I was fortunate enough to go on an international exchange organized by the International Federation of Medical Students (IFMSA) to Ghana for four weeks this past June. I completed an internal medicine elective at a teaching hospital in Kumasi, a city of two million people. I choose to go to a lower-middle income country because I wanted to experience healthcare delivery in a resource-limited setting. Medical care is restricted to some extent everywhere, but in Ghana, compared to Canada, there are additional challenges.
Despite having a new emergency department, the hospital in Kumasi is extremely overcrowded. Patient beds are lined up next to each other regardless of the patients’ medical complaints; this overcrowding increases the risk of hospital-acquired infections. While I was there I was mindful of my role as a learner and I received excellent teaching, but in the area of infection control, I inadvertently passed on my own knowledge. One of the few pieces of information I imparted was unknowingly through using my personal alcohol sanitizer between patients. The consultants (attending physicians) admired this practice and quickly implemented better hand hygiene practices for their medical teams as a result.
Another challenge in Ghana is patient fees, a well-documented barrier in many healthcare systems. In Ghana, fees are charged to most patients for their stay in hospital; however, there is national healthcare insurance, albeit limited, for some select populations. Without universal healthcare coverage treatment options are limited by the patient’s ability to pay; consequently, the financial circumstance of each patient factors into his or her medical care. The resource limitations and financial constraints are major determinants of how medical care is provided. Medical care wasn’t presented as a commodity as in the United States, but more as a limited resource that can only meet the very basic medical needs of patients.
Two of the many lessons I learned as a result of my experiences in Ghana are
- to foster reciprocity between healthcare professionals
- to be resourceful within systemic constraints, but advocate for a better standard of care
Students interested in Global Health electives through the IFMSA and CFMS can get more information here (http://www.cfms.org/). Application deadlines are usually in late September or early October – deadline to be announced soon!
The global health office also offers international electives to students in Med 1 & 2, Nursing and Pharmacy. Applications are due Nov 24, please visit our global health education page for more information.