KBNF FAQs

It is about helping West Africans suffering from conditions affecting the brain or the spine/spinal cord access an equivalent level of care closer to home, care available to patients in developed countries; using local resources and with the collaboration of local “champions” willing to work hard to make recognizable progress in this vastly “neglected” area of health care.

KBNF is addressing a need that is often the cause of the absence of and the loss of (brain drain) highly valued professionals (such as teachers, judges and health care professionals) in short supply in these developing countries. Stroke, (hemorrhagic and non- hemorrhagic) and hypertension (aka high blood pressure) are particularly common conditions in individuals age 40 and up. KBNF is thus bringing attention to a series of treatable conditions that are not currently a major focus of the World Health Organization (WHO).

Neuroscience is concerned with all parts of the nervous system, from the brain to the spinal cord and nerves, as well as the structures that contain them (skull and spine). Conditions commonly affecting the nervous system in West Africa are similar to those in developed countries (such as trauma with hemorrhage and/or fracture, stroke, tumours, seizures, hydrocephalus and spina bifida). Early treatment of these conditions can lead to a good outcome and a productive life. However, in West Africa, the limited resources and the small numbers of trained individuals makes obtaining timely treatment very difficult.

Trained professionals providing adult and pediatric neuroscience health care work in many fields include Neurology, Neurosurgery, Neuro-anesthesia, Neuroradiology, Neuropathology, Neuro-pharmacology, Neuropsychiatry, Psychology, Speech Pathology, Audiology, Physiotherapy, Occupational Therapy and Neurological, Geriatric and Psychiatric nursing. Few of these trained professionals work in West Africa. 

Research, education and training in the same fields also contribute to the advancement of neuroscience health care, as issues of local concern are better addressed when their scope has been documented and relevant solutions applied. 

The first request for neuroscience education and support came from a Ghanaian physician in 2000. Ghana has many favorable attributes, making it an easier place to begin improving neuroscience health care:

• Ghana is a progressive and democratic society, situated in the middle of West Africa (WA), south of the Sahara. It is ideally placed geographically to serve not only its citizens but also the entire region.
• Over the last six decades Ghana has transitioned from military dictatorships to a well functioning democracy and has free press. It is officially an English-speaking nation with several local dialects.
• Has gender equity for opportunity.
• Uses an open-business and free enterprise model.
• Multinational companies already operate in Ghana and are beginning to make a positive economic impact.
• Is favoured by the G7 nations and has received debt forgiveness because of its demonstrating accountability, transparency and credibility internationally.
• Boasts a teeming port of access called Tema. Just like Vancouver and Seattle are gateways to the countries of the Pacific Rim, Ghana is considered the gateway to the WA region

The first of multiple Ghanaian missions began in 2002. KBNF goes where we are invited. By 2009, an invitation to join with host Pro-Health International on their inaugural neurosurgery mission was conducted at the University of Benin Teaching Hospital, Benin City, Nigeria. By 2011, the President of Liberia’s family requested KBNF to assess the viability of neurosurgery in their country. Since then, multinational medical missions have occurred once or twice a year in one or two of the countries of Ghana, Nigeria, Liberia and Sierra Leone. 

Shipments of 40-foot containers filled with medical equipment and supplies number approximately 50 to date. These shipments provide some of the necessities to allow the missions to proceed. The collaboration with dedicated West African medical champions energizes KBNF’s commitment to advancing sustainable neuroscience care within West Africa.

Many humanitarian foundations, NGO’s and non-profits have been combatting infections such as HIV/AIDS, malaria, water-borne diseases and TB in low-middle income countries (LMIC) for decades. West Africans also suffer from the same medical/surgical conditions as North Americans and Europeans (ex.: head and/or spine trauma, tumours, seizures, strokes, hydrocephalus,) Diabetes and high blood pressure are very common in Africans and often cause strokes, for example.  Timely treatment of these ailments can return patients to a long and productive life, decreasing poverty in the family. Retaining capable individuals can only have a positive impact on their society. 

KBNF is one of only a few organizations actively focusing its activities on conditions affecting the brain and the spine. It teams up with local health care professionals in increasing their expertise (providing Western trained specialists to mentor, teach and train) and provides medical equipment and supplies as required to deliver quality neuroscience care (such as operating room tables and neurosurgical drills). 

