When Richard Douglass was an undergraduate at Alma College
in the 1960s, he spent his junior year in Ethiopia. Africa
stole his heart; the vast potential to improve people's
lives captured his imagination. His life has never been
quite the same since.
"There's something very special about being among
22 million people and you may be one of two or three that
has the skills you've got," said Douglass, 61. "Your
ability to change things, or even just to be heard, is
remarkable."
Douglass, a professor in the health administration program
in EMU's School of Health Sciences, spent May and June
at Ashesi University (http://www.ashesi.org/index.html)
in Accra, Ghana, setting up programs that could vastly
improve health care in the West African nation.
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INTERNATIONAL EXCHANGE: Richard Douglass
(above, right), a professor of health
administration
in EMU's School of Health
Sciences, discusses ways to
improve Ghana's healthcare
administration programs
with Albert Aasiedu-Ofei,
a senior manager in the
Ghana Health Service.
|
Ashesi is a new, liberal arts university dedicated to
training the brightest students in Ghana, regardless of
their financial means. Half of the students, often the
first members of their family to go to college, are on
scholarship.
As a Fulbright Senior Specialist, Douglass's original
mission was to work out an agreement through which Ashesi
health administration students would spend a year at EMU
taking classes in health administration, business and human
biology. The partnership, pending approval of governing
boards at both schools, will create a degree program at
Ashesi that will be the first of its kind in Africa. The
arrangement could become the core of a developing nation
health administration certificate at EMU.
"We have a great health administration faculty and
curriculum, and they have wonderful students that are eager
to learn and have some interesting healthcare concerns," said
Betsy Francis, director of EMU's School of Health Sciences. "It's
certainly an opportunity for students, and I think it's
important for us to get a sense of international health
issues."
But the articulation agreement is only the beginning.
Douglass now plans to spend his future winter semesters
in Ghana, teaching and guiding the EMU-Ashesi Health Management
Scholars program. He's also co-authoring a textbook that
addresses health service in a distinctly Ghanaian context
and rallying partners for a program that will use telemedicine
to bring primary care to remote villages.
Medical service in Ghana suffers from two forms of "brain
drain," Douglass said. Three quarters of the doctors
trained at the University of Ghana leave the country to
practice in the United States, Europe or Australia. This
leaves doctors in short supply, even before the best of
those who are left are promoted to hospital management
positions. The Ashesi University program will train hospital
and public health managers, freeing the physicians to practice
medicine rather than tend to management duties.
To make sure the new Ashesi program offered courses relevant
to Ghana, Douglass surveyed health service managers there
and found that most of their training was inadequate and/or
irrelevant to Ghana. It came from 30-year-old American
textbooks, which didn't offer help with day-to-day realities
the manager of a rural hospital in Ghana might face, he
said. The new textbook will include actual case studies
from Ghana Health Service and theory mixed with real-world
information such as: how to start a generator; how to deal
with interethnic conflicts between staff; and how to communicate
in a country with more than 40 languages.
Albert Aasiedu-Ofei, a senior manager in the Ghana Health
Service and one of the textbook's co-authors, said he hopes
the project will identify and address needs missed by previous
policy makers and health reformers.
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GIVEN GUIDANCE: Richard Douglass
(above,
right) poses with the Assistant
to the Iman of
Larabonga, site of the
oldest mosque in Ghana.
At left is Lydia
Odai-Tetty, Douglass's research field
coordinator
during his Fulbright period
Douglass is working to create a micro-
economic
development project that would
result in selling
hand-crafted models of the
Larabonga Mosque. Sales
could provide
substantial economic support to the
village, Douglass said. |
"I am optimistic that the curriculum being developed
by Professor Douglass will seek to create a new health
services administrator, who will have a better in-depth
knowledge and understanding of the Ghanaian health-sector
environment and further equip him to perform better on
the job," he said via e-mail .
Ghana is about the size of Michigan's lower peninsula,
but with roads that would make the Michigan Department
of Transportation blanch. The Ghana equivalent of driving
from Monroe to Traverse City can take as long as 19 hours.
Roads turn into plowed fields. Dust storms and animals
sometimes make them impassable.
As a result, many rural Ghanaians get no primary medical
care. Malaria is the country's leading killer, and many
treatable diseases develop devastating consequences. At
least 1,000 new cases of river blindness are diagnosed
every year, Douglass said. If half of them could be screened
in the previous year, that's 500 to 600 people who wouldn't
become blind.
"One of the earliest impressions I had as a very
impressionable 20-year-old was that rural people don't
get medical care," Douglass said. "And, in most
of Africa, most of the population is rural. That's a real
threat to the whole nation and an insult to our humanity."
Douglass proposed using satellite transmission equipment,
mounted on trucks, to bring patients and doctors together
virtually. Sending teams with this technology to villages
on a regular basis would be akin to having a visiting medical
team on a predictable schedule. A patient in rural Ghana
who's never seen a doctor before could be diagnosed by
a physician in Ann Arbor or Ypsilanti or Bloomington, Ind.
Douglass believes drive-by telemedicine could be a model
not just for Ghana, but also for Africa and the rest of
the world.
On this end, telemedicine would broaden the experience
of doctors and medical residents, and create business for
companies that make the equipment needed to support it.
"Developing a technology-based service system that
would serve hundreds of thousands in Africa has huge potential," he
said. "All of the pieces seem to be coming together
at the right time, and I'm not going to let go of it."
It has been a very heady experience working with creative
people who just won't take no for an answer, Douglass said.
"You come back from a trip like this and people ask,
'How was it?' and then they give you about a minute and
a half," Douglass said. "It's difficult to explain
to people who haven't done something like this. This is
more than special. This is astonishing. It will end up
defining my career."
