RAD-AID Ghana: A Success Story!

I have waited for this day for a while. While beginning to think about ways to improve the medical imaging sector of the Ghanaian healthcare, my goal was to understand exactly what, how, why, and who can be affected with such improvement in radiology in Ghana. I have been convinced over the time that RAD-AID is the best solution to attend resource-limited areas of the radiology world, in this case, Ghana. The strategy RAD-AID undertakes makes its solution to deploy a better healthcare delivery in developing countries a long-lasting and sustainable solution.

My first experience with the radiology-readiness program has molded me into an individual entrusted with integrity, self-responsibility, discipline, better communicator, continued learning and a servant-leader. For the sake of brevity, I will discuss some of the pros and cons of my experience, and also suggest a few pointers for individuals who plan to conduct future radiology readiness in developing countries.

Pros:

1. The 16-part survey is easy to understand, legible and analyzes crucial areas of the healthcare system

2. The categories are organized and coherent

3. Most of the questions can be answered from Annual reports or databases from the hospital(s)

4. Corresponding radiologists at the facility are willing to assist to answer the questions in the survey

5. A pre-assessment can be conducted prior to the visit to save time and also create room for secondary questions

Cons:

1. The survey is in adobe professional format. Without this program, it will be difficult to input the responses. I found a program similar to adobe professional but free. It’s called Foxit reader. One may google it and download for free. Future researchers can download this program as alternative to adobe professional.

Things to consider:

1. Cultural compatibility: future RAD-AID researchers must ensure they are culturally equipped and competent before visiting the facility. Respect of the culture is 50% towards building strong relationships and also facilitates easy communication. The GlobeSmart program provides a great tool for understanding cultural competencies prior to visits

2. Be clear, concise, and precise: I found out that it is quintessential to be clear, concise, and precise during communication between RAD-AID researchers and the medical staff at the facility. This is mainly due to cultural differences and understanding of the English language.

3. Grab annual reports of medical facilities: I found out that it was easier to get some information from the databases and recent annual reports. Most of the questions can be answered with the annual report of the facility; however, it is IMPORTANT to always double-check with administrators, radiologists etc.

4. Take lots of pictures: I find this very relaxing!

5. Remember to BACK-UP ALL ASSESSMENTS: In the case of unpredictable accidents or hiccups, it will benefit the RAD-AID researcher to always back-up responses to avoid going back to square one.

6. A blog might be a good way to remember events of the day and your experience!

7. Start out with the RAD-AID presentation: The RAD-AID presentation perfectly coined by Ezana Azene, MD, PhD gives its audience a better understanding of RAD-AID and its mission/strategies. Beginning the rad-aid assessment with this presentation will be the best ice-breaker at each facility visited

Acknowledgments:

I would like to use this opportunity to thank the following people/programs for making this project a success story:

Ronald W. Reagan Leadership Program

Dr. Daniel Mollura and Dr. Ezana Azene

Dr. Brad Sutton

Dr. Vincent Hewlett

 

RAD-AID and Other Ghanaian Hospitals: The Trust Hospital and Tema General Hospital

After completing the full assessment for 37 Military Hospital, I was ambitious on completing another assessment. However, it was Easter season and scheduling did not work out as best as I anticipated. I did, however, embark on a visit to create more interpersonal networks at the Trust Hospital. I met with Dr. Banke Ahove, Trust Hospital radiologist, and Dr. Osei, General Director of Trust Hospital in all of Ghana. We exchanged contacts and agreed to work together on future projects. I also exchanged contact information with Tema General Hospital for possible future assessments. Below are a few pictures:

37 MILITARY HOSPITAL & RAD-AID ASSESSMENT

My next RAD-AID assessment was conducted on 37 Military Hospital. 37 Military Hospital is also a tertiary referral unit that serves a majority of the population second to Korle-bu Teaching Hospital. Ran by the Ministry of Defense, the 37 Military Hospital carries the history of serving both national and international armed forces. I was interested in learning more about the 37 Military Hospital with the assistance from Dr. Ewurama Idun.

