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Health Around the World: PA Students Give Back in Ghana

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Think about your most recent trip to a physician’s office. Odds are that you took reliable transportation--your own car, a taxi, subway, public bus, or other vehicle--and were able to arrive at the office in under an hour, endure a short wait, and receive care and treatment from both a physician assistant (PA) and/or a doctor, in a sterilized setting with humming machines and modern equipment. 

But what if that wasn’t the case? 

Bay Path University PA students Courtney Perry G’18 and William Mohn G’18 recently learned in action just how different healthcare and medical treatment can be in other countries with fewer resources when they traveled to volunteer in Ghana with Assistant Professor Marie Meckel, PA-C. Meckel is passionate about the array of opportunities and experiences PAs can gain from connecting and collaborating with their counterparts across the globe, and had shared with Mohn and Perry’s class that she was connected with Wa West District Health Officer, Clifford Vengson, through a PA she had worked with in South Africa, and would be volunteering in Ghana over the summer. Interested in expanding their knowledge and experience beyond the classroom and country, Mohn and Perry asked to join Meckel on the trip and funded the opportunity themselves.

“In the Wa West region of Ghana, the doctor-to-patient ratio was one to over 91,000 in 2016,” Meckel said. “With so few providers, but a wide range of unique illnesses and health issues to address, we saw an opportunity to get involved and give back while also broadening our own understanding of the healthcare field.”

The group’s overall goal was to learn more about public health around the globe, and how resource-poor countries tackle healthcare issues head-on, as well as the most pressing needs.

“Will and I made it our goal to learn all that we could about the healthcare system, medicine, communities, culture, language, traditions, social-construct, and family dynamics. We wanted to know how we could be most helpful, first aiming to identify the healthcare needs of the people in the communities we were visiting, and if there was a realistic role for us in helping to meet those needs,” Perry said. “We spent a lot of time observing and asked a huge amount of questions. I think it was immediately clear to all of us how strongly we felt about the importance of building this relationship and collaborating with the community.”

Vengson worked tirelessly to ensure that the travelers had access to all of the health facilities and safe transportation to get there.  

“The first few days were spent traveling around the district with Clifford, who introduced us to all the healthcare workers and showed us around the clinics,” Perry said. “Additionally we were expected to meet the Paramount Chiefs (the highest-level political leaders in Ghana), and we had to get their permission to ‘walk on the land.’ They wanted to know what we would be doing and how long we would be there.”

After that, Mohn and Perry spent their days with either of the only two physician assistants (PAs) in the district, seeing patients with them at the clinics and assisting with the treatment of the most common illnesses--malaria and snake bites.

“On a typical day, we would gear up and travel to a remote health facility – usually 45 minutes away or more,” Mohn said. “There, we would talk with and observe midwives, community nurses, public health officers, and the two PAs. Most of the patients we saw in the clinic were young children being treated for malaria. However, we also saw a lot of prenatal visits.”  

In fact, the group learned that teenage pregnancy is a pervasive healthcare issue in Ghana. Beyond their time in the clinics, Perry and Mohn took part in public health outreach with the health teams who frequently gathered whole communities to talk about this issue, among others including the importance of children staying in school, the use of mosquito bed nets, contraceptive options, and more. Mohn, Perry, and Meckel also worked with UMass public health student Debi Christens to accomplish surveys and focus groups specifically about local opinions around the growing problem of teenage pregnancy.

“Deb put a lot of thought into the organization of these group and the specific questions that would be asked,” Perry said. “These groups gave us great insight on social normal and beliefs and traditions which play a role in maternal health.”

In their daily work, Mohn and Perry learned perhaps the most significant public health challenge in Ghana is the inaccessibility of health services.

“The [healthcare providers] do the best they can with very limited resources. There are many barriers to healthcare in Ghana, including lacking reliable transportation, for both providers and patients,” Mohn said. “Many residents walk to their destinations, and the nearest clinic might be six hours on foot. It really forces them to decide if their sickness or that of their children is worth missing a day of work, for example.”

This motivated Mohn and Perry to leave behind a lasting contribution of replaced and repaired motorbikes, made possible by their substantial fundraising efforts prior to the trip.

“We learned from Clifford that the district had 62 unusable motorbikes that were limiting the amount of home visits they could do,” Perry said. “Will and I agreed, this was an area where we could really make a difference, and were able to repair 45 bikes and purchase one new bike.”

An impact report from Vengson details the impact Mohn and Perry’s contribution had on the effectiveness of the transportation unit:

“The vision of the transport unit is to provide an effective and efficient transport management system for improved service delivery. As part of strategies to attain availability and utilization of transport for service delivery, the district health administration embarked on repairs and maintenance of sub-district motorbikes. The district has weak and aging motor-bikes constituting eighty percent (80%) of the total fleet. Some health facilities do not have motor-bikes to carry out outreach services and health staff in these facilities have to rely on their personal motor-bikes or private means of transport to carry out health services.

The District Health Administration was fortunate to receive financial support from health professionals (friends/partners) from the United States of America. The team supported the district with number of health delivery equipment including a projector, two (2) laptop computers and others. The team bought a new motorbike and supported in repairs/maintenance of broken motorbikes. The team again supported with cash for servicing, repairs and maintenance of motorbikes to strengthen the transport system of the district to improve service delivery.”

For Mohn and Perry, the biggest takeaway from this experience was the lasting relationships they built.

“Each day, we would take time to share a drink and a meal together alongside our new Ghanaian friends. We also spent some time in the villages wandering through the markets and taking in the lively and friendly culture. We made important connections and lifelong friends on this trip,” Mohn said.  

Perry added, “To describe the Ghanian healthcare workers as dedicated would be an understatement. With most of them working seven days a week and answering phone calls at all hours of the night, never complaining, just trying to make the best decisions possible to help the patient, their passion for their work and genuine kindness is deeply inspiring. We became very close with Clifford, the PAs, nurses, and other healthcare workers, and have been keeping in contact with some of them through WhatsApp since returning to the USA.”

Perry and Mohn agree that returning to Ghana in the future is in their plans.

“This experience affirmed for me the important role that PAs play in the setting of a clinic and the importance of patient education,” Perry said.