Trip to Accra, Ghana Samuel Asante

Accra,Ghana Ghana is a small country on the western part of Africa It has a population of about 26 million Bordering countries are Gulf of Guinea, between Cote d'Ivoire and Togo The capital is Accra Population of 2.277 million

Korle-Bu Teaching Hospital Korle Bu Teaching Hospital is the nations biggest, and busiest safety net hospital. It houses up to 2000 beds and is also the third largest in Africa. Korle-Bu Teaching Hospital which has six out of the fifteen neurosurgeons practicing in the country.

OR and ICU

Ridge Regional Hospital Ridge Regional hospital is a medium size regional hospital in the heart of the city. Ridge hospital was initially built in 1929 for the British nationals during the pre-colonial era. Ridge has undergone a $250 million dollar addition and renovation most recently (top picture). Right next to state of the art facility is the almost 90 year old run down building, which is still the main facility (bottom picture).

Objective Discuss the disparity of Neurosurgeon in Sub-Sahara Africa Discuss the path to training a neurosurgeon in Ghana Some reasons for the low number of neurosurgeons per population is the time it takes to train one. A physician is paid based on the level of expertise you are ie House Officer or Medical officer or Specialist or Consultant Discuss the healthcare system available in Ghana

Disparity of Neurosurgeon in Sub-Sahara Africa In 1998, Sub Sahara Africa had 1 neurosurgeon to a population of 6.3 billion In 2016 the neurosurgeon per capita is 1 per population of 3million (Dechambenoit, 2016). MRIs in Sub-Sahara Africa was 1 per a population of 25 million, Compared to 25 MRIs per a million people in the western countries

Path to training a Neurosurgeon in Ghana/West Africa Seven years of Medical school (post high school). Two years as a House staff in the hospital. The house staff is equivalent to an intern year in the United State. One to two years as a Medical officer, also called MO-ship. After MO-ship there is a final exam called Part 1. Passing qualify them to be a Specialist. Three years as a Specialist A specialist is someone training in what Ghana considers as the four main branches of medicine: Surgery, General Medicine, Obstetrics and Gynecology, and Pediatric. After specialist training one can pursue specific fellowship training. Three to four years of Neurosurgery residency which is a fellowship training after a general surgery specialist training. three years training for Ghana Board of neurosurgery certification, with one extra year of dissertation, for the West African board certification.

Healthcare Center Ghana’s health care center is generally grouped according to the expertise available. These can be classified into: Primary Secondary eg Ridge Hospital Tertiary eg Korle-Bu Quatanary health care centers eg UGMC

Healthcare Center Primary care center are grouped into Chief’s compound Usually is one building run by a nurse Health centers A clinic often run by a nurse and a physician assistant District hospitals A smaller hospital run by an average of two medical officers with support from physician assistant and nurses

Healthcare Center Secondary care centers These are medium size hospitals mostly made up by the regional hospitals and Polyclinics like Ridge regional hospital. There is some level of specialized care at the regional hospitals,. These hospitals are mostly run by either fellows and lots of medical officers or by some specialist and medical officers .

Healthcare Center Tertiary The teaching hospitals serve as the tertiary center. There are currently four teaching hospitals. Korle Bu Teaching Hospital Komfo Anokye Teaching Hospital Tamale Teaching Hospital Cape Coast Teaching Hospital Korle-bu teaching hospital is known to be the main teaching hospital in the country, as it serves as the main referral center for the other teaching hospitals. http://www.moh.gov.gh/?s=teaching+hospital

University of Ghana Medical Center Currently Ghana is still building their only quaternary center, University of Ghana Hospital http://ghanahealthnest.com/new-legon-medical-center-95-percent-complete-ghana/

Using What You have Locally made wheelchair

Reference Khamlichi, A. E. (2014). The World Federation of Neurosurgical Societies Rabat Reference Center for Training African Neurosurgeons: An Experience Worthy of Duplication. World Neurosurgery, 81(2), 234-239. doi:10.1016/j.wneu.2013.10.051  Dechambenoit, G. (2016). Access to health care in sub-Saharan Africa. Surgical Neurology International, 7(1), 108. doi:10.4103/2152-7806.196631 Major upgrade and Rehablitation of Regional Hospital, Ridge-Accra (420 Bed). (n.d.). Retrieved March 14, 2017, from http://www.moh.gov.gh/major-upgrade-and-rehabilitation-of-regional-hospital-ridge-accra-420-bed/ Ghana has only 15 Neurosurgeons. (n.d.). October 29, 2016. Retrieved March 18, 2017, from http://citifmonline.com/2016/10/29/ghana-has-only-15-neurosurgeons/ Korle-Bu Teaching Hospital. (n.d.). Retrieved March 18, 2017, from http://www.moh.gov.gh/korle-bu-teaching- hospital/ Construction and Equipping of 597- Bed University Hospital at Legon. (n.d.). Retrieved March 24, 2017, from http://www.moh.gov.gh/construction-and-equipping-of-597-bed-university-hospital-at-legon/ Abdallah, H. (2017, February 13) Personal interview The World Facts Book: Ghana. Retrieved March 27, 2017, from https://www.cia.gov/library/publications/the- world-factbook/geos/gh.html

City of Accra