Ghana Trip to Study Tuberculosis: Day 10

by Kaila Helm, Biological Basis of Behavior ’20; and Hope McMahon, Chemical and Biomolecular Engineering ’18

Ghana 10.1
A sheep spotted relaxing atop a speeding van as we travel from Kumasi in the south to Mole National Park in the north.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today we took a trip up north to Mole National Park. It was a little over a seven-hour drive from KCCR in Kumasi, but it went quickly as we drove past many communities. We were able to pick up food from vendors carrying it along the road. We picked up some of our favorites, like plantain chips, bananas, and groundnuts, and we even tried some new foods, like fried cheese.

Ghana 10.2
A sleeping selfie taken as we embark on our 7-hour bus ride from Kumasi to Mole National Park. (Left to right: Kate Panzer, Jason Grosz, Katharine Cocherl, Ethan Zhao, Kathleen Givan, Dave Pontoriero)

Once we arrived in Mole, we were greeted by baboons, which like to stay around the motel. We had to be careful with any food that we brought because they could chase us for it. After a brief dip in the pool, we enjoyed a nice dinner overlooking the terrain below us.

Ghana 10.3
The beautiful view of Mole National Park from the Mole Motel. (Left to right: Kate Panzer, Kathleen Givan, Katharine Cocherl, Kaila Helm, Danielle Tsougarakis, Hope McMahon)

We ended the night with another round of speed friending. By now, we had gotten to know each other to the point that leading questions weren’t necessary to carry conversations. After a few hours, we decided to retire for the night. When it became dark, we were amazed at how dark the sky was and how visible the stars were. We all went to bed, excited about the opportunity to go on a safari adventure tomorrow.

Ghana Trip to Study Tuberculosis: Day Nine

by Danielle Tsougarakis, Bioengineering ’20; and Kate Panzer, Bioengineering ’18

Ghana 9.1
Our group at the expansive Adum Market in the heart of Kumasi. (Left to right: Katharine Cocherl, David Pontoriero, Ethan Zhao, Dr. David Issadore, Benjamin [Ghanaian KNUST student], Jason Grosz, Danielle Tsougarakis, Hope McMahon, Kathleen Givan, Kaila Helm, Genevieve, Dr. Miriam Wattenbarger, Kate Panzer, Nana)
David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today, we visited one of the largest markets we have ever seen, the Adum Market in the heart of Kumasi. There, you can find almost anything you can imagine, from fresh produce and meats to clothes, jewelry, and other trinkets. The market seems to go on forever, with many twists and turns that can easily make a tourist lost. One of our most enjoyable purchases was the Ghanaian cloth, with hundreds of vibrant colors and patterns to choose from. Later in the day, a seamstress took our measurements and clothing orders so that we could get handmade clothes with our chosen cloth.

Ghana 9.2
Students explore the large selection of Ghanaian cloth. (Left to right: Hope McMahon, Kathleen Givan, Kate Panzer)

After a few hours of diligent bargaining at the market, we switched shopping scenes to the Kumasi City Center Mall, which was built a few months ago. Wide sections of the mall were partially open to the outdoors, welcoming us, as well as a nice breeze, into its various stores and hip social scene. We explored this more commercialized setting complete with a large supermarket, quite comparable to a Walmart. Many in the group invested in Ghana’s famed Golden Tree chocolate bars. The rich, creamy treats did not disappoint and served as the perfect snack after a full day of exploring.

Center for Curiosity Partners with Bioengineering

by Perry Zurn and Dani Bassett

Do not stop to think about the reasons for what you are doing, about why you are questioning. The important thing is not to stop questioning. Curiosity has its own reasons for existence. One cannot help but be in awe when he contemplates the mysteries of eternity, of life, of the marvelous structure of reality. It is enough if one tries merely to comprehend a little of this mystery each day. Never lose a holy curiosity.

–Albert Einstein1

This haunting passage prompts a series of difficult questions. Should we ever worry about where our curiosity goes? Is it true that curiosity is an end in itself? Or, are its justifications so obvious to us as to go unquestioned? Have we lost our sense of mystery? What makes curiosity holy? Einstein himself did not study curiosity, nor could he revolutionize the field of curiosity studies, which is just coming into its own today. But he does capture the compulsion of curiosity and its tantalizing promise.

