Day 9: Final Day in Tema

Friday was our last day at Tema General Hospital. The day’s agenda was the same as Tuesday, with the exception once again that the early week trainees became the later week trainers. The morning session provided instruction in trauma assessment and treatment. The afternoon session taught patient assessment in a practical setting.

Each team was given a trauma scenario in which they worked together to assess patient injuries and determine life-saving treatment.

Afternoon participants were divided into small groups and exposed to mock patient situations that required their assessment and recommendations. Patients were presented with a variety of visual and vital signs, coupled with an analysis of the injury mechanism (accident, fall, violence, etc.). Using the knowledge and skills learned and practiced from the previous day-and-a-half, participants worked in a team setting to assess and treat the patient.

This last session was followed by a post-test to measure learning from the start to finish of the two-day course. Overall, test scores improved a dramatic 88 percent, indicating not only the success of the course but a willingness to learn and to improve clinical skills and assessment.

The increase in test scores was greater in those trained by the newly-trained instructors than in those instructors who were trained by the LDS Charities trauma team. Part of the difference was due to the fact that there were fewer doctors in the second group, and the overall knowledge base on average was lower. Regardless of experience, however, the significant rise in test scores proved the sustainability of the train-the-trainer concept in trauma care.

The two trauma training teams meet together to evaluate the success of the course and to discuss next steps.

Following the last training session, the new Tema trauma training team met with the LDS Charities trauma training team to evaluate the effectiveness of the course, discuss improvements, and to ponder next steps to help the Ghanaian team reach self-sufficiency in conducting future training sessions with other local and regional medical providers.

Africanized Americans.

As we departed, the Tema General Hospital staff presented us with African print shirts! What a thoughtful, parting gift to remember our new friends and professional association!

LDS Charities builds its programs, like the new trauma training program in Africa, on the principles of personal responsibility, community support, self-reliance, and sustainability. These principles are employed even during times of critical aid and emergency response. Efforts are designed to give individuals and communities the tools they need to improve their own circumstances in permanent and meaningful ways.

-Howard Collett #ldscharities

Day 8: Trainees Become Trainers

Melony Nii Boye, an experienced accident center nurse at Tema General Hospital, instructs a new group of students with the same training she received just three days prior.

In many respects, Thursday was a repeat of Monday except this time the instruction was provided by several of those trained earlier in the week. Nine doctors and nurses from the original group of 25 were designated to be the trainers to train additional medical staff from Tema General Hospital.

Students from the second class in trauma training observe endotracheal intubation techniques from Dr. Lawrence Ofori-Boadu, attending physician, who attended the first class.

Following the pretest, the rest of the morning consisted of PowerPoint presentations and perspectives on global surgery and trauma, initial assessment, airway management, breathing & chest trauma, circulation & shock, burn care, and eye injuries.

After lunch, participants were divided into four groups. The groups were rotated among four skill stations where they viewed demonstrations followed by hands-on practice. Skill stations included airway management, breathing & chest injuries, and circulation management.

Medical providers at Tema General Hospital who completed the first trauma training course pose with the trauma training team from Salt Lake City.

One of the highlights of the Thursday training is that only 11 medical providers had pre-registered, but 22 showed up. Word about the value of the course had quickly spread throughout the hospital and many who could arrange their schedule decided to attend—even if for just part of the course.

 

-Howard Collett #ldscharities

Day 7 – Transition

Wednesday was a transition day. The trauma training team met with participants of the two-day class who were designated to be instructors in this “train-the-trainer” program.

The LDS Charities trauma training team meets with Tema General Hospital team leaders to transition the next training program to local Ghanaian medical providers.

One of the goals of LDS Charities is to help create self-reliance in those who receive aid, and the train-the-trainer format helps recipients achieve that goal long after LDS Charities volunteers leave for home. To do that, LDS Charities works with local partner organizations like the Ghana Health Services, uses their solutions and resources, and involves the beneficiaries as projects are planned and implemented to meet needs that are specific to their community. These trainers will train an additional dozen participants on Thursday and Friday after they modify the original program to more closely fit local needs.

The training team also visited with the deputy director of institutional care for the Ghana Health Service and the director of the Greater Accra Regional Health Service. We then toured Ridge Hospital, designated as a regional hospital for the area, to learn more about the Ghanaian hospital system.

