2017 PFIG Recipient Ted Obi
Journal Entry #1
Ever since my first visit to West Africa years ago, I have been eager to return. So far, I have had the opportunity to interact with genuinely happy people, a vibrant culture, and delicious ethnic food on a daily basis. My internship is in Koforidua, Ghana, a small city just north of Accra. Here, I work as a healthcare intern and conduct research on telemedicine at the Koforidua Regional Hospital. In the later weeks, I will switch roles to an education intern and teach 5th and 6th grade Ghanaian students about WAGiLabs (founded by Chic Thompson), which are social innovation incubators for kids' ideas. In other words, I will teach kids the tools to think creatively of ideas that they believe will help their communities. Ultimately, the goal is to empower the kids to prototype their ideas and potentially market thier prototype in their community. As an aspiring physician, I believe that it is of the upmost importance to gain a global perspective of healthcare in developing countries, and I am grateful for this opportunity.
My first two weeks have been very gratifying. I conducted interviews on patients in the ante-partum ward of the Koforidua Regional Hospital. During my interviews, I asked questions ranging from their daily activities to whether or not they believe telemedicine will be feasible and beneficial to their lives. So, what is telemedicine? Telemedicine is the remote diagnosis of patients by way of telecomunication devices. Telemedicine is useful for people who may be too sick, who may not have the means, or who may be separated by a geographical barrier and thus cannot travel to a clinic/hospital.
During the interviews, I used a series of storyboard pictures to explain telemedicine, which I 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. After talking to these women, I am even more excited to implement telemedicine in not only Ghana, but also West Africa. 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 take control of their healthcare.
For my interviews, I invoke a design-thinking approach and my primary goal is to empathize with the patient's life and co-ideate rather than just telling them what I think will benefit their lives. By using this approach, the interviews feel more like conversations, as I learn more about their lives and challenges they face in receiving healthcare in Ghana. 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 a total stranger. I noticed that many of the women were very willing to talk with me and felt empowered that their opinions were being accounted for, especially in their customary patriarchal society.
It has been wonderful to immerse myself in the Ghanaian culture, and speak with people about some of their challenges and inquire about solutions to these problems, together. I look forward to analyzing their responses. In the next few days, we will be interviewing healthcare providers including: physicians, nurses, and pharmacists, which will allow us to acquire a different perspective on the proposition of accessing the feasibility of telemedicine here. So far, I have received a great deal of information about healthcare and access to healthcare in Ghana. I am very excited to be a part of this research project, and I hope to be a part of the solution and fulfill my implicit obligation of closing the gap between those that receive health care and those that do not.
Journal Entry #2
Koforidua can be best described as a city-village. Although smaller and less industrialized than Accra or Kumasi, it is still a vibrant city filled with young people, eager to improve the quality of their lives. Since my last blog, Ghana has celebrated its 60th year of Independence. On July 1st, people marched down the streets wearing yellow, red, and green, and families gathered to cook food for the celebration. Aside from the fireworks, Ghana’s Republic Day was very comparable to that of America’s. It has been very gratifying to be able to learn so much about Ghanaian culture.
For the first phase of my telemedicine project, I collected a substantial amount of data from patients and healthcare providers, including physicians, nurses, and pharmacists, on the feasibility of implementing an aspect of telemedicine into the already established healthcare ecosystem in Koforidua. The data collection phase was very successful, as we were able to gain more culture-specific information about how healthcare is accessed in Koforidua than we intended. For example, we learned that most women must request and be granted permission to seek medical care from their husbands.
The next phase is analysis. Our main findings from the patient questionnaires are that patients often prefer to go to less-equipped and inadequately staffed local clinics than to visit Koforidua Regional Hospital, the largest healthcare facility in Ghana’s Eastern Region, where the wait times can last for the majority of the day. It appears that people wait until the last minute when the illness is most severe to seek healthcare. So, what’s the problem with a little waiting? In Koforidua, our data suggests that most patients make about 100-250 Ghana Cedis a month, which translates into 23-58 dollars a month. Along with the transportation costs of getting to the hospital, by seeking the best healthcare at Koforidua Regional Hospital, patients will consequentially have to forgo earnings for that day. Going further, the patient then has to make the tough and often unfortunate decision of whether her health or her financial security is more important. To scale this obstacle, patients usually self medicate or practice traditional herbal medicine, which may result in even more health problems.
Our main findings from the healthcare provider questionnaires are that physicians often feel overburdened with the high patient load thus they incur more stress while providing healthcare, knowing that not everyone will be seen. At Koforidua Regional Hospital, physicians and healthcare providers’ main priority is to expedite the consultation process, so patients often feel treated like a number instead of a human being suffering from an illness. Altogether, both patients and healthcare providers believe that telemedicine can work and benefit the people of Koforidua. Telemedicine will help save money on transportation, evade long wait times, increase the access of healthcare to a greater population regardless of location, and reduce the stress on healthcare providers.
Next Steps: In the following weeks, we will develop a prototype of what a telemedicine service will look like in Koforidua with the collaboration of Ghanaian nursing students at the Koforidua Nursing and Midwifery Training College. We hope that this collaboration will help us to design a tailored and empathic service for the people of Koforidua. Later, we will share our idea with people around the city and ask for their feedback.
For the education portion of my internship, we are about halfway done with the WAGi Playbook. The students are very excited about learning how to bring their ideas to life. By the conclusion of WAGiLabs, the students will present their prototype and pitch their ideas to judges in the “Guppie Tank” (modeled after Shark Tank) for 250 dollars or 1,075 Ghana Cedis! I will talk more about this in my next blog.
Journal Entry #3
The last week of my internship was one of the most rewarding weeks of my life. It was amazing to see our students so motivated in building their prototypes, and fully invested in their projects. All five of the teams competed against eachother in the "Guppie Tank" for the 250 dollars, but unfortunately only one idea was chosen. The winning group's idea was a low-cost chair that provided enough comfort and would relieve the students of back pain that they endure while carrying heavy backpacks from school and back, usually by foot. Most of the chairs at their school were hard, wooden, and in need of repair, so this idea was able to address a pressing problem that students faced on a daily basis.
My summer in Koforidua has been very rewarding and has left a lasting impression on the work that I see myself doing in the future. I have been able to interact with foreign medical professionals, whom I never thought I would encounter. I have been able to work on a telemedicine project that I am passionate about. Lastly, I have been able to learn from my students just as much as they have learned from me. In all, this has been my best summer yet, and I am grateful to have received the PFIG grant.