Curious 1
Kushal Sacheti, Founder and Director of the Center for Curiosity

The Center for Curiosity was established in New York in 2014 by Kushal Sacheti, a diamond merchant who was formerly an engineer. Its mission is to advance both the academic study of curiosity and the public practice of curiosity. A year after its founding, the first of its satellite centers was established at the University of Pennsylvania, in the School for Social Policy and Practice, under the leadership of Dean John Jackson, Jr. It is here that Mr. Sacheti’s dream of uniting engineering and curiosity came alive.

Given her work on the network neuroscience of human learning, Dr. Danielle Bassett, Associate Professor of Bioengineering, was one of the first faculty spotlighted in Penn’s Center for Curiosity seminar series. Her talk, “Flexible Brain Network Dynamics During Learning,” so perfectly represented the Center’s mission that she was quickly appointed to its advisory board. Shortly thereafter, Dr. Bassett invited the Center’s two postdoctoral fellows, Dr. Arjun Shankar and Dr. Perry Zurn, to lead curiosity workshops at the 2016 Penn Network Visualization program. This program provides young artists the opportunity to understand and creatively reimagine network science. Dr. Zurn’s seminar on structural models of curiosity, coupled with Dr. Shankar’s workshop on the affective elements of curiosity, inspired program fellows to explore curiosity not only in network science, but also in their own artistic praxis.

Curious 3a
Dr. Arjun Shankar, Center for Curiosity, Postdoctoral Fellow
Curious 3b
Dr. Perry Zurn, Center for Curiosity, Postdoctoral Fellow
Curious 4
Dr. Danielle Bassett (left) and Dr. Susan Engel (right) at the Curiosity Across the Disciplines Symposium, December 9, 2016

 

 

 

 

 

 

 

 

Behind Dr. Bassett’s Network Visualization program is a passion for thinking between the arts and sciences and a conviction that they are richer enterprises together. An even broader commitment to interdisciplinarity energizes Penn’s Center for Curiosity. Last December, Drs. Zurn and Shankar organized the Curiosity Across the Disciplines symposium. This day-long event explored the concept of curiosity across major academic disciplines (history, medicine, ecology, neuroscience, psychology, education, anthropology, comparative literature, ethnic studies, political philosophy, and film). As presenters (including Dr. Bassett) reflected on their fields’ contributions to curiosity studies, as well as the role of curiosity in their own scholarship, a deeper, shared conversation emerged about how curiosity can help us to collectively navigate the scientific, educational, and political challenges of our times.

The collaboration between Penn’s Center for Curiosity and the Department of Bioengineering has really only begun. This fall, Drs. Zurn and Bassett are co-organizing a symposium on The Network Neuroscience of Curiosity. Speakers will include Dr. Danielle Bassett, Dr. David Danks (Carnegie Mellon University), Dr. Jacqueline Gottlieb (Columbia University), and Dr. Celeste Kidd (University of Rochester). And, as a long-term project, they have started a conversation about reinvigorating the Bioengineering curriculum with an emphasis on student curiosity and creativity. Sharing Penn’s commitment to community outreach, moreover, the Center for Curiosity and Department of Bioengineering are also in conversation with Westtown School about building an art- and science-centered curiosity initiative there.

If indeed one cannot help but be curious about life and its mysterious design, that journey is perhaps best undertaken together—Einstein’s fabled solipsism notwithstanding. This exciting new partnership at Penn is yet another step in that direction.

1 Albert Einstein, Statement to William Miller, as quoted in LIFE magazine (2 May 1955); reprinted in Joseph S. Willis, Finding Faith in the Face of Doubt: A Guide for Contemporary Seekers (Quest Books, 2001), 58; and William Hermanns, Einstein and the Poet: In Search of the Cosmic Man (1983; Brandon Books, 2013), 138.

