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Report of eye-mission to Assin Praso and Adjoube, Ghana, June 18-July 3 2010
This mission was organized from the Ghanaian side by the Presbyteryan Church of Ghana. The main organizer was Rev Emmanuel Yaw Agyei, the chairperson of the West Akyem Presbytery. From the US side, it was organized by Right to Sight and Health, Inc, a non-profit organization without any religious affiliation. The aim of our organization is to provide eye care and medical care where there is none available. We have a long-standing relationship with the Presbyterian Church of Ghana and have organized five missions there since 2005. This was our first time in this area. We were informed by our organizers that there was no ophthalmologist there and the need for eye-care was great.
We arrived to Assin Praso in the evening of June 19, Saturday. Our group from the US consisted of 2 ophthalmologists, one of them also having oculoplastics fellowship subspecialty, 3 nurses, and 1 layperson. From the Ghanaian side we had with us Dr Kennedy Opoku, a young and ambitious ophthalmologist, who has completed his ophthalmology residency last year. He worked with us also last summer in Dormaa Ahenkro. Ernest Kwaku, a student who also was part of our team in Dormaa last year, joined us again as a volunteer.
Assin Praso is a small village with a population of 8000. There is a small health clinic with a few nurses and a midwife, and this is where we worked. The closest eye-care is 20 miles away in Assin Fosu, where there is an eye-nurse, and the closest ophthalmologist is 110 miles away.
We started clinic and surgeries on Monday and worked untill Saturday. We saw 876 patients and performed 37 surgeries, 36 cataracts and 1 pterygium. We distributed about 500 pairs of eyeglasses, mainly reading glasses and also distance and sunglasses.
On Sunday we packed our supplies and went to Adjoube, which is also a small village of 7000, more remote than Assin Praso. There is a small health clinic there with 2 midwifes. We worked from Monday to Thursday, we saw 1114 patients and performed 16 cataract and 2 ptosis surgeries.
The most important part of our mission was to train Dr Opoku. It is just a drop in the ocean of blindness to operate on a few cataract patients, but if we help to train a local doctor, who will stay and work in Ghana for the rest of his life, we can have a lasting impact on eye care in this country. We trained Dr Opoku in small incision cataract surgery. He has been operating with supervision for a year now, so we just had to refine his skills and boost his confidence. He performed all our A-scans and keratometries, and operated on more than half of our cases. He became excellent by the end of the mission. He wrote us since and told us that now he was operating alone without a problem. We donated him a 78D diagnostic lens and showed him how to use it and he has reported back to us that he was using it now on a regular basis. We also donated a direct ophthalmoscope and trained him in the use of the indirect ophthalmoscope. He also learned organizational skills – something Africans are sorely lacking in general – just by watching us. He actively took part in our case selection and we always listened to his advice when in doubt. He also taught us many invaluable things, as he has much more experience in third world ophthalmology than us. He “saved” our mission when our autoclave broke down and we had to sterilize the instruments by Chlorox and boiling – something we would have never dared to resort to without previous experience.
We also had Dr. Mercy Dawson, the ophthalmologist from Akwatia with us for 2 days. She interrupted her extremely busy schedule just to work with us. Dr. Dawson was extremely capable and shared with us her knowledge. We also watched each other’s surgical technique. She saw many patients with very serious eye-problems who needed care we were not able to provide and referred them to her clinic in Akwatia, which was only 30 miles away. Her salary is exactly the same regardless of the number of patients she sees, so we were worried that she would hate us for generating extra work for her. But she was “awesome”, as one of our volunteers put it, had tremendous empathy, and was one of the best third world ophthalmologist we have ever met.
Overall, this was a successful mission, even that we performed less surgeries than we would have liked to. The eye-care in Ghana has been improving significantly in the past few years since the introduction of the national health insurance, so if we decide to return there we will probably go to North Ghana where the need is greater.
Judith Simon MD