IFMSA SCOPE Exchange in Accra, Ghana

~Akito’s Diary 2007 Spring~

1.Standing Committee on Professional Exchange (SCOPE)

2.The aim of SCOPE

3.General information about Ghana

4.Exchange in Ghana 5.Junior Clerkship in Kore-Bu Teaching Hospital, UGMS 6.Duty night!! 7.Community Health Training 8.Public Health Department in VRA 9.Doctors in Ghana 10.Health System in Ghana 11.Why Ghana is stable for 50Years? 12.Independence Day!!! 13.FGMSA Annual Congress 14. Hostel in Ghana University 15.Mass in Ghana

16.Flea market

1.Standing Committee on Professional Exchange (SCOPE)

The Standing Committee On Professional Exchange (SCOPE) is

the first created IFMSA Standing Committee. It constitutes the

largest exchange program within IFMSA and it has been running

since the organisation's foundation in 1951.

2.The aim of SCOPE

The aim of SCOPE is to promote international understanding and co-operation amongst

medical students and all health professionals through international exchange of students.

The exchange program offers students unique educational and cultural experience in

addition to the regular medical curriculum. It also helps to broaden the students

understanding of medical and social conditions in different countries.

Currently over 6 600 international exchanges are made every year, and 78 countries

throughout the world are taking part in SCOPE.

The Professional Exchange is defined and regulated in the Standing Orders of SCOPE. A

professional means an exchange of a medical student who undergo a medical practice in a

hospital abroad. This practice, named clerkship, is purely educational for the student and

he/she will not receive a salary for it.

3.General information about Ghana

The Republic of Ghana is a country in West Africa. It borders Côte

d'Ivoire to the west, Burkina Faso to the north, To go to the east,

and the Gulf of Guinea to the south. The word "Ghana" means

"Warrior King",[3] and was the source of the name "Guinea" (via French Guinoye) used to

refer to the West African coast (as in Gulf of Guinea).

It was inhabited in pre-colonial times by a

number of ancient kingdoms, including the Ga

Adangbes on the eastern coast, inland Empire of

Ashanti and various Fante states along the coast

and inland. Trade with European states

flourished after contact with the Portuguese in

the 15th century, and the British established a crown colony, Gold Coast, in 1874.[4]

Upon achieving independence from the United Kingdom in 1957,[5] the name Ghana was

chosen for the new nation to reflect the ancient Empire of Ghana that once extended

throughout much of western Africa.

4.Exchange in Ghana Expenses: about 300EURO/month (exchange office covered accommodation and lunch)

Facilities: Room-share, Shower-cold and sometimes no water, Student’s Lunch-no

vegetables except for local food but fine, Computer- available, Internet-LAN and WiFi

available(I could use Skype!), TV-Cable TV available

Water: mineral water needed

Food: some good and reasonable restaurants near by hostel(You can eat vegetable there!)

Shopping: Small shops are in the university for your daily needed

Anti Mosquito: You can buy anything here except for Anti-Malaria Medicine

Security: Inside the university is very safe and outside also safe except for night

Weather: Basically hot in March but sometimes cold after raining

Clinical Training over view (Obstetrics and Gynecology ):

Monday: Clark and Physical Examination in Gyne Clinic

Tuesday: Observe operations in Theater

Wednesday: Clark and Physical Examination in Antenatal Clinic

Thursday: Ward round in Gyne Dep.

Friday: Ward round in Obst Dep.

Time line:

8:00~9:00: Morning Lecture all together

9:00~13:00: Clinical Training

Afternoon: Clark your own patients in Wards

+A duty in Delivery Theater / week

+Some Tutorials

Type to training:

You will join a group of Local medical students (6th year)

Events (My case in March 2007 )

1-Arrival

2-See Drama in Main University

4-Beach!!

5-Independence eve fireworks

6-Independence Day (50th anniversary in 2007)

12~16-Community Health Activity

17~18-FGMSA Annual Congress

22~23-Visited Private Clinic

24~25-Travel to Cape Coast and National Park

27-Visited Noguchi Memorial Institute and WACIPAC Office

30~31-UGMSA Annual Congress

31-Departure

5.Junior Clerkship in Kore-Bu Teaching Hospital, UGMS We had clinical training in Kore-Bu Teaching Hospital which was located next to UGMS.