Ghana Trip to Study Tuberculosis: Day Eight

by Kathleen Givan, Bioengineering and Political Science ’20; and Katharine Cocherl, Bioengineering ’20

Ghana 8.2
Students taking a tour of the Komfo Anokye Teaching Hospital (KATH) ICU. (Left to right: Katharine Cocherl, David Pontoriero, Kaila Helm, Hope McMahon, Benjamin [Ghanaian KNUST student])
David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Ghana 8.1
The vision statement, mission statement, and core values of Komfo Anokye Teaching Hospital (KATH) (click to enlarge).

We started our day by returning to KATH, although the clinical visits focused on HIV. We were lucky enough to see two patients, both heartbreaking and encouraging in their own ways. We were then shown around the sprawling complex that is KATH. The wards range from pediatrics and psychiatry to an elevated ward exclusive to those who can afford the price. We even got to see the oncology ward and speak to the head of the department. Interestingly, cancers such as skin and lung, which are prevalent in the U.S., are relatively rare in Ghana. However, cancers such as breast and cervical cancer account for 50% of the cases that they see. We finished our visit with a trip to the emergency room, which was somewhat oxymoronic, considering the grim conditions within the pastel walls.

We then had hoped to once again teach our students at the rural high school where we volunteer. Unfortunately, it looked too much like it was going to rain, so we were forced to turn back, since the children who must walk long distances to and from school were released early. For dinner, we headed over to a restaurant with live music and dancing. It was a nice emotional relief from our enlightening but taxing first week. The tilapia got rave reviews, and we learned that Ghanaian pizza tastes startlingly like cinnamon buns. We ended the evening by breaking out our middle school dance skills and having the Ghanaians show us up. All and all, a great start to a jam-packed weekend!

Ghana 8.3
Students enjoy a dinner of grilled tilapia and Alvaro (a popular soda in Ghana). (Left to right: Hope McMahon, Kathleen Givan, Benjamin [Ghanaian KNUST student], Priscilla [Ghanaian KNUST student], Danielle Tsougarakis, Katharine Cocherl, Kaila Helm)

Ghana Trip to Study Tuberculosis: Day Seven

by Danielle Tsougarakis, Bioengineering ’20; Jason Grosz, Bioengineering ’19; Ethan Zhao, Bioengineering ’19; and Kate Panzer, Bioengineering ’18

Ghana 7.1
At KCCR laboratories, Penn student Danielle Tsouragarkis checks out one of 120 GeneXpert throughout Ghana, which test for the presence of MDR TB.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today is a holiday, Africa Day! That being said, we were unable to go to any hospitals, clinics, or schools today. Instead, after breakfast we continued our morning with a tour of Kumasi Center for Collaborative Research in Tropical Medicine (KCCR). KCCR specializes in tuberculosis diagnosis among other diseases – they are partnered with 40 hospitals and clinics throughout the country. Hospitals will send sputum and blood samples to KCCR for further diagnostics. One of the scientists at the center explained the procedure for testing for multidrug resistant (MDR) tuberculosis. When patients are diagnosed with mycobacterium tuberculosis, they are given first line of defense drugs, which include rifampin, isoniazid, pyrazinamide, ethambutol, and streptomycin with the first two drugs being the most potent. When no improvement shows from theses antibiotics, the patient will provide a sample to be tested in the GeneXpert for resistance to rifampin and isoniazid. After the samples are decontaminated, the sample is run through the GeneXpert to test for resistance to rifampin as well as the amount of MTB present in the sample (low, intermediate, high). If the sample expresses rifampin resistance then it is MDR TB. In addition to our comprehensive information session, we were also able to go into various laboratories throughout the facilities and view much of the equipment used in TB diagnostics such as the GeneXpert, thermocyclers, and PCR machines. We also had the opportunity to view gram-negative strains of tuberculosis up close under a microscope.

Ghana 7.2
Penn students take a tour of the KCCR laboratories.

