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ELWIN INTERNATIONAL TOURS (est.1995) "A true knowledge of Africa"
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Here are some comments from our volunteers
Ours is a multidisciplinary health care volunteer program. The program offers opportunities to healthcare trainees in medicine and allied health fields, physicians and other qualified healthcare professionals to learn, teach and support the KEEA community in Ghana.The program is operated by the Edward A. Ulzen Memorial Foundation in collaboration with the District Administration. Below are comments from some of our earlier volunteers.
Through my stay at the clinic I spent time in the dressing room, consulting room, main doctors office, laboratory, and even went out to the villages to educate the people on hygiene and HIV. In the dressing room I learned how to attend to a patients wounds and attended to 10 patients on a regular basis while I was at the clinic. I also learned how to give stitches and remove them. While in the dressing room I was able to observe different emergency situations and learned how to go about handling them. One patient came in with a big fishhook through his finger so it was interesting watching them remove that. I made myself very familiar with the dressing room and was actually asked to open it up by myself for a few hours on my last day volunteering. I spent a lot of time in maternity and was able to observe 5 women give birth, and correctly guessed the sex of 3 of the newborns. One of the midwives taught me how to wash a newborn and I was given the privilege of giving one of the newborn girls her first bath. I was taught how to do an episiotomy and actually performed one on a handkerchief for practice. It was very interesting watching how much care had to be taken when removing the placenta to prevent hemorrhaging. Being in maternity was a great experience not only in my observations, but in everything I learned from the different CMs to when the oxytocin was added to induce contractions. The most common medical problem that comes up at the Elmina Clinic is Malaria. Seeing as Malaria was so common in Elmina the main doctor thought it was important to teach me all about it. The doctor taught me how to diagnose, treat, and even sent me to the lab to learn how to identify the Malaria blood parasite under a microscope. When I had free time I would sit in the consultation room and at times I was able to diagnose Malaria and understood what medication and how much of it would need to be taken by the patients. By my last day volunteering I had been through every area of the hospital, but had yet to go to the villages to talk to the people so that’s what I decided to do. When out in the villages we educated the people on proper hygiene and HIV. During my stay at the hospital I logged 40 hours of volunteering through a course of 7 days and every moment was worth it. I have taken so much away from the program and my experiences in Elmina. The knowledge I gained will help me in the future I feel like I took a big step forward and I am closer to accomplishing the goals I have set for myself. All my expectations were met through the program. Brandon Esianor, Pre- Med Student, University of Texas, Arlington, TX, USA January 2012
...In Ghana, things don’t happen when you think they should, or in the order you think they should. There is no timetable or itinerary, but everything still gets done, and it happens with warmth, wit and good-humored charm. As “supervisors,” we had been given the rare privilege of not only being able to learn and observe how important public health efforts are meted out in Ghana, but also to participate and vaccinate as well. Aaron and I had the opportunity to visit twenty- five of the tiny villages around Elmina. Bouncing through the rugged rainforest roads that connected one village to the next, we would pass families harvesting palm nuts, yams or pineapples from the bush. We would see people carrying enormous loads of firewood on their heads, and once in a while, the driver would stop to give a weary worker a lift.... Though we left Ghana, the K.E.E.A. district and the people there have not left us. Our hearts are changed. They are fuller and perhaps a bit gentler. Thank-you for your support and for the trip of a lifetime. We are forever grateful for this opportunity your kindness afforded us... Drs A. Krych & E. Rodruigez Interns from The Mayo Clinic, Minnesota, March/April 2005
...July was a nice time to visit, as it was not unbearably hot and nighttime rain cooled things down a bit. My month-long stay in Ghana was an unforgettable experience and I would do it again in a heartbeat. **Dr. Thad, Lucy, Frances, and the Foundation: Thank you for making my stay comfortable and giving me the opportunity to volunteer and learn about the healthcare system in Ghana.. Sandra Renee Goldsberry, Pre-med Student from Southern California,July 2005.

