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This mission was organized from the Ghanaian side by the Presbyteryan Church of Ghana. The main organizers were Rev Emmanuel Osafo Boateng, the chairperson of the Kwahu Presbytery, and by Alex Sekyere, the accountant of the presbytery.
From the US side, it was organized by Right to Sight and Health, Inc. We have a long-standing relationship with the Kwahu Presbytery, and we were in Ghana four times before, yearly, starting in 2005. This was our first time in Dormaa-Ahenkro. We were informed by our organizers that there was no ophthalmologist there, and the need for eye-care was great; that was why we decided to go there. A month prior to our departure we learned that actually there was an ophthalmologist in the hospital, Dr Kofi Amo Kodie. We could not establish contact with him until a few days before our departure, but luckily we got into contact with Dr Koole, who has been involved with the eye-care of the Dormaa Ahenkro Presbyterian Hospital for several years. He gave us detailed information regarding the situation and the needs there.
We arrived to Dormaa-Ahenkro in the evening of June 14, Sunday. Our group consisted of 2 ophthalmologists, one of them also having oculoplastics fellowship subspecialty, 2 nurses, and 4 laypeople.
We started to work on Monday. One of our doctors worked in the clinic, signing up patients for surgery (mainly cataract), and the other worked in the OR with Dr Kofi.
We examined an average of 250 patients daily, distributed about 800 pairs of eyeglasses (mainly reading glasses) and performed 87 surgeries over the 12 days we spent there. Of these, most were cataract surgeries, and 8 were oculoplastic cases. (ptosis-repair in a baby with frontalis sling, ectropion repair, scar repair with free skin-transplant) These were done together with Dr Kofi, who says he can perform these now alone.
We trained Dr Kofi in:
-small incision cataract surgery , which he can perform now alone with excellent results.
– Yag laser posterior capsulotomy and peripheral iridectomy – both of these he can do now. We will send him a YAG PI lens, as we had only and YAG PC lens, which is not ideal for PIs.
We gave him a 78D lens and showed him how to use it-he wrote us back and said he is using it now on a regular basis.
We trained him in A-scan and Keratometry – with the instruments which were there.
We discouraged him from operating on hopeless cases.
We donated him 2 cataract surgery sets, an autoclave which sterilizes in 15 minutes, and some other instruments, IOLs and viscoelastic.
We showed him the intravitreal vancomycin injection for endopthalmitis and the use of intracameral Cefuroxim for endopthalmitis prevention.
We also trained a resident, Dr Kennedy Opoku, who is just finishing his training, in the same things as Dr Kofi. He could perform Yag-laser and A-scan alone, but he needs more training for surgery.
We worked with Emilia, the local eye-nurse, who was excellent, but overwhelmed.
We also worked with 2 OR nurses, Martha and Hawa, who also were excellent. We encouraged them to switch to the use of autoclave from alcohol sterilization in between cases, and hopefully this will be feasible now that they do have the fast autoclave.
They started to roof the eye-center while we were there, but it still needs a lot of work, including painting, floor, electric wires, lighting, furniture, etc.
Unfortunately we did not have a chance to discuss further plans for the eye-center/personnel/etc – we were never asked by the management to get involved in this.
Overall though, we learned much more from the Ghanaians, especially from Dr Kofi.