Partnering in education and equipment
to prevent needless death in Africa

Update

A 40 foot Container full of medical equipment donated to Makurdi, Nigeria

A 40 foot container (a tractor-trailer load) of exclusively medical goods (the lion’s share, donated by Dr./Ms. England of Plum Creek Medical and 4 other contributors was shipped earlier this year to Makurdi Nigeria. Most of these equipment were donated through Africa Partners Medical (APM). This shipment was sent from Houston to Lagos, Nigeria and then to Makurdi, Nigeria for Drs. Orkurga and Keziah Malu, two of APM’s key partners in Nigeria. Continue reading

FIESTA CONFERENCE OUTCOMES

If you are like me, you are probably beginning to ask questions such as: “Is the annual FIESTA beneficial to Ghanaian physicians? Aren’t we wasting precious time and money?” Well, I have got some good news for you! To answer these questions and others, APM has commissioned Linda Caples, an independent researcher and educator at the CME Office of Wisconsin Medical School, to conduct a longitudinal study to assess the impact of FIESTA on physicians’ knowledge, attitude, and practice of Ghanaian doctors. Continue reading

Lewis Roberts trip to Ghana in February

On February 19th, President Roberts spoke to the Department of Surgery of Korle Bu Teaching Hospital, Accra, Ghana and repeated the same talk on the 26th with the staff of the Police Hospital in Accra. The topic, “The State of the Art in the Surveillance, Diagnosis and Management of Liver Cancer” gene rated an audience of approximately 40-50 physicians, nurses and other health care personnel. Continue reading

World Diabetes Day

November 14th marks World Diabetes Day. The International Diabetes Federation (IDF) and the World Health Organization (WHO) introduced World Diabetes Day in 1991 in response to concerns over the escalating incidence of diabetes around the world. It is now an official United Nations World Health Day that unites the global diabetes community to produce a powerful voice for diabetes awareness.

In the western region of Ghana, diabetes mellitus currently is one of the top non-communicable diseases causing high numbers of morbidity and mortality amongst patients. The Western Region Diabetes Association has made it part of their aim to raise awareness about diabetes amongst patients.

This was in the form of a weeklong celebration resulting in a continuous medical development program to educate medical personnel on the current guidelines in the management of diabetes. Management of diet and nutrition is one of the most important factors of diabetes as many patients with diabetes do take medications, but do not maintain a healthy diet that contributes vastly to the poor management of diabetes.

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Africa Partners Medical, Ghana decided to organize this CPD in conjunction with the western Region Diabetes Association and the Ghana Health Service (Western and Central Region).

Facilitators were from the Ghana Health Service
• Dr. Richard Anthony, Consultant Physician Effia Nkwanta Regional Hospital
• Dr. Ernest Yorke, Physician Specialist, Korle Bu Teaching Hospital
• Dr. Nana Ama Barnes, Physician Specialist, Effia Nkwanta Regional Hospital
• Mr. Isaac Baba Anagi, Nutritionist, Effia Nkwanta Regional Hospital
The program was organized in various sessions that included acute management of diabetes, foot care in diabetes, pharmacotherapy in diabetes and more. The first lecture, presented by Dr. Nana Ama Barnes, was an overview of diabetes. This was important as it allowed the participants to understand the various decisions that are involved in the management of diabetes based on the pathophysiology and also for myths about diabetes to be dismissed.

Most patients present at the hospital were due to acute complications of diabetes. Dr. Richard Anthony highlighted on the various presentations of patients including acute complications of diabetes and how best to manage them. Dr. Anthony also held a practical demonstration on how to manage high blood glucose, which has been modified to suit the medical system present in most hospitals. He also presented forms, which can assist medical personnel to manage patients with high blood glucose, a system currently being used in the Effia Nkwanta Regional Hospital.

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Dr. Ernest Yorke presented on the management of the chronic complications of diabetes. Diabetes unfortunately is a major cause of morbidity in many patients when not detected early. When faced with Type 2 diabetes, the most common type of diabetes, patients present complications such as retinopathies, peripheral neuropathies, nephropathies and vascular problems. Early screening or annual medicals are important and encouraged to the general public to prevent these complications. It is also important that patients diagnosed with diabetes receive adequate education and management in order to prevent most of these chronic complications.

