Cardiac Surgery Missions in Ghana: Why We Need Them

The year was 1964. Professor Charles Odamtten Easmon, the father of cardiac surgery in West Africa and Ghana’s first surgeon, performed the first successful open-heart surgery in the country. He performed the surgery at Ghana’s largest public teaching hospital, the Korle Bu Teaching Hospital (KBTH) in the capital city of Accra. It was a historic day with a lot of “firsts,” and was supposed to mark the dawn of a new era of surgery in Ghana and Sub-Saharan Africa. Unfortunately, this success was short-lived, as the hospital struggled to start and keep a cardiothoracic unit afloat.

Cardiothoracic surgery went into hibernation from then until the return of Professor K. Frimpong Boateng from his training in Hannover, Germany, in 1989. He eventually went on to set up the National Cardiothoracic Center at the Korle Bu Teaching Hospital in April 1992.

In October 2007, forty-three years after Professor Easmon’s pioneer surgery and about 250 kilometers northwest of the capital, a different story began to unfold in Kumasi, the second largest city in Ghana. Dr Francis Fynn-Thompson was writing a different history, together with his team from Boston Children’s Hospital in the United States. They made their way to Komfo Anokye Teaching Hospital (KATH), the second largest public teaching hospital in the country. The team pioneered not only the first open heart surgery outside the capital, but also a cardiothoracic surgery mission culture, offering free heart surgeries to children in need of urgent surgical intervention. This was the first of its kind at KATH, since the hospital had neither a functioning unit nor a fully trained cardiac surgeon. Plans for a cardiothoracic unit were in formation, but had to be put on hold until Dr Isaac Okyere—current cardiac surgeon, then in his fifth month of residency training—could complete his training and return.

Cardiac surgery teams from Boston Children's Hospital and Komfo Anokye Teaching Hospital on the last day of the surgical mission in November 2018.

The Boston team’s surgical mission was an impressive success, and the team was excited about the idea of coming back to do more. This paved the way for a culture of cardiac surgery missions in KATH that continues to this day, with participating teams from all over the world. Most notably, teams travel from Cardiostart International (United States), Guangdong Cardiovascular Institute (China), OLV Heart Centre (Aalst, Belgium), and James Cook University Hospital (JCUH, United Kingdom), recent newcomers who have already made two trips within one year. 

Recent missions to KATH have placed more emphasis on creating a self-sufficient unit by offering training to staff. For example, following their first mission in February 2019, the JCUH team opened their doors for a number of KATH staff to fly over to JCUH in preparation for the second mission. While there, the team focused on equipping staff with more hands-on training. During their mission in October 2019, the JCUH team helped in making history by preparing an entirely local team to perform their very first open-heart surgery on cardiopulmonary bypass on the last day of the mission. The surgery, despite some setbacks, was a success and bolstered confidence in the local team.

Dr. Enoch Akowuah (James Cook University Hospital, UK) performs a valve replacement surgery in Kumasi, Ghana, assisted by the Ghanaian team doctors, Dr. Isaac Okyere and Dr. Emmanuel Agbozo during the JCUH cardiac surgery mission in February 2019.

Currently, with one cardiovascular and thoracic surgeon, one general thoracic surgeon, one cardiac anesthesiologist, and an incomplete cardiothoracic team, the cardiothoracic surgery unit in KATH largely relies on this mission culture to perform surgeries of moderate complexity. Without this assistance, the majority of cardiothoracic patients are left to their fates—most being managed medically, a few heading to KBTH in the capital for surgeries that can be done there, and fewer still traveling out of Ghana for surgical intervention. 

Today, the culture of cardiac surgery missions is beginning to spread from Kumasi to other hospitals in the country, and many more patients are receiving care they otherwise would not have obtained.

Will we ever not need these missions? We would like to think so. We would like to imagine a day in the future when we are the only ones running the show—a completely local team. However, there is another side we may be overlooking in dreaming this dream: the humanitarian side. 

In a developing nation like Ghana, which does not have an efficient healthcare system, countless patients are unable to afford basic medical care. When in need of cardiac surgery, numerous are left hopeless. The free and subsidized cardiac missions thus form an integral part of our health system, reaching out to the less fortunate and restoring life and hope. 

So it would be nice for us to be independent in the future, but not for a lot of our patients. Truthfully, even if we had a self-sufficient, locally run cardiac unit, countless patients would still be left unoperated on because they cannot afford the surgeries. Until we have a better healthcare system in Ghana, we will need to augment our independent local practice with surgical volunteerism and funded cardiothoracic surgery missions, as some of our patients will still need them to survive. Until that time, we and our patients look forward to many more missions in Ghana.

References

1. Wikipedia. 2010. Charles Odamtten Easmon - Wikipedia. [online] Available at: [Accessed 30 October 2019].
2. Sodzi-Tettey, S., 2009. Kwame Nkrumah’s Revolutionary Health Platform. [online] GhanaWeb. Available at: [Accessed 30 October 2019].
3. Edwin, F., Tettey, M., Aniteye, E., Tamatey, M., Sereboe, L., Entsua-Mensah, K., Kotei, D., & Baffoe-Gyan, K. 2011. The development of cardiac surgery in West Africa - the case of Ghana. Pan African Medical Journal, 9(1). https://doi.org/10.4314/pamj.v9i1.71190

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