Research in Cardiovascular Disease Risk Factors in Southeastern Ghana

This was the major activity on this trip. We initiated this project a few years ago, but this is the first time that we are actually implementing an IRB (Institutional Review Board)-approved research protocol at the project site.  The focus of this research is to study the prevalence of hypertension and obesity, and its relationship with socioeconomic factors including family history and poverty in southeastern Ghana.  This area has a population of over 250,000 but no large cities.  Most inhabitants live in towns and small villages, with the border town of Aflao as the most heavily populated.  Apart from the large towns, poverty reigns in virtually almost all the villages, with less than $1 per day of income.  As a result, when the villagers decide on how to spend their money, buying food to survive comes before the procurement of basic health care. Over the years, we have observed the large number of villagers with severe hypertension, who go about their daily activities without knowing that they have severe hypertension.  Apart from those with impending complications, who are fortunate to present to a hospital, sudden death and hypertension-related stroke, and kidney and heart failure are some of the ways hypertension presents in the young. 

Mr. Ben Henkle of the University of Iowa, is working on this project.  He will use the data toward his Master in Public Health degree.  We are leaving Ben behind in Ghana for two additional weeks  to continue with data collection on this project.  So far, we have obtained consent and screened over 120 subjects at the following locations: IHDN Hospital at Weta; Worgbato (a village 3 miles from Agbozume); Agbozume Market; and Ketu District Hospital at Aflao.  The Sacred Heart Catholic Hospital at Abor will be the final site for this study.  The tools being used for this research are the Welch-Allyn blood pressure monitor, an analogue scale, height meter, and a 4-page questionnaire.  The knowledge gathered from this study will be submitted for publication in medical journals.  We will also use the information to guide us in developing an educational and interventional program on hypertension in the area.

The screening at the Agbozume market was quite a scene.  We recruited the help of some of the IHDN staff who still have shops at the market.  As a result, we were offered research space at the part of the market where Kente clothes are sold.  The Kente trading takes place early in the morning, so by 10 a.m. there was space available for us to use.  With the help of the Agamah girls ( Sarah, Aseye, and Miriam) and Ms. Sarah Blythe, we screened over 53 men and women.  Some of these subjects had unbelievably high blood pressure. One of the dramatic cases was a 42-year-old man with a blood pressure of 250/145.  Ideally, he should have been admitted to the hospital and treated with cardiac monitoring.  But this man had to be treated and observed in the market.  Thank God he did improve and later followed up at the hospital.  This was the first time he found out he had high blood pressure.  We can only speculate what would have happened to him if he had not been screened that day.

Screening at Ketu District Hospital at Aflao
We were very well received by Dr. Asare-Bediako and the staff of Ketu District Hospital at Aflao.  We screened both patients and their relatives who were at the hospital.  Most people were coming for clinical care, so I had to see these patients after their screening.  One striking observation was that the patients from the Aflao area were not as poor as those from the Agbozume area.

When the team leaves, Ben will continue with the screening and hopefully enter the data before leaving Ghana .

Computer Science Program
Student registration for the computer science classes was very low.  As a result, Mr. Jeremy Embalabala spent the time writing a program in Microsoft Access for the hospital.  This program will be used for record-keeping at the hospital so we can gradually position ourselves to using electronic medical records.  He was able to complete the computer network and each staff now has their own user ID and password.  The air conditioning to the server room broke down, but thank God, this was fixed on the Sunday we left Agbozume, so we can now keep it running 24 hours a day.  Jeremy, assisted by Mr. Ryan Petter, also spent the time completing the installation of the network jacks on the wall and training the staff on using their computer and the network.

English & Math Enrichment Program
Ms. Marcy Winkelman taught English classes at Somey Secondary School .  The last day she had to teach 5 classes.  Mrs. Marie Rhone taught English and Math at Junior High, while Ms. Mary Payne taught 3rd and 4th grade English & Math. 

Donation of Desks
Mr. Ted Hamilton was assisted by a local carpenter in assembling 15 desks we had previously shipped to Ghana.  We donated these to the Kpota Junior Secondary School.  This is the second such donation of desks to schools in Ghana.  These desks were donated by the Midwest Mission Distribution Center (MMDC) in Chatham, IL. It was quite gratifying for Mrs. Pat Wright, the director at MMDC, who is also a team member, to see these desks bless the children.

Nursing Staff training 
Mrs. Linda Kelly completed the training for the nurse staff at the Hospital.  This was a refresher course for some of the staff and new to others.  It was well received overall. 

Praise and Worship at the High School
Ms. Sarah Blythe, Ms. Sarah Agamah, Mr. Ryan Petter, and Ted Hamilton, who are all graduates of Springfield High, visited the Some Secondary School to perform worship songs during their morning devotion.  Ryan was fascinated to learn about the student life on campus and how they have to get up in the morning to sweep the compound before classes begin.

Youth Forum
The youth in our team hosted a youth forum for the students at the Kpota Junior Secondary School .  This was structured like a scholastic bowl.  This year, the students did not exhibit a lot of knowledge compared to previous years.  We learned from the teachers that the students are not as highly motivated as before. 

IHDN Mission Hospital
Work in the hospital is going on well.  We are still waiting for accreditation from the National Health Insurance Scheme to allow us to bill for insured patients.  Presently, the hospital is not able to break even from its operations, and requires about 30% additional funding to keep the doors open.   We hope and pray that things move on well for us to get all the documentation.

We have just completed another successful mission trip to Ghana.  We have done a lot in a short time, but more remains to be done.  We cannot solve all the problems, but we know that we have saved lives.  To God be the glory.  We are now off to the airport to catch a plane to London.

Report submitted by Dr. Edem Agamah on behalf of IHDN Ghana Mission Team

For more details about other mission activity reports, please read the IHDN
bi-annual newsletter.