Global Health Experiential Education in Ghana

I always dreamed and yearned to leave the country for study or internships while I was in college. At the beginning of August, I was finally given the chance to travel to Ghana with CFHI, not just for a practicum but also to take in the sights of a different nation. I merely adored it. I was quite nervous and eager because I was traveling to a nation where I didn't know anyone, but I realized that this was an opportunity for me to overcome my introversion.

Contrary to my expectation, I adjusted quickly since the CFHI made sure a coordinator and a preceptor were present for each step we took. Yes, there were instances when we solved problems on our own; that was also a valuable part of the experience. I improved my freedom and started to operate with less guidance. I had a great time and learned a lot during my rotations at Princess Marie Luis Hospital. In the classes I took at Liberty University, I came into contact with and experienced all the health facts I had learned. Through my interactions with others, I developed cultural sensitivity, but I never saw myself as superior to them. Instead, I learned to value the beauty in our differences. I also gained cultural humility as a result. I will always be grateful to CFHI for this transformation, and I eagerly anticipate traveling to other places with them. This program has my recommendation.

I decided to go with CFHI as part of my global health elective for medical school because of the wide variety of locations they have. I really wanted to go to Ghana and experience healthcare in another country, predominately in a hospital setting. CFHI provided me with an opportunity to rotate with different services at the Cape Coast Teaching Hospital and also provided me with everlasting memories that I will never forget. I made connections with residents and house officers who I deeply respect. There wasn't much help in getting there but once I was there things just started to fall together. I would suggest to anyone wanting to go to another country to look into CFHI due to its variety of program locations and also the ability to work in an already established setting. In addition, there are weekly lectures that introduce students to Ghana and public health. I do suggest that you be diligent and on top of making sure you have all of your required documents before hand and its correct because there wasn't much assistance with ensuring the information was uptodate. Take a look at the variety of things to do in both Cape Coast and Accra (3hrs away by van) for weekend activities as well. The program is what you make out of it. There is definitely time to explore and to learn so your trip is what you want it to be.

I am a second-year medical student and I went to Accra, Ghana through the CFHI program.

I rotated in the ER department and was able to round with the fifth-year medical students from Accra College of Medicine and Family Health Medical School. On my first day I rounded with the fifth-year medical students and I was terrified and intimidated. The way they presented, answered the doctor’s questions and interrogations on details about their cases, and dissected their differentials was astounding. With only one year of medical school under my belt, I felt useless and unknowledgeable compared to them. However, I tried to stay as engaged as I could, listening to patients’ hearts and lungs, interpreting x-rays and EKGs, and perfecting the craft of the history and physical exam. This coming year we’ll learn more about chronic illnesses and management, so I’ll be able to deepen my clinical knowledge and skills.

I was happy that I was able to recognize a lot of drug names since Pharm is one of my favorite classes and could ask questions about treatment plans and care management. Most of the pediatric cases were acute tonsillitis, acute otitis media, bronchopneumonia, bronchiolitis, and complications of sickle cell disease (SCD). I was able to see an infant that was diagnosed with Trisomy 21 aka Down syndrome and had a heart murmur. I was also able to see a patient that had a palpable thrill and murmur. I sat in on my first Morbidity and Mortality (M&M) meeting and learned a lot about that part of medical care. I also participated in various lectures on proper handwashing skills, stages and treatment of malnutrition, how to properly clean the umbilical cord postpartum, triaging, and common respiratory/cardiovascular diseases in children.

One of the most memorable days was when I clerked with one of the fifth-year medical students. His partner wasn’t coming till the afternoon, so I was there to make sure he asked all of the right questions. We exchanged mnemonics on the history of present illness (we learned OLDCARTS and he learned SOCRATES) and social history. I quickly jotted down all the aspects of the history that should be asked and felt grateful that my school had forced us to create our own SOAP note from scratch countless times. He was grateful that I was able to ensure he asked all of the necessary questions. Our main differential was Vaso-occlusive crisis as a complication of SCD. Our other differentials were osteomyelitis and cellulitis. Both doctors ended up supporting our top differential and it felt good to be able to come up with the correct diagnosis. The child also had otitis media but we weren’t sure if it was secondary to the SCD since they are more prone to infections, or independent of the SCD.

All in all I learned a lot this week, more than I ever thought I would and I’m so excited to rotate in other parts of the hospital. This experience is strengthening my desire to go into Family Medicine even more apparent and necessary.