...In the 2 weeks I was in Ghana, I saw 15-20 urgent/emergent cases daily. Examples of cases seen: lots of malaria, typhoid enteritis, decompensated heart failure, hypertensive urgency, MVAs (called RTAs there, or road traffic accidents), lacerations, sickle cell crises, strokes, labor in full-term patients, postpartum hemorrhage, filariasis, cellulitis, incarcerated hernias, strangulated hernias, gas gangrene, tetany, burns........Overall a wonderful, if sometimes sad, experience. There is much to be learned by a visiting physician when it comes to tropical diseases and improving clinical acumen. You will learn to rely more on history and examination, and less on diagnostic testing. What is sobering are the cases you know could have been prevented or treated better save for a lack of resources. Your time here is appreciated, and I only wish I had more time to give to Ghana. Richard Kwun MD, Emergency Physician, Mt. Sinai, New York, July, 2005
"...We have never seen so many babies at once as on the out reaches! One day, weighing babies in a district of Elmina over 200 mothers with their babies and older siblings showed up. Just for one district of the town! So we had our work cut out for us. Meeting moms and babies was so much fun and very rewarding. I think this is something we will always remember. Being on an Out Reach could get hectic; so many babies to weigh and charts to fill out and when you don’t speak or understand Fanti, things do tend get confusing. But with a little patience and the right attitude, everything works out just fine. The people from the Health Center we’ve worked with are all well intended and kind hearted, smiles and laughter from the moms also makes everything easy."...But just observing and being helpful was also rewarding, as we learnt new things each day about Ghana, the people and diseases we don’t see in our home country. We also managed to arrange a visit at the Ankaful Leprosy Hospital. Leprosy has been eliminated over sixty decades in Sweden so incidents of leprosy are something we would never have the chance to see. We got to meet the doctor at the leprosarium who does everything; from meeting new patients each day, to performing advanced surgery on them on his own. As a coincidence, the doctor turned to be a good friend of one of our Swedish professors! .." Amanda Allderval & Christer Nillson, Medical Students from Sweden June 2005
...Once things got rolling, we saw about 50-60 patients per day, with most of them coming in for acute gastroenteritis, URIs, and malaria symptoms. We also saw various skin infections, lacerations, failure to thrive, worms, and even diagnosed a heart defect. Occasionally, we’d have to refer a patient to the Regional Hospital, and even to the main teaching hospital in Accra for further studies. Our work at the regional hospital had us rounding with the attendings that consisted of Cuban physicians, and a few of the local physicians trained in Ghana. It was unfortunate to see so many sick patients who could not have certain lab tests or procedures done simply because of the lack of resources. Our only regret was that we wished we could have done more during our short stay in Ghana. Overall, it was an unforgettable experience. It not only made us appreciate how fortunate we are in the United States, but also encouraged us to do more work overseas. Thank you again Dr. Ulzen for your kindness and for giving us this wonderful opportunity to help those in need.... Dr.Davis Lee (Childrens' Hospital Los Angeles) and Dr Janet Yang (Cedars Sinai Hospital, Los Angeles)Nov/Dec 2005.

I was greeted by Ghanaians with the phrase “Akwaaba.” Literally meaning “you are welcome,” the term reflected the sense of openness, friendliness and generosity that I felt at every turn during my three weeks in Ghana. The three weeks that I spent in Ghana with the Edward A. Ulzen Memorial Foundation were truly unforgettable, and I hope to share at least some of the emotions that I felt during my time there…….I chose to spend much of my time working on outreach efforts with nurses from the EUHC, as well as some time seeing patients with the medical assistant at the EUHC, some time in the CCRH emergency room, two days at the Ankaful Leprosarium, and a day at the Ankaful Psychiatric Hospital. The variety of experiences provided me with an overview of Ghanaian health care that I would have been lacking had I been involved only with one activity…….On a number of occasions we took out our stethoscopes, sphygmomanometers, and ophthalmoscopes and offered free screening to anyone. The amount of undiagnosed disease was astounding. Hypertension was rampant, and our criteria for further care at EUHC was set at far higher levels than we would have been comfortable with in the United States. On one occasion, a local elementary school heard about our efforts and asked us to screen all of its 25 teachers. One 24 year-old teacher had a blood pressure of 220/110, and had no idea about his condition. Our group of three medical students identified several people with the signs of African River Blindness, and we found several children with prominent undiagnosed heart murmurs. Even when I wasn’t looking for it I would see pathology. Walking through Elmina one afternoon I saw a very young child with the unmistakable bowlegs of rickets……. I want to go back to Ghana soon, and continue to help the communities I worked in. Finding the time and money to do this during residency will be difficult, but I plan on making it a priority. Thank you for this opportunity and for your generosity. This experience truly has changed my life, and I cannot ask for a more perfect way to end medical school. Daniel Howard MD, Mayo Medical School, March – April 2006
