Differences in Care Approaches
As part of the group focusing on maternal health, Hilsenrath, Olney, along with Israel and Prescott, also did home visits to help with well-baby check-ups and experienced a different approach to healthcare and caring for mothers and children. While they don’t have all the tools that healthcare providers have in the U.S., Ghana has some healthcare advantages.
“Their healthcare system is very different from ours and more focused on prevention because that’s cheaper and more effective,” said Hilsenrath.
The clinics like the ones the MGH Institute students worked at are not full hospitals but still handle the needs of the people in the local village.
“Staffing isn’t an issue,” said Prescott. “There are a lot of nurses and midwives and usually each clinic had a PA, but in the whole district or directorate, they only had one doctor.”
The abundance of nurses and midwives in the health centers reflects the importance of women’s health in Ghana, especially maternal care.
“As a woman, it was amazing to see all of the work they are doing to promote women's health and the emphasis they have on ‘no woman should die while giving life’,” said Olney. “It was a fantastic experience to learn about the culture and how the healthcare system works in Ghana, where they are finding success, and where there are still barriers.”
One of those barriers is a lack of technology.
“It is interesting to see how healthcare works there,” said Israel. “There are no electronic health records, and they use diagnosis books.”
While at the health center, the group helped input information into the health center’s computer, since they were more familiar with using computers in a clinical setting. They also did home visits to help with baby check-ups. That is when they were able to see some of the ways that Ghana is a collective society.
“Whenever we would do a home visit, all of the moms in the area would come and bring their babies,” continued Hilsenrath, who experienced how the mothers wrap the children so they can carry the babies on their back. “They’d be passing them around and talking and laughing.”
In addition to taking part in home visits, the groups also took on projects the resulted from assessing the needs of the community, working together to figure out the best way to address that need while they were there, then putting their plan into action. One such project was coming up with strategies that could be implemented after their time in Ghana on sharing the benefits of increased paternal involvement during pregnancy and child rearing.
“The main strategies we discussed to enhance father involvement was mostly around providing education on how paternal involvement can help improve maternal and neonate outcomes,” said Israel. “We discussed promoting a group just for expecting fathers, suggested posting information at the health centers and flyers at local establishments such as a restaurants and bars where the men hang out, and getting a group of fathers who are friendly with each other to make each one feel more comfortable attending at first.”
Another project a group took on was helping to education people on mental health issues.
“We ended up making three different posters focusing on mental health,” said Macdevette. “One focused on the fact that mental health could affect you because it doesn’t discriminate. Another was on medication management, while the third was something we would produce in America on how to have good mental health by eating right, getting enough sleep, and having a good support system.”
The groups also held community health days where they did hypertension, diabetes, HPV, and vision screenings that attracted hundreds of people. They also gave out reading glasses and toothbrushes that they brought as donations.
“This was our favorite part of the trip,” said Muse. “The day started with well-baby screenings, a meeting with the village chief, followed by assisting in any way we could to weigh, measure, track, and screen all those clients who came for a wellness check that day. We brought many levels of nonprescription reading glasses and spent a few hours screening both school children and the aging populations identified by staff. It was humbling to screen, issue, and educate so many. The look on their faces when the glasses worked is something that will stick with me forever.”
Cultural Humility
In addition to putting their skills into practice and getting real-life interprofessional experience, the trip also served to reinforce lessons on interacting with patients from different cultures.
“Part of our goal is cultural immersion and developing some cultural humility,” said Muse. “Even if our students never practice in another country, they are very likely to see clients from other countries within their practice in the U.S. and we want to give them some exposure and experience to provide holistic care.”
Being able to understand that each patient has a unique background and perspective is a focus of the curriculum at the Institute but having that real-world experience is something that can’t be duplicated in the classroom – something several students noted when sharing their main takeaways about the trip.
“I was able to grow in just those 10 days of navigating an unfamiliar culture in a way I wouldn’t be able to here,” said Prescott. “I was able to feel more comfortable asking questions and finding that line of ‘should I keep digging deeper or should I just take that answer and roll with it?’ We practice it a lot at the IHP but being able to be fully immersed in a culture helped me grow a lot in a professional way.”
“[The experience] was a reminder that what works for someone may not work for someone else,” said Olney. “I hope to base my future practice on this statement and continue to remind peers and future co-workers of this because I believe it is something that all healthcare providers need to be reminded of to put the client first and provide the best care possible.”
“Understanding how people practice different things in terms of healthcare, in terms of occupational therapy, and in terms of people’s daily living skills is something I want to bring into my practice in America,” added Moreno. “Knowing there are different cultures that do things differently is something I should be aware of and take that into every room I enter as a physician.”
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