Lewiston, Maine (USA) -- It took Dr. Iris Silverstein two days to get used to the noise in a pediatrics ward at a hospital in West Africa.
There were dozens of children — with three sick babies to each crib — in an open-room unit, plus parental caretakers and medical staff.
The Farmington pediatrician traveled to Kumasi, Ghana, last month to learn more about medicine in a developing country and to do whatever she could to help the children there.
She’d collected medical supplies prior to her trip and took as many as she could carry, along with a used baby ventilator donated by Franklin Memorial Hospital.
Silverstein knew she would find poverty, but she didn’t know what to expect at the hospital. Though conditions disturbed her, she got accustomed to them. She also found a beautiful country with “marvelous culture and traditions.”
The pediatrics ward was a huge room, about the size of 1? classrooms, with 30 to 40 children and parents. Not only were two or three babies sharing each crib, but the infants didn’t have the same diseases.
“They’re all mixed up in terms of infection,” Silverstein said.
The ward had one sink, and each parent had a stool on which they sat and slept. Parents stay in the hospital as caretakers of their sick children.
Limited options
There are 1 million people in Kumasi, the second biggest city in Ghana, a country in West Africa. The per-capita yearly income is equivalent to $340 in the United States. The major industries are mining bauxite and harvesting cocoa, with the average pay about 80 cents a day.
“Everybody has to pay for health care and education,” Silverstein said.
Kids can only go to school if parents can pay and people tend to wait until they are very sick to visit a hospital, she said. Also, there are no ambulances, so everyone has to make their own way to the hospital.
The hospital has about 12,000 baby deliveries a year, compared to 350 to 400 babies a year at Franklin Memorial, where Silverstein has been on the staff for the past 10 years.
Although there are basic medications there, the hospital she visited lacked heart-rate, respiratory and oxygen-saturation monitors, she said. There was one CAT scanner in the country and no magnetic resonance imaging machine. And poverty restricts the level of health care that can be provided.
“There are many people who die there that wouldn’t die in the U.S.,” Silverstein said. “It’s really disturbing. It’s not that they have the worst diseases. They don’t have the ability to treat what we could treat and do for them here. It’s just tragic.”
Silverstein was struck by the lack of options for the people of Ghana, who have no way to work themselves out of poverty.
“People are very aware that they’re living without so much,” she said.
She was struck also by the generous nature of the people and the close family environment.
Very sick kids
Silverstein didn’t provide independent care in Ghana, she said, but she did participate in discussions about health care. While most physicians were welcoming and open to her ideas, she said, a few were not.
Among the cases she saw were malaria, diarrhea and dehydration, enteric fever, severe anemia, malnutrition and pneumonia. “A third of the kids I saw got blood transfusions,” Silverstein said. Oxygen was very limited and someone would have to be really sick to get it.
There were two youngsters who were admitted with tuberculosis, which was already widespread in their lungs, and who probably were not going to make it, she said.
“There were children who died there that just wouldn’t have died here,” she said. “Not many children die in our practice in our country.
Doctors and nurses are leaving Ghana in “fairly large numbers,” Silverstein said.
They want higher wages and they know that if they were in another country with the ability to treat people with modern technology, people would get better instead of sicker. The average annual nurse’s pay in Ghana equals $1,500 in U.S. currency.
Silverstein learned a lot on her trip, she said.
“I knew nothing about how to care for malaria,” she said. “I learned a lot about medicine without all the supports we have here.”
And despite stark differences between the countries, Silverstein said she would like to go back.
“I’m certainly thinking about going back over,” she said. “I would want to do more. I would love to work there and just be there and work full-time.
“My goal when I retire is to go to a developing country to work there, but I don’t have any plans to retire soon.”
