Two pieces of exciting news.....

The Wessex-Ghana Stroke Partnership has reached the final of the Health Service Journal Annual Awards, International Health Partnership category.  The application we submitted has been shortlisted and 3 of the partnership, Louise Johnson, Claire Spice and Liz Cullen, are presenting to the judges on Thursday 12th October.  The results will be announced at an award ceremony on 22nd November, so fingers crossed and “good luck” to Louise, Claire and Liz.

The second piece of news is that we are waiting to hear whether we have been successful with a further grant application.  The closing date for applications to THET was 1st October, and we expect a response any day, as the one year grant period begins on 1st November 2017.   Again, fingers crossed and watch this space!

Sarah Easton

Sharing our work - Dr Lucy Sykes attend ESC in Berlin.

On 24-26th May 2017 I attended the European Stroke Conference in Berlin. This was a fascinating and stimulating event bringing together Stroke clinicians not just from many European countries but also the Americas, Asia, North Africa, the Middle East, Australia...but none from sub-Saharan Africa this year so I was proud to be flying the flag for Ghana by presenting our WGSP poster. I had only 3-4 minutes to speak, so it was challenging task compressing 8 years' progress into a clear overview of what the Partnership has achieved. Afterwards there were several questions and the audience were all impressed with the depth and quality of our work. I hope we will have future opportunities to present WGSP achievements to raise the profile of this and similar work throughout the Stroke community.

Celebrations and Farewell…….for now?

 

Liz and I have just returned from another busy and hot week in Accra.  As usual, everyone made us welcome and we were proud to see the unit working so well.  Everyone was happily working together for the good of the patient.  The 8 weeks that Amelia and Debbie spent on the unit was certainly evident and everyone spoke highly of their time there and misses them. 

We took the opportunity to take slide-sheets and bedpans out to Ghana and whilst there we bought 2 wheeled commodes…. It was fun seeing Dorothy squeezed into a taxi with them to get back to the unit!!  After much searching we have found a way of getting a new transfer aid out to Ghana, which will hopefully arrive at the end of June.

The main purpose of our week was to collect the final observational evidence and data to enable us to quantify the huge development which has taken place over the past 3 years.  Ruth and Jude had the various spreadsheets prepared and 12 of the team received certificates and badges for completing all 8 competencies!  This group includes nurses, doctors, physiotherapists, pharmacists   and occupational therapists, which shows the true multi-disciplinary team work taking place within the stroke unit.  Many other members of the team have so nearly completed their competencies …..  hopefully they will be signed off very soon.  Please don’t forget!!!

WGSP Stroke Celebration

Liz and I presented the team with a montage of photographs taken since 2014, which brought back lots of happy memories. Our final evening in Accra was spent at the Noble Chinese restaurant, where many an hour has previously been spent.  As our visit was short, we did not have time to go to the beach, however we did manage 2 hours in the market, and returned back to Dean’s Guest House with no money!

It is sad to think that this could be our last visit to our friends at Korle-Bu Teaching Hospital.  The grant has come to an end and the project plan is completed; thoughts must now turn to potential areas for further partnership, hopefully with the Ghanaian team taking the lead and the UK team supporting!      

Good luck and thank you to everyone involved in the partnership, Sarah  

Church, beaches, monkeys and a bit of work too!

Well it all started with an unexpected but very pleasant trip to church with Dr Adjelolo – a really charismatic church with wonderful singing and music and a very enthusiastic preacher. It was way fuller than any church in the UK would be and this was the second service of the day! Dr A then took us on a drive round Accra – mainly round the other hospitals! The new out-patient wing at Ridge looks very nice but pales into insignificance compared to the amazing new hospital at Legon, attached to the University. This will be quite something when it opens – I am not sure how it will be staffed but I think (quite rightly) there is a bit of concern that it will be major competition for Korle Bu. Although from what I understand it will not have a Stroke Unit.

On the unit at Korle Bu the brilliant work continues. A busy week with several female admissions and several challenging male patients! The staff delivers the most amazing basic care to these patients and I do hope that this can continue to roll out across the hospital. The staff are continuing to complete their competency log books with at least 8 members of staff having fully completed the required competencies. The multidisciplinary team meeting was great again, with really meaningful discussion involving all the team members. Special praise to the OTs this week who came with some truly insightful information in regards to discharge planning for all the patients. The hoist is back working – even if the switches are all the wrong way round – we now have to press the buttons that open and close the legs of the hoist to make the hoist go up and down, and vice versa! Also a prototype chair raiser arrived this week – just what is wanted and we hope the other seven will follow shortly.

Patient Planning on KBTH Stroke Unit
Training Resources

We said goodbye to Dr Nortey who is now on leave for three weeks, but expect Freda back on Monday. Aunty Dorothy is off to Kumansi to assist with nursing exams next week and as it is the end of the month, we will say good bye to the interns and house offices (physios and Drs) that will hopefully all be replaced on Wednesday. We have a hello too with a new dietician – welcome Andy.

Had a wonderful day at Bojo Beach with a few members of the team; an absolutely stunning beach that is accessed by a canoe with an outboard motor – we crossed a lagoon about 50m in width before spending the day chatting, relaxing, enjoying the sun and sea. It was a great way for Eunice to spend her 30th birthday. Church with Cynthia was a different experience to that last week. It was a smaller more local church with only one service, but the music, singing and charismatic preaching were still in abundance – certainly no lack of enthusiasm! Back in for week seven.