They have medical school for 7 years and 1st year, they studied basic science and before

2nd year they have exam to be selected as Medical Students or other College students. 2nd,

3rd and 4th year they study medicine in lecture room and 5th, 6th and 7th year are clinical

training finally (Junior clerkship training). They rotate 8 months/department and divided

to 8-9 students / group. They have morning lecture with all and then spread out.

My department was Obstetrics & Gynecology

department and I jointed with the 6th years

medical students’ group. At first I applied

Family medicine and Community health

department, but the department was small

and they suggested me to be the department.

In addition, I were also in part of Fever

Unit(HIV/AIDS, and other serious fever

patients there) , HIV Child Clinic( Unit for

Children who are infected HIV through mother), and Community Heath department.

The training we received were similar as Japan; physical exam, see and talk with patients,

present it to cuter or chief of the unit, lecture, and see delivery. The funny thing was that

the students’ behavior was also the similar as Japan!! For example; doctors asked us a lot

of questions very fast and we try to

answer but sometime no idea….and

doctors complain about that. They had

exam next week and really didn’t want to

go to the round and chief of the Unit

disappointed so much and say” I had

never be impressed with the group!!! And

students also complained that they didn’t

understand how exam was

difficult…something like that. Medical

students are the same all over the world.

6.Duty night!!

Our group had duty, “Toucyoku”in Japanese in Obsti & Gyne

Department. We stayed in Gyne Emergency room and Delivery Theater

whole the night to assist delivery. The room was more realistic

atmosphere than my teaching hospital in Japan. Pregnant women were

screaming, praying, some babies are miscarriage or abnormality,

horrible bloody smell, and only one operation room for Cesarean

Section (Teiou Sekkai)……here was the place that human live starts.

The biggest different here was that they didn’t use anesthesia, and because of the pain

they were screaming very seriously. The funny thing was that midwife gets mad and

beating pregnant women during the delivery but still pregnant women gratitude her and

gave some gifts.

Berth was very cerebrate event here and

people working here got high reputation

from patients and high income. That’s why

a lot of doctors wanted to chose Obst&Gyne

as their specialty in Ghana. This situation is

completely different compare with

Japan……they are not respected, low salary,

too much work, high risk (to be sued by

patients), and nobody wants to specialize

the department. It’s really serious problem

in Japan currently, because of the lack of doctors and midwives some hospital close

Obstetrics department and pregnant don’t have place to delivery. When I told the situation

to medical students in Ghana, they were surprised and wanted to go to Japan as doctor!!!

7.Community Health Training

I went to Aksomblo which was the middle

part of Ghana and near by Volta Lake. Since

all the 6th years’ medical students had exam

and I chose Community Health Department’s

activity in ARV Hospital for a week.

ARV hospital was a private hospital which

covers Alsomblo and cooperate with Kare-Bu

Teaching Hospital for Community Health.

The facilities and services of this hospital

were good quality and clean.

I stayed in Reproductive Health and Child

Unit and Public Health Unit for each 2 days.

In the RCH unit, we had weekly check of

pregnant women and school health. We

checked their urine for suger and keton,

general condition of infant and mother, and

gave injections. They had Maternal Health

Record Book, Family Planning Book, and

Child Health Record Book. They are kind of

Mother and Child Book,

“ Boshitecyou” in Japan. They had

such record books for a long time. I

was surprised that the health care

system in this county is quite good!!

2nd Day, I went to primary school to

examine school children. It was really

nice, because I hadn’t had such a

experience in Japan and it had a lot

fun to examine them. When I entered

into the classroom, their face looked really curious to see foreigner. The funny thing was

that when a nerse say “Good Morning and How are you doing?” to them, they replied just

like copy machine “ Good Morning” and “ I’m fine thank you and you?”. Yah, it’s typical

school students.

I examined as general systematic examination and found some patients; anemia, diarrhea,

abdominal pain, ear pain, and skin disease….etc We gave advices to them to come to our

hospital within a week. They were very quite silent when I examined and looked very

shye…and their English speaking ability were not so high at this moment. There was a

paper on the wall “Speak English!!” and if they won’t speak, they will get punishment. It

sounds serious, right?

