Travel to Ghana _ppt_ - University of Michigan Health System
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Ghana
Alice Chi, Natalie Clark, Dipa
Joshi, Christine Pipitone
October 25, 2010
Travel to Ghana
Before You Go
• Getting permission
• Visa application
• Travel clinic for vaccinations and prophylaxis
• Travel insurance
• What to pack
Get Permission from U of M
• Decide when you want to go, and keep track of
period deadlines
• Inform Dr. Tim Johnson and Jennifer Jones (his
assistant)
• Fill out the following forms:
o M4 Elective Form for Outside Institutions (signed
by Dr. Johnson):
http://www.med.umich.edu/medschool/osp/forms/
M4_outside_elective.pdf
o Medical Student Acknowledgement
Form: http://www.med.umich.edu/medschool/osp/
forms/Med%20Student%20Acknowlegement.pdf
• Submit the forms to Cindy Murphy
• Cindy Murphy will create a dean's letter of good
standing for you to submit to the UGMS
Get Permission from UGMS
• Inform Kofi Gyan (kofigyan@umich.edu), the contact
at University of Ghana Medical School, about your
travel plans
o Can also contact Samuel Acheampong for this
information (academicaffairsugms@yahoo.com)
• Fill out the UGMS Elective Form (from Kofi or
Samuel), submit to Kofi
• Submit to Kofi the letter of good standing that Cindy
Murphy wrote
• Kofi will create a UGMS acceptance letter for you, as
well as a course description, both of which you should
also submit to Cindy Murphy
• Kofi will send you a letter indicating tuition and lodging
fees
Visa - $60 Single Entry
• http://www.ghanaconsulatenewyork.org/visa.html
• Supporting documents required besides 2 copies of
the application:
o Passport
o Photocopy of biodata page of passport
o Two passport-sized photos
o Travel itinerary
o Copy of student ID card
o Copy of UGMS acceptance letter including dates of
enrollment
o Copy of permanent residence card if applicable
o Self-addressed Post Office Express Mail Stamp, for
return postage
• Once submitted, the consulate took 1-2 weeks
Travel Clinic
• Follow instructions on U-M Travel Clinic
website: http://www.uhs.umich.edu/travelhealth
• Common vaccinations recommended/required: yellow
fever (proof of vaccination required to enter Ghana),
typhoid, hepatitis A, polio, TDaP, influenza
• Cost will depend on coverage and how many
vaccinations you need:
o http://www.uhs.umich.edu/sites/webservices.itcs.
umich.edu.drupal.uhs/files/uhsdocs/vaccines.pdf
Malaria Prophylaxis
• Doxycycline: Start 1-2 days before travel, daily while
traveling, daily for 4 weeks after return
o Pros: cheap, protects against traveler's diarrhea
o Cons: GI upset/reflux, photosensitivity
• Malarone: Start 2 days before travel, daily while
traveling, daily for 1 week after return
o Pros: better tolerated than doxy
o Cons: much more expensive
• Although the hostel has screened windows, you might
want to bring a net (e.g., Mobasa defender, a pre-
treated net)
• 35% DEET insect repellent (100% not necessary)
Travel Insurance
• http://www.uhs.umich.edu/tai/
• Required by U of M for any student traveling abroad
for elective
• Costs $1.25/day plus $5 administrative charge
• Coverage: detailed on website, includes medical
evacuation
• Cindy Murphy will purchase it for you - you are
required to reimburse the university
• Or you can purchase it on your own, just inform Cindy
ahead of time
What to Pack
• For international flights you can have 2 checked
pieces of luggage, a carry on, and a personal item
(eg. Purse)
• Keep in mind that there's a 50lb luggage limit and if
you exceed this, you can be charged up to $200
• Bring 2 smaller suitcases instead of one larger one
• Try to split up packing so that you and your travel
mates are not packing redundantly
What to Pack - Attire
• It is very hot and humid and there is no air
conditioning, pack accordingly.
