Wednesday, March 25, 2009
On March 4 Randi Burlein came to talk to our group about her trips to Ghana. This was the second time I'd heard her talk about Ghana. The first time was motivating as far as getting my paperwork to go in on time, this time, the second time was just exciting, now I'm ready go--- I can't wait to gorge myself on pineapple, to see our hotel, to see the market and most of all the meet some of the people she keeps talking about. Randi shared with us a video her department put together that had photos of the kids and adults they work with and of the students hard at work-- it was so great to put faces with names and to be able to give faces to the masses of kids I've been imagining meeting. The whole meeting was just great, it gave voices and faces to the people we hope to work with and an actually identity to the place I've been looking forward to visiting for the past several months.
In our fourth meeting our group discussed common disabilities and interventions seen in developing countries. The thing that left the biggest impact on me was the idea that an intervention that we take for granted here in the US, such as the placement of a shunt, would be ill advised in many areas in developing countries because the follow up necessary to properly carry out and maintain the intervention is available in such limited quantity or not at all in isolated rural areas that minor maintenance issues could easily become life threatening emergency care problems. It put into perspective for me just how different life is for some people and how vastly different the priority system for providing healthcare in such settings has to be. The reading for this week brings to light the importance of being able to understand the full circumstances and needs of the community and its individuals on their terms and shedding all of your assumptions and any preconcieved notions of who they are, what they need and what you can and will be doing in their community.
Wednesday, March 4, 2009
In the face of challenges ranging from physician shortages and unequal resource distribution, to underfunded training and practice facilities and inadequate infrastructure, it's hard to recommend a starting point for improving rehabilitation services for the disabled population. Just making sure people have access to safe water and toilet facilities presents a challenge, providing rehabilitation services for the 95% of the disabled population in Ghana that does not even receive services seems like an issue too huge to address-- and in many ways thus it has been treated by the infrastructure. The government issued a persons with disabilities bill which appears to attempt to address some of the challenges the disability population faces in Ghana, though in reality it seems the government has been able to do little to put the bill into action. It has fallen to the community to adapt and fulfill its own needs-- as we saw in the example with the villagers who used donated motorcycles to establish a system that allowed a nurse and a medical assistant to travel through rural areas to administer basic services resulting in an increase in vaccination coverage to 75% from 40%. It is the ingenuity, resourcefulness and determination of the villagers and the professionals who stay (or return) to practice in their own country who make the difference in their communities. They are the ones who identify the needs and the opportunities for change and are able to make and execute plans for change that will get those needs met. When I first did the reading I thought, where would you even start, people don't even have clean water?! But perhaps I need to think less about that and be ready to just jump in where ever and go with the motorcycle riding vaccination team and the home grown birth attendant carrying her wares in a wooden box and let direction for the infrastructure come from the people to the government instead of expecting it to be vice versa.