My schedule for the entire project was as follows:

1. RAD-AID presentation

2. Met with Chief Administrator

3. Met with Head radiologist and other radiologists in the department

4. Met with radiographer(s)

5. Reviewed responses with Dr. Idun

6. Dinner with Dr. Idun and the radiology members

Korle-bu Day 6 (Last Day)

 

My last day at Korle-bu was almost saddening. It has been an honor to work with the staff and members at the Korle-bu facility.  I spent the day with Dr. Hewlett to review the entire assessment to ensure everything has been answered precisely under the auspices of the hospital. I was relieved to have finished the assessment yet I still had a couple more hospitals I wanted to assess. To continue with the assessment at other hospitals, I did the following:

1. Contacted the head radiologist (or primary radiologist) who then contacted the head of administration of the Hospital about my visit

2. Upon approval from the hospital’s administration, discussed about the RAD-AID program and the radiology-readiness assessment

3. Set up a location and equipment for the introduction to RAD-AID presentation

4. Set up appointments with administrators, radiologists, radiographers, pharmacists etc. in addition to a recent annual report of the hospital

5. Find a location at the hospital premises to review assessment

Once I was able to secure all the above points, I gather all my necessities to begin yet another assessment!

Korle-bu Day 5

At this point, I was about 95% done with the RAD-AID radiology readiness assessment. Most of what I was left with were secondary questions for the purpose of clarification and precision e.g. the area of the facility, temperatures in and out the facility etc. I was very excited to cross the finish line for my first RAD-AID assessment in Ghana. My excitement wasn’t only because of the completion of the assessment but also building relationships with the Korle-bu staff, administrators, and faculty for future RAD-AID projects.

Although I had originally planned on starting off the project with the RAD-AID introduction, events did not start off well with everyone’s busy schedules. So I arranged for a formal presentation to all radiologists, radiographers, technicians, administrators etc. I set up the powerpoint in one of the lecture rooms with the assistance of a radiographer. The presentation went well, with a few questions here and there.

Later during the day, Dr. Hewlett and I visited Korle-bu Teaching Hospital General Overseer to debrief him of my experiences. He was impressed with the RAD-AID approach and asserted he will work with us to develop a better radiology at the facility.

A RAD-AID break…some interesting videos, pix from Ghana!!!

 

 

Korle-bu Day 4…more assessments!!!

So far, I have completed sections A (introductory), B (General Info), C (Community & Patient Satisfaction), F (Clinicals), G (Pharma), I (Training and CME), K (Communications), and M (Medical Imaging cap. & limitations). Today, I plan on completing Sections D, E, and H using the 2010 Korle-bu Annual Report as a guide. All information were double-checked with Dr. Hewlett and the chief administrator.

I also visited the nuclear medicine department for more information on CT, MRI, SPECT etc.

Korle Bu Day 3: Assessment, assessment, assessment!!!

So after a wonderful day 2 with the MED device, it was time to complete a major part of the readiness assessment. Today, I set up appointments with the head pharmacist, lab technicians and the chief administrator at the Radiology department. My goal was to complete sections F, G, H, K, N. Since I had already completed sections B, I, and M, I figured today would be a very productive day for me to complete at least 75% of the assessment. I spent most of my times clarifying some answers and seeking new information. The process was quite interesting and exciting because I was able to build relations with the Korle-bu faculty and staff while retrieving essential information from them as well. The best part of the assessment is to be able to foresee what I wanted to ask. For instance, if I wanted to know how many journals are available for radiographers/radiologists, I would ask for a copy of the journal or the titles or where they got them from! Once I finish with an appointment, I go back to the office to review the answers just in case I missed anything or if I needed more clarification on an answer. Below are pictures of Dr. Hewlett’s office where I usually go back for revisions and reviews:

Later today, Dr. Hewlett and I attended a General Electric (GE) conference at Holiday Inn, Accra. The conference discussed the latest development in contrast media and other pressing issues facing radiologists in Ghana and West Africa. I had the opportunities to meet some radiologists in the country as well as executive members of General Electric personnel in Ghana. Some pictures are shown above!

 

Korle-Bu Day 2 MED & Radiography Dept.

