But the greatest health improvements may not arise in Kumasi or its teaching hospital. They may come from 15 miles away, in the subdistrict surrounding Barekuma.
The relationship that links the two locales involves Ansong. After he treated and saved the life of a severely ill infant suffering from a secondary infection due to malaria, the grateful chief made him an honorary village member. When Hale’s students arrived in Ghana in 2003 and 2004, Barekuma was a place that Ansong wanted them to visit.
For Ghana’s Ministry of Health, places like Barekuma are where the rubber meets the road. Facing daunting challenges to rapidly improve maternal and child health, the government is prioritizing efforts that produce the biggest return.
As Alder puts it, this is where visitors work “to unlock human capacity in order to make a lasting difference in people’s lives.”
The community approach involves economics, agriculture, education, sanitation and public health. By collecting data through annual child health assessments, health care providers chart progress.
Geographic information systems mapping makes it possible to plot the home of every family, comprising roughly 30,000 individuals. Researchers can overlay malaria cases to determine if kids living closer to a river get more malaria than elsewhere. They can even monitor and factor in the use of bed nets (used to block mosquitoes from biting) and gauge effectiveness. Annual child health checkups — just as in America — provide data on how immunizations, diet and access to clean water contribute to better health.
Providing community health care requires community health workers. The Barekuma project and others identified the need for a training program for medical assistants — akin to the physicians’ assistants now so widely used in American health care delivery. Again, the U. medical providers are assisting.
“Collaborations like this are transforming the landscape of how health care delivery is even thought of in Ghana,” says Alder. “If we let it, the rebound will transform how we do health care delivery in the U.S. as well.”
KATH administrator Awuah calls the Barekuma effort “a really big boost to our efforts. We want to spread this project as an effective way of preventing the diseases that are killing women and children in our country.”
How does he see the future?
“Brighter and brighter, as long as we here in Ghana follow what I believe is the most important rule: tell the truth about the way you see things.”
At the U. medical school, Hale is not resting on his laurels. Building on the lesson of “don’t tell us what you’ll do for us, let us tell you what we need,” he is already expanding relationships in Lima, Peru; Hainan, China; Bangkok, Thailand; and Baroda, India. Each year, there are more overseas opportunities for University of Utah medical students, residents, doctors and nurses.
As impressive as the global outcome may be in the future, it can’t mean any more to these Utah health care providers than just one incident I observed at KATH.
I was standing with Dr. Daniel Jackson, a gastroenterologist, and Mary Jo Grant, a pediatric ICU nurse, outside an old wing of the hospital. They were waiting for a doctor to meet them and take them to see a patient.
Jackson and Grant have perfected a way to provide nutrition to a very ill baby or young child without having to deliver it through an I.V., which can be difficult and dangerous to do in Third World facilities.
They thread a soft, slim tube through the patient’s nose, down into the stomach, through the pylorus valve directly into the intestine, allowing the delivery of liquid nutrients. The day before, they’d shown the ICU staff how to do it for a sick baby. Afterwards, Grant placed a small teddy bear, taken from her backpack of toys, next to the child’s head.
As we stood on the hospital walkway, a young Ghanaian couple approached. The man, smiling broadly, identified himself as the father. He thanked the doctor and nurse profusely. He had just been to see his much-improved baby. He promised to cherish and preserve the teddy bear so that when his child was older, he could tell him how “the kind white lady had come to his aid and helped make him well.”
It was low-cost medicine with a priceless outcome.
Alyson Heyrend is a Utah native, who studied music and journalism at Utah State University, interning at the Deseret News while in college. She has two grown daughters who are both studying medicine. She's worked since 2001 for Rep. Jim Matheson.
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