To be effective in providing medical help in the developing world, it is necessary to be on-site full time. Even though I had already come to this realization from working on-site full time in Ghana for the past fourteen years, it was further demonstrated when I returned from an absence of two years due to the COVID pandemic. Among the clutter and general disorganization of equipment and supplies, I found three fiber optic endoscopes destroyed by not sterilizing with 2% formaldehyde, but instead using parasol after being clearly instructed that this would do harm, two non-operative ear drill handles, a malfunctioning camera and flashlights, otoscopes and pulse oximeters not being used due to lack of batteries. On a personal level, our rented house was dirty even though a cleaning woman was paid monthly during our absence and water pumps, toilets and lights all needed repair.
An ongoing presence is essential to resolve problems as they arise and to ensure a consistency of an effective and well run medical facility.
