I have just wrapped up another exciting and challenging week 2 and 3 at Cape Coast Teaching Hospital (CCTH).  I have started providing once a week outpatient echocardiographic imaging for the hospital besides providing free heart imaging for several children and adults who are inpatient. The two internal medicine residents who are training in the focused echo imaging are making significant progress. Getting and echocardiogram is difficult and expensive in Ghana. It cost $80 - $100 to get an echo done and sometimes one has to travel to the capital city which is 3 hours away. So far together with the trainees we have provided free cardiac imaging for nearly 80 patients for the past 3 weeks. One pediatrician has also started training for focused echo this week. I am looking forward to the first of 3 evaluations for the trainees in week 4. 

It has been long hours than I anticipated for the training, imaging, reading images , writing reports  and proving clinical care insights on cardiology but it is gratifying to know that I will be able to  train at least 2  people to provided focused echo care when I return to  Nashville. 

Week 3 brought some mixed feeling as I imaged a newborn with a complex single ventricle (Hypoplastic left heart syndrome) with no chance of survival in Ghana. It would have been a different conservation in the USA. For some kids I was able to clarify their diagnosis and provided the needed counselling and for some I was able to tell them there was nothing wrong with their heart despite being told there was at some point. Beyond imaging, I have had the opportunity to spend time with the public health unit and had interacted with several HIV infected children and their parents, providing care and sharing in their wonderful dreams and aspirations. 

I don’t think my work is going to get any easier in the coming weeks. I am on a faculty panel in the upcoming week presenting on Medical ethics and medical decision making, a host of pediatric cardiology topics and serving as a resource person for Neonatal resuscitation for newly graduated medical doctors in partnership with the Mayo Clinic in Ghana. And there are more exciting challenges ahead ….  

From right, Bright 18years HIV infected patient on ARV, a high school graduate preparing for college to pursue graphic design and David, 8year old HIV infected patient who want to be a doctor. 


Kwame and his mother both HIV infected patients on treatment.