Howard Collett

The final team member is Howard Collett. A graduate of Weber State University with a degree in business administration in 1970, Howard served in the U.S. Navy as a rescue helicopter pilot at Naval Air Station Whidbey Island in Washington state. He then helped establish or evaluate hospital-based helicopter medical transport programs in 35 states. He spent the next 20 years as a magazine publisher and helped launch more than a dozen magazines including WordPerfect Magazine, Creating Keepsakes Magazine, and LDS Living Magazine.

In 2005, Howard was employed by The Church of Jesus Christ of Latter-day Saints as a writer and photographer. He worked with Church educational institutions—primarily BYU-Idaho and LDS Business College—and with the Missionary Department and Humanitarian Services. He has published hundreds of print and online stories, produced a number of video mini-documentaries, and has captured humanitarian stories in a dozen countries in Africa, Asia, and South America.

Howard retired in December 2015 but was offered a part-time position at LDS Business College as director of public affairs. He also volunteers for LDS Charities and was sent on this current assignment to Ghana. He and his wife Joan have eight children and 12 grandchildren.

-Howard Collett, #ldscharities

Day 6: Second Day of Teaching

One of several buildings at the Tema General Hospital complex 18 miles east of Accra.

Similar to Monday, the Tuesday morning session consisted of large group instruction in trauma assessment and treatment. Tuesday afternoon, however, consisted of patient assessment in a practical setting.

Dr. Ray Price presents a mock emergency patient scenario to medical providers in the Tema General Hospital trauma training course.

Course participants were divided into small groups and exposed to mock patient situations that required their assessment and recommendations. Patients were presented with a variety of visual and vital signs, coupled with an analysis of the injury mechanism (accident, fall, violence, etc.). Using the knowledge and skills learned and practiced from the previous day-and-a-half, participants worked in a team setting to assess and treat the patient.

Dr. Tom Wood demonstrates how to set a dislocated elbow.

This last session was followed by a post-test to measure learning from the start to finish of the two-day course. Overall, test scores improved a dramatic 62 percent, indicating not only the success of the course but a willingness to learn and to improve clinical skills and assessment.

LDS Charities builds its programs on the principles of personal responsibility, community support, self-reliance, and sustainability. These principles are employed even during times of critical aid and emergency response. Efforts are designed to give individuals and communities the tools they need to improve their own circumstances in permanent and meaningful ways.

Dr. Mark Stevens

Our fifth team member highlight is that of Dr. Mark Stevens. He received his medical degree at the University of Utah (Salt Lake City, Utah) in 1981. He served his surgical internship and residency, including a year as a research fellow, at the University of Texas Health Science Center (Dallas, Texas).

In 1987, Dr. Stevens moved back to Salt Lake City to become a staff surgeon at LDS Hospital. Shortly thereafter, Dr. Stevens became the medical director of trauma services at the Intermountain Medical Center. He also serves as a trauma surgeon at Primary Children’s Medical Center and teaches at the University of Utah School of Medicine.

Dr. Stevens has conducted numerous trauma and intensive care courses in the intermountain area. He serves on several state and national committees and is a member of several trauma societies. He was the trauma medical advisor for the Salt Lake Winter Olympics, and has provided volunteer medical service in Ecuador. He is chair of the trauma committee for Intermountain Healthcare’s 22-hospital system. He and his wife Marilyn have five children and three grandchildren.

-Howard Collett #ldscharities

Day 5: First Day of Teaching

Dr. Samuel Kaba, Director of Institutional Services for the Ghana Health Service, welcomes participants to the trauma training course in Tema, Ghana.

Day 5 Following weeks of offsite preparation and three days of onsite finalization, Monday was our first day of instruction. There were 25 doctors and nurses in attendance, most from Tema General Hospital. As mentioned on day three, this hospital was selected because it is located along the international highway to Togo, Benin, and Nigeria to the east, and experiences nearly 2,000 highway and industrial trauma accidents every year.

Tema General Hospital medical providers take a pre-test to quantify their trauma knowedge before the commencement of the trauma training course conducted by LDS Charities.

Dr. Mark Stevens, a volunteer trauma physician from Salt Lake City, delivers a lecture on trauma assessment to medical providers at Tema General Hospital outside Accra, Ghana.

