My trip to Ghana went amazingly well! We were able to see over 400 patients, obtain 374 pap smears, and complete nearly 500 surveys regarding the perception and understanding of women’s health, contraception, and cervical cancer by local women. Aside from the success of our medical work, we were also able to embrace the beautiful Ghanaian culture by staying with host families, participating in the preparation of meals with local cuisine, visiting cultural and historical sites, and even learning some of the tribal language in our community, Twi.
Our biggest roadblock during the trip was perhaps the preparation beforehand, namely the communication with our local partners. As we learned during the planning phases, “urgent” means something very different for many countries outside of the United States. Thus, email communication, though probably the most effective and time-efficient, was still quite slow. Before leaving, I was concerned as to whether the laxity in email responses would be indicative of the organization of the clinic, or of patient turnout. Upon arrival at our clinic sites in the Ashanti region of central Ghana, however, we were impressed and relieved to find a waiting room full of women with consent forms in hand and inquisitive questions for us. Although frustrating at the time, I think it was a very valuable experience for me; I learned to be patient and, in time, even better appreciate the pace with which tasks are carried out abroad.
Aside from medical care in general, my experience confirmed that there is indeed a strong need for more women’s health care in Ghana. In one of the hospitals, the executive director, who was one of only two physicians in the town, did not know how to do a Pap smear and was even unaware of the indications and guidelines for getting them. He was very grateful for our partnership, and even shadowed us for a morning to learn how to do the procedure himself. The lack of knowledge, even amongst educated Ghanaians, is indicative of the shortcomings of the health system. Although we learned that pregnant women receive health insurance from the government during their pregnancy, this is limited to prenatal rather than gynecological care. The strong presence of machismo in Ghana may also be a factor that impedes the advancement in and attention to women’s health.
Perhaps the biggest impact that I foresee in my professional life is a strong desire to advocate for women who don’t have a voice. More than that, however, is a strong desire to empower underprivileged women, most likely both in the US and internationally. It was clear that the Ghanaian women appreciated the opportunity to ask questions about gynecological issues, receive advice about preventative health care, and become more informed about cervical cancer. In my time in country, I observed that the Ghanaian women work extremely hard, often times spending a significant amount of energy on raising children and keeping up the household. Although not limited to the Ghanaian culture, it seemed that the women took very little time for themselves. It was great to see their faces light up as they were given a chance to focus on themselves and their own health. On another professional note, I was grateful for an opportunity to pilot a liberation theology-based approach to international work, especially since I knew that I wanted to incorporate international work into my future practice but I was never really sure what that would look like. After this project, I feel as though I have more tangible ideas about what works and what does not. I was immensely pleased at how rewarding the liberation approach was, both on a personal and educational level. Although I have participated in many international endeavors, this was perhaps one of the most successful and meaningful ones I have experienced so far. I firmly believe that working so closely with the people and local institutions was a strong contributor to such a positive outcome.
The trip was multifaceted in the types of “lessons” I learned. On a medical or academic level, I became much more proficient at Pap smears and became more comfortable educating women on issues like cervical cancer, family planning, and sexually transmitted diseases. On a personal level, I feel as though I learned quite a bit about teamwork. Although I have long since recognized the value in delegation and shared responsibility, I learned to appreciate a different aspect of teamwork, namely the value of personality contribution, on this trip. Planning a research project for the first time can be a stressful task on its own, and with the added pieces of international partnership and execution, the project had its fair share of hurdles. I learned to appreciate not only the help from my colleagues, but also the type of help that they provided. I was amazed at how well each personality contributed to a different aspect of the study. For example, being task-driven and organized, my strength was organizing logistical items. If I would become stressed or if something wasn’t going as planned, there was a colleague who excelled in crisis management and another whose strength was keeping spirits high and being positive. The combination of these personalities kept morale high and the project working efficiently regardless of any roadblocks that appeared once we were in country. On another personal note, I really enjoyed the opportunity to experience another culture by interacting quite closely with local people. As I mentioned in my application, this aspect was incredibly important to me at the advent of this project. I firmly believe that a liberation theology-type approach is an excellent way to work with others and create sustainable change. Before you can induce change, however, it is important to understand the people whom you wish to serve. I thoroughly enjoyed learning about everything from local customs, religious practices and beliefs, traditional medicine, local cuisine to perspectives on life from the locals. I was honored and humbled that each person I met welcomed me with open arms and was willing to share their culture and country with me. Finally, I was able to better appreciate the rights that I have as a woman in the United States. While surrounded by a culture where women are expected to be more submissive, I recognized how much I take for granted at home, from having gynecological medical services available to being able to make decisions for myself.