At the Urban Health Center and the Cape Coast Regional Hospital, we quickly learned to recognize the lethargy and glassy eyes of a child with malaria, or an adult with typhoid fever, two of the most common conditions that we saw. I spent a morning helping nurses with prenatal visits, baffled by the plastic fetal stethoscope (but an ultrasound machine would be out of the question). The facilities were spartan but well-kept and well-used. The same nurses who did outreach also ran a family planning and counseling center and an adolescent health information center. One afternoon we had the opportunity to spend some time at the adolescent health information center. In addition to exchanging national anthems and answering each others’ questions about the U.S. and Ghana, we helped the nurses quiz the students on HIV and other STDs. Our visit to the Psychiatric Hospital, about 10 miles from Elmina, was sobering. The wards were overflowing with people, with nearly twice as many people as there were beds. The acute male ward had 59 beds, 94 patients, and a single nurse. Again, however, I was struck by the friendliness of the patients and of the staff members, who, despite being overwhelmed with the patient load, took time to talk to us about psychiatry in Ghana and show us around the wards. Unlike medical care, psychiatric care is essentially free in Ghana, so access to care is less of an issue. However, in order to finance this free care, doctors must prescribe the less expensive medications, often using psychotropic drugs that haven’t been first line therapies in the U.S. for decades. At each site, we were so warmly received, both by the Ghana Health Service staff and by the patients. We were greeted with smiles and the phrase “you are welcome”. By the end of our three weeks in Elmina, we had grown quite close with Lucy, Francis [ Cultural interpreters of EAUMF, in Elmina] and the outreach nurses. On our last night in Elmina, we took them out to a beautiful seaside restaurant, where we spent the evening enjoying food, dancing, taking pictures, and laughing. The nurses surprised us with bright, handmade African clothing, about which they had heard us rave for the preceding three weeks. I know I am not the only volunteer who plans to return to work in Elmina when my schedule next affords it. Rheanna Platt MD, Mayo Medical School, March – April 2006
"I was very surprised to find that there is no full-time physician at the clinic despite the large volume of patients served--when no volunteers are present, the medical assistant sees as many as 100 patients by himself. The work was very fast-paced--I would see 40-50 patients/daily. I was given an exam room and a nurse to assist and translate. The patient population was very different from what I have become accustomed to in general medicine practice in the US. Because the life expectancy is mid 50s in Ghana, the patients seen there tend to be younger patients with infectious diseases, rather than the older patients with cardiovascular illness that we see in the US........ Usually those patients would be over 40 and presenting with an infectious complaint such as fever and the chronic condition would be found incidentally. Routine screening check-ups are unheard of in this patient population, which I found very frustrating! I also spent quite a bit of time counseling women about family planning--there actually is an excellent family planning centre on-site but I found that many women wouldn't even think about visiting the family planning nurses unless we discussed it with them beforehand..... I spent a day each week at the HIV clinic in the Regional Hospital. This was a very interesting experience. I found their HIV program excellent. Though they only have a few combinations of HAART tx available, the compliance is close to 100%. They require patients to attend three separate counseling visits before they initiate anti-retrovirals. Some of the patients with untreated disease are extremely ill, which was disturbing.....I also had a wonderful time living with Lucy and Francis at the Java House. They were warm, welcoming, and fun to be around. Lucy's an amazing cook--I kept telling her she should start a Museum Restaurant and Coffeeshop!" Sujatha Sankaran MD, Internist at Columbia University College of Physicians & Surgeons, NY EAUMF volunteer from July -Sept 2006.

"Dr.Sankaran and I were able to write some basic protocols to help these individuals in providing care for basic diagnoses including UTIs, hypertension, vaginitis, malaria, skin conditions, etc. A private lab was available across the street to perform basic tests including malaria smears, widal tests (typhoid), pregnancy tests, urinalysis, and blood counts. Cholesterol, metabolic panels and other testing could be sent to Cape Coast, about 10 km away. Several times, we did need to send patients to the hospital in Cape Coast for hospitalization or treatment of severe injuries. I was also fortunate to visit an HIV clinic in Cape Coast where they were just starting a program for ARV medications. I also worked for a day with some physicians in the Ankaful Leprosy Hospital which provided primary care, as well as treatment of many skin disorders.....Lucy and Francis were wonderful hosts and helped us to learn more about Ghana's history and culture. It was invaluable to stay with them. It was also wonderful to be close to the clinic and to be able to have a room and a shower at night to relax. Ann Terry ARNP, Seattle, WA September 2006.
