Penn Bioengineering Blog

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

by Allaire Morgan (Electrical Engineering, ’22)

Today, the team took various field trips related to water supply and public health. After being picked up on the bus, we drove for about an hour through the busy (and bumpy) streets of Kumasi to the Barakese Headworks of Ghana Water Company Limited. We spent the majority of the morning and early afternoon on a tour of the plant, following in chronological order the retrieval and treatment of water from the reservoir.

Upon walking up to the dam, the roar of the water was powerful. We went into a garage-like building which housed the four large pumps from the dam, pumping water uphill for further processing. After climbing approximately five stories on a shaky ladder, we reached the top of the dam to observe the reservoir from which the Ghana Water Company extracts its water. From there, our team ventured up the hill to observe the water treatment plant.

With the sun beating down, we slowly made our way through the facility, observing each stage of the treatment process in which millions of gallons of water were being treated at a time. The first stage, aeration, takes about six hours to complete. From there, water is pumped into giant drums for sedimentation, where water is stirred and polymers are added to force harmful chemicals to settle at the bottom. Clean water then slowly rises up in the million-gallon drum, with the clean water spilling over the edges to be collected and further processed in large sand filters. The sludge at the bottom of the drum is currently pumped back into the river, which may propose a serious public health problem in the future. The team then followed our guide into the labs, where we observed the various tests which are performed daily on the water after treatment to ensure proper sanitation. Lab technicians perform chemical experiments and culture the water to ensure that water-borne diseases cannot be carried by the filtered water.

After learning so much at the treatment plant, the team jumped on the bus to escape the heat and then traveled, after lunch, to the Komfo Akoye Teaching Hospital to observe the patient intake process in the hypertension clinic. We watched carefully in small groups from the corner of each doctor’s office to see how patients are treated and diagnosed. The doctors see around twenty to thirty patients per day, but on worse days they can see up to forty, with around two being new referrals from peripheral clinics. After speaking with the patient, the doctor makes a prescription recommendation on the patient’s paper file and gives it to the nurse for further processing. Each patient has a paper book which contains all of their medical data and history since coming to the hospital, and they retrieve it from a records room every time they visit. When asked about digitizing the process, the nurses were surprisingly resistant, arguing that they already were used to the paper filing system and they do not have the proper training to efficiently use a computer to file records.

After a long day of observations, the team traveled back to the guest house to eat dinner. Over our meal of pizza , spring rolls, and ambiguous but delicious juice, we discussed the events of the day and refocused our project, ironing out a specific plan for how we want to design our program and creating a vision for its implementation. We went to bed exhausted from a long day’s work but motivated for the project developments to come.

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

by Aime Bienfait Igiraneza (Computer Science, ’20)

Operation: Relaxation…and laundry

Itinerary:

• Breakfast: Eggs, bread and tea. 8:30am
• Laundry
• Lunch at the Magnificent Foods
• Running (or more of walking in my case) and swimming at the KNUST university

After what was a fun, informative, but busy week filled with hospital and clinic visits and walks through communities (and not forgetting the activity-filled day we had before, of course), this Sunday was supposed to be the time to relax…and do laundry.

Our breakfast started a little later than usual. Though breakfast was ready at 8:30 am, most of us had a lazy morning in and came out to eat at 9:00 am. When all the team members were assembled before the usual omelet and tea breakfast, we decided to do an impromptu recap of the week and brainstormed on how we could adapt our initial project to fit the clinics and hospitals we had visited during the week. This session, as spontaneous as it was, became a good way for us to build on our observations from the week not just for the applications of our project, but for identifying certain problems that can become future projects for future APOC teams.

Keeping the theme of lazy Sunday in mind, we did not start laundry until late morning, around 10:30 am. This didn’t prove to be a very wise idea, especially since we were supposed to do laundry the old-fashioned way with water, a bar of soap, and our good old hands. Furthermore, there proved to be a shortage of buckets for all of us to do laundry at the same time, which didn’t seem to leave enough time before the bus was supposed to pick us up at 1:00 pm for lunch. Nonetheless, we bonded as we shared our buckets (who knew that manual laundry-washing was such a social activity) and we made it in time for lunch; also nothing a little adrenaline and team work couldn’t fix.

After laundry, we had lunch at the same restaurant we visited last Sunday: Magnificent Foods. The food was just as fantastic as we know it is in Ghana (the serving sizes are still too large for any of us to finish), but the most eventful thing was that the tailor came to take our measurements for the traditional clothes we are to wear to the King’s palace next Sunday. Everyone had their designs on their phones, their cloths bought from the market, and a bit of excitement on their faces as we saw our plans on the clothes being born. We anticipate receiving the clothes sometime this week. (Emotion check: beaming with excitement!!)

Once our long lunch meal was over, we decided to do a very un-lazy thing and went running on the KNUST campus before the sun set. This created another team bonding moment and we went swimming afterwards. This was the most memorable part for me because, though I can’t swim, I had my teammates with me and they taught me some basic swimming skills.

The rest of the night was very lazy. We played cards until late and each prepared for the week to come. (Emotion check: tired but excited to start the week.)

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

We started the day very early at 7:00 am with a drive to the Suntreso General Hospital where we were to visit Dr. Agyarko-Poku, a venerologist who would help us understand more about mother-to-child transmission of HIV/AIDS to aid in our study of noncommunicable diseases.