Later, one of the Ghanaian students drove us around to see his house and the area where he grew up.  Distance-wise, his home isn’t far, about 4-5 miles away.  However, driving took more than half an hour, not because of traffic, but because there were so many holes on the road that it was necessary to drive slowly over them at less than walking speed.  We first visited the market where his mother owned a store.  There, a large group of kids gathered and stared at us.  Unable to communicate with those who only spoke Twi, we took out our deck of cards and managed to set up a game.  Everything seems to be given more freedom, as children and chickens alike are allowed to roam the market freely, trusted to return to their respective homes at the end of the day.  We then visited his grandmother’s house.  His grandmother was originally from Northern Ghana, and she only spoke Hawza, a language spoken primarily by the Nigerian Muslim community, and not Twi, in contrast with the majority of the population.  Overall, it was a great experience to go off campus to see the environment in which everyday Ghanaians work and live.

Ghana 7.3
Penn students (left to right) Kate Panzer, Kaila Helm, Katharine Cocherl, Jason Grosz, and Ethan Zhao visit a nearby neighborhood where one of the KNUST students grew up.

SockRocker Aims to Rehab Sprained Ankles

Ankle sprains are among the most common injuries suffered. Not only do 23,000 sprains occur annually, but nearly two-thirds of people with sprained ankles don’t finish their rehabilitation programs, and more than one-third will sprain the same ankle again. A senior design project team that addressed this topic was one of this year’s three winners: the SockRocker

SockRocker
The SockRocker

Among the problems with the currently available rehab technologies are issues of effectiveness, lack of personalization, and poor accessibility. The team — which consisted of Aras Fanuscu, Andrea Frank, David Hernandez, and Angel Xiao — sought to address these issues, coming up with the SockRocker (right). The device, which cost approximately $350 to produce, combines targeted muscle therapy, individualized physician input, and a universal design. The patient places his/her foot into the SockRocker and is then able to move the ankle 30° in either direction, thus strengthening the injured joint. In a pilot study, the design team found that the SockRocker rated 4.8 out of 5 for comfort. In addition, the device is fully portable and can run on 24-volt battery for one month.

Going forward, the team hopes that the SockRocker can be tested clinically to determine its long-term efficacy. According to Timothy Dillingham, MD, MS, chair of the Department of Physical Medicine and Rehabilitation in the Perelman School of Medicine, the device has potential to close “an unfortunate gap in our clinical rehabilitation and management” of patients with ankle sprains.

Ghana Trip to Study Tuberculosis: Day Six

by Kaila Helm, Biological Basis of Behavior ’20; Kathleen Givan, Bioengineering and Political Science, ’20; Kathryn Cocherl, Bioengineering ’20; Hope McMahon, Chemical and Biomolecular Engineering ’18; and Dave Pontoriero, Biotechnology MS ’18

Ghana 6.1
Students speak with a clinician about the X-ray machine used for chest X-rays as a preliminary technique for diagnosing tuberculosis among other respiratory infections.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Our day started early. We woke up for a 7:00 a.m. breakfast of our usual combination of rolls with jam, sausages, omelets, and a beverage. After breakfast, we headed for the bus, where Uncle Ebo (our bus driver) was waiting to take us to a rural hospital about an hour away. We soon arrived at the Agogo Presbyterian Hospital. We were amazed by the organization and structure. At our previous hospital visit, we only saw a TB clinic. Today, we got to see a hospital that served a very different community. After spending some time in an old Presbyterian church, an administrator greeted us to begin our tour. We entered the main atrium, a large waiting room filled with more than a hundred people. We even saw a sheet used to characterize patients’ symptoms — a comprehensive list of numerous traits and experiences. We then continued our tour by entering the various wings and sections affiliated with TB treatment. This provided a wonderful opportunity to see a different side of the hospital’s operations.

Ghana 6.2
Penn students wait to enter the tuberculosis clinic of the Agogo Presbyterian Hospital. (Left to right: Katharine Cocherl, Danielle Tsougarakis, Kaila Helm, Hope McMahon)

Initially, we were allowed to peek into the diagnosing wing. The first room was small and was purposed for smear microscopy tests. It had a few light microscopes and many technicians. Adjacent to this room was the GeneXpert room. Tucked away in the back corner was a small box (the GeneXpert), maybe 18 inches high. We were surprised at how small and streamlined it was — finally seeing the machine we have talked about for a solid semester was an almost surreal experience. It seems that they value it highly and therefore keep it well maintained and protected. We learned more about how they use the GeneXpert and the limitations they face, such as a limited number of cartridges, problems with overuse, and slow maintenance.

