Category: students

By Xuanjie (Lucas) Gong, Biotechnology MS ’19; Shihan Dong, Biotechnology MS ’19; and Princess Aghayere, Health & Societies ‘19

Today, we all went to the Maternal and Child Health Hospital in Rural Kumasi. The main purpose of the visit was to observe malnutrition cases in children and to interact with doctors and nurses who treat children suffering from malnutrition.

While visiting the clinic, the nutrition group asked the questions that we prepared yesterday. It turns out that the situations here match up with our research. Doctors and nurses use WHO standards to determine the nutrition status of the kids. Also, they use MUAC tape to determine the severe acute malnutrition. Children who have MUAC less than 11.5 cm will be sorted into a severe acute malnutrition group.

As for solutions or treatments, they do know about and have RUTF (Ready-to-Use Therapeutic Food). We also learned that they have therapeutic milk, F-75 and F-100, to treat malnourished children in different phases. They have F-75 to use at the starting phase of treatment. If F-75 helps to stabilize the children, they move onto F-100, and they use diluted F-100 for children under 6 months.

We had 2 cases that we mainly focused on. The first case was of a 3-year-old girl who suffered from Kwashiorkor, Marasmus, and Marasmic Kwashiorkor. All 3 diseases are signs of severe acute malnutrition. She had been there for 3 weeks for treatment, and her condition was not improving. The doctors attributed her declining condition to poverty and the mother’s psychiatric problems. The patient’s mother has already lost two children to the same condition. The doctors describe the girl’s status as unstable because she often vomits and isn’t gaining weight. The second patient is a child exposed to HIV as a result of her mother being positive for the disease. Because she is only 3 months old, blood cannot be drawn, and testing cannot be done to ensure her HIV status.

In the evening, we went to a church to give a presentation to local women with little to no education. We started by asking them what they eat everyday, and luckily we received a lot of responses. From their responses, we could clearly see that their diet lacked components of vegetables and fruits. Then, we delivered a brief speech containing basic nutrition knowledge, mainly based on the six essential nutrients. We explained the function of these nutrients and some local sources to obtain them. Surprisingly, one of the female audience members said that this was her first time hearing about vitamins and minerals.

During the question and answer segment of our presentation, some women asked about the different types of sources for minerals and vitamins. In particular, one woman asked about the foods that she could eat to help with her hypertension. To our surprise, another women asked whether her intake of fruits was excessive. This question made us think about people’s awareness of obesity and other diseases related to overeating. At the end of the presentation, the audience was happy about what we presented today and looked forward to learning more on our next visit.

By Xuanjie (Lucas) Gong, Biotechnology MS ’19; Shihan Dong, Biotechnology MS ’19; and Princess Aghayere, Health & Societies ‘19

This morning, we had our official kickoff in the morning. It was a great meeting with Dr. Ellis, the Dean of School of Public Health. In the afternoon, professors from different schools delivered three lectures about the state of mental health, maternal and child nutrition, and health systems in Ghana.

The mental health lecture, given by Dr. Emma Adjaottor, was impressive and surprising. We are so lucky that we met one of the psychiatric physicians among a hundred across the country. The doctor frankly introduced mental health development in Ghana. Though they have lagged behind, they have made a lot of progress, with the number of psychiatrists in Ghana  recently increasing from single digits to the double digits. Dr. Adjattor emphasized that the epidemiology of mental health in Ghana is nearly identical to the rest of the world, particularly in terms of incidence and prevalence, even though it is severely under-reported. The doctor explained that, although the epidemiology is the same, the terms used to describe these issues are often different, relying on more local ideas, such as spirits and witchcraft.

The maternal and child nutrition lecture, given by Dr. Samuel Newton, was even more astonishing. Kangaroo mother care (KMC), in which a prematurely born infant is given constant skin-to-skin contact with the mother, is undergoing study in Ghana, and it has shown promising outcomes. Even with limited studies, KMC has been found to greatly increase the likelihood of survival even when using “surrogates,” such as grandmothers and even fathers. The professor also introduced another study that found that the application of oxytocin during the third stage of labor in mothers at risk of postpartum hemorrhage (PPH) greatly decreased the likelihood of PPH.

