by Kaila Helm, Biological Basis of Behavior ’20; Kathleen Givan, Bioengineering and Political Science ’20; Katharine Cocherl, Bioengineering ’20; Hope McMahon, Chemical and Biomolecular Engineering ’18; and Dave Pontoriero, Biotechnology MS ’18
A set of classrooms within the campus of Achinakrom Senior High School (ACHISS), a rural high school in 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.
Dr. Miriam Wattenbarger tutoring a class on soil conservation.
Today was a day of reflection. To our great sadness, two of our fabulous leaders, Dr. Issadore and Dr. Ocek, left early this morning. We then split into teams to work on our projects for the remainder of the early afternoon. Given our newfound knowledge of the Ghanaian healthcare infrastructure and the standards of care for tuberculosis-related symptoms, our designs were altered to optimize their value. It was interesting to pull up our old classwork from Philly and realize how much it needed to be edited.
Penn student Jason Grosz discusses the math curriculum with a teacher of Achinakrom Senior High School (ACHISS).
Following our intense project meetings, the group shared a lunch of ground nut soup and rice balls, one of our favorites. The advantage of cooking food ourselves is that we can tolerate the spice level and learn how to cook another delicious meal ourselves. We then left to do our community service at the rural high school we visited last week, Achinakrom Senior High School (ACHISS). Each APOC student led a class on a topic of interest to both him- or herself and the class. The focus of these classes spanned mathematics, science, and English. It’s a great opportunity to learn more about the Ghanaian education system and talk to more of the students about their day-to-day lives, while exposing us to the problems faced with both cross-cultural communication and teaching.
Penn student David Pontoriero tutoring a classroom filled with high school students attending Achinakrom Senior High School (ACHISS), a rural high school in Kumasi.
After returning home, we enjoyed a relaxing evening. One highlight was trying a traditional Ghanaian snack, mashed fante kenkey, which was prepared by our trip leader, Nana. (We love you Nana!) We ended the night with a group ab workout, a roundtable discussion, and yet another fun-filled team-bonding activity. It was a good day!
A group of students studying French at Achinakrom Senior High School (ACHISS).
by Danielle Tsougarakis, Bioengineering ’20; and Kate Panzer, Bioengineering ’18
The majestic ram that was given to King Otumfuo Nana Osei Tutu II as a greeting gift.
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 had the honor of meeting Otumfuo Nana Osei Tutu II, the current Asante (also spelled Ashanti) king. The Ashanti Region is one of Ghana’s 10 administrative regions and expands across the southern part of the country. Once a large empire, the Ashanti kingdom now serves as a state union. After getting off the bus, we walked through the scenic palm tree-lined palace grounds, observing beautiful peacocks roaming the gardens. We entered the historic Asante museum and toured through generations of leaders, seeing sculptures of past kings, ancient artifacts, sacred Kente cloths, and more. Afterwards, we gathered outside the king’s palace, awaiting his presence. Many guests were dressed in their finest traditional African garb. We donned our vibrantly colored dashikis and other newly acquired traditional clothing. Groups of guests went up to the king and presented him with various gifts. Our group brought some high-quality Coca-Cola and Malta beverages, while other groups garnished him with bottles of wine, spirits, and even a large majestic ram. We all had the opportunity to individually bow to the king and shake his hand.
The APOC crew visiting the Asante museum in Kumasi during our opportunity to meet the king. Dr. David Issadore is centered as he signs a book to document our visit (Left to right: Jason Grosz, David Pontoriero, Salim [KNUST student], Professor Ellis, Kaila Helm, Hope McMahon, Dr. David Issadore, Danielle Tsougarakis, Ethan Zhao, Dr. Miriam Wattenbarger, Benjamin [KNUST student], Kathleen Givan, Katharine Cocherl, Kate Panzer, Nana Yaa, Dr. Ocek Eke).Following our royal visit to meet the king, we returned to KCCR and attended to our laundry and assignments. Some of us went for a run before dinner and got caught in a torrential downpour. We have come to know that such rapid onset of rain is quite common in Ghana, particularly during the rainy season. Despite the quick change in weather, the rain was cool and refreshing as we ran throughout the expansive campus.
The APOC crew posing at the Golden Tulip hotel in Kumasi. (Left to right: Dr. Miriam Wattenbarger, Dr. David Issadore, David Pontoriero, Danielle Tsougarakis, Benjamin [KNUST student], Uncle Ebo, Hope McMahon, Kaila Helm, Ethan Zhao, Kathleen Givan, Katharine Cocherl, Jason Grosz, Kate Panzer, Nana Yaa)In the evening, we had our own feast fit for royalty at a fancy hotel called the Golden Tulip (shout-out to Dr. Eke for the special connection). The restaurant in the hotel reminded us more of a Western-style arrangement, with a wide variety of international food, including salad, noodles, squid, and fruit, along with American pop music playing lightly in the background. Even dessert was served, including caramel flan, red velvet cake, and cheesecake, which is a rare sight in Ghana.
by Kaila Helm, Biological Basis of Behavior ’20; and Hope McMahon, Chemical and Biomolecular Engineering ’18
During the seven-hour drive from Mole National Park to Kumasi, students take the opportunity to catch up on their Zs.