• Hospital Attire
• Ladies: knee-length skirts, capris, light
blouses, nice sandals
• Men: slacks, collared shirt (can be short-
sleeve), tie, dress shoes
• Flip flops, walking/hiking shoes
• Light raincoat or hoodie
• Long sleeves and pants for national parks
• Hat and/or sunglasses
What to Pack - Hospital
Supplies
• MCard for ID (and student discount) purposes
• 1-2 pairs of scrubs
• OR masks, hats, shoe covers, reusuable eye
protection
• OR shoes
• Stethoscope
• Penlight
• Latex gloves
• Small and large bottle of Purell
• Pregnancy wheel
• Pharmacopeia
• Basic OB/GYN book
What to Pack - Electronic
Items
• International adapter(s)
• Laptop (you can purchase internet there for approx 60
cedis - beware it is not fast)
• Camera w/charger
• If you have space, travel speakers and small fan are
nice
• SIM card capable cell phone
• Flashlight and batteries
What to Pack - Personal
Items
• Toilet paper (1-2 rolls, you can buy more there)
• Toiletries
• Luggage and laptop locks
• Ziploc bags
• Alcohol swabs and/or wet wipes
• Some cutlery (or you can buy stuff there - we had a
Swiss army knife and plastic cutlery)
• A string is helpful for hanging hand-washed clothing,
although they have laundry services there for a cost
(they will not wash underwear)
• Medipore tape (helpful for blisters)
• Duct tape (always helpful)
• Fast-drying towel
• Flip flops for shower
What to Pack - Personal
Items (cont'd)
• Sunscreen
• 30-40% DEET mosquito spray (you do not need
100%)
• Earplugs!
• Eye mask
• Travel pillow
• The hostel provided sheets and a pillow for us
• Bradt Guide Book
• Pens, books, journal
• International phone w/SIM card capability (Kofi might
have one for you to borrow, or you can buy one there)
• Granola/protein bars/snacks
What to Pack - Cash
• At least $500 USD cash (if not more) for the first day
to cover tuition, lodging, transportation
• Traveler's checks are not easily exchanged and not
that helpful
• VERY few places take credit card, so bring a debit
card (VISA only)
• You can exchange money at the airport or at a Forex
bureau
• 1 USD = 1.43 cedis
What to Pack - Meds
• Malaria prophylaxis (doxy or malarone)
• Cipro for traveler's diarrhea
• Ibuprofen
• Bandages
• Neosporin
• Benadryl (for mosquito bites, anti nausea, and sleep
aid prn)
• Don't forget your personal prescriptions
What to Pack -
Paperwork
• Passport and visa (with copies just in case)
• Proof of yellow fever vaccination
• Acceptance letter from UGMS
• Travel health insurance card
Communication
• Everyone communicates by cellphone in Ghana -
having one is essential to get a hold of your travel
mates and Ghanaian friends
• Bring a phone w/SIM card capability (or borrow one
from Kofi Gyan or purchase one)
o Can purchase local phones from Vodafone or Zain
o Vodafone sells phones for 35 cedis (included in
this is 10 cedis of phone credit)
• Vodafone phones receive phone calls and texts for
free
• Internet cafes are all over Accra
• You can purchase wireless internet for your laptop for
approximately 50-60 cedis from Zain or Vodafone - it
is slow but we found it helpful to check emails
Once You're There
• Getting to the ISH
• The first day
• Costs
• Clinical Teams
• A Typical Week
• Conferences and Curriculum
• Sightseeing
Getting to the ISH
• Travel from the Kotoka airport to the International
Student Hostel at Korle Bu Teaching Hospital costs
approximately 10-20 cedis in a regular taxi
• Kofi Gyan will arrange transportation for you that
includes a stop to the grocery store and Forex bureau,
however, this cost 60 USD
• Korle Bu Teaching Hospital is in the opposite corner of
Accra from the airport, so, in traffic, the ride might take
a while
• The ISH is very deep in the campus, and not close to
