was very cerebrate event here and people working here got high reputation from patients and high income. That’s why a lot of doctors wanted to chose Obst&Gyne as their specialty in Ghana. This situation is completely

different

compare

with

Japan……they are not respected, low salary, too much work, high risk (to be sued by patients), and nobody wants to specialize the department. It’s really serious problem in Japan currently, because of the lack of doctors and midwives some hospital close Obstetrics department and pregnant don’t have place to delivery. When I told the situation to medical students in Ghana, they were surprised and wanted to go to Japan as doctor!!!

7.Community Health Training I went to Aksomblo which was the middle part of Ghana and near by Volta Lake. Since all the 6th years’ medical students had exam and I chose Community Health Department’s activity in ARV Hospital for a week. ARV hospital was a private hospital which covers Alsomblo and cooperate with Kare-Bu Teaching Hospital for Community Health. The facilities and services of this hospital were good quality and clean. I stayed in Reproductive Health and Child Unit and Public Health Unit for each 2 days. In the RCH unit, we had weekly check of pregnant women and school health. We checked their urine for suger and keton, general condition of infant and mother, and gave injections. They had Maternal Health Record Book, Family Planning Book, and Child Health Record Book. They are kind of

Mother

and

Child

Book,

“ Boshitecyou” in Japan. They had such record books for a long time. I was surprised that the health care system in this county is quite good!! 2nd Day, I went to primary school to examine school children. It was really nice, because I hadn’t had such a experience in Japan and it had a lot fun to examine them. When I entered into the classroom, their face looked really curious to see foreigner. The funny thing was that when a nerse say “Good Morning and How are you doing?” to them, they replied just like copy machine “ Good Morning” and “ I’m fine thank you and you?”. Yah, it’s typical school students. I examined as general systematic examination and found some patients; anemia, diarrhea, abdominal pain, ear pain, and skin disease….etc We gave advices to them to come to our hospital within a week. They were very quite silent when I examined and looked very shye…and their English speaking ability were not so high at this moment. There was a paper on the wall “Speak English!!” and if they won’t speak, they will get punishment. It sounds serious, right?

8.Public Health Department in VRA VRA is a Public Sector which covers around Volta river and the dam. There were some departments in VRA and one of it was Health Department. The health section were VRA hospital, and Public Health Dep( lake side health unit and environmental sanitation) The Public Health Department in VRA deals with Aquatic need, Bilharzioma, Mobile health services, Water pollution control, Disease vector pesh control, and life style disease management. The reason why they had these activities was completely different environmental changes river side because of the dams and they had responsibility to monitor and control the side effect. They visited community around the river and if they fiound some problems, they tried to solve them or gave advice to the community to solve them. Especially the things I was interested in were mobile health and Disease vector pesh control. They use

ship and visit and provide medical treatment in very small villages which didn’t have health sectors and give health lectures to villagers. It took for about 2 weeks and medical students also joint the activities. (Unfortunately, I couldn’t have time to join this time….) I felt that it’s exactly, community health activity. Today, I went to the river side village to collect some samples of Bilharziosis (a parasite disease). The parasites live

on the small shells as intermediate host and it also contain

polluted water by the parasites. If you drink it, you will get it and have some kind of diseases. Since the parasite makes serious damages to people living there and also tourism around the river, the prevention is needed. So we went to some community to collect sample and based on the result, give advice to go to hospital or change the place to collect water,

and

provide

some

health

education.

9.Doctors in Ghana According to the paper of New England Journal, a lot of Young doctors work abroad in Ghana.(http://content.nejm.org/cgi/content /full/356/5/440) The number of doctors was not enough here and young doctors abroad was one of the reasons. I also thought that only 3 medical schools was also the reason)

I asked some

medical students in University of Ghana Medical School why you want to go abroad. There are following reasons; 1. Low salary (Public Hospital) 2. Not enough facilities in the public hospital 3. Easier to get high position in Ghana after working or researching abroad Main country they apply was U.S.A because of a lot of opportunities there. It was also a lot of Ghanians in UK before, but because of some changes in the working condition it’s getting very difficult to apply there now. Basically, they won’t think to work abroad all

their life and would back to Ghana around 10 years. Normally, they would apply Private Hospital, Open the private clinic, and position in teaching hospital. They felt that they didn’t want to work all their life abroad and desire to come back here with high skills and a lot of money to start working. I also asked them if they were satisfied with Medical Education in Ghana. They felt fine as medical students, but as doctors they need more high facilities; CT, MRI, 3DCT…etc.

10.Health System in Ghana We had party in one of the Doctor’s house. The house was really huge and it’s just amazing. I heard that doctors in private hospital earned a lot in Ghana much more than private hospital. Normally, private hospitals

were

founded

by

European

Company. The quality of these hospitals was much better as Europe and a lot of doctors who came back from abroad to apply for these hospitals. I also heard that there was National Health Insurance in Ghana but there were some levels of the insurance and it’s depend on how much you could pay for the insurance….it’s different from Japan. I couldn’t heard more details and try to ask public health doctors to explain more details about the Health system here later.

