Preventive Healthcare

On Friday May 19, 2017 I joined community health nurses (CHN) from the hospital and traveled 3 miles Northwest of Ankaase to Dumakyi, a small farming community, to conduct vaccination screening, also known locally as a health outreach program. Dumakyi lacks running water, electricity and basic public transportation. Residents, mostly cocoa farmers living in mud thatched houses, walk to the hospital, 3 miles away, when they are sick. The distance and lack of transportation discourages them from bringing their children for scheduled clinical review and obtaining the required vaccinations. To combat this problem, CHNs visit and vaccinate the children right in their backyard.

CHNs setting up under the teak tree. Some students milling about the place before class.

We arrived at 9:30 am on Friday morning and set up office under a teak tree in front of the local primary/middle school. Despite bringing the free vaccination exercise to the community, parents are still reluctant to bring their children. As a result, some of the nurses walk to individual homes and remind them that vaccinations have begun. This is arduous process because their houses are very far apart. I joined two of the nurses and walked to different homes to remind community members about our arrival. We walked for 30 minutes and almost lost our way in the forest. I was glad when we came back to the teak tree and joined the rest of the group.

Moses (in white) and Adu heading to the middle of the forest to remind parents about our arrival

During the screening, CHNs assessed the weight of the children to track growth and development and evaluated them for any required vaccinations. Based on age, a child may be administered yellow fever, meningococcal, pneumococcal, MMR, Tdap and BCG (protects against TB) vaccines. Others are also given Vitamin A. About 30 children were seen on this day including a 4 -year old boy diagnosed with down syndrome. We had a very successful exercise and returned to the hospital just before noon. We had traveled there in a truck with a 6-passenger capacity. Due to the aforementioned problem of transportation, 3 extra people joined us on the way back. Six of us had traveled to Dumakyi. Nine people in a truck meant for 6, in a 100-degree Fahrenheit weather, makes for an interesting ride!!!

Mud thatched homes

At the hospital and especially in the emergency unit, we have observed an increase in the number of patients presenting with hypertensive emergencies and Stroke. We hope that a community oriented intervention will contribute in reducing the incidence of Stroke in the Ankaase and surrounding communities. One of the ways we think will help in achieving that goal is through church based health teaching and screening. The other goal is to dispel erroneous teaching by herbalists whose main objective is money-making from illiterate customers. I once heard a herbalist proclaiming boldly on radio that the main cause of hypertension, stroke, malaria, HIV, hepatitis among other common diseases in Ghana, was mucus. He promised that buying and using his concoction will melt the mucus away and thus, heal the buyer of every ailment. Needless to say, I was flabbergasted.

I have been attending the Wesley Methodist church. This church is in Ejuratia, a small community close to Ankaase. The head pastor, also the hospital’s chaplain, and I had discussed the revival of a health screening exercise for the members a few months ago. After some planning and deliberations, we had our first monthly health screening on Sunday May 21, 2017. The goal was to assess the blood pressure (BP), random blood glucose (RBS), and also teach congregants about stroke and hypertension in an effort to enlighten them and also dispel false knowledge being propagated by greedy herbalists.

a young man checks his BP

After the teaching, we assessed the BP and RBS of almost 50 members. About a third of those assessed were in the pre-hypertension range (systolic 120-139 mmHg, diastolic 80-89 mmHg) with an average age of 45 years. A small number had values in the hypertension range. We counseled those with abnormal values about diet modification, appropriate exercise and to visit the hospital for review. The plan is to conduct this screening once a month and hopefully travel to other places of worship. According to the Chaplin, the members were very pleased with the exercise and look forward to next month’s health talk.

Other members waiting to be screened

We are hopeful that a community-based change process will be initiated by this preventive healthcare practice and reduce the incidence of stroke and hypertension in our communities.

A child being weighed at Dumakyi