This experience was more than I could have ever asked for. The local coordinators made sure that you constantly felt safe and comfortable. They brought us around town and made sure we felt comfortable navigating around. If you ever had a problem they were more than willing to help out in any way possible and turned into great friends. At the hospital I was in the physical therapy department. The therapists were very kind and welcoming as soon as I arrived. They made sure to answer any questions I had and were eager to teach me about their profession and culture. The most interesting case I saw was a baby girl who was born with only a fibula in one leg. She was there for casting for club foot in her other foot but it was interesting to see the X-ray of her leg. I would definitely recommend putting yourself out there when at the hospital. Don't be afraid to ask questions, get to know the people working there & talk to the patients. There are great relationships that can be made by just talking with others. For me, this experience was unforgettable, but it really is what you make of it. Make sure to try new things, step out of your comfort zone, and build relationships with the people around you.

I went to Ghana last summer with a group of students from Stanford through the CFHI program. We went in with very little information, expecting to be on a service learning trip that turned out to be mostly a learning experience. However, as a learning experience, it was the best thing I could have done coming out of my freshman year. For eight weeks, I got to live in a foreign country (it was my first time leaving the US) and learn about a way of life I'd had no prior experience with. I was struck almost daily by the positivity the Ghanaian people so freely express, and by their dedication to their work. Throughout the entire experience, I learned invaluable lessons regarding my future path as a doctor, seeing the challenges the doctors in Ghana faced in bringing care to their patients.

