Rheumatic Heart Disease – Renewed Attention to an Old Problem

Rosalyn Adigun, MD PharmD 2013 Graduate, The University of Texas Medical Branch at Galveston

Rheumatic Heart Disease – Renewed Attention to an Old Problem-Ghana 2013

Rosalyn shares:

“During my second visit to Korle-Bu Teaching Hospital (March — April 2013),  I was interested in evaluating the burden of Rheumatic Heart Disease (RHD) diagnosed via echocardiography  in the patients at the National Cardiothoracic Center located on the grounds of Korle-Bu Teaching Hospital in Accra Ghana.

Rheumatic heart disease (RHD) remains a major cause of cardiovascular morbidity and mortality in developing countries and with the transatlantic migration of people for various reasons, it is increasingly important  to implement better surveillance by health care personnel  in developed nations.  Although the preceding infection Acute Rheumatic fever (ARF) and RHD are rare in developed countries, they pose major public health problems among children and young adults in developing countries where these diseases are endemic with their most devastating sequelae presenting during the most productive years of the affected population.

The objective of my project was to evaluate the burden of RHD in Ghana by evaluating the echocardiography data in patients evaluated at the National Cardiothoracic Center Accra Ghana between November 2010 and November 2012. I was able to review over 9000 echocardiograms conducted during this period, and the World Heart Federation criteria for echocardiographic diagnosis of RHD was used to determine if a patient met the criteria for RHD.

While there are still limitations to capturing the real burden of the RHD in Ghana, this information learned from the project will provide evidence-based information to clinicians in educating patients, establishing surveillance programs, and providing better care to patients presenting with RHD. I hope to submit an abstract of my research findings for publication in the near future.”

KBNF Recognizes UTMB Research Students

The Korle-Bu Neuroscience Foundation (KBNF) Recognizes Students from the University of Texas Medical Branch (UTMB) at Galveston who have performed Health-Care Research in Accra, Ghana.

A goal of the Korle-Bu Neuroscience Foundation (KBNF) is to encourage student interest in the continued development of healthcare and medical research in West Africa. As Chair of Research for KBNF, as an Associate Professor in the Department of Neurosciences and Cell Biology and as a University of Texas Distinguished Teaching Professor, I find it significant to inform students of the importance of viewing healthcare, education and research on a global level.  I relay to them my experience with the KBNF, in regards to assisting in creating a team to develop a neuroscience research program at the University of Ghana.

We want to recognize the outstanding students from UTMB who dedicated their time and service to contribute to health-care and research in West Africa. I served as a faculty mentor to the students listed below and The Global Health Program at UTMB provided financial support and additional mentoring to the students for their travel to Ghana. Posted on our website the coming week are comments from Rosalyn Adigun, MD PharmD,  Roslyn Oduro and Amara Uzoma-Uzo regarding their experience in Ghana. We congratulate these ladies for their unselfish commitment to others.

Lisa Cain, Ph.D.

Chair, Research for the Korle-Bu Neuroscience Foundation

Techiman and Nsawkaw November Mission Visit

Samuel teaching in Techiman

Marj’s visit to Ghana in late November 2012 got Jocelyne and me involved in a flurry of fruitful ventures. Notable among them was our visit to Techiman and Nsawkaw, two towns located in the upper section of Ghana.  The visit was upon the invitation of Dr. Kessie, a great volunteer who had been the proud recipient of a container full of medical equipment from KBNF on the behalf of the Nsawkaw government hospital.

Dr. Kessie, who hosted us, drove us to the Nsawkaw hospital for a firsthand look at how the beds and other donations from KBNF had been utilized.  Apart from a few broken beds, most of the equipment was still in use in the hospital. The hospital had also generously donated some of beds to another needy hospital close by.

We had the opportunity of visiting Dr. Kessie’s private hospital as well as his new 100-bed hospital, which is at the final stages of completion. Jocelyne and Marj gave him some general insight about the structure as well as how to get the community behind him in support of his efforts.

Much as he is running a private hospital, its apparent he is also running a charity given the endemic nature of poverty in the area and the high demand for health care.  He however serves his community with his heart, and that has greatly endeared him to the people. It is most probable that his new 100-bed hospital might turn out to be the toast of the area in the near future, provided he implements some of the good counsel Marj and Jocelyne have graciously offered him.

Nonetheless, there remains many avenues to touch the heart of the community through generous support to hospitals in that area. It is in the light of this that Dr. Kessie appreciated the suggestion to ship a container of medical supplies to his hospital. He willingly agreed to find the resources to pay for the shipping costs and clear them on arrival in Ghana.

One feature of the visit was a three-hour teaching session of two groups of students in care giving from Dr. Kessie’s school. They received insights into radiology, life-saving basics in health care and some of Danny’s Heart Power lessons.  I am convinced that they will long remember their encounter with the two Canadian ladies and a gentleman from KBNF, as much as we ourselves will cherish that memorable visit.