We then went into the X-ray room. As per our past lectures, this is the preferred initial screening methodology, so it was exciting to see how well established their systems are. There were two X-ray machines that were donated and used by the entire facility. The nurse also showed us how they store all the scans and showed us a scan of a pneumonia patient’s lung. They hope to introduce digital X-rays in the future, which will be better for analyzing and diagnosing. She taught us what to look for on the scans, saying that pneumonia is differentiated from TB because it is localized at the bottom lobes of the lung, whereas TB is more widespread and present in the top lobes as well. The tour concluded with a trip to the isolation room for TB patients, but time was limited, so we didn’t spend much time there.

Once we took the bus back to KCCR, we attended a lecture by Dr. David Issadore, who spoke about his research to a packed room filled with Ghanaian clinicians and researchers. They were very interested in his work, especially in how microfluidic chips could be used as a diagnostic for TB. Interestingly, the room was filled with clinicians and research scientists, but engineers were poorly represented. Dr. Issadore definitely made us proud!

Ghana 6.3
Students taking a tour of the Agogo Presbyterian Hospital complex.
(Left to right: Hope McMahon, Salim)

After the presentation, our group scattered. Some of us took control and hand-washed our clothes. A few numb fingers made for a very nice reminder about the little things we take for granted back in the States. After we worked up an appetite, we introduced the American classic of peanut butter and banana sandwiches to the Ghanaian students and Nana. We received some mixed responses, and we won’t be getting many returning customers, but it was nice to have a little bit of role reversal. Considering how much we have learned about Ghanaian culture through their food, it was nice to help them see a little bit of what America has to offer.

Ghana Trip to Study Tuberculosis: Day Five

by Danielle Tsougarakis, Bioengineering ’20; Jason Grosz, Bioengineering ’19; Ethan Zhao, Bioengineering ’19; and Kate Panzer, Bioengineering ’18

Ghana 5.1
Dr. Anthony Enimil (left) and Nana Yaa (right) in the pediatric tuberculosis clinic at Komfo Anokye Teaching Hospital (KATH), Kumasi.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

The first thing we did today was visit the Komfo Anokye sword, which is a sword buried in the ground that represents the power and stability of the Ashante Kingdom. Rumor has it that, if the sword is removed from the ground, the Ashante Kingdom will collapse. To this date, no one has been able to remove the sword from the ground, and it is a tourist site frequented by famous visitors, including Muhammad Ali.

After seeing the Komfo Anokye sword, we visited a pediatric tuberculosis clinic at Komfo Anokye Teaching Hospital (KATH), the major hospital in Kumasi, which is well equipped with medical infrastructure. Upon entering the clinic, we were immediately struck by the appearance of the waiting area and check-up room. The check-up room was small and consisted of a wooden desk and plastic chairs. The windows and doors remained open to the outside and waiting area such that any passers-by could listen to the check-up. The clinic was not very busy while we were there, but the doctor said that that was atypical; typically, he is completely booked and has to rush from appointment to appointment.

The first patient was a five-year-old child who was referred from another doctor for persistent coughing, weight loss, fever, and vomiting. These are all classic symptoms of tuberculosis, so the doctor ordered a smear microscopy diagnostic on the patient’s sputum and a digital X-ray. If the sputum sample is viable, it will also be sent for molecular diagnostics with the GeneXpert. One thing that we found surprising was that the cost to the patient for the diagnostics and the check-up was $0 — it is all funded by the government and NGOs.

Dr. David Issadore with students at a rural high school in Kumasi, following his physics tutoring session.

The second patient was also a five-year-old child currently being treated with anti-tuberculosis medication and anti-retroviral therapy for HIV. His symptoms included wheezing, coughing, and an extremely rapid heartbeat. Given the patient’s history of HIV, the doctor suspected acute pneumonia and/or drug-resistant tuberculosis and admitted him to the emergency room for observation and treatment. One thing that we found surprising was that infant patients in the emergency room usually share beds with up to seven other infant patients. This makes hospital-borne infections extremely common and dangerous. We also found it interesting that only the mother was allowed to accompany the child to the emergency room, but the father was given the final say for all important medical decisions.