As far as transferable learning to the United States, I think the general knowledge and appreciation of other cultures is an invaluable asset in our society. As America continues to become more diverse, I recognize the importance of being able to work with people who are different than I am. Also, I noted on the trip that being a leader is not necessarily about taking charge and dictating orders to people. Rather, I found that the most effective “leadership” seemed to arise when we were working with people and “serving” them. I realized that therein lies the servant leadership model that was adopted by Jesus, and it continues to be effective over 2000 years later. We found that in order to establish the best rapport with our patients and the most favorable outcome, it was necessary to work with them instead of for them. In other words, leadership should not be a goal, but rather a byproduct of our actions. This particular learning outcome was one that I found especially important, and one that will certainly impact my future career and goals.
Following the overwhelming success in recruitment and participation in the project by local women and partner organizations, we have high hopes for the impact of the project. Based on the results of the surveys, the goal is to design a curriculum that may be used to better educate Ghanaian women on reproductive and gynecological health. We hope to use our data to identify areas of inadequacy and compile a set of modules based on the areas we feel most need to be addressed. We are optimistic that any future educational endeavor to pilot these modules would be well received by local women; based on the answers to the survey questions, nearly every woman expressed interest in receiving more education on these topics. As far as the cervical cancer results, we have not determined the exact outcome we’d like to pursue, as we have not yet processed any of the samples. Our direction will rely heavily on how prevalent premalignant or malignant findings were. If we find that the prevalence is high, we may pursue collaboration with a Canadian physician who recently piloted a cervical cancer screening protocol in China that is specifically designed for low resource situations. The project met great success in China, and is currently being run by local nurses, technicians, and physicians who were trained by the Canadian physician and his team. If indeed we do find that there is a need for a more effective screening program, we may try to initiate this program in Ghana.
This project substantially expanded my world awareness. This trip was a unique one, as it was my first time to Africa, as well as my first time in a country where I did not speak the language. Africa’s rich cultural heritage was a joy to explore and learn about, especially since it was all new for me. Although the official national language of Ghana is English, not all Ghanaians speak it, opting for one of the local dialects in daily conversation. I feel like the inability to understand conversations was a valuable one, for it allowed me to experience what immigrants and foreigners likely feel when they are in the United States. I have a better appreciation for the difficulty of communication, as well as the gratefulness for the compassionate passerby who will stop to translate or assist with directions in times of need. The trip also expanded my awareness and perception of Africa in general, dispelling many of the preconceived notions I had prior to the trip. Ghanaians were an immensely friendly culture, taking every opportunity to make sure that we had an enjoyable experience in their country. From the restaurant owner who left his store to walk us to the taxi station to the seamstress who volunteered to make us traditional Ghanaian dresses, there were constantly people willing to help us with anything we might need. Additionally, Ghana is a very safe place to travel. In contrast to other trips, this was the first where I never felt concerned for my safety, which was quite a welcome surprise to me.
At the culmination of this trip, I would just like to take this opportunity to thank the generous donors who made this trip possible for me. As is evidenced by the immense amount learning outcomes, this trip made a substantial impact on me personally and professionally. More importantly, though, these donations made it possible for me to serve over 400 women in a clinic that is otherwise unavailable, unaffordable, or located an unreasonable distance from their homes. Words cannot express how humbled I am to be able to reach out to these communities on behalf of the donors, my supporting organizations, and God. I am truly awed by the way in which God continues to work through all of us to bring about a better world. My sincerest gratitude goes out to these donors and the scholarship committee for making this experience possible for me.
Posted on
Thu, July 7, 2011
by molitor