Dr. Thomas Dakurah, the first Ghanaian to graduate from the Neurosurgery training program at the Korle Bu Teaching Hospital (KBTH, Accra, Ghana) and be certified by the West African College of Surgeons, was given the opportunity by the Federation for International Education in Neurological Surgery (FIENS) and the government of Ghana to complete a year’s fellowship (i.e. sub-specialization) in 1999-2000 under the direction of the University of British Columbia  Neurosurgery Division and its Chief Dr. Felix Durity (first KBNF Vice-President).

His experience with Neuroscience health care in Vancouver B.C. led him to request the help of Marjorie Ratel RN BSN in educating and training his nurses and providing equipment and supplies for his hospital (KBTH).  Upon his departure from Vancouver, a small group of nurses began to pursue tangible support for his neurosurgery team and quickly evolved into a team of surgeons, health administrators, Ghanaian leaders and community supporters, engineers, health planners and members of the construction community. The signing of an Agreement of Collaboration between the Korle Bu Teaching Hospital and Vancouver General Hospital in 2001 resulted in the initial shipments of supplies and equipment to KBTH (250 manual hospital beds with side rails).  

After a Ghanaian national launch in 2002, hosted by Dr Dakurah and Mrs Ratel and endorsed by the Canadian High Commissioner His Excellency Mr. Jean-Pierre Bolduc at the Canadian High Commission in Accra, the Korle-Bu Neuroscience Project became international. The Korle-Bu Neuroscience Foundation (KBNF, a British Columbia non-profit society was officially formed in 2003.  Its related Canada Revenue Agency registered charities, Korle-Bu Foundation (KBF), our Public Charity, and Excellence in Africa Neuroscience and Health-Canada (EANH-C), our Operating Charity, were launched in 2005. These were established to facilitate income tax deductible donations by Canadians and to conduct project development in West Africa. 

Korle-Bu Teaching Hospital in Accra, Ghana is the country’s national teaching hospital. Korle-Bu in the Ga language is defined as ‘in the valley by the sea’, describing its actual location. It was built by a Canadian-born, British Governor of Ghana, Sir Frederick Gordon Guggisberg (1869-1930), who opened it in 1923. It was first named the Gold Coast Hospital (as Ghana was known prior to 1957) and later was renamed Korle-Bu Teaching Hospital, based on the name of the neighbourhood of Accra it is situated in. At that time, it was the envy of the entire West African region. 

Governor Guggisberg believed in the full potential of the African people. Given the right resources, empowered Ghanaians would be fully capable of self-governance. Why did he have such faith in the African people? He had served as the land surveyor for the Gold Coast (1902-1908), and trekked the land for years with African guides that convinced him they could learn if taught. Eventually sending his British surveying team home, he continued his journey with an African team that he felt was superior to his own men. Meeting the villagers, the children, the elders, the people, day by day, he began to appreciate their promising future if given the right resources. Returning as Governor in 1919 and serving until 1927, he established the first port, post office, roads and highways, and leading schools. Guggisberg replaced foreign officials in places of authority including law courts and police forces with qualified nationals. In 1923, founded the Korle-Bu Teaching Hospital, as a tertiary training centre for the nation believing it could be a world class centre. It was the first hospital established to treat nationals and foreigners alike at the same time by the same practitioners. He set the stage for a strong national identity and indeed Ghana was the first sub-Saharan country to realize its independence in 1957.

The statue of this forward-looking, well-respected and still-revered individual stands at the entrance of the hospital that is one of his many legacies to Ghana. 

At its inception, many notable individuals including government officials from Ghana and Canada, the University of Ghana and Korle Bu Teaching Hospital executives, professionals from various branches of health care, and especially neuroscience health care participated in the creation of KBNF and its early missions to Ghana. 

The current members of the Boards of Directors, Canadian, American, Ghanaian and Swedish, of the three legally registered entities (KBNF, KBF, EANH-C) serve three-year terms (renewable) as unpaid volunteers. The members of the 9 Executive Committees fulfill the mandate of KBNF. All can be found under “About”. 