After the clinic visit, we went to a nearby rural high school, where we planned to tutor the students in science and math. Upon arrival, we were told which subject we would be teaching just before we were essentially thrown into the classrooms without much preparation. This tutoring session was held after the usual class period, but the students were eager to stay, learn, and interact with us. The school was split into two forms similar to the British school system, with the underclassmen in Form 1 and the upperclassmen in Form 2.

The high school has about 900 students, split into eight classrooms with sides that open to the warm Ghanaian air. The rooms hold classes of varying sizes from 25 to 50 students, with ages between 13 and 18 years. Some of the subjects taught in the different classrooms include physiology (the cardiovascular system), math (algebraic expressions, change of subject, quadratic equations, etc.), and language arts (article and essay writing). Each room was filled with goofy, lively students who would occasionally break out in giggles and applause to encourage their classmates who volunteered to come to the board.

We all had a blast interacting with the students, attempting different teaching techniques on the spot and brainstorming ways to get the students excited about the class topics. Despite the initial nerves of not knowing what we would be teaching until just before entering the classrooms, we look back at this experience with excitement, and we are looking forward to returning to the classrooms to tutor on Friday.

Ghana 5.3
Students lining up for a dinner of fish, boiled plantains, (white) yams, and palaver sauce.

Ghana Trip to Study Tuberculosis: Day Four

by Kaila Helm, Biological Basis of Behavior ’20; Kathleen Givan, Bioengineering and Political Science ’20; Kathryn Cocherl, Bioengineering ’20; Hope McMahon, Chemical and Biomolecular Engineering ’18; Dave Pontoriero, Biotechnology MS ’18

Ghana 4.1
Dr. Anthony Enimil (local pediatrician) giving a lecture on tuberculosis in Ghana.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Our team woke up and hit the floor with some Zumba. Following this exercise, we went to the campus cafeteria for breakfast. The food consisted of rolls with jam, sausages, omelets, and coffee, tea, or Milo (Australian chocolate milk).

Ghana 4.2
Students pose with Dr. Anthony Enimil following his lecture on tuberculosis in Ghana. (From left to right: Salim, Katharine Cocherl, Ethan Zhao, Danielle Tsougarakis, Kate Panzer, Kathleen Givan, Kaila Helm, Dr. Anthony Enimil, Jason Grosz, David Pontoriero, Dr. Miriam Wattenbarger, Hope McMahon, Dr. David Issadore, Priscilla, Benjamin)

Our first academic activity of the trip was after breakfast! We made it back to the house for a lecture from Dr. Anthony Enimil, a local pediatrician. During his initial lecture, he spoke about Ghanaian culture and how it related to our group, both as tourists and and as medical professionals. Dr. Enimil said that misconceptions mostly stemmed from tourists who think they are above Ghanaians. Ghanaians are multilingual, intelligent, and very proud of their culture. This pride is particularly prevalent in Kumasi and the Ashanti region, which is considered the cultural capital of Ghana. The question and answer period was particularly interesting, considering that we have spent a semester learning about tuberculosis without necessarily having any ability to learn specifics about the situation in Ghana. One fact that we found remarkable was that the WHO estimate of tuberculosis prevalence was found to be only one-quarter of the actual prevalence in Ghana.

The next portion of the day was critically important, if somewhat futile: a tour to get us oriented around campus. The KNUST campus is, according to a casual guestimation poll of the Ghana Nine (the nine Penn students on the trip), approximately five times bigger than the Penn campus. To make matters worse, large parts of the campus are, to our untrained eyes, identical stretches of unkempt jungle. We ended our tour with fufu for lunch at a chop bar, a casual Ghanaian restaurant that apparently serves the purpose as Wawa: keeping the Ghanaian students happily fed for cheap. We knew the food was spicier when our right hands (used in Ghana as utensils) tingled for a solid hour post-exposure. However, the fufu we ate was legitimate and delicious, and there were no complaints from the Ghana Nine about the food, particularly when we had a lovely post-meal Icy Cup (a tangy yogurt smoothie). It distantly reminded most of us of yogurt.

