Through My American Eyes: Days 3 and 4 in Koforidua, Ghana

Day 3: Monday, June 20, 2017 by Grace Patrice Anyetei-Anum

Today was our first official day interviewing patients and educating them about telemedicine. We briefly described what telemedicine meant and asked them for their opinion regarding this service. We asked questions like, what does telemedicine mean to you? Do you think it would work? How do you believe we can make this service amiable to people who cannot speak and write English? We got positive and exciting feedback from these questions.

As a Ghanaian who lived in Ghana for over eighteen years, everything seemed normal until my colleagues started to point out cultural norms I did not notice. One particular cultural norm that surprised me was the fact that most Ghanaians avoided eye contact during the interviews we conducted. I was surprised when I heard this, and decided to look out for it myself during my next interview. I, however, found this to be very accurate.

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Interviewing school children about the importance of health.

Most of the women with whom I interacted avoided eye contact when they were giving me their opinions. The few I made eye contact with looked at me only when I asked them questions. This experience was a real eye-opener for me since it brought me to the awareness of my cultural blind spots. I hence decided that for the rest of my stay here in Ghana, I would take a more critical look at the Ghanaian culture; not as a Ghanaian, but rather a tourist visiting the country. I will probably still miss a few things, but I am excited nevertheless to try to do this.

For today, we decided to split ourselves into two groups; Morgan with Vida and Ted with me. We also decided to have a rotating schedule i.e. a group would go in the morning whilst the next group would go in the afternoon. We did this so that we could randomize our interviewees as much as possible. Ted and I arrived at the hospital at 8:00am. Interviews, started at 9:00 am because it took some time to set-up and rehearse our process.

I spoke to most of the interviewees in Twi and translated what they said to English to my interview partner. I must say I was astonished at the illiteracy rate in Ghana. Even as a Ghanaian, I had a single story about Ghana. A story about how most Ghanaians could speak and write in English. Little did I know that I was wrong.

During interviews, I briefly described telemedicine as a concept that would help patients communicate with their physicians without having to travel all the way from their villages and homes just to see a doctor in the urban areas. To most, I likened telemedicine to the idea of WhatsApp video calling; an analogy that resonated well with most of our interviewees. They were all excited about the prospect of having a way to talk to doctors at the click of a button without necessarily having to come to the hospital. Most people spoke on how this would greatly benefit them since all the women we talked to woke up at around 4:00-5:30 am just to make it to the hospital on time.

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Children playing in the courtyard outside of their school.

Upon arriving, they waited for approximately two hours before seeing the doctor. Spending this much time at the hospital made them unable to do anything else with their day. They complained about losing the day’s wages when they could not go to work, and how tiring it was, having to stay in the hospital the whole day. Overall, I must say that today was a huge success in term of getting willing and cheerful patients to interact with.

For tomorrow, we all plan on going to the hospital at the same time. This is because when Morgan and Vida arrived later during the day, most patients were getting ready to go home. They, therefore, could not get the chance to conduct their interviews.

Day 4: Wednesday, June 21, 2017 by Ted Obi

Today, we conducted interviews on women at The Koforidua Regional Hospital. We had conversations and asked questions, ranging from their daily activities to whether or not they believe telemedicine will be feasible and beneficial to their lives. During our interviews, we invoke a design-thinking approach and our primary goal is to empathize with the subject’s life and co-ideate rather than just implement what we think will benefit their lives.

While conducting the interviews, I noticed how open and friendly Ghanaian people are. Multiple women revealed aspects of their past that were undoubtedly tough subjects to talk about with total strangers. I noticed that many of the women were very willing to talk with us and felt empowered that their opinions were being accounted for, especially in their customary patriarchal society. In fact, a man approached us and asked why we were only taking the opinions of women.

We arrived at Koforidua Regional Hospital (KRH) at 9AM. We split up into two groups of two–one native speaker of Twi and one transcriber per group. We set up two interview stations on the KRH compound, while another team member walked up to women passing by to explain our research and invite them to our station for their informed consent and then an interview.

During the interview, we used a series of storyboard pictures to explain telemedicine, which we found was more effective because of the high illiteracy rate in Ghana. Respondents were highly receptive of telemedicine. One woman raved of how beneficial it would be to her life (she traveled 2.5 hours to get to the hospital). Another woman revealed that she would no longer feel like a burden because every time that she is ill, someone would have to accompany her to the hospital.

I expected people to want to stick to the old conventional ways. However, after speaking to these women, it is quite the opposite. Many women were enthusiastic about the proposition of telemedicine, and some even asked when we would be implementing it in Ghana. Others gave us prices that they would pay for a service that would allow them to talk to a doctor from the comfort of their home. In all, the Ghanaian women that I interviewed believed in innovation and are ready to control their healthcare.

Tomorrow, we will be moving to another location on the hospital’s compound to conduct similar interviews. By the end of the week, we plan to have finished interviewing patients. We plan on analyzing their responses then. In the next weeks, we will be interviewing healthcare providers which will allow us to acquire a different perspective on the feasibility of telemedicine.

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