A Daily Video Blog From a Medical Mission to Ghana: February 23 to March 1, 2019

Between February 23 and March 1, 2019, Dr Enoch Akowuah led a heart surgery team from the James Cook University Hospital in Middlesbrough, UK, on a mission to Kumasi, Ghana, to perform adult heart surgery and to place pacemakers. The Middlesbrough team members were also tremendously lucky to be joined by Dr Emily Farkas, who supported them on their first mission with her wealth of experience in performing missions in a variety of places around the world. Learn more about the team’s experience by reading below and viewing their video blogs during the surgical mission.

Day Zero: Arrival

Day One

Day Two

Day Three

Day Four - Part One: A Critical Event

Day Four - Part Two: More Successful Procedures

Day Five: Report From BBC Journalist Jonathan Swingler

Final Day

Traveling Home

Background

When we saw Dr Farkas' video on her experience in Nigeria, which was posted on CTSNet in 2017 [1], it made us feel that we needed to help in some way, and Dr Akowuah brought together a team of 12 people to embark on the task of setting up a medical mission to Kumasi, where his parents grew up.

Now a year later, we are about to set off on our first mission, and we want to share our experience in the hope that it might stimulate you to think about whether you and your team might want to embark on missions to underserved areas of the world.

It is an unsettling fact that Ghana, with a population of 28 million people, has only one functioning cardiothoracic center in Accra, the capital, in the far south of the country. This unit itself struggles for funding and performs around 230 cardiothoracic operations per year, of which around 70% are congenital heart surgery and only 20% are for adult rheumatic heart disease. Although the unit serves the whole population of Ghana, over a 10-year period it has performed only 100 mechanical valve replacements, mainly in patients who are able to self-fund [2].

The incidence of acute rheumatic fever in Ghana is very high. Thirteen percent of the population are throat carriers of Group A Streptococcus and up to 40% of carriers go on to develop rheumatic heart disease.

In a study conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, rheumatic heart disease accounted for 22% of all admissions with heart failure, with the Western condition of ischemic heart disease accounting for only 4% of cases. The median age of the patients admitted with heart failure secondary to rheumatic heart disease is just 29 years old. Of all deaths in this hospital, 29% are due to heart failure. No patients receive surgery for their rheumatic heart disease [3].

Therefore, the mission’s aim is to firstly establish a regular program of cardiac surgical missions to KATH, commencing with our first mission from February 23 to March 1, 2019, and then a second mission from the October 19 to 27, 2019. Hopefully this will establish a link, and the possibility of doing further regular missions thereafter in 2020 and beyond. It is also an aspiration to support Dr Okyere and his staff to become independent operators and to support the establishment of a regular program of heart surgery in the hospital, in line with the mission of the recent “Cape Town Declaration on Access to Cardiac Surgery in the Developing World” [4].

If you are interested in doing a mission or supporting our aim of setting up missions to Ghana, please get in touch with us. If you feel able to make a donation to our aim of funding the second mission to Ghana, please contribute here.

References

1. Dunning J, Farkas E. Making a Difference: A Cardiac Surgery Mission to Enugu, Nigeria. CTSNet, Inc. https://www.ctsnet.org/article/making-difference-cardiac-surgery-mission-enugu-nigeria. Published November 28, 2017. Accessed February 5, 2019.
2. Tettey M, Tamatey M, Edwin F. Cardiothoracic surgical experience in Ghana. Cardiovasc Diagn Ther. 2016;6(Suppl 1):S64-S73.
3. I Owusu. Causes of heart failure as seen in Kumasi Ghana. Internet J Third World Med. 2006;5(1).
4. Zilla P, Bolman RM, Yacoub MH, et al. The Cape Town declaration on access to cardiac surgery in the developing world. Eur J Cardiothorac Surg. 2018;54(3):407-410.