One Happy Family And "Tuck In Those Mosquito Nets"

                           Excellent Anesthesia

                   Donated Karl Storz Telescopic Forceps

          Groundnut (Peanut Shell) which blocked his trachea and breathing.

   The happy mother and child the day after the removal of the obstructing groundnut (peanut) shell.

             This past Wednesday morning we were to perform the first laryngectomy and neck dissection in northern Ghana. At eleven o’clock the evening before, we were called to the hospital for a three year old child who aspirated a groundnut shell into his trachea causing him severe airway obstruction. The peanut shell was successfully removed with the help of donated Karl Storz telescopic forceps and a Project Cure video monitor and camera. The child’s family was overjoyed at the remarkable life-saving outcome for their child and subsequently thanked us several times. After finishing this case at four am, I was unable to retrieve my house keys due to a faulty clinic lock, so I slept in the hospital until 7 am, ate two cartoons of cookies, drank two cartoons of juice and performed the laryngectomy, finishing that evening at 7 pm.
Northern Ghana is presently in its rainy season, with 76 degree Fahrenheit temperatures, many mosquitoes and numerous patients with malaria. Malaria worldwide kills one person every two minutes. Here ninety percent of the mosquitoes carry the malaria parasite and can inject one thousand malaria parasites into you with each bite. Only one malaria parasite has to survive to result in a person getting malaria. For a week I had been bitten four times a night until a visiting  guest mentioned that they tucked their mosquito net under their mattress and when I did the same, there were no longer any bites and I had a restful night’s sleep. The only reason I do not have malaria is due to my daily anti-malaria malarone.

Severe complications resulting from untreated minor disease

As expected in a place with few dentists and one physician per 27,000 inhabitants, our patients present late with severe complications from tooth infections resulting in airway obstruction, neck abscesses and septicemia. Other diseases which progress to severe complications due to the lack of health personnel are: 1) Nasal polyps resulting in sinusitis, brain and forehead abscesses, 2) Laryngeal, sinus and parotid tumors which are no longer curable and 3) Untreated congenital cleft lips, palates and cysts. Our acute cases are trauma from road traffic accidents, falls from trees, and foreign bodies in the lungs and esophagus.

The necessity of drug regulation was evident by a boy with a sore throat who took a local medicine and began bleeding from several sites, resulting in his death.

There are only two headlights for eight examiners. We ordered six portable camping headlights hopefully to be brought over today by a visiting otolaryngologist. There are an additional four headlights in a container which should arrive in two months.



Untreated tooth infection which spread to the neck.



Untreated nasal polyp which lead to sinusitis and brain abscess.

Recently, we heard an excellent lecture on macular degeneration by Professor Chapman, a visitor from the University of Louisville. Macular degeneration, which usually develops later in life and responds to vitamins, is not common in Ghana because the life expectancy here is 56 years.

What one man can do, the birthing hole

Eighteen kilometres north of Tamale, the farmers earn 50 cents a day. Here there has traditionally been a high infant and maternal mortality rate until a young physician introduced a local custom into the hospital. He noticed the pregnant mothers were not attending the prenatal clinic nor choosing to deliver in the hospital. He also learned that there was an unpleasant nurse who was working there. The nurse was eventually fired, but still the pregnant mothers did not come. When the physician visited their homes, he discovered that the women deliver while squatting over a “birthing hole” in the floor. The birthing hole is the size of a basketball, flush with the floor. He then decided to place birthing holes in the hospital delivery room and the woman now come, resulting in a great reduction in maternal and infant mortality.


He also eliminated their custom of dealing with malnourished children who were thought to be punishments from God. The mother would steal away to the forest with the malnourished infant in a shawl on her back, run and loosen the shawl, allowing the baby to fall to the ground. The woman would then return running to the village, not looking back for she believed if she did so, her next child would also be malnourished. A malnutrition center was built to care for these children and it was made to resemble the village’s own compounds. The women were amazed at the resulting weight gain and improved health of the malnourished children. They have come to understand that help is available and now bring their malnourished infants into the malnutrition center, no longer leaving them to die in the forest.

Obtaining Needed Medical Equipment

Currently I am home in New Jersey and have obtained needed medical equipment from various companies and organizations. This equipment increases our ability to save lives, results in less patient pain and a faster recovery.  Donated funds have been used to purchase supplies and repair broken instruments.

Anspach-Synthes, Karl Storz, Smiths Medical, Designs for Vision, Carl Zeiss, Jedmed, Corvidien, Orthocare, Johnson and Johnson, ArthroCare, Dale, Boston Medical Products, Becton Dickenson, Medtronic, Ortho-McNeil-Janssen Pharmaceuticals and Surgitel have generously donated equipment.

The American Academy of Otolaryngology-Head and Neck Surgery Foundation, Catholic Medical Mission Board, International Aid, MAP International, AmeriCares, Medicares and Precision Instruments have forwarded their donated medical equipment and supplies.

Very dear to my heart is the promise of Starkey Labs to visit Ghana this year to disperse several thousand hearing aids to the children in the schools for the deaf and to our patients.  None of these children have hearing aids.  Our ear, nose and throat department will visit the schools for the deaf, clean the children’s ears and take ear impressions in preparation for the fitting of their hearing aids.  A microscope is sorely needed to adequately and painlessly clean their ears and I am confident our medical manufacturers will contribute if it is at all possible for them to do so. With a team effort, so much can be accomplished.

A Good Month

Amidst problems and conflicts, a child life was saved in the past few weeks.  So, overall it was a very good month.

A girl of twelve, who always had a hoarse voice, presented with severe airway obstruction of two weeks duration.  The girl was disorientated and was not going to live through the night.  At surgery, papillomas were grossly removed from her larynx enabling her to breath and thus to survive.  The papillomas were caused by a viral infection that was obtained from her mother during childbirth. These papillomas will recur since they cannot be removed totally and there is no cure.  She may need a tracheostomy.

I am presently home in the US enjoying my family and the holidays until January 19^th. I have gained six pounds in ten days - so difficult to stay slim in our affluent environment.