..."Overall my experience in Elmina was phenomenal. It was an eye-opening experience I will never forget. I learned a lot about a culture and a people that I will never forget. I learned a lot about what medical care means in a third-world country with little resources and even less man-power. This experience definitely furthered my training in international health and will benefit me for years to come. I also felt that I was part of the team and was able to contribute, even if it were ever so slightly. All of this and I had time for some wonderful traveling"... Kimberly Spillman MD MPH, Florida State University - College of Medicine, Jan- Feb 2007.
I have only wonderful things to say about the EAUMF foundation as they certainly were great to us! Lucy and Francis were the most wonderful, genuine people I have met in a long time. Everything you promised us, certainly came true. I felt so safe and between Edwin. Oku, Lucy and Francis we were so well looked after. I have spread the word at work that you are a great group to volunteer with!.... I think everyone should live this experience once in a life time and lots here would never speak about" if you had my life". I thank you for organizing this experience of a life time for me. Hope I left something behind to help out these wonderful people! Ann Nickerson, Pharmacist, Halifax, NS Canada, April 2007

To begin with, everyone involved in your program, and with the Elmina Urban Health Center were truly generous and kind in so many ways. From Edwin’s prompt greeting at the airport, to Lucy and Francis’ generosity and openness at their home to the Health Center’s eagerness to allow me to become an integral member of their team, I felt truly welcome. The Java House is a great place to stay, and having to experience temporary power outages and minimal running water to me added to the ‘experience’ of living in a country like Ghana....I enjoyed getting to taste literally all of the local Ghanaian cuisine; Lucy is a great cook! In addition, transportation was for the most part adequate...In the medical setting, I felt the experience met and even exceeded my expectations. I am a general pediatrician, and seeing kids in the outpatient setting was really what I set out to do. The volume of patients was good – not too many, not too few. I got to deal with many standard pediatric diagnoses that I see in the US, and got to treat many things that I do not see at home. Namely, I saw kids with malaria, typhoid, worms, elephantiasis and yaws, among many others. I was provided with local Ghanaian medical texts that were very valuable...And finally, I enjoyed having ‘time off’ on the weekends to travel around the country and see some of the local sites. I even dragged a nurse, Lucy, and her mom to one of the local beaches one day, which was very fun. In sum, this was an incredible and unforgettable experience that I will keep with me forever. I would love to return some day to work there again. I thank you Thad for organizing this program, and you are helping to improving health care in Elmina. Keep up the great work, and please let me know if I can ever help out more in the future. Andrew Tenenbaum MD, Pediatrician, Portland, ME, USA February 2007.
My trip to Ghana was a once in a lifetime experience. This was the first international medical volunteer trip in which I stayed in a family’s home, which gave it a whole other dimension. I believe that despite the short time I was there, each person who experiences providing medical care in this type of setting will be forever changed. I am currently preparing a presentation on the EAUMF medical volunteer program along with my personal experiences to present at a emergency medicine residency conference next week. I hope that others will be inspired to volunteer their time and skills to this cause. Thanks to everyone involved for making this such a great experience. Nancy Creech, Chicago, USA, February 2007.