Finally, Professor Ellis Owusu-Dabo gave an extensive lecture covering the health systems of Ghana, which are logically and hierarchically managed, with administrations at the national, local, district, sub-district, and community levels. We also learned about the insurance program in Ghana. For formally employed workers, national insurance participation is mandatory, as it is funded by a mandatory tax on their income, like in many socialist countries. However, insurance coverage is a more complicated matter in Ghana, in which a very large proportion of the population is not formally employed and instead earn its living through trading and cash-paying jobs. For these people, other than the free public health services provided by the government such as malaria, tuberculosis, and HIV care, they must pay out of pocket for many other services.

Tomorrow will be the very first clinic visit, where we can observe children suffering from severe acute malnutrition. So the three of us in the nutrition group, Princess, Shihan, and Xuanjie, gathered together after dinner to discuss what we would ask the doctors and nurses during the visit. We agreed that, at first, we should ask whether we can take pictures to record. As for nutrition, we will ask how healthcare workers there define malnutrition.

To our knowledge, malnutrition standards are normally based on BMI, which is a composition of weight, height, and age-related data. We want to know whether Ghanaian healthcare professions use the same standards here, as well as how the local standards differ from the established WHO standards. Furthermore, we will ask for access to their local data sets. In addition to the results of malnutrition, we also want to know what the major causes of malnutrition are. We assumed that the principal cause is poverty, and based on this assumption, we want to ask them whether there are any welfare systems or NGOs helping to resolve the problem. We hope to find out what the clinics’ initial steps are to resolve malnutrition. Our last question involves how macronutrients are measured.

Tomorrow evening, we will give an open presentation in a local church to female market workers. We first planned to deliver the presentation in a discussion form, but considering the language barrier and other factors, we decided to give a speech, but we will ask simple questions. We thought that the scope of our research was not appropriate for local life in Ghana because much of the research was done in the U.S.; thus, it was necessary to get the input of local people. By asking them questions about what they eat on a daily basis, we want to make our research as appropriate as possible. In relation to our presentation, we will briefly introduce what nutrition is and explain the 6 essential nutrients through definitions and explanation. For example, when introducing carbohydrates, we will refer to fufu or banku, which are local main dishes basically consisting of starch. Also, we came up with an educational idea for the future. If we have a projector, we could possibly show some dishes to let the audience choose which is more nutritious, to provide general idea of a nutritious diet.

By Sandy Tang, Bioengineering ’19; Eliza Culp, Fine Arts ’20; and Jessica Fan, Biotechnology MS ‘18

This morning, we had a chance to sleep in a bit and recover from our busy travel day. We had a delicious breakfast that consisted of porridge with sugar cubes, sausage, hard boiled eggs, a locally specialized donut made of beans, watermelon, butter bread, and a variety of hot drinks: yum. After our breakfast, a group of us went on a walk around campus, and another group went to a church service at First Love Church.

The church service started with praise worship, followed by numerous student performances. There was a dance group, a drama group, a praise group, and a traditional Twi praise group, and the congregation members were bursting with energy. The pastor then gave her sermon and afterward greeted the congregation. We made a few friends who happened to be students at the university we are staying at: KNUST.

For the other group, we explored KNUST’s expansive campus. We started to wander, and only when we noticed excessive nature did we realize we were no longer on campus. Once back on track, we saw some lizards, baby goats, and plenty of flora and returned to the residential area of campus. We accidentally entered a boy’s dorm but caught a glimpse of what it would be like to be a student at KNUST. Inside the dorm, a pastor was giving a fiery sermon, and many students were hand washing laundry in the courtyard. After leaving the dorms a few of us bought some amazing meat pies, for only 1 Cedi (about a quarter)!

Around 1 p.m., we all got into our bathing suits to head to the pool! The ride was short, and we were excited to have some relief from the heat. We ordered some food before entering the water; there was a choice of jollof or fried rice with either fish or chicken. After ordering our food, we applied sunscreen and dove into the water. There were many other people in the pool already, so we made some friends with the swimmers our age, many of whom were instructors. Shortly after being in the water, Genevieve and Estabelle, two young girls, joined us in the pool, and we played with them and carried them around in the pool. It was such a great time.

We stayed until the pool closed at 6 p.m. and then dried off and took the bus back home. A few of us bought sweet treats from the little shop in our graduate student hostel, Tek Credit. Then, dinner was brought to us by Nana Yaa: a meal of yams, spinach fish stew, rice, fried fish, beef and water melon. We had a brief Twi lesson from Nana Yaa on basic greetings. Our night ended with a quick debrief from Dr. Wattenbarger about our upcoming week.

Excited for the days that lie ahead!