Dr. Lyle Archibald, team leader for the LDS Charities trauma training course who now lives in Victor, Idaho, leads a morning discussion on trauma care.

Following the pretest, the rest of the morning and early afternoon consisted on PowerPoint presentations and perspectives on global surgery and trauma, initial assessment, airway management, breathing & chest trauma, circulation & shock, burn care, and eye injuries.

Following lunch, participants were divided into four groups. The groups were rotated among four skill stations where they viewed demonstrations followed by hands-on practice. Skill stations included airway management, breathing & chest injuries, and circulation management.

Pictures are worth lots of words, so here ae the photos.

Dr. Tom Wood, a volunteer LDS Charities physician from Ogden, Utah, teaches airway management to emergency department medical providers.

Dr. Ray Price, an LDS Charities volunteer general and trauma surgeon from Salt Lake City, shows Ghanaian medical providers how to insert a chest tube to relieve pressure on the lungs following a traumatic chest injury.

Here’s our third team member highlight, Jody Carter, ACNP. He graduated with an RN/BSN degree at Weber State University (Ogden, Utah) and went on to earn a Masters Degree in Nursing as an acute care nurse practitioner at Johns Hopkins University (Baltimore, Maryland) in 1999. He began work with Intermountain Healthcare in Salt Lake City, Utah the same year, and has worked on the trauma surgical team for 17 years.

Jody Carter, ACNP

At the Intermountain Medical Center, Jody manages a group of 18 nurse practitioners and physician’s assistants for trauma, orthopedic and neuro/spinal injuries. His clinical duties include meeting trauma patients in the emergency department with the ER team and trauma surgeon, and following these patients all the way through the intensive care unit to discharge.

Jody teaches a critical care course for paramedics, directs a trauma outpatient clinic for followup, and is a volunteer trauma course teacher at the University of Utah School of Nursing. He had no idea what career he wanted following his Church mission, but fell in love with a health class required in college. He signed up for a first aid class, became certified as an EMT, worked on an ambulance crew, qualified as a surgical technician and then was admitted to nursing school.

“I’m so lucky to go to work and love what I do,” said Jody. I love to figure out what’s wrong and try to make a difference in someone’s life. He has been married for 24 years and he and his wife Rhonda have four children. His involvement with the Ghana trauma training team is his first involvement with LDS Charities. He is the skills station coordinator, and is setting up four skills stations as well as stations to simulate trauma scenarios.

-Howard Collett #ldscharities

 

Day 4: A new beginning

Day 4 Today (Sunday) we attended the Cantonment Ward of The Church of Jesus Christ of Latter-day Saints, and had a wonderful experience with our new Ghanaian friends. It is always refreshing to see the strong spirit, commitment, hard work, and faith of African members of the Church.

Members of the LDS Charities trauma training team meet with doctors, nurses, and administrators of Tema General Hospital in Tema, Ghana. They were later joined by two directors of the Ghana Health Service.

This evening, we hosted a dinner meeting with two representatives of the Ghana Health Service and the Tema General Hospital. We were joined by Dr. Samuel Kaba, the Director of Institutional Care for the Ghana Health Service, and by Dr. Dinah Odoom, Deputy Director of Institutional Care. A neurosurgeon, Dr. Kaba has been the catalyst to help improve trauma care in Ghana and we are in Ghana as his guests.

Dr. Samuel Kaba (center), Director of Institutional Care for the Ghana Health Service addresses LDS Charities and Tema General Hospital Team Members.

The meeting was held so the trauma training team could to get to know those with whom they would be working with for the next several days. Expectations for the course were voiced and questions were explored. Dr. Kaba concluded the meeting by stating his appreciation for the opportunity to work with doctors from LDS Charities. He indicated that many charities come and leave gifts, never to be seen again. “But I always want to see people like you who cross the ocean for a noble cause.”

Dr. Kaba expressed his appreciation for the fact that LDS Charities is taking a teamwork approach to developing solutions for rural trauma problems in Ghana. “I am extremely impressed from one thing that has arisen from our discussions,” he said. “We are talking of teamwork. The difference between this activity and others is going to be that teamwork. To have a common trauma approach worldwide, irrespective of how rich you are or how poor you are, and to develop what I call ownership by each one of our team members . . . leads to stability. Then when you leave, we can still function. It’s not what are the expensive things you are putting in, but what are some of the common things that in your absence we can still carry on. So on this note I just want to say thank you so very much. I want you to think of Ghana as your second home and hope we can have that kind of exchange program.”