Dr. Yorke also emphasized the complications each medical personnel managing a patient with diabetes should look out for and work at managing these problems. Kidney disease associated with diabetes can be delayed by the addition of drugs that act on the rennin- angiotensin aldosterone system. These drugs can also help to control blood pressure potentially found in patients with diabetes.

Based on the numerous complications associated with diabetes, Dr. Yorke highlighted that diabetes care was a multidisciplinary care involving nurses, general practitioners, medical assistants, ophthalmologists, neurologists, nephrologists, cardiologists, podiatrists and psychologists, just to mention a few. In an environment where most of these personnel are not available, the medical personnel managing such patients must have some knowledge on all these in order to effectively care for these patients.
Lifestyle modification is paramount in non-communicable disease management and one of the most important components is diet. In the early management of diabetes, starvation was the mode of treatment. Current guidelines indicate healthy diet with the elimination of simple sugars from the diet.

Mr. Isaac Baba Anagi presented on the current guidelines in the dietary management of diabetes based on the International Diabetes Federation (IDF) modules modified for the local diet in the country. Dr. Anagi emphasized making the dietary care for patients as practical as possible as it helps decrease the probability of non-compliance. Dietary sheets should be given to patients when diagnosed, for patients to indicate what foods they have available in their homes and then based on this have a one-to-one consultation with them in order to guide them in planning their healthy meals. He also noted that it was important not to impose strict rules but allow for flexibility in the diets and to encourage fruits and fiber in the diet.

Dr. Anagi also commented on the need to decrease cholesterol and salt in the diet as well as encouraging patients with high body mass index to lose weight by demonstrating the plate and fist/hand model as a guide to help patient to know how much of each food group should be taken and in what quantities.

Considering the fact that diabetes is a life long condition, it is important that children with diabetes require adequate management in order to prevent complications that may occur in future. The most common type of diabetes in children is type 1 diabetes that requires management with insulin. Due to the changes occurring due to the lifestyle changes in our population, type 2 diabetes in children is gradually increasing.

Management of diabetes in children was no different from that of adults, however education and support of the family is paramount in order to effect optimal management. It is important to teach the children to identify complications such as hypoglycemia and immediate management of it. Teachers are important in managing diabetes and it is crucial to educate them on the various problems, which may be encountered by a child with diabetes and how to effectively manage them since the children spend a greater part of their days in school.

Diabetes may occur in pregnancy or patients with diabetes may become pregnant. Gestational diabetes occurs as a result of the hormones produced during pregnancy in some women and this may disappear after delivery. Management mostly involves insulin, so for patients with diabetes in the reproductive ages, it is important to plan the pregnancies as they may require switching from their oralhypoglycemic drugs to insulin and also planning delivery at a well-established heath care center if possible in the care of an obstetrician and a pediatrician.

An important educational fact is to educate patients that diabetes is not passed on from mother to child, but at delivery, babies born to mothers with diabetes are prone to low blood glucose and must be fed as quickly and often as possible. Dr. Nana Ama Barnes presented on foot care in patients with diabetes. One of the most common complications of diabetes is foot infection, which more often than not results in amputations. Due to the loss of sensation associated with poorly managed diabetes resulting in inability to detect ulcers early on the foot and poor healing, many patients present to the hospital with severe gangrene of the foot warranting amputation. Every medical personnel managing patients with diabetes must be able to educate the patients on basic care of the foot to prevent complications.

Prompt administration of appropriate antibiotics is also important as in involvement of surgeons to manage diabetic ulcers. Practical measures in foot care include daily examination of feet, wearing appropriate footwear, care of the nails, and never walking bare footed. Dr. Richard Anthony talked on the assessment of a newly diagnosed patient with diabetes. Dr. Anthony noted that it is important to stabilize a patient who comes in with diabetes, take an adequate history, fully examine the patient to detect any complications that may be present and adequately manage them. Since diabetes affects all the organs in the body, it is also important that thorough laboratory investigations be carried out.
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Education about diabetes is important to relay to the patient and the patient’s family to encourage support in the management. Drug therapy in diabetes ranges from insulin in patients deficient in insulin to oral hypoglycemics for patients with insulin resistance. Mr. X talked about the various groups of oral hypoglcemics highlighting on their mode of action, dosage and side effects. He also talked about the importance of discussing the treatment options with the patients so as to allow the patients make an informed choice together with the doctor.