Current Association Partnerships and Alliances

• Founding and Permanent Council Member since the inception in 2016 of the G4 Alliance (Global Alliance of Surgical, Obstetric, Trauma & Anaesthesia Care). G 4 Alliance is dedicated to building international political priority for these four essential pillars within health care delivery in the entire world by 2030. 
• Agreement of Collaboration between the Korle-Bu Teaching Hospital and the Vancouver General Hospital (2001)
• Memorandum of Understanding (MOU) with the Ghana- Canada Association of BC (2006)
• Memorandum of Understanding (MOU) between the Korle-Bu Neuroscience Foundation and the Mount Olives Hospital Foundation (in Techiman, Ghana, 2014) 
• Founding members of the Institute of Global Perioperative Care, an American charity that achieved its 501C3 charitable status in late 2019. KBNF’s American non-profit partner is facilitating American donors while collaborating on the establishment of an Anesthesia residency and critical care program at the University of Liberia. 
• KBNF-Liberia is being launched 2020 as a Liberian non-profit organization authorized to support neuroscience and health care provision and expansion. Majority membership will be held by KBNF (BC) and will facilitate project development in Liberia and neighbouring countries.

Dr Francis Kateh, Liberia Deputy Minister of Health and Chief Medical Officer, was born under a tree in a rural Liberian village. He longed to be a doctor from the age of 5 when his mother lost an eye due to maltreatment by a village ‘doctor’. He informed the local Methodist Bishop upon graduation from public high school. The bishop sent this 15 year old boy to Gunta United Methodist Hospital.  Upon arrival, Francis informed the administrator that he wanted to be a doctor. He was handed a broom and dustpan, mop and pail, and told to clean. While cleaning, he met an American surgeon from Los Angeles. When observed frequently peeking through the surgery door window, the surgeon learned of Francis’s yearning and his dream of becoming a doctor became a reality. Francis also acquired Disaster Preparedness and Hospital Administration master’s degrees in America after medical school, which would prepare him for what ahead to save his people. 

His leadership led Liberia to eliminate Ebola sooner than other West African neighbours. His key Ebola weapon was education. In every village, every chief and wife, every elder, actually the entire population, their beloved doctor delivered information with truth, compassion and devotion. Trust grew, demanding instructions were followed and Ebola was wiped out. The nation devoid of a vast resource base stood up with resolve and courage in the case of imminent destruction.

Dr Gladstone Kessie, Mount Olives Hospital Director, Techiman, Ghana, received his medical training in Russia. Returning home after 5 years, he was sent to Nsawkaw Hospital. Considered one of the most deplorable hospitals in the country, he was devastated, however, his wife Faustina, insisted that they make the best of it. Transforming the hospital and preparing for a replacement hospital complete, they relocated to Techiman, desiring to serve those that do not have access to health care. 

Their first clinic was 3 shanty buildings held together with tarps. Gladstone, his wife and their baby daughter lived on one side of the building while the patients stayed in the other. Pursuing his dream, property was purchased on the outskirts of the city when he had few resources. Purchasing a brick making machine, Faustina and Gladstone made bricks on weekends when they had enough money to purchase the clay. Eventually, an architecture friend helped them design a 100 bed hospital. Reaching out to KBNF, we helped to outfit the hospital with beds, furnishings, operating rooms equipment, linens and supplies. 

Serving up to 7,000 patients / month, it has become a hub for health care in the region. A stroke rehab program was launched in 2014 with KBNF’s support. Gladstone just doesn’t stop dreaming. More land has been purchased on the Kumasi Hwy for expansion.

KBNF believes transparency is critical to its integrity and the credibility and outcome of its efforts. Being a volunteer-based organization, minimal staff administrates the foundation’s essential operations and overhead costs are kept as low as possible. 

Transparency

• A Finance Committee and a financial comptroller oversee disbursements of funds. Disbursements must be approved by the Executive Committee.
• Financial reports for the three charitable entities (KBNF, KBF, EANH-C), described above under How Did KBNF Start) are presented and discussed at each entity’s separate Annual General Meeting. 
• 2014 saw the transition of our two CRA registered charities to the new Federal Government Act (as per all registered Canadian charities). Depending on the amount of donations received per fiscal year, a Review engagement or a formal Audit must accompany the Canada Revenue Agency annual filings, which are accessible to the public, on the Charities Directory website (https://www.canada.ca/en/revenue-agency/services/charities-giving/list-charities/list-charities-other-qualified-donees.html ).
• Since their inception, legal representation for the entities has been by local law firms, Preston Law (KBNF) and the Benefic Group (KBF and EANH-C). Starting in 2020, due to the closure of the Benefic Group, the latter two entities will be represented by Kuhn LLP of Abbotsford B.C.

