The Difference Of An Ear, Nose and Throat Practice in New Jersey and Rural Ghana

My ear, nose and throat practice in a teaching hospital in northern rural Ghana is different than when I practiced in community hospitals in New Jersey, USA. My patients now are younger. The 2019 median age here is 21 years, in USA, it is 38 years. Weekly we remove tracheal and esophageal foreign bodies and see caustic ingestions and stridor in children. 

Another difference is how poverty influences patient presentation and treatment.  Because of their concern about expenses, the patients or their parents first attend a local villager who has a reputation for health knowledge and only after worsening of the sickness and obtaining permission from the village elders, do they come to our hospital in late stages of diseases and in septic shock. Resuscitation is necessary before definitive treatment can be done. There are three dentist in northern Ghana and septic shock and deep neck abscesses from molar infections is common. We now have a maxillofacial surgeon who will extract the carious teeth which we previously struggled at doing. Frequently the patients and the hospital cannot afford their antibiotics and we buy their antibiotics using donated funds.

Somewhat similar to the USA practice is the trauma caused from road traffic accidents, which here is the leading cause of adult deaths. The motorcycles and old imported cars along with inexperienced, risk taking, fast driving teenagers result in many deaths and injuries. The police have to do a much better job.