We arrived in Accra, Ghana, late Tuesday night. The airport was crowded and for a moment we were terrified, realizing that we knew not a single person in the entire country. However, as Dr. Ulzen had promised, an incredibly friendly man named Edwin was waiting for us at the arrival terminal...On our first full day in Elmina we met Mariatu, a coordinator at the Elmina Health Clinic. She drove us to all of the sites that we would rotate through, introduced us to the directors at each and took us on tours. Afterwards, she met with us to discuss our goals for the rotation and together we created a schedule, outlining at which sites we would spend each day of the week.....Cape Coast Regional hospital: This site offers the opportunity to learn about many medical specialties (e.g. surgery, general medicine, pediatrics, obstetrics and gynecology, intensive care, HIV and infectious disease, emergency medicine, wound care and others). We spent time in the emergency room, participated in rounds with the gynecologists on the in-patient ob-gyn ward, observed the gynecology out-patient clinic and observed the HIV outpatient clinic. There were always many attending physicians, residents, nurses and nursing students who were eager to answer our questions and encourage our participation and contribution to case discussions...Elmina Clinic: We saw about 25 patients a day, ranging in age from just a few weeks to people in their 80’s and 90’s. We saw a variety of pathologies, including malaria, typhoid, pneumonia, anemia, malnutrition, scabies, thyroid disorders, cirrhosis, elephantitis, worms, mastitis and traumatic injuries...Out-reach Vaccination Program: Every morning a van leaves from the Elmina Clinic at about 6 AM, carrying a scale and vaccination equipment. The van goes to villages that are too far from the clinic for parents to bring their children in for routine weight checks and vaccinations. When we arrived at a village we walked all around, meeting the people and announcing that we had come and that parents should bring their children to a designated place. We then set up, hanging the scale from a tree and preparing the vaccines. The children all come with special shorts that have a strap which allows them to suspend from the scale so that we can weigh them and make sure that they are gaining weight appropriately. We then gave the children vaccines (oral polio, BCG, hepatitis, diptheria, measles, mumps) and vitamins according to their age and vaccine history...Ankaful Leprosarium:We also participated in the clinics where we saw, discussed and learned about various skin diseases including leprosy, pemphigus vulgaris, scabies, eczema, chronic dermatitis, cutaneous manifestations of river blindness, fungi (tinea corporis, tinea capitus, tinea pedis) and serious drug reactions. The attendings allowed us to examine all of the patients and discuss the diagnosis and appropriate treatment for each...We spent our weekends traveling around the country, visiting various places including Tema, Koforidua, Kumasi (which has the largest open market in West Africa), Busua, Nezulezo (a village built on stilts), Kakum National Park (which has a canopy walk through the rain forest) and Hans Cottage (which has alligators that Anthony pet!)...We cannot say enough wonderful things about this program and encourage anyone interested in a health elective in Africa to participate in EAUMF. Melissa Frey & Anthony Rossi Cornell Medical College, May/June 2007

Our experience at the Java House was very pleasant. The Obeng family is very kind to their visitors and we felt completely comfortable there....Our time at the Urban Health Center was a challenging experience. Fighting our way through the language barrier, hoards of illnesses, and cultural differences encouraged us to humbly remember how small we are, how fragile life is, and what a privilege it is to live in the US where healthcare is readily available. We were grateful for the nurses (especially Sarah) and midwifes (especially Elizabeth) who helped us navigate through our first experience in tropical medicine. I found myself thinking quite often, ‘I wish I knew more, could do more, and had more to give for these deserving people....We will try and encourage a new group of first year medical students to visit Elmina next summer as well, as our experience was invaluable to our medical training. Jen Vesely MSIII Univ. of Minnesotsa, August 2007
I was very impressed with the whole process, from applying to volunteer , being met at the airport by Edwin, taken to the bus, met in Elmina, the welcoming hospitality, the great food. I love the Ghanian food the best. I was the first midwife to volunteer and was put to useful work and did a few deliveries and worked in the ante natal clinic, etc. I loved the staff and was made so welcome. It was great. I was so impressed with the midwives at the clinic and formed a bond with them. They do so much with so little. I must say I thoroughly enjoyed my time and felt useful there and now that I know what they need and am sending some supplies to the midwifes...I know that when i can go back I will bring a lot with me. Thank you for your work and I think you are providing a wonderful service. I felt well looked after and I would recommend this organization to any provider who was looking for a volunteer position. Thank you for the opportunity. I am willing to talk with anyone who has questions. Deborah Crabbe,CMN, MS; New Mexico, USA, October 2007
What a wonderful, challenging, rewarding experience! The people in Accra, at Java House, at the clinic, on the outreach visits – all of them so friendly and so hard to leave after just two weeks. I had been a little nervous about the whole trip, but needn’t have been.... the clinic staff translated for me and guided me as I learnt more about tropical medicine and ways of dealing with up to 100 patients who wait from early morning to be seen, and must be diagnosed and treated with almost no advanced equipment or investigations....Ghana has a good national health care system, but there are always those who fall through the cracks, like the malnourished baby who presented after her twin died the day before. I don’t think the mother had been able to attend the mobile baby health clinics I went out with on two occasions. One of my great memories of the work is hanging the babies up one by one from the branch of a tree, their weighing shorts hooked onto a portable scale and recording the weight and immunization status in the baby health books that each mother brought with her. I wished so much that I could speak the local language as there was a lot of laughter and banter on those days and I would have loved to join in fully......I learnt not to take my digital camera out unless I was happy to spend the next ten minutes photographing all the children in sight – which of course I was! I learnt that the Internet café doesn’t work in the rain, that the local Key soap makes a great home-coming present, and that being in a different culture and working there is the best way to see another country....Sorry it’s taken me so long and thank you so much for setting up the program. It was a wonderful introduction to tropical medicine for me and I am very grateful for the opportunity to have been part of it....just put that it was all brilliant, because it was! Cassandra Arnold MD, Australia, October 2007.