We arrived at the hospital, where the in-charge for the STI-OPD unit welcomed us and gave us a general overview of how events are run at the hospital’s HIV clinic which occurs on Wednesdays for adults and on Fridays for children. She gave us also an overview of how viral testing, data collection, and drug dispensary and treatment occur for the confirmed patients in the hospital. We got to see the relevant data points that were collected on each patient visit to help us better understand how well to modify our machine learning system.

We then went to the Disease Control Unit where the professionals there have the job of collating all hospital cases at the end of the week to identify diseases that are on the rise and have the potential to become public health concerns. We also got to understand more about how tuberculosis is diagnosed in the clinics and how treatment occurs for the disease. We found out also that drug-resistant tuberculosis has not been much of a problem for that particular hospital, contrary to what we thought. After this, we split into teams and went to visit the ART center, the counseling center, the dispensary, the data management room, as well as the consulting room where we got to interact more with the health professionals (i.e. nurses and pharmacists) in order to understand the processes that the patients have to go through from entrance into the hospital facility to diagnosis and the reception of their medication.

We left the Suntreso hospital and came back to KNUST where we had lunch before meeting with the civil engineers to discuss writing a report and making possible recommendations for the communities that we visited in order to improve their sanitation and water supply. We arrived at the Komfo Anokye Teaching Hospital’s Nursing Training School at about 2.30pm where we presented our Tuberculosis Triaging system to the students and received their questions which ranged from the usefulness of our algorithm and project to concerns about data contamination and invalidation. From KATH, we made a final run through KFC to grab dinner before making our way back to the guest house to enjoy our meal and conclude the day.

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

On this beautiful Tuesday, we woke up at our hotel to a lovely breakfast of sausage and pepper omelets. After our meal we loaded up on the bus to drive over to Aprade. On the way to Aprade we picked up our water and sanitation expert of friends: Sophia, Kingsley, and Alfred. We first stopped at Aprade Government School where we met with the entire population of the school to present a demonstration on hand-washing. After the presentation we took a tour of the school to survey their existing water and sanitation systems. We learned about their construction projects and about the school itself, which educates about six hundred students!

Our second stop was to the main village of Aprade. We were taken through the village and observed their rainwater collection systems and boreholes. We discovered the public and private boreholes around the village. Everyone was so hospitable and welcoming. Before continuing we took a quick break to eat lunch on the bus. The food was catered and we had a delicious meal of jollof rice and fried chicken. There was refreshing mango and ginger juice to cool us down from the hot day.

After lunch we drove over to Mmeswam. We were able to make an appointment with the Chief! He brought us into his home with welcoming arms; it was amazing being able to shake the chief’s hand. The chief showed us around Mmeswam and led us to his boreholes and wells. The main borehole pumps water to a large elevated tank. Underneath that tank is a pipe and valve mechanism where villagers come to collect water in large basins. The chief encouraged us to take the basin on our heads and try to carry some of the water. Ellie, Kyler and El were chosen among the group to test their strength.

From the boreholes we walked over to the village’s wells. The oldest well was spoiled and is unusable. The working well in the village was a traditional pulley system well. Several of our students cast the bucket and fished up some water. After our day of water we thanked the chief and hopped back on the bus. We drove back to campus, dropped off the graduate students at campus, and made a stop at the mall. We grabbed dinner at Game and quickly made our way home. It had been a long day so we chowed down on dinner and passed out for the night. A great and very busy day!

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

by Allaire Morgan (Electrical Engineering, ’22)

This wasn’t your typical 8:00 A.M.

The bus came and picked us up just after 8 and took us to the Kwame Nkruma University of Science and Technology (KNUST, for short) for our orientation to the program. We pulled into a small lot guarded by a fence and some old barbed wire to greet Professor Ellis Owusu-Dabo, a charismatic and accomplished professor in public health in Ghana. We were ushered to a board room where we began a meeting with Ghanaian students and professors. They sang their national anthem, and then asked us to sing the Penn fight song—which we learned the words to the night before in the hostel. Throughout the morning, we heard remarks from Professor Ellis as well as his distinguished colleagues regarding the program and introducing us to the university. Then we closed the session with a prayer, as is custom in a Christian nation such as Ghana, and went to have lunch and tour the university some more.

During our lunch break, I got the chance to chat with Kingsley, a Nigerian student at KNUST in the Water Supply Management program (the program gathers students from all over West Africa to train them as young “water professionals” to better combine ideas from across the region). Kingsley was very passionate about the field he worked in, explaining that about 90% of the issues related to public health and electricity in Ghana and the region at large were due to issues with the water supply—whether it be sanitation or accessibility in general.

As we toured the university by bus, I talked to Kingsley some more about water systems currently in place, to which he explained the role of politics in the amount of technology able to be implemented. “Trust me, we have the technology,” he exclaimed. “It’s just the will of the people, and the government, that prevent us from using it.” The government here is peculiar compared to that of the United States: Where we had always been focused on separation of state and church, religion and culture here serve as the two strongest influences on the government and their decision-making, which can serve both as a blessing and a curse in some cases like that of water supply funding.

We wrapped up our tour of the university, which looked verydifferent from Penn with its vast fields and cream-and-orange-colored buildings in all their glory. The afternoon session introduced us to the most prevalent medical problems in Ghana to date, as well as giving us a general idea of what the Ghanaian health system looks like. We were given guidance on our project which we had prepared during the spring, and then promptly sent on our way before the sunset, which abruptly ends each day around 6:30 P.M.