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 ended our three-day trip to Mole National Park. For breakfast, we had omelets and toast with some spread for bread and jam paired with our usual combination of coffee, tea, or Milo (Australian chocolate milk). After packing up the bus with water in hand, we set out for another long car ride (but not before seeing some elephants swimming in the lake and baboons leisurely walking around the property). On the way back to Kumasi, we stopped at a rest stop to use the washroom and have another delicious Ghanaian meal. Some ate jollof rice and chicken; others were more adventurous with goat and fufu with peanut soup. After our long journey, we arrived back to KNUST, pleasantly surprised by the petrichor and rainbows after a brief burst of rain.
A few of us decided to take a walk around campus, stopping by a convenience store and walking around the Guss Hostel. When we arrived back at KCCR, we soon learned we would be joining Dr. Ellis for the evening. After greeting Dr. Ocek Eke, we all ran to our rooms to quickly change. We headed to dinner. There we tried different combinations of smoothies, with a fútbol game projected on a screen in the background. We ate a lot: chicken kebabs, gizzard, liver, joloff rice, fish, and even some French fries. To end our jam-packed day, we headed back to KCCR, greeted at the door by a praying mantis.
by Jason Grosz, Bioengineering ’19; and Ethan Zhao, Bioengineering ’19
Penn students have a close encounter with two friendly elephants in Mole National Park. (Left to right: Jason Grosz, Kate Panzer, Hope McMahon, Kaila Helm, Danielle Tsougarakis, Kathleen Givan, Katharine Cocherl, Nana Yaa, Ethan Zhou, David Pontoriero, Benjamin)
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 set out on a 7 a.m. morning safari drive in Mole National Park. We rode on seats built on the roofs of Jeeps and drove along dirt roads dodging trees and spotting animals, such as cobs and wart hogs. A safari guide accompanied us on the roof to give directions to the driver, and the guide carried a large rifle in case an encounter with an animal went south. The highlight of the safari was running into two elephants right outside a building complex in the park. We saw two young males, one of which visited so often that park employees had named it Nash, and they were feeding on the wild mint plants that grew in the park. The guides told us that there were many such frequent visitors and that many of the elephants were named, a testament to how cordial the relationship between the park and the elephants was. They suspected that the elephants were just as curious of us as we were of them — as soon as we left, the elephants left the building complex as well. By the time the safari was over, it was around 11, and after lunch, we jumped into the pool as a reprieve from the blistering 100°F weather.
Local members of the Bmognorie village in Mole perform a traditional dance.
After lunch we visited a traditional African village named Bmognorie near Mole National Park. The village had a population of around 420 people who all lived in mud huts. Polygamy is practiced in the village, although monogamy is more common, and most families have around ten children. Our tour guide told us about life in the village and demonstrated how the villagers make shea butter, which can be used as a skin cream. He also said that sick villagers must travel on the back of a motorbike or bicycle for 30 km to reach the nearest clinic. The nearest hospital was 40 km away. After the shea butter demonstration, we watched and participated in traditional Ghanaian celebratory dances. Most of the dances featured everyone arranged in a rotating circle with complicated foot movements.
After the dances, we played with some of the children in the village. The children’s favorite game was to quickly roll bicycle tires with sticks for as long as possible. Although we tried to play with them, we were not nearly as talented and could not roll the tires for as long as the children could.
A young boy plays a popular game within the village of Bmognorie in Mole. From our observations, this particular child is the reining champion of bicycle tire rolling.
by Kaila Helm, Biological Basis of Behavior ’20; and Hope McMahon, Chemical and Biomolecular Engineering ’18
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.
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.
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.
by Danielle Tsougarakis, Bioengineering ’20; and Kate Panzer, Bioengineering ’18
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.
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.
by Danielle Tsougarakis, Bioengineering ’20; Jason Grosz, Bioengineering ’19; Ethan Zhao, Bioengineering ’19; and Kate Panzer, Bioengineering ’18
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.
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.
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.
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
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.
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!
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.
by Danielle Tsougarakis, Bioengineering ’20; Jason Grosz, Bioengineering ’19; Ethan Zhao, Bioengineering ’19; and Kate Panzer, Bioengineering ’18
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.
Students lining up for a dinner of fish, boiled plantains, (white) yams, and palaver sauce.
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
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).
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.
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.