...Due to the limited availability of supplies and hospital beds, most of the surgical procedures I was involved with were general surgery, orthopaedics and obstetrics/gynecology. As emergencies came in, we dealt with them, though surgically this presented a problem due to resources. From an anesthetic perspective, monitoring equipment was frequently unavailable due to power outages or simply being unavaible. ECG monitoring was occasionally available as was pulse oximetry, though blood pressure was often performed using a manual cuff and in at least one instance, this was unavailable. I was called to the emergency department (Accident and emergency - or A&E - as it is known) one afternoon to help assess a female patient requiring an urgent c-section. The hospital, at that time, had no running water available for sterilization of equipment, no piped-in oxygen and no electricity due to the intentional black-outs. As such, the decision was made to transport the patient to the nearby District hospital where the essential services would be available. I was loaded into a waiting ambulance along with a case of IV fluids and we set off down the highway with lights and sirens blaring, headed for the nearest hospital. When we arrived, we had few to no drugs available and Harry, the nurse anesthetist, induced the patient while I attempted to repair the anesthetic machine and obtain some vitals. The patient survived, as did her child, though it was an eventful delivery!...As for the EAUMF, I can't say enough of the hospitality that was shown to me by all members of your staff. All of the transportation worked out, seamlessly, and Francis and Lucy (And Lucy's mother and sister) were some of the nicest and most helpful people that I have ever met. All of them truly went out of their way to ensure our safety and comfort and made sure that we not only worked hard, but enjoyed ourselves while we were there. It has been nothing but a pleasure to keep contact with them and I hope that this continues...I truly enjoyed my time spent in Elmina and Cape Coast and would recommend it to anyone thinking of traveling to experience the medical system in a developing country. The Foundation provided us with everything we needed and went out of their way to ensure our comfort while in Ghana. Thank you very much for your hard work! Jason Nickerson,BHSc, RRT(A), Department of Anesthesia, Capital District Health Authority, Halifax, NS - April 2007
....Instead of staying the whole time at the outreach clinic, a nursing student invited me and to go to a nearby school to perform a hygiene check. Not knowing what this entailed, I quickly found myself engulfed by a class of 300 students, inspecting their hair, fingernails and skin. I learned a few words in Twi, most importantly, “wash” and “cut” referring to the many dirty and long fingernails. There were a couple of children with ringworm, a few with infected wounds, and many looked malnourished. We encouraged the children with medical issues to have their parents take them to their district clinic. Families with insurance (approx 10 USD per year, depending on a family’s earnings) have access to many free medical care services and treatment at their district clinic. The teacher asked that I give a lecture of nutrition to the children. Although English is Ghana’s national language, I found there was only a very limited amount being taught in the more rural schools. Most children looked at least 10 years old and knew only a couple of English words. Trying to come up with a lecture about nutrition to over 300 Ghanain children of differing ages with most likely very limited resources of nutrition, and practically no understanding of the English language proved to be a challenge. But I must say, it ended up being a great highlight. The teachers collaborated with me and then translated for me, and it was a great success. The kids gave me hugs and high-fives, and a few beautiful pictures of them. I found that basic education about nutrition, hygiene and medical care proved to be a powerful nursing tool. It was a thrilling experience to take part in a third world country’s health care system. I learned a lot about how it works, had the chance to talk to locals about their concerns regarding the system, worked first hand with doctors and nurses, and was able to see what seemed to be working, and what might be more efficient if changed. Ghana seemed to be at the forefront of revamping its healthcare system from the recent subsidizing of healthcare just last year, to the many donations of vaccines from UNICEF and WHO, and the recent attention being placed on healthcare education. I had the opportunity to attend a UNICEF rally on the prevention of mother to baby transmission of diseases, and talked with a board member who told me Ghana has really been seeing some improvement due to these efforts. It was an encouraging experience, as well as a very humbling one. Kathryn Quenneville, Registered Nurse, Napa, California, September 2007