the MD or local student housing, about a 20-minute
walk from the wards (there is a morning shuttle that
leaves daily at 7:45)
The First Day
• At the ISH, you will receive a receipt for lodging
• Go to the Administrative building near the medical
school, speak with the administrative assistant, who
will ask for your acceptance letter, and your lodging
receipt
• He/she will direct you to the cash office, where you
will pay for tuition
• Go to the OB/GYN block to meet with Dr. Obed and
his secretary to find out your team assignment and
where you should meet your teams
Costs
• Lodging: 5 cedis per day in regular rooms, however,
you will likely be offered the elective student room
(10 cedis per day)
o Regular rooms: public bathroom, TV or fridge not
guaranteed
o Elective student room: private bathroom, TV,
fridge
• Tuition: <____> cash
Clinical Teams
Structure of Clinical
Teams
• There are 5 teams, A-E
• Each team has ~10 medical students, ~3 house
officers, ~1 junior resident, ~1 senior resident, ~1
consultant, and ~1 specialist
o Medical students: Start after high school, 6 total yrs
of training
o House officers: MDs that rotate through the major
fields of medicine for 2 years prior to picking a field
and applying to residency
o Residents: MDs that have completed house
officership and have chosen their field (e.g.,
Ob/Gyn resident)
o Consultants: like our attendings
o Specialists: like our specialists
• Each team is assigned to a obstetrics floor, and round
on their obstetrics patients every morning
o Prior to this, they attend morning meeting where
the cases in the previous 24h are discussed
• Then they attend the activity assigned to that team for
that particular day
o E.g., on Monday, Team B is assigned to take call
A Typical Week
Day 1: Theatre (OR)
• Try to scrub in so that you may assist (you may
need to be a bit aggressive, otherwise you will
just watch)
• Air conditioned
• You may be provided scrubs but bring your own
just in case, and bring OR attire (shoes, shoe
covers, cap, mask, eye protection)
• When scrubbing, grab a rubber apron and put it
on over your scrubs
• Follow your house officer's or resident's example
when scrubbing
• Everyone is generally very nice to the med
students in the OR, especially scrub nurses
• If you really want to go to the OR right when
cases begin, follow a resident out of morning
meeting, since house officers may spend much
time rounding on their ward patients
• Types of cases: open, range from simple TAH, to
myomectomy, to long gyn-onc cases
• The consultant or specialist surgeon does the
majority of the case with assistance from another
consultant, a resident, or house officer
Day 2: Call
• Rounds are quick
• One of the house officers will admit patients
through the Emergency Department (or "Accident
Centre")
• Another house officer will go to L&D and assist
with cesarean sections (emergent and scheduled)
o Your residents and consultants won't start
performing c-sections until 5pm, otherwise they
are done by the morning team
o There is one OR for c-sections
o The warden in this area will provide scrubs and
lunch
o Try to assist in c-sections
• A third house officer will go to prenatal/postnatal
clinic
• Midwives perform all uncomplicated vaginal
deliveries
o Try to attend as many vaginal deliveries as you
can, and try to observe breech and twin
deliveries
• You are welcome to stay overnight on call, though
you are not required to
Day 3: Post-Call
• Your team will present at morning meeting, followed
by obstetrics rounds, then gynecology ward rounds
• This is a good day to go perform and observe
vaginal deliveries with the midwives
• Otherwise, this day ends early, and you can take
your time to explore Accra or get errands done
when there is no traffic.