8.Public Health Department in VRA

VRA is a Public Sector which covers around Volta river and

the dam. There were some departments in VRA and one of

it was Health Department. The health section were VRA

hospital, and Public Health Dep( lake side health unit and

environmental sanitation) The Public Health Department

in VRA deals with Aquatic need, Bilharzioma, Mobile

health services, Water pollution control, Disease vector

pesh control, and life style disease management. The

reason why they had these activities was completely

different environmental changes river side because of the

dams and they had responsibility to monitor and control

the side effect. They visited community around the river and if they fiound some problems,

they tried to solve them or gave advice to the community to solve them. Especially the

things I was interested in were mobile health and Disease vector pesh control. They use

ship and visit and provide medical treatment in very small villages which didn’t have

health sectors and give health lectures to villagers. It took for about 2 weeks and medical

students also joint the activities. (Unfortunately, I couldn’t have time to join this time….) I

felt that it’s exactly, community health activity.

Today, I went to the river side village to collect some samples of Bilharziosis (a parasite

disease). The parasites live on the small shells as intermediate host and it also contain

polluted water by the parasites. If you

drink it, you will get it and have some

kind of diseases. Since the parasite

makes serious damages to people living

there and also tourism around the river,

the prevention is needed. So we went to

some community to collect sample and

based on the result, give advice to go to

hospital or change the place to collect

water, and provide some health

education.

9.Doctors in Ghana According to the paper of New England

Journal, a lot of Young doctors work abroad in

Ghana.(http://content.nejm.org/cgi/content

/full/356/5/440)

The number of doctors was not enough here

and young doctors abroad was one of the

reasons. I also thought that only 3 medical

schools was also the reason) I asked some

medical students in University of Ghana

Medical School why you want to go abroad. There are following reasons;

1. Low salary (Public Hospital)

2. Not enough facilities in the public hospital

3. Easier to get high position in Ghana after working or researching abroad

Main country they apply was U.S.A because of a lot of opportunities there. It was also a lot

of Ghanians in UK before, but because of some changes in the working condition it’s

getting very difficult to apply there now. Basically, they won’t think to work abroad all

their life and would back to Ghana around

10 years. Normally, they would apply

Private Hospital, Open the private clinic,

and position in teaching hospital. They felt

that they didn’t want to work all their life

abroad and desire to come back here with

high skills and a lot of money to start

working.

I also asked them if they were satisfied with

Medical Education in Ghana. They felt fine

as medical students, but as doctors they need more high facilities; CT, MRI, 3DCT…etc.

10.Health System in Ghana We had party in one of the Doctor’s house.

The house was really huge and it’s just

amazing. I heard that doctors in private

hospital earned a lot in Ghana much more

than private hospital. Normally, private

hospitals were founded by European

Company. The quality of these hospitals was

much better as Europe and a lot of doctors

who came back from abroad to apply for

these hospitals.

I also heard that there was National Health Insurance in Ghana but there were some levels

of the insurance and it’s depend on how much you could pay for the insurance….it’s

different from Japan. I couldn’t heard more details and try to ask public health doctors to

explain more details about the Health system here later.

11.Why Ghana is stable for 50 Years? It’s big question during my staling in Ghana.

You see around Ghana, these countries face serious poverty and unstable political situation.

(Of course unsafe!!). Compare with other African countries, Ghana is very safe, well

developed, very stable government, and stable local currency.

During my staying, I asked a lot of people about the reason and these are some answers;

* No conflict between tribes (possible to get marry with different tribe here and not strict

regulation)

* No conflict between religions (possible to get marry

with different religion even if he is Muslim!!)

* Strong Nationality (all of them love Ghana)

* Independent tendency (they want to solve problems

by themselves and not rely on others)

* A lot of good reader( Kofi Annan, ex-secretary

general of UN, is Ghanian and J.A.Kufuor, President

of Ghana is also chair parson of African Union)

* They prefer to discuss rather than fighting

* Not enough natural resources past 50 years(Less risk

to be invaded by others )

* The first independent country in Africa

* Only one English speaking country around this area(Prevent people living this area to

enter this country because of the language problem)

* The existence of river which is available for hydroelectric power generation and other

factories

****They are not from academic research and no responsibility on the contents......

The image of Ghana is completely

different than I have expected. It’s

stable and safe country. Although the

40% of National Budget of this country

rely on ODA and other Multi-lateral

funding, I hope this county will

develop and be a good leader of Africa

in the future….