Administration of the drugs and storage of medications such as insulin also is important as improper insulin storage can result in denaturation and loss of effectiveness of the medication. In most communities where by electricity is not readily available, challenges with insulin storage are met and there are various appropriate technologies used to store insulin in cool environments. These include placing the bottles in earthenware pots in cool parts of rooms or placing insulin bottles in cut up foam and then in a clay pot.
The final session of the program was the group discussion of 3 problem clinical scenarios that were discussed in groups and after 15 minutes presented to the whole group.

Partnering for life – young doctors’ conference

Partnering for life

 

The goal of this training was to empower our young physicians to aim for the highest possible standards of healthcare for their patients by balancing medical knowledge, practice, physician patient relationships, ethics and limited resources. It was a three day conference with plenary sessions in the mornings and several practical training sessions in the afternoons.
Our distinguished facilitators are internationally recognized scholars, seasoned physicians and scientists who are also engaging and passionate educators. APM provided scholarships to 50 participants which included transportation to and from Accra, training materials meals and three day night stay at the Hephzibah Christian Centre, Aburi.

 

Larry Ebert Medical Center – by Felix and Nema

He has done all things well. Mark 7:37
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February 18th 2016 was like just another ordinary day, but here at the Larry Ebert Medical center, it was not to be. The Clinic was celebrating her ten years of existence marked with pomp and pageantry. In attendance were both the American and Nigerian ambassadors to Burkina Faso, as well the Pastor Mamadou Karambiri. The senior pastor of the largest Church in Burkina Faso was the guest of honor as well as many eminent personalities.

We had also our friends from Park Chapel Christian Church from Greenfield Indiana, Dr. Rolf Pelleboer representing the NGK Church in Eindhoven, the Netherlands, and Lowell Noreen representing Africa-Partners Medical as well as a team from the Navigators Nigeria represented by Zach Barki, Dr Stephen Daniyam and Edwin Majam.

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(Welcoming the American ambassador to Burkina Faso at the ceremony).

The occasion was festive, featuring singing, speeches and the planting of the anniversary trees by the distinguished invitees. The ceremony was rounded off with a tour of the facilities of the Medical Center and a family picture. In ten years, God has been faithful to us; we have seen over 160,000 patients and had over a 1,200 deliveries. We started with one building in 2006 and now we have four hospital buildings with various departments offering different services. Indeed, God has been good to us and the celebration was to highlight this and give Him all the glory.

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(Planting of the anniversary trees by the American and Nigerian ambassadors with the special guest of honor).

We want to thank all those who were able to come as well as all those who prayed and gave so as to make the event possible. May the good Lord bless you all. As it is often said, the best is yet to come.

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(Family picture)

We are therefore trusting God for greater things He has in store for us in the coming years as you too continue to be part in what He will continue to do among us. We want to particularly thank each and every one of you who has stood by us these past ten years. We toiled together and made it together and God made it happen. Nema and I are grateful for your partnership in this ministry.
May God bless you all.
Felix and Nema with Blessing, Joy and Praise

2015 Ghana Medical Fiesta Conference

The Ghana College of Physicians and Surgeons in partnership with APM will hold the annual Medical Fiesta conference from September 14th -17th. This conference will bring medical professionals together from all over West Africa to improve medical practice through education.

 

The Medical Knowledge Fiesta conference seeks to promote evidence based medical practice in Ghana and provides a platform for continuous education and knowledge sharing between international health professional and their counterparts in Ghana.

 

Last year, over 400 physicians with 65 facilitators, including 44 from Ghana participated in the conference. The theme of this year’s event is to “improve the quality and safety of patient care .” The September Medical Fiesta is also co-sponsored by Ghana Physicians and Surgeons Foundation of North America.

Africa Partners Medical Nigeria and Kenya Trip

Dr. Chris Lantz, Dr Dave and Gail Simon, Dr. Keith and Carol Plate (U.S), Dr. Rolf Pelleboer (Holland), Dr. Chinenye Iwuji (England) were the team from Africa Partners Medical who went to Nigeria from June 19th 2015 until July 6th and then also to Kenya from July 7th until July 12th 2015 for Continuing Medical Education(CME) conferences and Prayer retreats with doctors and their families in the two countries.