Ghana Mission Post 14 – Mount of Olives Hospital

Dr. Gladstone Kessie, KBNF Board members and Gladstone's staff

Two weeks ago, Jocelyne Lapointe, Samuel Ampen-Asare, and I headed up to Techiman, a city of 5,000 in the Brong Afahu region, in the interior of Ghana. We flew up to Kumasi, then headed north, a two to three hour drive along a beautifully paved road. I noticed groups of people, mostly women, gathering up garbage in piles along the roadsides along the way. I learned that the government has a program to deal with garbage, paying citizens a small amount to retrieve the trash.

Arriving in Techiman, we were met by Dr. Gladstone Kessie, medical director of Mount of Olives Hospital. Gladstone was the medical director of Nsawkaw Hospital in Tain District, when KBNF sent in a container shipment of equipment and supplies four years ago. Currently, Gladstone is managing to deliver basic care to many patients in the district from a dilapidated facility and aged equipment. They have a simple operating room, and a nurse anesthetist provides support one-day a week. Their facility is simply overflowing with outpatients while they house approximately 30 patients in cramped quarters. They have a simple lab, a pharmacy, and a very organized medical records department.

Gladstone took us to the new 100-bed Mount of Olives Hospital under construction and expected to be ready for patients March 2013. It is very impressive. It will house two operating rooms and two floors of patient rooms, with bathrooms and showers in each room.  A dental clinic, conference rooms and apartments for visiting medical mission teams are housed on the 3rd floor. A separate facility will be constructed on the property for kitchen and catering services, as well as toilet facilities for the community. Dr. Kessie and his wife are undertaking this project, funding it independently. His passion for his people is quite simply palpable. KBNF will be pleased to partner with his hospital in providing a container shipment of hospital equipment and supplies, along with teaching, training and medical mission support.

Gladstone runs an ultrasound clinic in Wenchi that provides service to the community. It also offers free ultrasounds for the district’s pregnant mothers. He explains that this advocates for their unborn children; otherwise, many mothers would not receive the prenatal care they need.

Mount of Olives Hospital houses a school for caregivers. Many of these students are hoping to become nurses someday and this is their entry option into the field. Jocelyne, Samuel and I taught two classes of approximately 30 — 40 students over the course of four hours. What is becoming so very clear is that we can teach skill, but without compassion and caring, it is practically worthless. In my visits with nursing and hospital administrators everywhere, from Sierra Leone to Liberia to Military 57 to KBTH to the UK, they are all saying the same thing, that many nurses are missing a critical ingredient: HEART. We’re hearing how so many nurses are focused on the job as employment and not as delivering health care.

Please click here to see images of the mission.

KBNF Participates in Major Medical Conference in Accra

Two KBNF Board Members, Dr. Paul King (a neurosurgeon from Atlanta) and I (a neuroradiologist currently working at the Korle Bu Teaching Hospital), gave presentations at the weeklong 2nd Annual Medical Knowledge Fiesta in Accra in August 2012, held at the Ghana College of Physicians and Surgeons. It is the largest medical meeting held in Ghana, apart from the annual meeting of the West African College of Surgeons, which is held in Ghana about every six years — the last time in 2006. A brief report details some of its activities: Medical Knowledge Fiesta 2012.

KBNF also held a two-day neuroscience conference at the Korle Bu Teaching Hospital in June and provided staff and medical students of the John F Kennedy Memorial Center in Monrovia, Liberia with 1.5 days of presentations the previous week. The aim of all these presentations is to increase knowledge about neurological conditions and their management among health care workers, in order to improve the level of recovery of patients.

Korle-Bu Neuroscience Club – Victoria

We are always so pleased to hear of university students eager to support our neuroscience projects in West African. Our University of Victoria students are raising interest and awareness on behalf of KBNF. Join Bernard Osei, President of KBNC, and our KBNF family in extending a big congratulations to our dear students for all these wonderful developments!

Ghana Mission Post 4 – November 2012

We are on a pillow making journey, as Jocelyne and I prepare to begin teaching KBTH nurses in the med-surg and trauma units the critical importance of nursing care. Topics include Neurovital Sign Assessment, Communication is the Key, Pillow Talk, Stroke Teaching and Basic Patient Care is Not Basic, It is Life Saving. The need to reposition patients faithfully every two — three hours and ensure excellent hygiene are areas that all nurses worldwide must deliver. Research supports that good oral care equals an average reduced stay in hospital of five days! Why? Bacteria from gums and mouths can facilitate pneumonias, brain abscesses, lung abscesses, heart value destruction, etc. Oral care saves lives!

I firmly believe that a picture is worth a 1,000 words! It sure is for me. Consequently, Jocelyne will be illustrating brain scans to the nurses, enhancing the principles taught.

Pressure sores are another area that is entirely preventable and yet all too frequently encountered. Consequently, in order to prevent pressure areas, the resources are required. And one of the main resources is repositioning regularly using pillows. So we’re on a pillow and pillow cover hunt. My day tomorrow includes heading to town to meet with companies that sell waterproof fabric. The DON and I met with the KBTH seamstresses and covers will be sewn beginning next week, if we’re able to procure fabric. A KBTH stamp will be applied to each pillow cover.