Ghana 4.3
Students enjoy fufu at the chop bar nearby the campus of Kwame Nkrumah University of Science and Technology (KNUST). (From left to right: Katharine Cocherl, Danielle Tsougarakis, Kathleen Givan, Priscilla)

Our second academic activity of the day was a continuation of the lecture led by Dr. Enimil. This time we got into the nitty-gritty details of the tools that are used to diagnose TB. Even with the progress made with technological advances, a recurring issue is stigma. TB is curable, but the perception of it as a “disease of death” has made it highly stigmatized. Much work needs to be done to reach some of the benchmarks set. For example, the hope is to eliminate the disease burden by 2035. To do this, Ghanaians must continue strengthening diagnostic methods. We discussed the microscopic culture molecular examination, chest radiographic findings, and sputum sample usage with the Gene Xpert. After another very stimulating question and answer session, the Ghana Nine took a 90-minute break, filled with naps and a competitive game of cards.

We then enjoyed a delicious dinner that consisted of salted fish, plantains and (white) yams (collectively called ampesi), palaver sauce, and avocado. After dinner, the whole group took a walk to the shopping mall on campus to get an ice cream treat to cool us off. We ended the night reflecting on our day, speed friending, and discussing all the new information we learned about TB in Ghana to prepare for our visit to the clinics.

Ghana Trip to Study Tuberculosis: Day Three

by Danielle Tsougarakis, Bioengineering ’20; Jason Grosz, Bioengineering ’19; Ethan Zhao, Bioengineering ’19; and Kate Panzer, Bioengineering ’18

Ghana 3.1
Danielle Tsougarakis (left) and Kathleen Givan (right) on a paddleboat along Lake Bosomtwe.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

This morning, we headed to Lake Bosomtwe, which is in the Kumasi metropolitan area. The setting was surreal, with an expansive lake surrounded by rich vegetation and puffy white clouds. Lake Bosomtwe is the only natural lake in Ghana, formed by a collision with a meteor millions of years ago. However, the local story behind the lake’s origin involves a hunter who seeks to shoot an antelope. The first day, he goes into the forest and successfully shoots an antelope, but the animal runs away. The next day, the hunter once again goes into the forest and successfully shoots the antelope, but the same escape occurs. Finally, on the third day, the hunter decides to follow the antelope after it has been shot. The hunter ends up at a small pond and sees the antelope enter the water and disappear. The hunter determines that the antelope is a ghost and decides to name the pond “Antelope god,” or Bosomtwe in Twi, one of the languages of Ghana. Bosom translates to “god,” and twe means “antelope.”

Ghana 3.2
Students enjoying jollof rice and fufu by Lake Bosomtwe.

Now there are 22 communities surrounding the perimeter. We found out it would take eight hours to walk around the entire lake – a trek no one wanted to attempt. However, we did get to wade into the warm water and explore further with the paddleboats. At first glance, the water appeared polluted with scattered plastic bottles. Upon further examination, we realized these were actually makeshift flotation devices for fish traps. We later saw a group of young boys wading through the water catching fish with their hands. Overall, there weren’t a lot of other people there, and we were the main tourist group.

After dinner, we converted our dollars to Ghanian cedis by a currency exchanger named Aness. Aness was a Muslim born in Kumasi with heritage in Niger, and we had an extensive discussion about the various aspects of his identity, including his identifications with Kumasi, Ghana, and Islam.   First, even though his parents came from Niger, he identified more strongly with Kumasi and Ghana since he was born here, saying, “You must be proud of where you are born because it’s the only thing you have.” He was extremely proud of the fact that Kumasi was the cultural center of Ghana. He seemed to have very strong stereotypes against people from Accra, claiming that the businessmen were dishonest and cared only about making money, not the way it was made. He also explained to us the use of various regional dialects across Ghana.  In Kumasi, the primary language of communication is Twi.

Ghana 3.3
Students playing card games and board games by the scenic Lake Bosomtwe.