Pioneering Respiratory Care in a Developing Nation What a Journey!! Kansas Respiratory Care Society Annual Education Seminar Dr. Lisa M. Trujillo, DHSc, RRT
What defines a developing nation? High infant mortality Low economic development High levels of poverty Low utilization of natural resources Heavy dependency on industrialized nations Poor with unstable government High rates of population growth, illiteracy and disease Lack of middle class
Statistics US vs. Ghana UNITED STATES Population = 318 million Average Annual Income = $55,000/yr Life Expectancy = 76M/81F Deaths under 5 years = 6.5/1000 Deaths from communicable disease, prematurity and malnutrition = 6% Tuberculosis = 3/100,000 Nearly all births have skilled birth attendant Expense on health care per capita = $9,145/year (17.9% of budget) GHANA Population = 25 million Average Annual Income = $1600/yr Life Expectancy = 62M/65F Deaths under 5 years = 83/1000 Deaths from Communicable disease, prematurity and malnutrition = 62% Tuberculosis = 281/100,000 Only 48% of births have skilled birth attendant Expense on health care per capita = $100/year (4.8% of budget) World Health Organization (WHO, 2014). Countries: United States of America. http://www.who.int/countries/usa/en/ World Health Organization (WHO, 2014). Countries: Ghana. http://www.who.int/countries/gha/en/
Map of the World
Living on Over $200/day
Living on up to $1.00/day
Early Neonatal Mortality
Birth Injury Related Deaths
Mortality in 1 4 Year Olds
Malaria Deaths
The Back Story Where did it all begin and why Ghana? The journey from 2006 to 2016
A little bit about us
Is RT needed in Ghana? Who is caring for respiratory patients? What interventions are available? Examples of current practices Extremely limited resources Lack of critical care education Patient s inability to pay for care Lack of urgency in response to emergent situations CDC lists respiratory disease as an equal in terms of mortality to malaria in Ghana.
Identifying the need What a difference! Without a flash Without a flash
PFTs for 750+
Identifying the need Organizing donations in the NICU
Identifying the need Called to assist with a 26 week baby
Identifying the need Humidity is better than Christmas
The Big Picture Before we began we had to look at the big picture!
Things to we had to consider New profession Would it be accepted? Support Government, institution, private Availability of resources Lab and facility Education Who will teach in the program? National exam How do we create one? Pay Round peg in a square hole Management Who will run the program and who will manage graduates in the hospital? Continuing education An important part
Introducing the Profession Making connections with those who would listen Ministry of Health and Ghana Health Services Ministry of Education Korle Bu Teaching Hospital CEO (2000 bed facility) Medical Group Anesthesia Group Neonatology and Pediatrics Help provided by a few US trained Ghanaian RTs
Send Out the Invitations! Invited Dr. Audrey Forson to apply to become an AARC International Fellow
Send Out the Invitations! Invited Dean and Provost from University of Ghana to visit WSU
Send Out the Invitations! Dr. William Obeng Pediatrician and future faculty member
Send Out the Invitations! Invited Dr. Esther Brobbey to visit WSU and participate in the AARC International Congress
We are the Champions!
Develop Curriculum Based on WSU BSRT Program Program includes a semester at WSU for a lab and clinical experience between year 3 & 4 Developed collaboratively University of Ghana approved curriculum Accreditation process began following approval
How do we train them? They can t come to us, so we will go to them
Cohesive and Enthusiastic Team of Educators Faculty is mostly made up of physicians
Next Steps Finalize collaboration agreement Weber State University University of Ghana Ship container of supplies lab and clinical Collect baseline data at KBTH Create national exam Support new faculty Provide faculty and exchange opportunities Vendors to provide sustainable support
Keys to Success Establish a strong foundation: Anesthesia, medical, pediatrics, emergency Provide a vision of respiratory care Support faculty and department development Patience, persistence, diplomacy and more patience!
It s taken us 5 years! We are well on our way The next 5 years will be telling Have we developed a sustainable program? Will it impact the healthcare system in Ghana? Will it impact the patients? Will it become a model for other developing nations? Only time will tell
Questions?