Another busy and heavy week on the stroke unit at Korle Bu. We now have 12 functioning chair raisers – so most patients should be able to sit at a comfortable height. This is a minor aside to the major work of the week which the nursing staff completed tirelessly – nursing for some really unwell patients. Unfortunately we lost three patients this week – most of them unacceptably young – but all had had what can only be called massive strokes. I have not seen too many CTs showing that a patient had lost their entire right hemisphere to an infarct.

On a happier note it was good to see Dr Freda back and we welcomed new medical officers David and Sani.

After being let down by a travel company our planned expedition to Mole did not happen so we made do with a trip to Shai Hills Reserve instead, and managed to see Kobs, Baboons, several bird species and some amazing butterflies – a good day out.

Next week is our last week – we will be so sad to leave the unit and the wonderful staff there – but have some amazing memories to take home with us. I hope that we will also be able to keep in touch with the good friends that we have made here and we both hope to visit again in the future.

Improving Global Health Fellows. Week 5: Blood Pressures, Learning and all that Jazz!

The hard work continues on the Stroke Unit at Korle Bu. After a relatively quiet week with all the doctors on IMPACT training, the unit is now much busier and the patients are certainly keeping all the staff on their toes. I’ve never seen Aunty Faustina move so fast as when one of the patient’s got himself out of the chair and had a slight wobble on his way to his bed! Most are doing really well and engaging in the early stages of rehabilitation whilst preparing for discharge home.

The high percentage of haemorrhagic strokes continues – 6 of the eight patients most recently admitted have had a haemorrhage; and even one with an infarct has had a haemorrhagic transformation – so the doctors are busy working out the best forms of treatment. This week it has not been unusual to see blood pressures of 220/110, which would explain some of the bleeds!

The highlight last week was the really constructive multidisciplinary team (MDT) meeting we attended. The structured format allowed all members of the team to give feedback and be involved in the debate, leading to effective decisions being made about patient care. But it was not all about the clinicians – the thoughts, feelings and circumstances of the patients and their families were central to the discussion and led to some really patient centred care. This excellent MDT working continued afterwards as it expanded into a more managerial meeting and consensus was reached on how best to move forward a few things on the unit – again everyone had their say and contributed to the conversation.

It has also been good to see some really constructive discussion on the ward around a few topics that keep cropping up and this has led to some peer learning and therefore better patient care. One of the hot topics at the moment is cognition - how to assess it and how to differentiate a cognitive problem from a communication problem.  It would appear that as the Ghanaian population ages these cognitive problems (stroke related or not) are becoming more prevalent.

We ventured out to Akosombo this week too – we explored the Volta Dam – amazing scenery and quite a feat of engineering too!

Volta Region

After our weekend trip it was back to the Stroke Unit on Monday and a busy week with an average of 9 patients on the ward most days.  The variety of patients is as great as would be expected on a stroke unit in the UK, ranging from those with mild weakness and good rehabilitation potential to those who are very unwell and requiring nasogastric (artificial) feeding.

Nasogastric Feeding

It is good to see how many of the staff have now completed their competency logbooks and how many are nearly there. The willingness of the staff to learn new information is inspiring and hopefully our presence here is helping to consolidate some of the learning.

The weekly trips out continue! After an evening of live Jazz with Dr Akpalu and Dr Nkromah on Friday, we headed to the beautifully tranquil Botanical Gardens in Aburi on Saturday – a welcome change from the hustle and bustle of Accra.

Amelia Shaw and Debbie Bartlett (IGH Fellows)

Improving Global Health Fellows at KBTH. Week 3: clinical care, culture and castles!

Having spent three weeks in Ghana and working on the Stroke Unit at Korle Bu I think it would be fair to say that we both feel confident in our daily routine and feel that we are able to make a positive contribution to the partnership. Our understanding of the project has been an exponential learning curve and we are truly grateful to Sarah and Lucy who supported us during our first two weeks and who were essential to ensuring our time here is as effective as possible.

We now know most of the team members and are enjoying getting to know our Ghanaian colleagues. I think we still have a long way to go to understand Ghanaian culture as well as Twi!

The level of knowledge of the staff on the unit is exceptional and the work they are carrying out to spread this knowledge across the hospital is inspiring. It has been a challenging week on the unit with several extremely unwell patients and even those who were stable had relatively limited rehabilitation potential. But the team continued to deliver the best possible care and tried to smooth the transition to home as best they could.

KBTH Stroke Unit

It has not all been hard work though! We are trying to get out and see a bit of Ghana and having exhausted most of the tourist sites of Accra we decided to head out of town. We went west to Cape Coast and Kakum National Park. Having survived the rope walkway suspended 40m above the rainforest floor we found ourselves in the more sobering Cape Coast Castle with its truly superb guided tour highlighting the appalling situation faced by those caught up in the slave trade. Not a moment that I was particularly proud to be British.

Having fought through the Ghanaian Saturday traffic we made it back to Accra and look forward to another 5 weeks at Korle Bu.  Amelia and Debbie.

Cape Coast

Ghana Visit January 2017

Improving Global Health Fellows arrive in Ghana!

Amelia (physiotherapist) and Debbie (nurse) arrived in Ghana last week to start their 8 week Improving Global Health Fellowship - a new partnership between the WGSP and the Improving Global Health Scheme at Health Education Wessex.  They travelled to Ghana with Sarah Easton, and were joined this week by Dr Lucy Sykes.  Here is their first blog...

We arrived safely, if very late, on Saturday evening and everyone has made us very welcome.  Amelia and Debbie have quickly settled into the Exchange Students Hostel, and after a few shopping expeditions they are now set up for their 8 weeks here.  I have been welcomed back at Dean’s, where the TV keeps breaking down…… however they manage to repair it very quickly as the Africa Cup football is on at the moment!!!