.... In my work at the Ankaful Hospital I found direct patient care to be difficult because of cultural and language restrictions, but I was struck by the opportunities for potential involvement by volunteers, and especially in the area of public health. A start might be an assessment of needs. What does the District think it needs and where would volunteer efforts be useful? It might make sense for Dr. Ulzen and the District physicians to develop several projects and then have the volunteers fit into those projects. That would give a structure that the volunteers could fit into, each advancing the project a bit further in small increments until completion. This would also avoid the problem of each volunteer having to “re-invent the wheel” when they arrive and would help the local physicians to have an ongoing project that would be enduring and helpful rather than splintered and split off projects. A modification of this would be to give a volunteer a specific project before they go. It might be to provide specific in-service education or to assist in developing web-based services or whatever. The point is that they could prepare before leaving the U.S. and carry with them supplies that would be more targeted and specifically useful, and could also fit the volunteer’s areas of expertise. This may be a level of organization that is uncommon is Ghana, but a start could be helpful in and of itself. That is, function will help provide structure.... Outpatient education is important and could begin in the clinics themselves where televisions could be placed running educational tapes on a variety of public health/mental health subjects. Done in local dialects they could provide information on HIV/AIDS, hygene, birth control, common illnesses, and measures to avoid them, etc...Thank you for the opportunity to work in Ghana. It was a tremendous experience and obviously I’m still reflecting upon even eight months later. I hope that these thought will be helpful in the ongoing design and development of EAUMF and its work in Ghana. Charles Zapf MD, Psychiatrist, Emory University, Atlanta, GA April 2007

We found Ghanaians everywhere to be very friendly and welcoming. With all of this, our expectations were certainly met and superseded. I would recommend this experience to medical students, nurses or other healthcare practitioners who are looking to learn about healthcare in an international/tropical setting..... When you go, you are there to learn, and the opportunities for that are tremendous. You will learn a lot from the nurses who do an outstanding job running the EUHC....It is most certainly a privilege to learn from the nurses who work at EUHC, and respect that when you come there for a few weeks you are not there to change things or have your own patient load, but to learn everything you can from the nurses and patients you do see. We enjoyed our three week trip tremendously. It was an outstanding learning experience, and we were so grateful for the generosity of the people who taught and hosted us in Ghana. Thank you! Gita Thanarajsingam & Ben Sandefur MS3 students, Mayo Medical School, MN, USA April 2008
I had an incredible experience living and working with the Elmina community. Everyone was extremely welcoming and friendly while always making us feel at home. Working in the Cape Coast Hospital Emergency Dept. was an experience I will never forget thanks to the wonderful staff. Because the culture and pace of life in Ghana is so different from the West, it is imperative to have an open mind and involve yourself in the project and community even if no one pushes you to do so. This project is really what the volunteer chooses to make of it. Living at the Java House was wonderful thanks to Lucy and her family. Dr. Ulzen, Edwin, Charles, and Margret also made the experience easy and hassle free, they were always there when we needed them. It was also great to have a chance to explore the country on our off time. Ghana is a special place that’s spirit is extremely positive. I encourage anyone who is interested in an amazing cross cultural experience to join in.... Ilan Navah EMT March - June 2008, California
"During my elective in Ghana, I gained greater self-confidence in my clinical decision making and increased my cultural awareness and sensitivity. It was a great way to learn about communicable diseases and social determinants of health in a developing country. I was exposed to the challenges (successes and frustrations) of providing healthcare in a resource poor environment. I would strongly recommend this program." ...."My only complaint was that I felt too well taken care of!" Erin Reich MSIV, University of Western Ontario, London ON Canada - Nov. - Dec. 2008

I was able to really experience the healthcare system from a viewpoint that most do not have the privilege to see and for that I am very grateful. I think that for a first time international medicine experience, it did a good job acclimating me to these types of experiences and I will hopefully be even that much more prepared the next time I embark on something such as this. This experience also helped me realize that it is very difficult to show up in a foreign country and expect to just dive right in and work in the healthcare field—not only is the system different, but so are some of the medications and cultural beliefs/expectations of the patients...Overall, it was an incredible experience and one that I would recommend to others...The Java House was a great place to live for the few weeks I was there. The outside travels were also incredible and wonderous!! I had the pleasure to travel to Beyin, Nzuelezo, and Mole, as well as lots of local travels. Karrie Murphy OB/GYN 3rd Year Resident, CA February 2009
