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Making a Difference in Africa
By Pamala Lupo, CO
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Pam Lupo, CO, casts a five-day-old baby with a hyperextended knee. |
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The first two things you learn in Ghana are
patience and to always carry your toilet paper with you. I visited
Africa this April as a guest of FOCOS (Foundation for Orthopedics
and Complex Spine). This international organization is dedicated to
bringing state-of-the-art free and affordable care to those who are
afflicted with spinal deformities and disorders.
There are 18 million people in Ghana, but only two practicing
orthopedic surgeons and only about 20 orthotists and prosthetists.
Our FOCOS team was composed of 20 orthopedic surgeons and a support
staff. My role was to assess the orthotic and prosthetic services
and to aid in patient care and clinical education.
When I arrived at the airport in Accra, the capital, the
unfamiliar setting was exhilarating. Everyone brought medical
supplies of one specialty or another, which presented some issues
with customs. Some of us breezed through, while others had to
"negotiate" permission to bring them into the country.
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These patients were scheduled to receive surgery from FOCOS. |
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There is a calmness and easy pace in Ghana that
doesn't mesh well with our American ways. Though we rose at 7 AM to
head for the hospital, our driver didn't arrive until 10:30 AM.
When we finally arrived at the hospital, I assisted Dr. Mendelow
with clubfoot surgery for a three-year-old girl. The opportunity to
assist such a gifted doctor is an experience I will not soon
forget. Her foot is now without any detectable deformity, and I
cast her for orthotics the following week.
O&P in Ghana
My primary goal was to seek out clinicians. I was informed that
orthotists and prosthetists are called orthopedic technicians. By
the third day, I was directed to a crowded section of town and a
building that had a sign, "The Ministry of Health." I walked into a
sparsely furnished room with a crushed velvet sofa that looked like
it was from the 1950s, crutches leaning up against the wall, and a
cabinet containing prosthetic devices. The man sitting behind the
desk was Mr. Kodi, the director of Orthotic and Prosthetic
Services. Initially, he was guarded and quite reluctant to speak
with me. He explained later that many people had come before me who
either had not kept their promises or had financial motives.
After some discussion, he sensed my genuine intentions and
toured me through the facility, introducing me to the staff. The
machinery was mostly from Germany and in quite good condition.
However, the technology of the orthotic and prosthetic devices was
of the late 1950s or early 1960s. It is apparent that Ghana is
seriously lacking in the availability of supplies, materials, and
ongoing education. Commercially made devices are nonexistent, and
therefore the technical skills of the seamstresses and shoemakers
are impeccable. A select few clinicians received their education in
Egypt, Uganda, or Germany.
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Pam Lupo, CO, prepares to assist with a surgery. |
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Before leaving, we made plans for me to return to
the lab to share ideas and present one of my lectures on orthotics.
I had confirmed that orthotic and prosthetic services were provided
through five Ministry of Healthy facilities and four privately held
facilities. There is no government or privately funded
healthcare-only patients who are able to pay receive services.
The rest of the time was filled with filming surgery, taking
inventory of supplies, visiting wards, assessing patients, and
seeking clinicians. I made friends with patients, families,
hospital staff, and strangers who were excited to meet an American.
I constantly took pictures to share with everyone when I returned.
While the pictures show the many images I wanted to portray, they
couldn't begin to share the experience!
Disability Prevalent
What was most unexpected for me were the disabled persons we saw
on every street corner. Polio strikes nine out of every 1,000
persons, and pediatric amputees are unbelievably prevalent.
Children sell goods on the streets to help support their families.
The children are often hit by cars, and there are no means of
saving their limbs. Prenatal care is almost nonexistent, so birth
defects are abundant. There is still the social stigma that
disabled persons should not be seen in public. One can only imagine
how many more are hidden in their homes and villages.
Wright & Filippis To Help Ghanaians
 Wright & Filippis has committed to a five-year
plan in education and patient care in Ghana. We will assist in the
development of the Orthotic and Prosthetic Technician Program at
the University of Ghana. W & F will partner with FOCOS and the
Ministry of Health to develop their technology and knowledge. FOCOS
has developed the Ghana Club Foot Program, modeled after the
successful Uganda Club Foot Project. We will begin teaching and
developing this program throughout the country. In addition,
several of our suppliers have already donated parts and supplies as
well as products unavailable in the hospitals. I have received very
generous donations from PEL Supply, Becker Orthopedic, Camp
Healthcare, DonJoy Orthopedic, Cascade DAFO, and Jobst, to name a
few.
How quickly the 12 days passed. We saw patients at the Trust
Hospital up to the minute we left. The halls were crowded with
patients who heard we were coming-and there were still so many we
couldn't help. We hastily evaluated patients for the care they
would receive from the next returning FOCOS group. When my friend
said it was time to leave, I broke into tears. I was eager to
return home, yet it broke my heart to leave such an adventure.
My Outlook Changes
The night I returned, my daughter had a soccer game. When I sat
in the stands, as I had so many times before, everything was
somehow different. The waving American flag, the green grass, the
bright stadium lights, and the haze in the air all seemed crisper.
I drifted to the place I had been just a day before. All I could
think of were the images and the faces I had left behind. Ghana is
truly a land of extremes. The people are educated and not, the
seasons are wet and dry, people have and have not. Leisure time was
not something I observed Ghanaians enjoying. I never took for
granted watching my children, but now it is a treasure.
The importance of material goods is different as well. Only now
do I realize that items I once viewed as being "on sale" are equal
to a month's wages in Ghana. When shopping, I pick up item after
item, only to put it back because it doesn't hold the same
enjoyment. It seems I don't need things like I used to. I was
horrified at a recent dinner banquet where too much food was served
and the uneaten food was discarded by the bucketfuls.
My experience has changed my outlook on life. I am told that
these feelings will dissipate with time and I will welcome that-or
will I? I have had some people comment that I am calmer since I
have returned. I smile and think to myself, "I am on Ghana
time."
For more information or if you would like to make a donation,
contact Pamala Lupo, 248.829.8284 or plupo@wright-filippis.com. For more information
on FOCOS, visit: http://orthofocos.org Director of Orthotics Wright & Filippis Inc. 
Table Of Contents - March 2003
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