BUFFALO, N.Y. – Traditional medical missions often involve medical professionals from well-resourced, high-income countries traveling to under-resourced, low-income countries to provide health care to a local population for a limited period of time.
Earlier this year, a group of University at Buffalo infectious disease physicians traveled to Ghana with a plan to do things a little differently.
“There’s this concept of global health that in some ways can be an extension of colonialism, where you go into this country to ‘save’ the local population with your advanced medical care,” says John C. Hu, MD, PhD, clinical assistant professor of medicine and CTSI K Scholar in the Division of Infectious Diseases in the Jacobs School of Medicine and Biomedical Sciences at UB.
“That’s the wrong way to look at it. As infectious disease physicians, we want to have the humility to approach it in a different way,” he explains. “The important aspect is to try and build something bidirectional, to not come in as outsiders but to partner with ongoing initiatives in Ghana.”
The trip was led by Dorothy Siaw-Asamoah, PhD, clinical professor of organization and human resources and faculty director for global programs in the UB School of Management. Siaw-Asamoah, a native of Ghana, leads interdisciplinary groups of UB faculty and students to Ghana every year.
Hu led the medical portion of the trip, along with Seth Glassman, MD, clinical assistant professor of medicine; Alyssa S. Shon, MD, clinical assistant professor of medicine; Patrick Kenney, MD, who is finishing up his adult/pediatric infectious disease fellowship at UB this semester; and Shipra Goel, MD, UB internal medicine resident with the Catholic Health System-Sisters of Charity Program.
“The ultimate goal is to establish education, clinical and research exchanges with our partners in Ghana,” says Hu. “Infectious disease is such a geographic and locality-driven practice, we really learn from each other in terms of the disease process but also how hurdles are tackled with different levels of resources.”
He notes that while the conventional perspective is that African countries are low- to middle-resourced, the HIV research he observed in Ghana is world-class.
Kenney, who will be joining UB’s clinical faculty this summer, says that in a way, his experience in Ghana was exactly the experience he was seeking.
“My goal in medicine was to work in under-resourced areas,” he says. “That’s why I went into infectious disease in the first place.”
Working with colleagues from the UB School of Pharmacy and Pharmaceutical Sciences led by Gina Prescott, PharmD, clinical associate professor of pharmacy practice and director of global and community outreach, the UB physicians conducted four clinics and saw 650 patients.
Kenney says the focus on partnering with local providers was especially appealing. “One of the things we were trying to do was to engage with the local health care system, more than just bringing medicines into this country without hope of follow-up or building systems,” Kenney says.
Kenney is one of only about a dozen current fellows in the U.S. who have chosen to specialize in infectious diseases in both adult and pediatric patients. “I chose this specialty because I wanted to be in a position where I can treat whoever needs treatment, no matter who walks in the door,” he says.
Those skills served him well on the trip, where he was able to treat both children and adults.
But sometimes the most helpful thing physicians can do on such trips is less about treating patients than about providing health information.
“A big part of what we did was patient education,” says Hu. For example, when they diagnosed hypertension in a person, they would work on making referrals to local health care providers, to establish continuity of care.
Hu, Kenney and Glassman are partnering with physicians and researchers they met in Ghana, and plans are being made for next year’s trip.
“This is a reframing of global health trips,” says Hu. “We want to empower local health care providers. We want to turn over to them the care of these patients; we don’t want to take away from the health care system that already exists there.”