Journal excerpt from week three:
“The morning rays begin to peak through the window beside my bed. Off in the distance, I can hear the wild goats beating and the rooster that seems to crow at all hours of the day. As I look around me, I can see the others in the room starting to stir. I pull on my scrubs and join them in the main room for breakfast. Brittney and Basil are already at the table with the other volunteers mixing together the water and condensed milk. The peanut butter and crackers are passed around the table, and the bags of Crystal Water are packed for later in the day. After a quick discussion about what hospital department we plan to shadow, we grab our bags and head out the door. It is only 7:30 in the morning, but the air is already a bit warm. After a few futile attempts with our handkerchiefs to dry off the sweat, we begin the walk to the hospital, which is a little less than a mile. We are all anxious to return to our patients and check in with the physicians we shadow. Along the way, we briefly review the concepts we were instructed to study, such as the names of the metatarsal bones or the modes of healing. We have only been here a few short weeks, but have already grown to love working here in the hospital. As I make my way to A & E (Accident and Emergency Department), I am greeted by smiles from strangers calling out “Akwaaba” (meaning welcome). The people here are so genuine, it’s hard not to feel at home.” This program is an incredible opportunity for students hoping to learn about global health and the medical field. I have never had the opportunity to witness such hard work, compassion, and expertise combined. It renewed my passion for medicine and gave me a completely differest perspective on medical care. The physicians I worked with were incredible about showing me the process ad explaining how certain procedures were performed. It was an opportunity like no other for a pre-med student like myself. The highlight of my experience at Cape Coast hospital was scrubbing in to see a C-section and a baby being born for the first time. It was something I will never forget!
Home is exactly what it became for me. Living here for five weeks, I became a part of their community. I wasn’t just the outsider watching them from a distance. In a way, I was one of them. I was working side-by-side with them, eating the same foods, drinking the same drinks, and (in small sentences) speaking the same tongue. I learned about their cultural values, family customs, social interactions, and even their medical approaches. I think one of the most symbolic moments in embracing their culture, was when my house mother took us to Church with her. We got to attend weekly Mass with the community and at the end, they had a “birthday into the community” ceremony for Brittney, Basil, myself, and a few of the other volunteers we were living with. We were given our Ghanaian names at that ceremony based on the day of the week we were born. I became known as Esi. From that point forward, I had an instant connection with all other Tuesday born Ghanaians. I enjoyed feeling a part of their community and learning from their example.
We also had the privilege of having two a few local coordinators, Augustine and Roland, from the FEB foundation. These two were not only key to learning about this new land, but they also became good friends. They were so welcoming and excited to show us around town. We were incredibly lucky to have them. With their help, by the end of the trip, we knew the words to a few of their songs and had a snap in our handshake like the rest of Ghanaians.
The trip as a whole was an experience that I will never forget, and one that altered me in ways I didn’t expect. At first, I was definitely challenged to adjust to the cultural differences, unique living conditions, and cuisine options. I needed to learn how to adjust to bucket showers, water shortages, and regular power outages. Although I struggled at first to figure out ways to wash clothing or communicate back home, I soon developed new methods and learned to acclimate myself. I discovered how to wash entire loads of laundry in only half a bucket of water and shower using only a bottle of water. I then learned to translate these water conservation methods to cleaning bedpans and towels to help aid the patients in the hospital. Adjusting to life in a developing country became a challenging, but an enriching experience. It changes your entire perspective and doesn’t leave you once you return to the United States.
Things like the careful use of resources and respect for others were vital aspects of the Ghanaian community. There have been numerous times already since I have returned, that I find myself thinking how resources are being allocated, or how certain actions could be perceived. Since coming back, I have felt a bit frustrated at times with the disregard for the struggle of others. There are so many people here in the U.S. that cannot think beyond their next Starbuck’s latte, never mind the people that are struggling just to access clean water. It makes me realize that I want to be careful in determining where my priorities lie. I don’t want to spend my life concerned with trivial matters when I could be contributing to the livelihood of others. It solidified for me my passion for continuing outreach and medical care.
When I stepped off the plane as a Global Medical Volunteer, I realized I might never look at healthcare or cultural differences the same way. During my first week as a volunteer, I met a young woman who was a patient at Cape Coast Hospital in Ghana. She had a tumor obstructing her airway, along with a case of pneumonia. With each labored breath, I could hear her struggle alone in her room. Concerned by her state, I went to check her vitals. As I unwrapped the blood pressure cuff, she reached up and grabbed my hand. I squeezed her hand in return to let her know I was there. She looked up at me, surprised, and a small smile crept across her once distraught face. It was the first time I had seen her smile and was determined not to let it be it her last. When the doctors asked someone to check her vitals and nebulizer every hour, I readily volunteered. To lighten her spirits, I made smiley face balloons from the rubber gloves. When she passed away, my heart dropped. I realized, however, that her story did not end here; her hands would continue to work through me as I care for those around me. In those five weeks, I was not able to eradicate malaria or even suture a wound; however, I know the people of Ghana will be forever imprinted on me as I go forth into the medical field. I will carry the sense of community and compassion shown me, and use that to guide me as a future physician.
I know that as a future physician, this experience will forever shape how I treat my patients, how I practice medicine, and how I extend that care to others. I watched the physicians in Ghana take the time to listen to their patients, make them laugh, and to offer them a kind word. I have never met such devoted and self-sacrificing individuals, who often spent even their “nights off” living in the hospital. They rolled up their sleeves and treated each patient with extraordinary care that often when beyond the walls of the hospital. I hope to follow their model, and cherish the moments that allow me to improve another person’s quality of life, whether that be in terms of housing, medicine sanitation, resources, or emotionally. I have learned from the people there that we all have great capabilities for doing good. In choosing to support one another, we build a community that strengthens itself. This has significant impacts on each individual both emotionally and physically. One of the physicians at Cape Coast Hospital once said to me at the end of his 48-hour shift, “If I look back on my life someday, and someone received a second chance because of me, then my life was worth something.” Those are words I will never forget, and I believe will guide me as I navigate my way through life.
I am extremely grateful for this opportunity to join a completely different culture, and understand how living with limited resources doesn’t need to limit you as a person. I have learned more in these short five weeks than I thought possible. I learned about myself and how to manage in extreme settings. I have become more conscious of my respect towards others, especially those who are my elders. I have discovered that reaching out and simply saying Akwaaba, or hello, can brighten anyone’s day. Most of all, I have embraced the idea that everyone is your brother (or sister) and that you have a duty to yourself and to them to bridge that divide.

My time in Ghana with CFHI was one of the most impactful components of my education in Public Health. This experience allowed me the chance to see the theories I'd learned playing out in a real-world setting, before my very eyes. Not only did I get to see these health challenges and disparities in person, I was also able to participate in efforts to counteract them through community outreach programs.
During my internship, I was fortunate that my schedule overlapped with another NGO in Cape Coast, and I was able to participate in a health clinic day in a rural village. This was one of the highlights of my time in Ghana, as I was able to meet the village elder and get a tour of her village, while she told me about the beauty and difficulty of the lives of those within her community.
I'd recommend CFHI Ghana to anyone looking to gain a better understanding of health and social disparities in a developing country. Entering into this program with an open mind and a willingness to expand your comfort zone will likely result in enjoying this program fully.

As a third-year pediatric resident who has some prior experience abroad, I came to this rotation with specific learning goals. The program and hospital staff were extremely hospitable and allowed me to tailor my experience to meet those objectives. At the same time I was given enough autonomy to see patients mostly independently (with appropriate supervision when needed, of course) and actually be useful instead of just being a burden to them. Housing was clean and more importantly safe, even though I was there alone for most of the month. The local coordinator did an excellent job of orienting me to the city and hospital.