Monday, February 22, 2016
By: R. Bruce Canham, MD
In August 2015, thanks to the support of the Washington University Department of Orthopedics, I traveled to Kumasi, Ghana in West Africa to work with the surgeons in the Directorate of Trauma and Orthopaedics at Komfo Anochie Teaching Hospital (KATH). I was especially fortunate to be accompanied by my brother, Colin, who is also a chief resident in orthopedic surgery in Rochester, New York.
Ghana is better off than many of the other nations in Africa, however it is still a developing country, and as a result it must struggle with providing healthcare for its citizens in the face of limited resources. It was in this setting that my brother and I found ourselves arriving in the middle of a doctors' strike. The doctors whose main source of income was from the government including those at KATH were striking with the goal of obtaining "conditions of service" which included things similar to workman's compensation, pension and reimbursement for work expenses. As an example, under the current situation if they contract a disease such as HIV or Tuberculosis while on the job they are on their own to pay for the costs of treatment and disability. The strike was very unpopular with many of the rest of the population as obtaining health care was very difficult. However the doctors' situation was also a difficult one as they did not have any alternative constructive avenues for advocating for themselves. It was certainly a thought provoking situation. While I couldn't fathom the notion of doctors in the United States going on strike, we are also much better reimbursed compared to our Ghanaian colleagues. In fact, it is not uncommon for the government not to pay the doctors for many months at a time.
The doctors were still working in a limited capacity, though were not taking new patients. Similarly we were able to be involved in the care of some patients that had come to the hospital prior to the strike, or that somehow got admitted despite the strike. We were however, grateful when the doctors voted to return to work at the end of our first week despite not receiving the conditions of service from the government.
My trip to Ghana gave me a new appreciation for how orthopaedics can be practiced with far less resources than we have in the United States while still striving to provide the best possible care for patients given the situation. The individuals that I encountered there are an inspiration to me to provide the best care that I can to my patients now and in the future. The Washington University Department of Orthopedic Surgery in St. Louis made this experience possible for me in so many ways, and I will always be grateful for this life-changing experience.