 

There was a CME conference at Jos University, June22nd through the 24th the theme this year: “Updates in Cutting Edge Medicine” There was another CME July 1st 2015 at the Benue State University Teaching Hospital. APM remains committed to its mission of educating medical personnel through continuing medical education to prevent needless death in Africa.

 

There is a lot happening in different countries and we will update you in the next newsletter as to what happened at these conferences and other items through out the region.

New APM Partner Hospital in Wubel, Nigeria

Africa Partners Medical partnered with Project C.U.R.E., the largest provider of donated medical supplies and equipment to developing countries around the world, to provide medical supplies to LePan Clinic in Nigeria. LePan is a new partner clinic being set up by Dr Dan and Biola Mwanmut who have made a significant commitment to the Chakfem people of Nigeria to build a medical clinic in Wubel to provide care to the people of this village and surrounding communities. This clinic is now providing hope and medical care to many and the Mwanmut’s express sincere gratitude on behalf of their people for all the giving that made it possible.

 

The donated items include medical hard goods such as an ultra sound, X-ray unit and blood analyzers and disposable supplies. A team of Africa Partner Medical doctors and volunteers visited the LePan Clinic July 29th and were able to see first hand what they had prayed and labored for. We hope to bring you a full report and pictures in our next newsletter.

Keeping the Lights On So Mothers and Babies Can Live!

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APM contributed to a solar generator system for Obaatan Pa Women’s Hospital in Ghana, a non-profit hospital run by Dr. Amelia Laing, which is one of APM’s partner hospitals. Dr Laing’s article below gives us only a small taste of the difference this significant contribution makes towards achieving the “fund a need” purpose!APM3

 

“Obaatan Pa received a patient who was fairly high risk given her age, and her elevated blood pressure. She was carrying her second child, and was three and a half weeks before her due date, her blood pressure was so out of control that we decided she needed to be delivered in order to correct her condition of Severe preeclampsia. Untreated, this could lead to seizures, strokes and or death for both mother and child. As is common in these parts, despite a lot of talking on our part, she did not really appreciate the seriousness of her condition. Her care would have been routine in the US, however, it took a lot of nurses and talking and teaching and hands on care to get her where she is now, delivered with improving blood pressures. She would definitely have required one on one nursing in the US, and considering that the standard of the average nurse here, is not quite that of the average one in the US, and that the nurses at Obaatan Pa are still learning to use some of the technology we have, it was quite a production.

WeAPM1 needed and used our IV pump for delivering drugs to prevent seizures. The pump is important because without it, it is very hard to estimate drug doses accurately- most hospitals in Ghana count drops per minute, which you can imagine is not ideal, though it works. These drugs also have a narrow margin of safety, so one can easily under dose the patient and not have an adequate response or worse, overdose the patient and cause complications. Sometimes intramuscular doses are used, every 4-6 hours, which are painful and miserable for an already sick person. They definitely raise their blood pressure which is already an issue, too.

She came in last night and as we started her in labor, we monitored mother and baby closely, using our fetal monitors. Baby, to our great relief behaved great throughout. The mother received IV Magnesium through the pump, quite painlessly. The fans kept her cool, as intravenous magnesium makes one feel very warm. We were using solar power when she came in, and it powered both the fetal monitors, the IV pAPM2ump, and of course lights and fans. The power from the grid came on at 0600 this morning, and we switched over automatically. At noon (unscheduled), there was a power outage, which continues till this minute. Again we did not miss a beat- hardly noticed it. Mother was delivered at 1030, we had great lighting, and baby was in great condition, we were able to use our warmer, as we did expect a tiny baby who might need a lot of help. Fortunately she was quite feisty and did not need much assistance. The mother will need the Magnesium for another 24 hours, and we are not at all concerned about what the electricity corporation of Ghana might do or not do. We know we can give her a high quality of care, without interruptions.

I hope I have given you some idea about how much difference the solar generator has made to our ability to care for patients, and the general quality of life on the premises. We thank you , and I know we will bless your names even further when the weather gets really hot. It is a fairly cool 80-85 degrees Fahrenheit right now.

Greetings from Accra,

Amelia Laing, MD

Dr. Amelia Laing is a board certified obstetrician/gynecologist in Orrville, Ohio and runs Obaatan Pa Women’s hospital in Accra, Ghana.