A first KBNF meeting with Samuel Ampen-Asare took place this afternoon, as he begins his journey as a Board of Director. We have been invited by Dr. Gladstone Kessie to visit Nsawkaw and Techiman towns up in Northern Ghana. Nsawkaw is the town where we sent a container shipment in 2006 at the request of HE Dr. Margaret Amoakohene, previous Ghana High Commissioner to Canada. Jocelyne and I Googled the terrain and highway and discovered that it is very flat while many trees are in evidence. Dr. Kessie is now opening up a 100-bed hospital in Techiman and requests professional guidance.

Ghana Mission Post 2 – November 2012

Seth and Marj meeting Megan and Patrick for the first time.

Late Monday afternoon, I met with the KBTH Director of Nursing (DON), Mrs. Victoria Aku Quaye. She is so very pleased to hear of the developments at KBNF, including my availability to teach nursing skills plus the opportunity to receive hospital linens, stretchers and mattresses for the hospital. They are so very dearly needed. Nii Otu Nartey, Victoria, and our team will put forward a proposal to solicit the funds from KBTH / MOH for shipping. I am so pleased! I expect to be spending quality time with the nursing department on Wednesday as we embark on various teaching sessions. My focus at the moment is teaching the value and skills of turning of patients, giving quality mouth care and general care, as well as charting skills. The DON is eager to visit Vancouver and meet with nursing departments, learning how they deliver North American standard care. We will arrange a visit for next spring.

Today began with a visit to meet with the KBTH Chief Orthopedic Surgeon, Rev. Dr. Abendigo Addo, Administrator Dr. Holdbrook Smith, and nursing sisters, as I handed over the donation of orthopedic instruments useful for their surgery cases. (Dell, they were so pleased with the quality of instruments. Thank you so very much!)

I shared the opportunity for shipping stretchers over. They were overjoyed and asked if we could raise the number to 30. As I walked through the emergency department, I observed decrepit stretchers perched high or collapsed in the hallways holding precious Ghanaians in every possible nook and cranny. And many other patients waiting in hallways and out on the lawn. The need for the new emergency centre is fully evident everywhere you look.

Seth Ayettey and I went to visit Patrick and Megan. Patrick, a Sierra Leonean, suffered a serious C7 spinal injury September 19th, when a tree struck him while driving in SL. Megan, his devoted fiancée, made every plea possible to get him transported to KBTH for emergency neurosurgery and care. He was stabilized by KBTH neurosurgeons and is now recovering at the Dean’s Guest House, while currently challenged with quadriplegia. Patrick has limited abilities in his grips and arms (right superior to his left) and thankfully, has sensation throughout his body. We are following up on his progress and how KBNF can support this tragic situation. Advanced physiotherapy will be pursued and we’ll arrange for Jocelyne to give expert recommendations on follow-up MRI scans. Seth will be following up as well with rehab. We trust his recovery will continue steadily.

Speaking of rehab, this is an area that is critically needed here and everywhere. Whether trauma, stroke or other maladies, there is no designated in-house rehabilitation unit.  Jocelyne is recognizing this as a serious need and something that needs to be addressed sooner than later.

I’m heading over to meet with the KBTH neurosurgeons and deliver neurosurgery drill bits for their OR cases. Many thanks to Loretta Chan for her diligence in collecting them for our service here. And also to Dr. Felix Durity, for his inspiration in ensuring donations of these kinds are made possible.

Click here to see additional images from the mission.

University of Ghana Anatomy Department Studies

I am so pleased to introduce Prof. Fred Addai, Chair, Anatomy Department, College of Health Sciences, University of Ghana to you all. He is the Chair of our Neuroscience Research Graduate Program and his passion for advancing neuroscience health care in West Africa and around the world is palpable.

We are now able to begin providing Anatomy Department studies for our readership, courtesy of Prof. Addai. Thank you so very much, Fred! I believe these documents and those anticipated in the months and years ahead will be very insightful and encouraging. Through these communications, networking may also enhance developments.

Click here to view the content Prof. Addai has provided so far.

KBNF Mission Trip – Neuroscience Conference

On our recent mission trip, we conducted our second neuroscience conference for doctors, nurses and others in Ghana at Korle Bu Teaching Hospital. It was well received and well attended. I also taught in Liberia and Ghana on neurovital sign assessment and caring for the unconscious patient. They have requested materials for these presentations and the others from the team. So we will be filming my presentations and sending copies over for the attendees. Jocelyne has been compiling the other materials from our wonderful speakers for another DVD to be handed out. I taught at their Military Hospital and realized that they truly need our hands on direction in order to make sustainable advances. Once they have confidence in a skill they are eager to perform it, but it takes a lot of encouragement to get them to that confidence. This is an area Brenda and I are gifted in and I believe can effect change. It will save lives. No doubt.