GLOBALHEALTH
Blogs from
Abroad
GHANA
Making a Difference 5,365 Miles from Durham
Ilhan Eli, MD
FELLOWSHIP CLASS OF 2023
I
n February, I had the incredible opportunity to participate in my very first global health trip to Ghana. The experience left me with unforgettable memories that I will always cherish and that have had a positive and lasting impact. During the two-week trip, we spent half of our time at Tema General Hospital, where we focused on improving maternal care during and after cesarean delivery and gynecological procedures. One of the most significant lessons we taught the care team was appropriate dosing for intrathecal opioids and utilizing multimodal analgesia for postoperative pain control. Additionally, we helped change the current practice of having mothers lie flat for six hours post-cesarean to prevent spinal headache and hypotension, to having them sit up immediately in the Post-Anesthesia Care Unit to help facilitate neonate bonding and decrease Neo-
natal Intensive Care Unit admissions. Overall, the nurse anesthetists were very appreciative and open to receiving helpful tips on how to improve care for their patients. We were able to witness practice changes happen in real time after our training sessions. During the second half of the trip, we spent time observing the anesthesia teams at the Greater Accra Regional Hospital and taught very bright anesthetist students about blood products, respiratory mechanics, monitors utilized in the Intensive Care Unit, and burn management at the Ridge Hospital Nurse Anesthesia School. While in
Drs. Eli, Olufolabi and Ernst; Dr. Eli teaching about blood products.
54
| DUKE ANESTHESIOLOGY
the operating rooms, I witnessed firsthand how the hospital staff made the best use of their limited resources. Even with limited supplies, they managed to think about the big picture of utilizing their resources to provide for the population of patients instead of giving one patient all the medications they had available. I also witnessed the use of thiopental for induction during a case, which is a drug I have only ever read about in anesthesia textbooks. Furthermore, it was interesting to see how the hospital systems are structured and how patients are supposed to pre-buy most of the medications they will need for their procedure, as well as bring in items from home including clothes, sheets, food, and toiletries prior to admission into the hospital. It was an eye-opening experience to see how they can make do with what they have. Outside of the hospital, we were able to explore the city of Accra. As a group, we experienced the enriched cuisine, culture, art, music, and most importantly, the traffic. My interactions with the Ghanaian people were nothing short of positive. They are very welcoming and hospitable. We visited historical sites such as Kakum National Park, Elmina Castle (the biggest slave castle for transatlantic slave trade), and the Ghana National Mosque (the second largest mosque in West Africa). Dr. Adeyemi Olufolabi was kind enough to arrange for me to pray with the Muslims in Accra in the Grand Mosque on a Friday, which is the day of worship for Muslims.