Thursday, March 26

With the thoughtful guidance of our hosts from the Ministry of Health, Dr. Edwin Ampadu and Charles Yeboah, we had another full day of driving from Kumasi to remote clinics with varied levels of services. Our day was spent in the Amansie Central District (pop'n 85,000 in 206 communities). We began with the Catholic Mission St. Peter's Hospital where we visited with the staff, including their one doctor. At every clinic, during our staff meeting, it is interesting to hear their thoughts on the cause of Buruli Ulcer. Today the issue of land disturbance due to sand and gold surface mining was discussed. This has been mentioned at other sites as well.

The doc at this clinic sees over 100 pts per day, not including inpatients. Inpatients today included Malaria, Sickle Cell Disease, cellulitis of the leg, and a post op hernia patient. They have a functional lab where they can do blood smears, urinalysis, blood cross matching, as well as some other tests. They have surgical services with an operating theatre.

Interestingly, this clinic sees mostly adult Buruli patients. Their "temporary" Buruli ward was a short distance from the main hospital and much more basic than any other inpatient facility we have seen thus far. It had five inpatients (ages 40-75).










The facility had few physical resources: mats on the floor for beds, a few linens, unreliable electricity, and some supplies.








This clinic has been using the McCord wound care hydrogel product according to a pilot protocol put in place by the Ghanaian Ministry of Health. It was fascinating to see the product in the "supply room."




















Despite the fact that this hospital sees mainly adult patients with BU, the disease impacts the children of those adult patients. We met a sweet 12-year old girl who accompanied her guardian to the hospital since no other caretakers for this child were available. The girl had lost both her parents. When her guardian required hospitalization due to BU, there was no option but to have her live at the hospital as well. She cared for her "mother." As a consequence, she had not attended school in almost 3.5 years. Overall, the level of need at this site was very sobering for the entire group.

From here we visited the Office of the District Chief/Director. It is a the district level that many health related policies and programs are initiated in Ghanam. (There are 10 regions in Ghana, which are divided into at least 130 districts). Our discussion included issues such as medical staff retention, the Ghana Feeding Program for inpatients (also for one free meal per day per inpatient), and progress in building a much needed new Buruli patient ward.


On our way back to Kumasi we stopped at Akutuase ("Under the Orange Tree") to visit with an elderly villager whose leg ulcer healed completely with antibiotics, wound care and (McCord) hydrogel. She was an inpatient for approx. 6 months). The success for this elderly woman was a success for the entire village. Her successful healing did a great deal towards demystifying Buruli Disease and lessened the fear of Buruli Ulcer disease in her village. The attentions paid to her during today's health care visit, and other visits, have made this lovely woman a rather popular village figure. Children no longer shun this lovely woman out of fear of the Buruli Ulcer.


The gentlemen dressed in his funeral garb is the local health surveillance volunteer. He has been trained by the Ministry of Health to detect various diseases and medical conditions in his village. He was very moved by the fact that visitors had come from such a long distance to witness the positive results of the McCord hydrogel.





Finally, we were invited to dance at a funeral taking place in the Village. The event was truly a celebration of a ninety year old woman's life.















We were all honored to experience this joyful event.