Day 4: Major Ward
Rounds
• Formal, extensive teaching rounds, where medical
students get questioned extensively on patient-
specific health topics (e.g., post-partum hemorrhage,
sickle cell disease in pregnancy, etc)
o This is kind of like "Reynolds Rounds" on gyn-onc
• You probably won't get questioned too much, and if
so, the questions are generally about American
medical practices
• Very educational
• Afterwards, there might be inpatient
procedures/biopsies to watch, or you can go to the
labor ward with the midwives
Day 5: Gyn OPD
• Gynecology Outpatient Department
• This is a day of clinic with both obstetric and
gynecology patients
• Like usual, you will start out at morning meeting,
then go to your floor to round, then you will attend
clinic w/the house officer
• Although the official language of Ghana is English,
most of these patient encounters will be in mixed
English/Twi, and many patients may not
understand enough English to complete an
interview
• That said, if there is a patient who is willing you
can conduct the interview and do the physical
exam
• Otherwise, you can make the most of your day
at the labor ward
• Usually clinic ends at 1-2 pm
Conferences and
Curriculum
Conferences
• Morning Meeting
• Daily 8 am meeting going over previous day’s
cases and deliveries
• Mortality Conference
• Last Thursday of the month
• Very different from our Morbidity and Mortality
conferences
• Incredibly eye-opening and educational; try to
take notes
Curriculum
• The curriculum consists of daily clinical duties, and
didactic lectures
• Professor Obed, the chair of the UGMS Ob/Gyn
department, will lecture you on specific
obstetrics/gynecology issues in West Africa
o Take advantage of this valuable educational time
with the department chair
• Residents may also offer review lectures to the
medical students
Accra
What to do in Accra
• Kwame Nkrumah Memorial Park
• National Cultural Center (shopping)
• Osu for Ghanaian and international food
• Lighthouse of Jamestown
• National Museum
• La Beach/Labadi Beach Resort
• Local soccer match
Travel Within Ghana
Cape Coast
Cape Coast
• 1st capital of Britain's Gold Coast Colony
• Castle
• World heritage site, one of the largest slave-
holding sites during the colonial era
• Slaves traded to British by local tribes in return for
EtOH and guns
• Great beaches
• Oasis Beach Resort
• Elmina Beach Resort-beautiful pool on the water
• Where to stay
• Oasis Beach Resort: good food, on the water,
near the castle
• Getting there
• STC buses: 4 cedi, run daily, buy tix early
• Awesome Nigerian TV shows
• Tro tro: cheap, but less comfortable and more
difficult to figure out
Kakum National Park
• ~1 hour away from Cape Coast
• Take a tro tro or hire a taxi (make sure the driver
stays there and waits for you)
• Canopy Walkway: 40 m in the air, only one in Africa
• Go early in the morning, less crowded!
• Not if you are afraid of heights
• Forest walk
• Medicinal plants, greater chance at seeing
wildlife
• Museum
• Camping overnight on platforms available
• Animals you may see: forest elephants, monkeys,
birds
Mole National Park
Mole National Park
• Getting there
• Flight to Tamale Antrak Air ($175 cash one way,
book early)
• Or…STC bus to Tamale via Kumasi
• THEN Metro Mass bus from Tamale to Mole
park
• Best idea: get a driver from Accra via Avis
(~$300/person w/4 people)
• Along the way from Accra stop by
• Kumasi
• Tamale
• Boabeng-Fiema Monkey Sanctuary (mona
and black and white colobus)
• Kintampo Falls
• Staying there
• Mole Motel
• Sits on a cliff with a restaurant and
swimming pool overlooking 2 watering holes
Mole National Park
• National park since 1971
• Ghana's largest wildlife sanctuary (4840 sq km),
the best for game viewing
• There are 90 mammal species and at least 344
bird species
• Elephant, buffalo, warthog, antelop, monkeys
• Walking or 4X4 safaris
• Other things to do:
• Mongori village
• Canoe safari
Kumasi
Kumasi
• The cultural capital of Ghana
• Visit the Ghana Cultural Center - includes a
museum on Ashanti history and a large crafts
center
• When we were there, Ghana was playing Sudan in
soccer
• Palace
Other Places to Visit
• Wli (Agumatsa) Falls
o On Togolese border in eastern Ghana
o largest waterfall in west Africa
o within Agumatsa Wildlife Sanctuary with
numerous straw-colored bats
• Volta Region
o Theoretical ferry
o Hippos!
• Boabeng-Fiema Monkey Sanctuary
Contact Info
• Ghana contacts:
o Kofi Gyan: kofigyan@umich.edu
o Samuel Acheampong:
academicaffairsugms@yahoo.com
• Michigan contacts:
o Jennifer Jones (Dept admin,
Ob/Gyn): jjlynn@umich.edu
o Tim Johnson (Dept chair, Ob/Gyn):
trbj@med.umich.edu
o Cindy Murphy (OSP): camurphy@umich.edu
• Us:
o Natalie Clark: naclark@med.umich.edu
o Alice Chi: amchi@med.umich.edu
o Christine Pipitone: pipitone@med.umich.edu
o Dipa Joshi: dmjoshi@med.umich.edu
References
Flag on first slide: http://think0.deviantart.com/art/Ghana-
Grunge-Flag-153462332
Briggs, P. (2010). Ghana: The Bradt Travel Guide.
Guilford, Connecticut: The Globe Pequot Press.
