Our Global Impact: The Ghana Emergency Medicine Collaborative

When Rockefeller (Rocky) Oteng was a child living in Ghana, he noticed that people who went to Europe or the United States for their education often didn’t come back home. Instead, they stayed in those other countries to work, live and thrive. This made him wonder – Why did Ghanians have to go someplace else to become somebody?

When he was 9, Rocky and his family left Ghana and moved to Northern Virginia. He went on to earn a medical degree from the University of Cincinnati College Of Medicine and then joined the University of Michigan as a resident in the Department of Emergency Medicine. Rocky always believed that there would come a time when he could help make a difference in the world. One of the reasons he chose to study emergency medicine was because it would give him knowledge and skills to help the greatest number of people. Throughout his training, the question of why Ghanians needed to leave home to be “somebody” remained on his mind, and in 2009 he decided to dedicate his work to bringing emergency medicine to Ghana.

According to Rocky, prior to 2009 the state of emergency medicine in Ghana was dismal. There were terrifying stories within the Ghanaian community of family members presenting to the hospital and dying from easily preventable causes. There were studies that showed that the acutely ill and injured people were dying at a higher rate in Ghana than in other developed nations. Rocky dreamed of doing something to change this, starting with creating an in-country emergency medicine training program.

Of course, every dream requires support and for Rocky this help came in two forms: a pilot grant from the Medical Education Partnership Initiative http://www.mepinetwork.org/, which funds medical education and research in Sub-Saharan African institutions, and matching funds provided Dr. William Barsan, who was chair of Emergency Medicine at the time.

Thus, the Ghana Emergency Medicine Collaborative was born.

Rocky is a man of great compassion, vision and ambition. But, to build a successful Collaborative, you need partners. Fortunately, Rocky also is a Michigan (Health System) man and therefore has access to incredible mentors like Drs. Barsan, Robert Neumar, Joe Kolars and Terry Kowalenko, as well as like-minded and like-hearted colleagues, such as Sue Ann Bell, MSN, FNP-BC. Working with partners from Kwame Nkrumah University of Science and Technology, Komfo Anokye Teaching Hospital, the Ghana Ministry of Health and the Ghana College of Physicians and Surgeons, Oteng, Bell and the rest of the team have made great progress with the Ghana Emergency Medicine Collaborative through exchange and in-country training programs. To date, they have graduated seven Ghanaian physicians from the residency program, with 15 more physicians and 27 nurses currently in training. Additionally, they have been engaged in efforts to continue to build an academic department and local emergency response systems. It is impressive work that will serve the people of Ghana for decades to come. Take a look:

When we talk about our Health System’s global impact, we mean more than just going into other countries to help, though that is certainly an important part. We also mean creating programs like the Ghana Emergency Medicine Collaborative and partnering with in-country agencies, universities and governments to build sustainable and culturally-appropriate local health infrastructures and medical training programs. In doing so, we help bolster the health and productivity of citizens, communities and economies.

Today, as we celebrate Earth Day, let’s reflect on our role as global citizens.

What is/will be your global impact?

 

 

Dr. Denis Mukwege: Uncompromising Humanitarian & Defender of Human Dignity

In November 2010, the University of Michigan honored Dr. Denis Mukwege, Medical Director of the General Referral Hospital of Panzi in the eastern part of the Democratic Republic of Congo, with its Wallenberg Medal because of his heroic work treating survivors of sexual violence in the Congo. Two days ago, he was almost murdered because of this work.

As a University community, we were shocked to hear of the threat to Dr. Mukwege and want to express our deepest concern and support for him, his family and his team. At the heart of our institutional values is a commitment to public service, and the belief that one person can make a difference in the struggle for a better world.

Dr. Mukwege and his colleagues at Panzi Hospital have been responding to a calamity of a scale that is simply beyond our imagining. Since the founding of Panzi Hospital in 1999, Dr. Mukwege has performed reconstructive surgery on more than 21,000 women and children, many suffering from severe wounds and mutilations spurred by rapes and violence during the deadly regional war.

A team of University of Michigan faculty, representing multiple disciplines and our global initiatives has been working with Dr. Mukwege to continue to improve the health of women and children throughout the world.  Additionally, we are committed to launching a research and clinical hub in the Congo with Dr. Mukwege for the improvement of the lives of women and children. We call on the international community to recognize the importance of this work and push the appropriate authorities to ensure his safety.

Timothy R.B. Johnson, M.D., Professor and Chair, University of Michigan Department of Obstetrics and Gynecology
Ora H. Pescovitz, M.D., Executive Vice President for Medical Affairs, University of Michigan, and CEO, U-M Health System

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Back to School

With the start of a new academic year, I’ve been thinking about our University of Michigan Medical students. In addition to superior academic credentials, they bring a multitude of impressive successes, unprecedented commitment to their craft, inspiring global awareness and wonderful diversity.

For example, this year’s incoming class of 177 new U-M medical students has a mean MCAT score of 34.2 and a mean GPA of 3.78. Sixty-three percent of the class received simultaneous offers from other top 10 medical schools in the country, 48% speaks at least one language in addition to English, 87% have been involved in medically-related volunteering or community service, 26% are entering medical school with at least one peer-reviewed publication already on their CVs and 12 students spent a year or more participating in intensive service activities through AmeriCorps, Teach for America or the Peace Corps. Additionally, the class features jugglers, beat boxers/DJs, cross-country cyclers, musicians and avid climbers. This is a truly extraordinary group!