Dr. Tom Wood, Emergency Department Physician

Our third team member spotlight is Tom Wood, MD. He graduated from the University of Utah School of Medicine (Salt Lake City, Utah) in 1996. He has served as chief of emergency medicine and later president of the medical staff at McKay-Dee Medical Center (Ogden, Utah), where he has been practicing for 17 years, He is president of the Utah Emergency Physicians Group which provides more than 100 physicians and six advanced practice care providers for five hospitals in northern Utah.

He has volunteered his medical expertise on numerous occasions in Haiti as a part of the Haitian Health Initiative before and after the devastating earthquake in 2010. The initiative provides medical care and screening to improve health in children and women of childbearing age. Its focus is to develop a self-sustaining model for community and health development physically, intellectually and emotionally by partnering with local organizations.

Dr. Wood’s trip to Ghana is his first involvement with LDS Charities. “It is my observation that LDS Charities is seeking to elevate communities by partnering with local organizations by helping to improve their skills and resources,” said Dr. Wood. I’m doing this simply because I have made a covenant with the Lord to do so. That’s so important because it isn’t about us. In return, the Lord has covenanted with us that He will make up for our deficiencies to provide for a greater outcome of our efforts—more than we could ever do on our own.”

Dr. Wood also believes he has an obligation to give back. “I’ve been very blessed in my life,” he said. “My parents taught me that when you’re asked to do something, you don’t ask why; you just contribute the best you can. I came to Ghana to teach airway management, but my goal is to find ‘the golden nuggets’ or key elements where I can adapt my training to make a real difference in rural trauma care here in Ghana.”

In his role both home and abroad, Dr. Wood gets great satisfaction out of seeing doctors in his group practice having successful experiences. And for his patients, he enjoys using his skills and training to make a difference in someone’s life. “It doesn’t take very long to see that,” he said. Dr. Wood and his wife Kathy have three children.

-Howard Collett #ldscharities

Day 3: Preparation Day

Today was a day of preparation. It’s difficult to anticipate every scenario for a teaching event, especially when planned from 7,085 miles and 7 time zones away. So we drove 45 minutes from our hotel in Accra to Tema—not for the faint of heart even on a Saturday. But under the able skills of Elder and Sister Baker, we made the journey unscathed.

The Bakers are from Burley, Idaho, and are serving in Ghana as humanitarian missionaries. Perhaps the fact that they survived raising 13 children should have given us some comfort on Ghanaian highways. And the fact that they left these 13 children and scores of grandchildren to come to Africa for two years should give other potential missionaries courage to do hard things.

John Buah (Area Welfare Manager), Dr. Lyle Archibald (trauma team director), Leslie Apau and Ernest Awinimi (Tema Hospital emergency room nurses) and Sister Baker (LDS humanitarian missionary) make final changes to the training schedule for the coming week. 25 doctors and nurses from Ghanaian hospitals will collaborate with the LDS Charities team to find solutions to improve rural trauma care.

We arrived at the Tema hospital and were warmly greeted by the administrative, medical, and nursing staff there. The hospital is along the international highway to Togo, Benin, and Nigeria to the east, and experiences about 5,000 highway and industrial trauma accidents every year. Last year they asked LDS Church leaders in Ghana for help to improve their trauma care—thus the reason for the LDS Charities trauma team visit.

Dr. Tom Wood, Jody Carter, and Dr. Lyle Archibald explore the capabilities of the Tema Hospital emergency room with two ER nurses.

The LDS Charities trauma team spent several hours at the hospital, talking with the staff, visiting several departments in the hospital and planning the training for 25 doctors and nurses which starts on Monday.

Dr. Ray Price, General/Trauma Surgeon

 

As promised, here is a brief bio on our second team member, Ray Price, MD. Dr. Price graduated from the Harvard Medical School (Cambridge, Massachusetts) in 1987. He is a general/trauma surgeon at Intermountain Healthcare in Salt Lake City, Utah, where he is also the chairman of graduate surgical education. He is also a clinical professor of surgery at the University of Utah and the director of the Center for Global Surgery. He is a prolific medical journal author and reviewer, and serves on several national and international committees including the National Committee on Trauma.