11.Why Ghana is stable for 50 Years? It’s big question during my staling in Ghana. You see around Ghana, these countries face serious poverty and unstable political situation. (Of course unsafe!!). Compare with other African countries, Ghana is very safe, well developed, very stable government, and stable local currency. During my staying, I asked a lot of people about the reason and these are some answers; * No conflict between tribes (possible to get marry with different tribe here and not strict

regulation) * No conflict between religions (possible to get marry with different religion even if he is Muslim!!) * Strong Nationality (all of them love Ghana) * Independent tendency (they want to solve problems by themselves and not rely on others) * A lot of good reader( Kofi Annan, ex-secretary general of UN, is Ghanian and J.A.Kufuor, President of Ghana is also chair parson of African Union) * They prefer to discuss rather than fighting * Not enough natural resources past 50 years(Less risk to be invaded by others ) * The first independent country in Africa * Only one English speaking country around this area(Prevent people living this area to enter this country because of the language problem) * The existence of river which is available for hydroelectric power generation and other factories ****They are not from academic research and no responsibility on the contents...... The image of Ghana is completely different than I have expected. It’s stable and safe country. Although the 40% of National Budget of this country rely on ODA and other Multi-lateral funding, I hope this county will develop and be a good leader of Africa in the future….

13.Independence Day!!! Ghana was independent 50 years ago (6 March, 1957) form UK and they had independent day every year, but this time was the biggest one. We woke up 6AM and went to the Independent Square and saw ceremony of the anniversary. There were so many

people there and dusty…. as I could see anything except for people.……The President’s speech should start at 9AM, it was too late and we just decided to go back home. I putted on Ghanian Flag and 50th T-Shirts there and most of them also did so. The place was filled with Red/Green/and Yellow colors. * After going back to our hostel, I realized that almost all the medical students were in the hostel and just watched TV. One of my Ghanian friends told me that medical students in this country were not so active and were prefer to stay home. *Their flag was red/yellow/green with Black star. The meaning

was

a

independent/Gold(Ghana

lot

of

produced

fighting a

lot

before of

Gold

before)/agriculture with hope of Africa.

13.FGMSA Annual Congress We

had

FGMSA

Annual

Congress

(Federation of Ghana Medical Students’ Association) in Ghana University. In Ghana, there were only three medical schools and 3 of them are active members of this organization. Of course, this was the NMO of IFMSA in Ghana. I wanted to see the different style of conference from IFMSA and IFMSA-Japan, I attended almost all the events. We had Business Meeting (Plenary meeting), Debate match, sports games (Football and Volleyball), BBQ party, and Mass( they are Christian). In FGMSA, Ghana Uni Medical students and Kumasi Uni Medical students always competed each other in the plenary, debate, and games…..Actually, they didn’t have Standing Committees’ meeting and it’s one of the disadvantage in this NMO. But now they are very motivated to set up SCORA (Reproductive Health inc’l AIDS) and hopefully the make it.

14. Hostel in Ghana University The hostel I was staying was the same as other medical students in Ghana University. 90% of them were in the hostel. The condition of the Hostel was not enough compare with western countries, but felt confortable and safe. I set up mosquito’s net, mosquito’s coil, mosquito’s

spray,

and

take

Mararon(Anti-Malaria pill) in order to prevent Malaria. The electricity condition here was not good enough….it stopped sometimes and the most worry thing was that hospital did’t have reserved battery. How are they doing if it stops during the operation or using respirator……medical students complain about that. Water condition here was also not good enough….it also stopped sometimes. So we had to collect water in tabs and used it for bath. About drinking water, of cause I bought mineral water for safe. About temperature here, it’s the end of the dry season and it’s really hot & dry. (about 36 degrees)

15.Mass in Ghana I went to Church to have Mass. As you know, Ghana was a colony of UK and 60% of people are Christian (Chatric and Protestant) . Ghanian Mass was a little bit different from Japanese (and European) one, sounds like typical African’s!! The order was the same and I thought the father’s lecture was a bit long, but the music was really great. They played local drums and sang songs very strongly. It’s the good example of the style of religion is changed by the local culture. The content of his lecture was something about Love. Between man and woman, and god and us. I heard the same lecture before in Japan and I thought he cheated the contents somewhere.

16.Flea market I went to the flea market to buy some staffs for 50th Anniversary of Ghana independence’s day. The market was very crowded and smelled spice and fish. All of them said “welcome to Ghana!!” I bought T-Shirts for 50th Anniversary and flag of Ghana. I think it’s enough for 50th Anniversary. About food in Ghana, they eat a lot of meat and don’t eat enough vegetable. It’s not nice for me and I missed vegetable. I thought they had so many cardio vascular diseases, but not so much as I had expected. Maybe they had something good enzyme to reduce Cho….I envied them. About Foot ball in Ghana, they really liked it and they were all in TV room to watch it all the time in the weekend. I’m sure football was the most famous national sport here.