Fiscal responsibility

• The majority of the work is provided at no cost, on a volunteer basis. 
• Currently, only two part time positions are remunerated, administrative assistant and director of operations, for a fixed monthly number of hours.
• Consultants for specific projects (most recently marketing and communications including updating the KBNF website) are hired on a fixed budget. 
• Liability insurance for the directors, consultants, and for the volunteers in the KBNF warehouse is maintained. 

Well-trained and well-equipped on-site local neuroscience professionals are the most critical component in creating the self-sustaining, high-quality type of care required by patients afflicted with diseases of the brain and spine. KBNF’s efforts to date have included the following:

Specialized facilities: 

• Elaboration of professionally produced documents to support the construction of a Neuroscience Centre of Excellence for KBTH has included a Project Brief (2005), a Sustainability Program (2006), a Functional Program (2007) and a Facility Program (2008).
• Elaboration of Master Plans for the Korle Bu Teaching Hospital site and for the College of Health Sciences of the University of Ghana’s Legon Campus (2010). These Master Plans were used by the Government of Ghana to secure the loans required to complete two projects, 

1. 1. A new Accident and Emergency Centre at KBTH was officially inaugurated on July 21st 2018. 
   2. The University of Ghana Medical Centre (UGMC) including a multi facility campus and 650-bed hospital providing specialized medicine was officially opened on July 23rd 2018.  

The assistance provided by KBNF in these two instances was recognized at an official reception hosted June 2017 by the University of Ghana Council and dignitaries.

• Providing operating room tables, operating microscopes, hospital beds, neurosurgical drills and/or other donated equipment and supplies to assist in the establishment of neurosurgical wards and services include: 
  • Korle Bu Teaching Hospital, Accra, Ghana (2000 – 2012)
  • University of Benin Teaching Hospital, Benin City, Nigeria (2011, 2013)
  • Jackson F. Doe Memorial Referral Hospital, Tappita, Liberia (2015 – 2019)
  • Lagos University Teaching Hospital, Lagos, Nigeria (2019)
  • Obafemi Awolowo University Teaching Hospitals Complex, Ife, Nigeria (2018)
  • John F. Kennedy Memorial Hospital, Monrovia, Liberia (2019)

In addition to the institutions above, multiple national and regional hospitals, medic services and clinics in all 4 designated countries have also received containers of medical equipment and supplies (see Impact Map).  Includes: 

• • Nsawkaw Hospital, Brong Ahafo, Ghana (2009)
  • Mount Olives Hospital, Brong Ahafo, Ghana, (2012, 2014, 2015)
  • Connaught Hospital, Sierra Leone (2017, 2018 – portion)
  • Princess Christian Maternity Hospital (national) in Freetown, Sierra Leone (2018 – portion)
  • Ola During Hospital (national pediatric hospital), Sierra Leone (2018 – portion)
  • Tetteh Quarshie Memorial Hospital, Ghana (2015, 2017)
  • Ahomka Foundation, for 21 clinics and Komfo Anokye in Ghana (2019)
  • Liberian Medic Service, Liberia (2019, 2020 – portion)
  • Buchanan Hospital, Liberia (2018)

Launch of a KBNF-Liberia warehouse / distribution centre sited at ELWA campus, Monrovia, commenced 2020. 

Under consideration

• Exploration of neurosurgery expansion and prosthetic clinic at Jackson F. Doe Hospital, Liberia 2018 – 2019. A project management mission conducted. 
• Proposal for a Neurosurgery Centre of Excellence to serve Liberia and neighbouring countries. 
• Construction of a Legacy Centre to serve KBNF as our warehouse and headquarters in Vancouver.

Education and Training (includes):