Dr. Price has worked for several years to help improve surgical and medical care in Mongolia, where he received the Presidential Friendship Medal, the highest award given to foreigners. He also received the International Volunteerism Award from the American College of Surgeons in 2012. He is an Advanced Trauma Life Support instructor, a member of the International Medical Surgical Response Team, and has done volunteer work in ten countries on four continents. Following the earthquake in Haiti, he was the medical director for the LDS Charities emergency response team. He and his wife Anne have nine children.

“My parents always taught us that where much is given, much is expected,” said Dr. Price. “And they were always serving others behind the scenes. I have tried to follow their example. In high school, my friends and I formed the ‘Zero Club’. Anyone could join—they didn’t have to have any special abilities.”

“My Patriarchal blessing told me to train my hands and my mind to serve mankind,” said Dr. Price. “I experienced that working in humble villages in Thailand while serving my mission. Moroni 9:6 essentially tells us that when all seems lost, even if there is little hope, we still have a responsibility to do what we can.”

-Howard Collett #ldscharities

Days 1 & 2: Safe travels

Ghana sunrise from 35,000 feet

The Ghana trauma team departed Salt Lake City at 9:00 Thursday morning and arrived in Accra, Ghana at 7:30 local time Friday morning. We cleared customs easily, which surprised us as we were toting four large duffel bags of assorted body parts, otherwise known as medical training mannequins.

On our drive to the hotel we passed the beautiful Ghana temple. Adjacent to the temple is the construction of the new Ghana Missionary Training Center.

Ghana Temple

We arrived at our hotel, took a warm shower and power nap, ate lunch, and had an informal planning meeting with John Buah, the Area Welfare Manager for the Africa West Area. It encompasses 13 West African nations, including seven where the Church is operational.

Dr. Lyle Archibald with John Buah and Dr. Tom Wood

Prior to his current position, Brother Buah served three years as president of the Nigeria Enugu mission. LDS Charities always works with a local partner when it provides services anywhere in the world. Brother Buah is the liaison with the Ghanaan Health Ministry for the trauma training course to be conducted this week.

Dr. Lyle Archibald, Trauma Training Team Leader

Each day of this post, I’ll introduce you to one of our six team members. Today features the trauma team leader, Lyle H. Archibald, MD. Dr. Archibald graduated from the University of Utah School of Medicine (Salt Lake City, Utah) in 1971. He practiced as a general and trauma surgeon and later as an oncology surgeon at McKay-Dee Hospital (Ogden, Utah) until his retirement in 2011, performing an average of 700 surgeries per year. He has held numerous leadership positions culminating in serving as the medical director for surgical services for the 22-hospital Intermountain Healthcare network.

 

In 2010, LDS Charities received a request to provide cancer surgical equipment to a hospital in Sri Lanka. Dr. Archibald was recommended; at the time he was helping IHC develop oncology programs. Soon after his retirement, he and his wife were asked to serve six months in the Micronesian state of Chuk. There he helped develop procedures to deal with preventive and treatment measures for diabetes, a prevalent disease in the Pacific basin.

Since that time, Dr. Archibald has worked extensively as a medical advisor and trainer with LDS Charities in Paraguay, Ghana, Guatemala, Marshall Islands, Haiti, and the Dominican Republic. He is an Advanced Trauma Life Support Instructor. He and his wife Roslyn have four children.

-Howard Collett ‪#‎ldscharities

Why LDS Charities cares

Traffic accidents are the leading cause of accidental deaths. The global problem–especially in rural areas–is illustrated by the following slides and is an indicator of why LDS Charities is engaged in rural trauma training.

-Howard Collett

Out of Africa

On Thursday, January 21, 2016, a team of four trauma physicians, a trauma nurse practitioner, and I will be journeying from Utah, USA to Ghana. As volunteers for LDS Charities, we will spend a week in Tema, Ghana collaborating with local physicians to improve rural trauma care.

I have the opportunity to document this event, just one of more than 1,200 such efforts carried out by LDS Charities in local areas. Beginning Friday night I will post a daily blog showing the progress of this effort.

-Howard M. Collett