Typical traffic-congested day…Roads were very busy but managed to travel a 40 mile trip in an hour. Today, I will be meeting the chief radiographer at Korle-bu Hospital, Radiographer Boateng. We will discuss the following:

1. General and Background Information about the hospital including name, address, type of institution (public, private or religious), other health institutions that serve the community, top three challenges faced by the hospital and especially the radiology department

2. Training and Continuing Medical Education: Highest level of education required for a typical radiologist, radiographer, nurse, sonographer etc. in Ghana (and at the hospital); accessibility of medical imaging educational resources

3. Medical Imaging Capabilities: availability and working conditions of modalities in radiography, mammography, fluoroscopy, planar nuclear medicine, Bone densitometry; availability of radiology consumables such as iodinated contrast, gadolinium contrast, barium oral contrast, film, film cassettes, radiopharmaceuticals etc.

4. MED In-service Project:- One of RAD-AID’s current galvanizing move to assist developing countries through educational resources. With the MED (mobile electronic device), medical imaging practitioners will be able to gain access to current and quality educational resources. The Kindle fire device (also MED) contains over 10 radiology textbooks, medical terminologies, and documents helpful to the medical imaging community. With the “sync” features, information and textbooks can be sent wirelessly and efficiently to “hard-to-reach” hospitals around the world.

 

Korle-bu Day 1

The flight came by faster than I thought. I flew through Detroit to JFK International Airport then to Ghana. I could see the airplane submerged in the clouds as we slowly descended about 8 degrees right above the equator. It is about 1:30 pm that warm Saturday afternoon. Our safe, smooth flight was welcomed by the warmer tropical atmosphere as we jumped into the buses towards the Kotoka International Airport arrival terminal. “We are home again” was perhaps the slogan for most of the Ghanaian visitors. Everyone looked exhausted but I was too excited to begin the RAD-AID project already!!! After I got my bags, I joined my sister and left for home. At home, I sorted out my materials for the project, clothes, and other necessities for the 2-week visit in Ghana. I begin work the next day, March 26, 2012.

The next day…..Woke up around 5 am to avoid the morning traffic to Korle-bu Hospital. The morning was cooler than expected as it had rained heavily the previous night. I joined Dr. Owusu-Asare, previous Narh-Bita hospital mentor, to Korle-bu around 6:10 am but did not arrive till 7:45am. We had breakfast, and Dr. Owusu-Asare promptly dropped me off at the Korle-bu radiology department to meet Dr. Vincent Hewlett for the radiology-readiness assessment program. It was quite amusing to see Korle-bu yet I was curious to witness its facilities and talk to healthcare practitioners later during the day. Finally, I met Dr. Hewlett, who had a big smile from ear to ear on his face, shook hands with him and spoke a while about my journey. We rushed down the hall momentarily to meet staff, members, nurses, radiographers, and radiologists in the department.

I exchanged couple contact information with radiologists from other health institutions in the surrounding area who also sought interest in the radiology-readiness program. Dr. Hewlett also gave me a quick tour of the radiology department. Since then, I have been talking to the health practitioners I have met thus far to share with them what RAD-AID is all about…

Quick facts on Korle bu Hospital:

Korle-bu Teaching Hospital is one of Ghana’s premier and leading teaching hospitals in West Africa. Established on October 9,1923, the hospital is currently the thrid largest hospital in Africa and leading national referral center in Ghana. “Korle Bu” which means ‘the valley of the Korle lagoon’ was established to address the health needs of Ghanaians under the administration of Sir Gordon Guggisberg, the then Governor of the Gold Coast¹

Korle-bu, at the moment, serves clientele from Ghana, Nigeria, Burkina Faso, Togo, Tanzania, Ivory Coast, and Liberia. The clinical and diagnostic departments are Medicine, Child Health, OB/GYN, pathology, laboratories, radiology, anaesthesia, surgery, polyclinic, accident cener, allied surgery and pharmacy. Korle-bu also provides specialized procedures in various fields such as Neuro-surgery, dentistry, eye, ENT, renal, orthopedics, oncology, dermatology, cardiothoracic, radiotherapy, radiodiagnostics, pediatric surgery and reconstructive plastic surgery and burns²

Korle-bu recently carried out a first ever kidney transplant in West Africa, and is also one of few hospitals in Africa where DNA investigations are carried out. Korle bu’s mission is to provide healthcare to a majority of the Ghanaian and West African populations at an affordable and low-cost value³

Dr. Vincent Hewlett is the Head/Chief Radiologist at Korle-bu Teaching Hospital. I am privileged to work with him on the RAD-AID assessment project!

1,2,3 Annual Report 2010. Korle-bu Teaching Hospital. Accessed March 28, 2012.