First sights of Koforidua, Ghana

Day 1: Sunday, June 18th 2017

We visited The Apostolic Church’s Central Assembly in Koforidua for the cultural experience. Christianity has a significant influence on Ghanaian society. In addition, most of the people we are working with attend that church. Our visit allowed us to introduce ourselves to our partners; inform those in attendance about our work and be part of an important event in their lives.

On Sundays, most shops are closed, the roads look empty and it would seem like most of the population has left town for the weekend. Except that on almost every road you turn on, you can hear loud music or a sermon coming from churches nearby. To most people, the church is more than a place you go to get a sermon and sing hymns. It serves as a family, an insurance provider, and as we learned this Sunday—a place where people go to receive public health lectures on preventing transmittable diseases.

The Yedea team’s student members arrived in Koforidua this past weekend. In the two preceding weeks Professor Cleckley and I organized a Design Thinking Boot Camp for students, faculty and recent graduates of All Nations University College, Koforidua Technical University and the Nursing and Midwifery Training College. This phase of the project was to help them prepare to work with our American students from the University of Virginia: Ted Obi, Morgan Brazel, Vida Sarpong and Grace Patrice Anyetei-Anum.

Likewise, when the American students arrived, we decided to take them to church as part of their cultural immersion experience in preparation for collaborating with their Ghanaian colleagues. We observed several interactions during the service that illustrated the previously stated roles of the church in the lives of the people we met.

First, for about 50 minutes, several families were given the microphone in turns to talk about significant events in their lives, and express their gratitude for the church’s support during those events. In some cases, church members who spoke were thankful that church representatives had showed up to family funerals to mourn with them or weddings to celebrate with them. Some speakers specifically thanked the Church for financial support during such times.

After that period, a medical doctor from the congregation gave a public heath lecture on a range of topics including vaccinations, hand washing and HIV prevention. While the doctor spoke, Morgan, one of the Yedea team members leaned over and asked me, “Is this where people get their health information?” We found out that it was the last in a series of talks as part of the church’s healthweek.

The doctor took questions after her talk and from those she received and her responses to them, my team and I began to wonder if there is a place for on-demand health expertise. We imagined that such a service should be readily accessible by phone or similar means to debunk widely spread health myths and offer scientifically supported disease prevention advice. Our interviews with patients, starting tomorrow would provide more insight.

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Day 2: Monday/ 06/19/2017 by Vida Sarpong 

Ghana has been great so far, the people are very welcoming and eager to see what our research is all about, and how it can better them in any shape/form. Today marked our journey to the Koforidua hospital, where my team and I are collecting data to see how telemedicine can help the people there.

While going to the hospital, I noticed that drivers don’t stop at a stop sign. I realized that they rather honk whiles they approached an intersection, to give any incoming driver a signal of their existence at that moment to avoid any accident. When there is a car also coming at that particular time, one stops and lets the other pass before they also continue. It was very interesting to see how drivers don’t pay attention to stop signs, but have devised a way for themselves to go around that.

On our arrival to the hospital, we met the person in charge of the hospital’s research department called Mr. Twum. He was very nice, welcoming and eager to show us around and introduce us to the staff. When we got to the hospital, he did a tour for us. We went to every department in the hospital and got introduced to the staff there. He made the staff aware that we are in the hospital doing research. The staff were so nice and gave us a warm welcome. Mr. Twum also gave us a quick run through of how patients are registered upon arrival and prepared for consultation. This overview helped us understand the patients’ journey from the moment they enter the hospital to when they leave and the times most patients arrive at and leave the hospital.

We decided to start by interviewing women coming into and leaving the hospital. Before we started our research, we did a trial interview just to get a feel of what the next day will be all about. Emmanuel, our team leader, broke us up into 2 groups. There are two Ghanaian natives in each group—myself and Grace. Morgan and Ted who are not Ghanaian natives got paired with each of us, so Morgan with me and Ted with Grace. We started each interview by introducing ourselves to patients and obtaining their informed consent orally.

We interviewed one person per group today. I had one person jokingly say in Twi that we shouldn’t come to her if no one spoke Twi, so I assured her of my fluency in Twi by answering her in Twi and she nodded and smiled as, we drew closer. We interviewed them using our research questions and explained what telemedicine was about. We told them it’s a way to connect patients and doctors together, if distance, natural disasters or any other thing is a hindrance to the patient coming to the hospital to seek care. The patients were very receptive of the idea and asked lots of questions to make them better understand the concept.

We found out that a lot of people in we met could not speak English, so Grace and I had to do most of the interviews. Before the interview, I could see that patients get so relaxed and are willing to talk to us when they hear me or Grace speak the local dialect called Twi. They felt at ease when they realized they were talking to their fellow Ghanaian and that really helped a lot in our interview process.

Through the trial interviews, we noted that people really wanted this telemedicine idea and thought it could work when brought to their communities. They thought it should be something that everyone could access and benefit from. It was a little tricky to explain telemedicine to them without any pictures to go along with it, so we decided to bring pictures illustrating our explanation to telemedicine to give them a visual sense of what we talk to them about.

Prior to our visit to the hospital, I did not expect the interviews to go on so smoothly as it did. I didn’t know if people will want to talk to us; if they even had the time; if they will be accepting of the idea and be interested enough to ask questions, and others. It was very interesting to see that none of these circumstances became a hindrance to us conducting the interviews.

We decided as a group that our next steps should be to bring photos to create a visual guide to explain telemedicine better, and come earlier because patients come early and wait for the doctor, so it is easy to talk to them while they were waiting for their turn. Overall, it was a very productive day and I really enjoyed every bit of it. I can’t wait for what lies ahead of us.

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