. I also worked with patients with poorly controlled diabetes and/or hypertension, a man suffering from an inguinal hernia, and several patients with skin lesions. I also observed health professionals suture a man whose ear had been almost severed in a motor vehicle accident, and the procedure took place without the benefit of generalized anesthesia. It was apparent that there was a shortage of medical equipment, and therefore, the metal tools used in procedures were not discarded, but rather sanitized in solution and reused...Health education played a large role in Elmina. This included education about the benefits of breastfeeding, the need for vaccinations, how to limit exposure to malarial mosquitoes, and limiting palm oil in the diet...I received a thorough tour of the Cape Coast Regional Hospital. I was able to visit the emergency room, outpatient area, and inpatient wards. These included pre-and post-surgery wards, exam rooms, and a burn unit. I also toured the laboratory, where I was also able to see malaria-causing plasmodium under the microscope...I also spent time at the Ankaful psychiatric hospital. There were over 400 patients and very limited staff. The psychiatric hospital in Elmina used psychiatric medication and various types of therapy. Male patients were subject to electroconvulsive therapy and medication for treatment...I also visited Ankaful Leprosy/General Hospital. Staff advised me on the diagnosis and treatment of Hansen’s disease (Leprosy), and I was able to talk to a few of the patients in the leprosy unit...The opportunity to visit the markets in Elmina and Cape Coast, and to tour Elmina Castle and parts of Accra also enhanced my experience. I was familiar with the Castle’s history and as such, this was a moving and emotional experience. I was also a guest in the house of several staff members and I was able to learn more about Ghanaian culture in our discourse and interactions.... It was also interesting to see the preparations being made for the upcoming visit of U.S. President Barack Obama to Ghana on July 10th, 2009, and to see local billboards and signs of welcome.Lynnette Morrison MSII, Meharry Medical College, TN, USA - June - July 2009
Thank you so much for the opportunity to volunteer my services at the elementary school in Elmina.Teaching the kids the importance of oral hygiene was not only a rewarding experience for me, but also made me realize how much I have a to offer as a Dental Professional.I was more than pleased to see the information I imparted was clearly understood.I will cherish the eagerness,and appreciation of the children,as their young minds absorbed the information.My only regret,was time.There just wasn't enough of it!I am truly looking forward to returning to Ghana very soon to continue my volunteer service...Sharon Dawkins, PDA, Dental Assistant, Toronto, Canada. November 2008

I am in fact safely back in the US, reacclimating to life in a First World country. I had an amazing time and I don't think I can ever practice medicine the same way again. I'll try and get on these documents over the weekend. I wish I could have stayed longer but I don't have the luxury of more than 2 weeks at a time like the residents who join the program do. Thank you for everything, Dr. Ulzen, none of this would have been possible without you. I loved every minute and would do it again if the opportunity arises. Heshy Zaback,Physician Assistant, NY, February 2009
The emphasis of most of my work, in collaboration with the local staff (Ester) consisted of trying to optimise child health in the surrounding areas. We conducted several clinics in the nearby villages, providing vaccines against polio, hepatitis B, yellow fever, and diptheria. The vaccination schedules and content were based on the international guidelines of UNICEF. Regular clinics also meant that the growth of infants could be monitored. While children often maintained average weight and length parameters for the first year of life, the majority of two and three year olds were observed falling below the 25th percentile. This malnourishment was attributed to insufficient energy intake following the cessation of exclusive breastfeeding, which UNICEF recommends for the first six months only. These clinics were extremely busy, with over 200 mothers and babies in attendance on each occasion! I really enjoyed these clinics, though I was certainly soaked in sweat by the end – I had never seen so many babies!.....Overall, my time in Elmina was an enjoyable and eye-opening experience and gave me a good insight into health issues in the region. The planning on the ground was a little difficult at times, but I feel I am capable of self-directing myself to the activities I was most interested in – and was able to do this most of the time. It would have been nice to be accompanied by another student while on this placement, but there was more than enough to do to keep me busy most of the time and I would recommend it to other medical or health professionals/students with similar interests.Vince Anderson, M3 Student, University of Sydney, Australia - Dec 2009 to Jan 2010
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