Of course, our students are just as impressive when they complete their Michigan medical school training. Of the most recent graduating class, 99.3% matched – exceeding the national average of 95% – and of those that matched, 93% matched into one of their top five choices. Matching is the very competitive process by which graduating medical school seniors seek entrance into a residency program. Residency directors from schools across the United States consistently rank U-M medical students as among the most desirable. In fact, the most recent US News & World Report ranking of medical student desirability placed U-M second behind Johns Hopkins and Harvard, which tied for first.

So, I’ve addressed the beginning and ends of the Michigan medical school experience, but what happens in between? The answer is exceptional didactic and hands-on learning. From the lecture hall to the clinic to the OR to the lab to the community, students immerse themselves in absorbing as much knowledge and experience as possible so they can launch exceptional careers that will shape the future of medicine and science.

Recently, I was forwarded an e-mail from Emma Lawrence, a member of the UMMS Class of 2015. In the e-mail, Emma described her experience this summer helping to establish a center for fetal monitoring in Ghana. Below is an abbreviated version of her story. It is a terrific example of the remarkable character and caliber of UMMS students:

Unlike past trips to Ghana, my primary responsibility this summer is research. Along with a University of Michigan undergraduate student, I am based at Komfo Anokye Teaching Hospital, a large tertiary care center in one of Ghana’s busiest cities. The hospital is a maze of crowded wards, hurried health workers and an unrelenting inpouring of patients. I spend my time in the “A ward,” a 4-floor block dedicated to OBGYN. The high-risk antenatal ward, where I recruit patients and follow up on their care, is constantly hovering at the brink of barely controlled chaos. Physically, the room is bursting at the seams with laboring patients; hospital beds are always full and the doctors weave among the extra mattresses squeezed into every spare space, attempting to hang IVs from window sills and examine the women as they lie on the floor. Women are rushed from nearby hospitals in the throes of eclamptic seizures, with blood pressures at impossibly high levels, and with obstetric histories full of loss. Last year, the hospital averaged 33 deliveries a day, a staggering number by any account.

My research involves the implementation of cardiotocograph monitoring, a form of electronic fetal monitoring that is routinely used in the United States. In an effort to reduce the staggering number of stillbirths at Komfo Anokye, the monitors give an inside look into the health of the fetus and allow doctors to take action, by inducing labor or performing a c-section, in the critical period that precedes fetal death.  My work has been both fascinating and challenging on every level. We started with a bare room and a hospital staff largely unfamiliar with the indications and interpretations of cardiotocographs. After countless phone calls and meetings, endless trips to the ATMs, and an impressive battery of stabilizers, surge protectors, voltage transformers, and socket adaptors, the “fetal assessment center” is newly equipped with patient beds, privacy screens, 3 cardiotocographs, and an ultrasound machine. An additional 15 cardiotocographs have been distributed to OBGYNs in two of Ghana¹s other major teaching hospitals and to 6 district hospitals.

Despite the strides we have made, we are just scratching the surface.  Doing this research and working with patients has been a clash of emotional highs and lows. On a daily basis, I struggle with the ethical dilemma of my own place in the hierarchy of medicine (as a rising second year medical student with no business making critical care decisions) and the conflicting realization that the doctor I¹m sharing a strip with might not understand the importance of the lines and wiggles and black marks that now mean so much to me.

After finishing my first year of medical school with a short sequence on embryology, words like “spontaneous abortion” and “intrauterine fetal death” conjured images that seemed only remotely connected to the idea of life and birth. However, as we began to monitor patients, these words and numbers have taken on a new reality.

When I stop by on the weekend to monitor a single patient and end up leaving 8 hours later, I leave exhausted and invigorated and emotionally drained and so deeply amazed at the dedication and fortitude of the physicians here. I know that medicine is never easy anywhere, but I cannot imagine that most doctors in America will have to help a women deliver in a chair because the labor beds are full or manually squeeze bags of saline into a women dying of septic shock or induce labor in an eclamptic women to save the mother¹s life, knowing full well that the baby will die here in Ghana because of the limited capabilities of the NICU.

I have grown enormously from this experience. I realize both the remarkable gains in knowledge my classmates and I have made, and the enormity of what I have left to learn. (Read the complete version of Emma’s story on the Global Reach website.)

To sustain a top 10 medical school takes many things in addition to outstanding students. It takes incredible faculty and staff who educate and support students throughout their time here. And it takes superb medical school leadership, which we are very fortunate to have in Dean James O. Woolliscroft, Dr. Joe Kolars, our senior associate dean for Education and Global Initiatives, Dr. Rajesh Mangrulkar, associate dean for Medical Student Education, Dr. Steven Gay, assistant dean for Admissions, Robert Ruiz, director of Medical School Admissions and the entire Admissions team.

I doubt I could have competed with our incoming medical students for a spot in the U-M Medical School class when I started medical school in 1976, but I am so thrilled to be a part of it today. I hope all of you take as much pride in our Medical School as I do. When we refer to the ‘future of health care’, our medical students are at the center of that future. And, because they are so exceptional, I know that our future is a bright one!

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