Unreliable electricity, no access to a clean water source and beds lined with tarps is not the usual description of a medical clinic. However this is the reality for those in Ghana, Africa.

Sarah Breon, D.O., M.S. of Waterford, Penn. got the chance to observe these clinics up close. As a member of First Presbyterian Church, their partnership with the Upper Northern Presbytery Evangelical Church of Ghana allowed for yet another trip to the formerly known Gold Coast.

Over the past 10 years, First Presbyterian has built medical clinics and churches in Ghana. Breon’s trip in October 2019 was in part celebratory of the 50th year of Chosen International Medical Assistance.

Together, Chosen and Lake Erie Presbyterians raised over $50,000 through the Labors of Love initiative.

“The whole purpose of my trip was to assess four medical clinics that the UNP Evangelical Church of Ghana already has up and running to see how we could spend that money to either make some of their equipment better or explore other ways we could help,” Breon said.

After a long day of travel, Breon and her team arrived in Ghana to first meet with the liaison between the church and clinics. Accompanied also by a pastor, the three representatives from Chosen and three representatives from Lake Erie Presbyterian, made their way from clinic to clinic.

“We rode in a 14 passenger van,” she said. “The roads weren’t paved and it became a fight to dodge the potholes.”

Their first night’s stay was in a hostel run by a bible translation community. There, they met a man who developed an app that would allow women to register with doctors for prenatal and postnatal visits.

“If they weren’t able to make it to the clinic, they could post questions or any concerns through the app and it would go straight to the clinics,” Breon said.

According to Ghana Web, Ghana is one of Africa’s largest mobile markets. Although not everyone may have internet connection, cell phones are very popular.

Breon disclosed that the app, Mobiles for Life, will be one of their dispenses for money.

Each clinic visit involved meeting with staff, nurses and physician assistants.

“They would give us a tour of the building and we would go over what their wish list was,” Breon said.

Many of the clinics were in the process of building new maternity wards, she said. As a result, a lot of the focus turned to fetal and maternal help.

“We want to make sure that women are actually coming into the clinics to deliver rather than in the home which has always been their custom because the clinics weren’t available,” Breon said.

With birthing beds that lack padding and rough wooden cribs, there was no sense of modernity or proper hygiene. “Everything was very old and rickety,” she said. “It looked like it was from the 1950s.”

Since the clinics do not possess their own source of water, the staff must carry water from the village to the clinics. The Wapuli clinic, specifically partnered with First Presbyterian Church, has a cistern that was built by UNICEF however, it is not being used to its full potential.

“They do have a bore hole but it’s not connected to the clinic,” Breon said. “We’re trying to figure out how to make that connection as part of our funding.”

Another necessity for these clinics is that of reliable electricity. Although there are back-up generators, they are broken and without gas.

“They have the equipment but it’s not being used because the maintenance just hasn’t been done,” she said. “When the electricity goes out they use their cell phone lights.”

There is no refrigeration to keep blood on hand or air conditioning to prevent the spread of disease.

“All these clinics are open air,” she said. “They’re trying to focus on washing hands and changing bed garments but they don’t have all the equipment to do those things.”

The Ghanaians told Breon and her team that the top three diseases they treat are malaria, typhoid, and any kind of viral diarrhea.

The government has begun to provide insecticide-treated nets for pregnant women in order to prevent malaria, according to the Centers for Disease Control and Prevention. “The mosquito netting is also so the baby isn’t exposed immediately to malaria or some other diseases,” Breon said.

First Presbyterian Church recently replaced the roof on the maternity ward at the Wapuli clinic. “They’re in the process of building underneath with new rooms and walls so that was cool to see,” she said.

The Wapuli clinic’s acting physician assistant just took ultrasound courses in an effort to provide better care for pregnant women.

“We’re looking to purchase an ultrasound machine for him to be able to use,” Breon said. “They’re nervous that if they don’t get one they will lose him.”

A large focus within the Ghana medical clinics is simply education. Knowledge about hygiene and how diseases start will help people prevent them, she said.

“For example, typhoid is because their waste is going into their water and then they’re drinking the water and get these horrible diarrhea symptoms,” she said. “Then they die from it because they waste away and they’re already malnourished.”

This cycle is the reason for so many deaths in Ghana. Despite being a doctor herself, Breon was not able to treat anyone.

“I’m family practice and going over there doing family practice is completely different,” she said. “I’ve never seen typhoid or malaria.” She admits she would be learning more from them then they would her.

“They might learn hygiene techniques from me,” she said. “If I were to do something I would be more beneficial running a vaccine clinic or something like that.”

Another substantial issue that the Ghanians face is a poor government that is unable to pay the clinic’s staff.

“Their government is about a year behind paying people from the patients’ insurance,” Breon said. “One of the staff members we met hadn’t been paid in three years.”

This then brings about the question of whether or not they should still be practicing without pay.

“We don’t have to deal with that here because we have a wealthy government that is able to pay out almost immediately even if it’s behind,” she said.

Breon’s team did bring over blood pressure cuffs, Tylenol, Aspirin, Ibuprofen, bandages and women’s kits for menstrual cycles.

“They were very grateful to get those things but they definitely want to be involved in the decision making as to where we put our funds,” she said.

In an effort to strengthen their economy, the Ghanians stressed that they do not just want things to be bought and shipped to them.

“They want to use the money and have things made and bought in Ghana to support their economy and see double benefit from the money we’ve raised,” she said. “They don’t want just hand-outs, but rather support for their people so they can better themselves and provide better health care.”

During the visit to the Wapuli clinic, Breon’s team met with a board of community members that were trying to brainstorm ways in which they can make the clinic run more like a hospital system, seeing that the nearest hospital is two and a half hours away.

“It was impressive to see that they are trying to come together and support each other by figuring out how to get better care for the whole community,” she said.

With many people coming into the clinics and children playing soccer in the yard, it is clear that Ghana has much more of a community-driven health care system than we do, she said.

Breon’s biggest takeaway from this experience was that she is angry with God. Throughout her travel time, she realized that she does not pray as much as she used to.

Medically, Breon noticed that as Americans we take our health care systems for granted. The LECOM facility she frequently works at is newly built and state of the art.

“Everything is brand new and two of the physicians I work with complained that they didn’t like the beds we got because they were different from our old ones,” she said. “I keep thinking that they should see what other people are practicing with in other parts of the world.”