By: Madeline Kubiseski, Dalhousie Master of Health Administration student

Fourth-year Dalhousie Medical students, Allan Kember, Madeleine Böhrer and Kirsten Kukula, recently returned from a remarkable experience in Ghana, West Africa. The three students chose to do a global health education experience, which landed them at the Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Accra is located on the Atlantic Coast of West Africa and is home to an urban population of approximately 2.3 million. The KBTH is the third largest hospital in Africa and is associated with the University of Ghana.

Under the supervision of Dr. Jerry Coleman, a Consultant Obstetrician-Gynaecologist at KBTH, the three students spent 3-5 weeks in the Obstetrics and Gynaecology Department. The students were immediately amazed by the size of the hospital, with the Obstetrics and Gynecology Department having over 350 beds in total. Likewise, the Department provides care for thousands of patients, with roughly 12,000 deliveries each year – almost double the volume of deliveries at the IWK Health Center in Halifax. The students spent their time observing, examining, and learning from the staff and medical residents at KBTH. They returned to Canada with an enhanced understanding and appreciation of OBS/GYNE and the delivery of medical care in a healthcare system different from their own.

During this clinical elective, the students learned alongside medical students from Ghana and various countries around the world. In comparison to what they were accustomed to, Allan, Madeleine, and Kirsten observed the provision of care with a higher volume of obstetrical complications and emergencies, alongside less resources to manage them. They emphasized the seemingly profound and routine ability of staff to apply clinical experience and skills to carefully select or avoid further tests and imaging. This was all the while optimizing quality of care and being acutely cognizant of the competing factors for limited resources. In addition, the staff work collaboratively to enhance patient wellbeing and safety while maintaining efficiency. This was evident through the expanded roles of midwives, nurses, and other health professionals at KBTH in the delivery of obstetric care and was tremendously inspiring for the students.

Furthermore, Allan, Madeleine and Kirsten commented on the sense of community at KTBH between families, patients, staff, and healthcare providers. Providers, families, and friends are considerate of the healthcare related costs that patients may face and will ensure that the appropriate care is provided even if that means helping the patient to pay these costs. Additionally, family members are usually present supporting their loved ones and they are an integral part of the patients’ care, which is similar to Canada. During their time at KBTH, the students witnessed the medical community come together to develop a solution to increase blood donations to the blood bank. Within two weeks, the department organized a blood donation site in the Obstetric Outpatients Department where family members of patients can donate blood while accompanying their loved one to their antenatal care appointment. All three students were impressed by the KBTH’s adaptability and capacity, as a community, to quickly develop and implement solutions to pressing issues.

Outside of the hospital, the students had the opportunity to explore another part of Ghana. One weekend, they travelled to Wli falls in a public minibus/taxi known as a Tro Tro, a common form of transportation in Ghana. The Wli falls are the highest waterfalls in Ghana and the second highest in West Africa, measuring approximately 143 meters. Accompanied by a local guide, they hiked to the Upper Wli Falls. They spent the weekend at a wilderness lodge enjoying the local food, beautiful nature, and the peacefulness outside of the hustle and bustle of Accra. Experiencing the Volta region of Ghana was well worth the ten-hour journey there and back.

In describing how this experience relates to their current studies and their future as clinicians, Madeleine expressed her continued desire to be involved in global health. She wanted to further her understanding of how cultural factors can influence medical care and she will use this as she moves forward into her residency in Pediatrics. Likewise, Kirsten has an interest in providing care in rural and remote communities, and was eager to learn more about provision of quality care with limited resources. She was reminded that we are often too focused on the resources we do not have, instead of recognizing the clinical skills and knowledge we possess. She looks forward to using the lessons she learned at KBTH in her Family Medicine residency. Lastly, Allan, who will be completing a residency in Obstetrics and gynecology, agreed that the exposure to a different system of healthcare was invaluable. All three students emphasized the awareness that “global health starts at home”, and they plan to carry the knowledge gained from this experience with them in their future practices as clinicians.

Allan, Kirsten and Madeleine are all very excited about the possibility of returning to Ghana in the future. They thoroughly appreciated the educational experience and they already miss the copious and daily fresh fruit and coconuts, the friendly and welcoming people, the beautiful clothing, and the balmy weather. They would like to thank the MD Class of ’72 for the travel bursary that made this experience possible, and to Dr. Heather Scott and the Global Health Office at Dalhousie Medical School for their support from home. Lastly, they would like to thank Dr. Jerry Coleman for his warm hospitality and guidance at KBTH.

For more information on the MD Class of ’72 travel bursary

For more information on global health education experiences