13.Independence Day!!! Ghana was independent 50 years ago (6

March, 1957) form UK and they had

independent day every year, but this

time was the biggest one.

We woke up 6AM and went to the

Independent Square and saw ceremony

of the anniversary. There were so many

people there and dusty…. as I could see anything except for people.……The President’s

speech should start at 9AM, it was too late and we just

decided to go back home. I putted on Ghanian Flag and

50th T-Shirts there and most of them also did so. The place

was filled with Red/Green/and Yellow colors. *

After going back to our hostel, I realized that almost all the

medical students were in the hostel and just watched TV.

One of my Ghanian friends told me that medical students in

this country were not so active and were prefer to stay

home.

*Their flag was red/yellow/green with Black star. The

meaning was a lot of fighting before

independent/Gold(Ghana produced a lot of Gold

before)/agriculture with hope of Africa.

13.FGMSA Annual Congress We had FGMSA Annual Congress

(Federation of Ghana Medical Students’

Association) in Ghana University. In Ghana,

there were only three medical schools and

3 of them are active members of this

organization. Of course, this was the NMO

of IFMSA in Ghana. I wanted to see the

different style of conference from IFMSA

and IFMSA-Japan, I attended almost all the

events. We had Business Meeting (Plenary meeting), Debate match, sports games (Football

and Volleyball), BBQ party, and Mass( they

are Christian). In FGMSA, Ghana Uni Medical

students and Kumasi Uni Medical students

always competed each other in the plenary,

debate, and games…..Actually, they didn’t

have Standing Committees’ meeting and it’s

one of the disadvantage in this NMO. But

now they are very motivated to set up

SCORA (Reproductive Health inc’l AIDS) and

hopefully the make it.

14. Hostel in Ghana University The hostel I was staying was the same as other

medical students in Ghana University. 90% of

them were in the hostel. The condition of the

Hostel was not enough compare with western

countries, but felt confortable and safe.

I set up mosquito’s net, mosquito’s coil,

mosquito’s spray, and take

Mararon(Anti-Malaria pill) in order to prevent

Malaria.

The electricity condition here was not good enough….it stopped sometimes and the most

worry thing was that hospital did’t have reserved battery. How are they doing if it stops

during the operation or using respirator……medical

students complain about that.

Water condition here was also not good enough….it

also stopped sometimes. So we had to collect water

in tabs and used it for bath. About drinking water,

of cause I bought mineral water for safe.

About temperature here, it’s the end of the dry

season and it’s really hot & dry. (about 36 degrees)

15.Mass in Ghana

I went to Church to have Mass. As you know, Ghana was a

colony of UK and 60% of people are Christian (Chatric and

Protestant) .

Ghanian Mass was a little bit different from Japanese

(and European) one, sounds like typical African’s!! The

order was the same and I thought the father’s lecture

was a bit long, but the music was really great. They

played local drums and sang songs very strongly. It’s the

good example of the style of religion is changed by the

local culture.

The content of his lecture was something about Love.

Between man and woman, and god and us. I heard the same lecture before in Japan and I

thought he cheated the contents somewhere.

16.Flea market I went to the flea market to buy some staffs

for 50th Anniversary of Ghana independence’s

day. The market was very crowded and

smelled spice and fish. All of them said

“welcome to Ghana!!” I bought T-Shirts for

50th Anniversary and flag of Ghana. I think it’s

enough for 50th Anniversary.

About food in Ghana, they eat a lot of meat

and don’t eat enough vegetable. It’s not nice

for me and I missed vegetable. I thought they had so many cardio vascular diseases, but

not so much as I had expected. Maybe they had something good enzyme to reduce Cho….I

envied them.

About Foot ball in Ghana, they really liked it and they were all in TV room to watch it all

the time in the weekend. I’m sure football was the most famous national sport here.