• Hands-on training for three months in neuroscience care at Vancouver General Hospital for four Ghanaian Korle Bu Teaching Hospital nurses (2004)
• Neuroscience Conferences (2-3 days) held for medical and nursing staff at KBTH in 2011 and 2012
• Multiple presentations by KBNF members at the annual weeklong Medical Knowledge Fiesta of the Ghana College of Physicians and Surgeons (2011, 2012)
• Heart Power and Ethics training sessions held by KBNF professors at Accra College of Medicine (a core value), and at all partnering health care establishments. 
• Neuroscience and nursing classes held at all partnering hospitals.
• Critical care / Emergency care courses held at Korle-Bu, Komfo Anokye, Connaught, and Lagos University Hospitals, led by Dr. John Sampson, Johns Hopkins.
• Internal Review (and formal report) of the KBTH Radiology Department, its Radiology Residency Program and its associated Medical Radiography program conducted by a KBNF member, experienced in using a similar process for the Canadian Medical Association (2011)
• Visiting Radiology consultant for 18 months spent working with the KBTH consultants, residents and technologists (2012-13). In addition to presentations by this consultant at the Bi-Annual Radiographers Conference (2012) and the Annual Ghana Association of Radiologists Conference and Scientific Session (2013), a three-day Neuroradiology conference was held for local radiologists, otolaryngologists, ophthalmologists and their residents (2013).
• Missions conducted by Canadian team members to mentor and support Ghanaians, both in neurosurgery and biomedical engineering in the early years (2002-04, 2009) followed by multinational Neurosurgical Medical Mission teams composed of Canadians, Americans and Nigerians in the middle years (Ghana and Nigeria (2009) Liberia (2012, 2015).  In more recent years, efforts at building a neurosurgical service has been concentrated in Liberia, where its first permanent Liberian neurosurgeon started work in 2017. Since then Nigerians and Ghanaians have participated with Canadians and Americans in the neurosurgical missions to Liberia. 
• Impact Assessment Mission to Ghana, Liberia, Sierra Leone was conducted by Compassionate Resource Warehouse & KBNF team (Spring 2016).
• Because good neurosurgical outcomes are heavily dependent on anesthetic care, in November 2019, KBNF ratified its position as a partner in the Anesthesia residency training program in Liberia, as part of the Collaboration on Anesthesia & Perioperative Care program at the University of Liberia being developed by KBNF Board member Dr John Sampson and his colleagues of Johns Hopkins University. 

Research: 

• Between 2010 and 2014, KBNF collaborated with the National Resource Council of Canada on its Neurosimulator Project (Neurotouch). KBTH was chosen as an overseas site to test its long-distance mentoring of a procedure called 3rd ventriculostomy (used to treat hydrocephalus without a shunt catheter; a very useful procedure where follow-up of patients with a shunt is problematic). Its success has seen it evolve into a very advanced virtual reality neurosurgical simulator, now called NeuroVR. As shown on its website and linked to McGill University, “NeuroVR aims to provide rehearsal, training, planning and evaluation systems, integrated with MRI for patient-specific neurosurgical oncology and other advanced surgical procedures”.
• Participation in international publications including Lancet.

Special Projects

Projects that KBNF has recently embarked on are:

1. Ambulances and medic training. Providing Liberia with fully outfitted ambulances, capable of safely transporting spine injured patients to hospital. So far, due to our extremely generous sponsors, two such vehicles have been sent to Liberia (2018 and 2019), along with appropriate medical equipment and supplies, in our shipping containers. KBNF has launched training sessions and is spearheading a credited training program for the Liberian ambulance medics. 
2. Newborn baby gift boxes. A shoebox size gift for a newborn boy or girl, containing two sets of baby clothes of different sizes, a small blanket and other assorted items is used as an incentive for mothers to choose to receive prenatal care and deliver their baby under the care of trained health care workers. It is KBNF’s hope that this type of supervision will reduce the high neonate and maternal mortality rate associated with childbirth and prevent infant nutrient deficiencies (eg. Folic acid).
3. Neuro-endoscope. A neuro-endoscope (to treat hydrocephalus without the need for a shunt tube) for the neurosurgeons at KBTH
4. Legacy Centre. A permanent, KBNF warehouse and head quarters in the Lower Mainland, to better serve the foundation and manage the donated medical equipment and supplies. 

• Make a Donation.
• Become a monthly donor. 
• Join our team: Become a member. 
• Give of your time and resources: Network on behalf of the future of Africa, encourage formal educational partnerships
• Join us at our local Acquisition and Storage Facility in Surrey. Come alone or with your friends and family. We can always use helping hands to sort and pack medical supplies in preparation for container shipments.
• We are looking for volunteers that can help with Social Media, newsletters, design and photography. Please contact info@kbnf.org if you have some time available that you can donate to us.
• Volunteer your neuro / critical care professional expertise: Make it “a vacation with-a-purpose” or a sabbatical. 
• Not a health care professional? Engineers, construction experts, gardeners, cooks, we often have need of your services. Let us know.
• Contact us at: 1.604.738.2076 (North America) or 011.604.738.2076 (International) or E-mail:info@kbnf.org