Occupational Therapy Students Learn Valuable Lessons During Trip to Ghana

Lisa McEvoy

Date

February 20, 2025

Topics

Interprofessional Education

Area of Expertise

Global Education

Global Health

Students help people in Ghana and bring back interprofessional and cultural knowledge for the future

When Elspeth Olney and Hope Hilsenrath visited Africa before becoming MGH Institute students, they each knew they wanted to return one day. Olney had traveled to Kenya in 2016 and had encountered a group of medical students working in the community while Hilsenrath had visited Ghana on a 2018 service trip to teach in an elementary school.

“I remember thinking that was something I could do in the future once I was in graduate school,” said Olney, a second-year, entry level occupational therapy student.

“I loved it,” her classmate Hilsenrath recounted. “It’s such a beautiful country with such beautiful people so I have always wanted to go back and do something more specifically healthcare related.”

They both got the chance to go back earlier this month when they joined four of their fellow OT students, Michaella Israel, Erin Macdevette, Isabella Moreno, and Caitlin Prescott, as well as physician assistant and pharmacy students from other Massachusetts schools on a 10-day trip to the West African nation. Led by Assistant Professor Colleen Muse, who teaches the six students in a global immersion elective, and four faculty members from the other schools, the trip is part of an interprofessional Ghana Collaborative that has been visiting the region for four years.

This year, the students were divided between four health centers in different locations. Each student chose one subject area — chronic disease focused on diabetes; infection control focused on scabies eradication; youth mental health; and maternal health — and worked with an interprofessional team at each site.

“We’re really there to meet the unique needs of the health centers and learn what they are doing,” explained Muse. “What are the needs they have? What’s working? What’s not working and how can we support them by using our shared knowledge and cultural humility to support their needs sustainably?”

Interprofessional Teams in Practice

The staff at the health centers are led by physician assistants and staffed with community health workers, and nurses.

“Occupational therapists are spread thin in Ghana, but their services are valuable so having OTs from the U.S. added a needed lens in these centers that did not have OTs on hand,” said Muse.

In addition to showing the contributions that OTs can make to patients and health center staff, there was also an opportunity to highlight the OT’s value to the PA and pharmacy students they worked with while in Ghana.

“This was a unique opportunity to learn more about what occupational therapy looks like abroad,” said Macdevette. “The interprofessional aspect intrigued me because you not only see where we fit in and show the unique lens of occupational therapists, but you can educate some of our American colleagues.”

woman facing away from the camera stands in front of mothers and children

Occupational Therapy Service Trip to Ghana

The interprofessional approach was on display when some of the students did home visits. Moreno was able to visit the chief of a village, who has type 2 diabetes, along with a PA student and two pharmacy students, to ensure the chief understood his care and assist with strategies to help him follow through successfully with his care and his care team.

“It was interesting to hear his take on his illness and his family history and what he does to manage his diabetes. It was also interesting to hear the pharmacy students ask about the medication side so they could understand what he was doing,” said Moreno. “I focused more on whether he had numbness or tingling.”

“They all worked together so well and respected each other,” said Muse of the students. “They felt comfortable asking each other questions and learning from each other.

“Interprofessional practice is something we talk so much about here at the IHP so it was really interesting to see it come to life. We spend so much focus on interprofessional practice and practice with impact courses, but this experience allowed students to put that knowledge and learning into action and problem solve live, in the moment, on something that was a real case with long term impact. They had the skills they needed, and it was really fun to watch them be able to put those skills into action confidently.”

Four women standing next to each other pose for the camera — (l-r) Isabella Moreno , Hope Hilsenrath, Elspeth Olney, and Caitlin Prescott at the Berekuso Health Center.

A woman stands with a baby tied on her back — Hope Hilsenrath learned how women in Ghana wrap their babies so they can carry them on their backs.

A tent with people sitting under it next to a health center — The Berekuso Health Center was one of the sites where occupational therapy students from the MGH Institute helped during their service trip.

A woman holds a card for a child to look at while another woman looks on — Caitlin Prescott helps with a vision screening during the community health day.

A group of people sit around on a low rock wall — Hope Hilsenrath (pointing), Michaella Israel (next to Hope), and Caitlin Prescott (next to Michaella) took part in a home visit to help with a well-baby check up.

Three people stand holding posters with information about mental health — Erin Macdevette (center) helped to create posters to educate people about mental health.

A sign saying "No woman should die giving life" taped to the wall — Signs with this reminder were displayed on walls around the health center.

A woman holds a baby — Michaella Israel holds one of the children at the health center.

A woman hands something to a woman holding a child — Hope Hilsenrath hands out items during the community health day.

Seven women pose standing on a rock with mountains behind them — (l-r) Elspeth Olney, Caitlin Prescott, Isabella Moreno, Michaella Israel, Colleen Muse, Erin Macdevette, and Hope Hilsenrath were able to visit some of the beautiful places in Ghana before going to the health centers

Baby being weighed — During check ups, babies were weighed using scales like this one.

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 Education

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.” 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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