U-M delegation travels to Ghana to witness impact of health mission

Efforts to curb maternal mortality rates are a key aspect of the mission to Ghana

ANN ARBOR, Mich.- Giving birth -- while a momentous occasion -- is not generally a life-threatening event for a mother in the United States.

That's not the case in the rest of the world. More than 342,000 women worldwide died in 2008 from pregnancy or childbirth - a rate that's decreased from 526,000 in 1980, according to a study released this month funded by the Bill and Melinda Gates Foundation.

But the new rates still are unacceptably high, experts say.

High maternal mortality rates are the reason the University of Michigan Health System became engaged in a health initiative in Ghana more than 20 years ago.

According to UNICEF, the annual maternal mortality ratio in Ghana in 2008 was 450 deaths per 100,000 live births, compared to 8 in the U.S.

While the program is growing in many other disciplines, its main goal still lies squarely in reducing maternal deaths, says  Timothy R. B. Johnson, M.D., chair of the University of Michigan Department of Obstetrics and Gynecology and the program's founder.

"Our main goal is to reduce the maternal mortality rate," says Johnson.

The program will be the subject of a trip next week for faculty, alumni and community members - the first trip of its kind. The group will travel there May 1 to 9 and will visit teaching hospitals, medical schools, government agencies, as well as meet with students, residents, post-graduates and faculty.

"We want to show the group the depth and breadth of Michigan's involvement in health education in Ghana," Johnson says.

One of those partnerships is with the Ghana Postgraduate Training Program in Obstetrics and Gynecology. The five-year residency program was created in 1989 with the purpose of training Ghanaian medical students to become OB/GYN physicians.

Medical students in Ghana work in conjunction with the Safe Motherhood Initiative, which was created to help Ghanaian women with complications during pregnancy and childbirth.

Johnson, who has been traveling to Ghana since the 1980s and has visited there over 30 times, has spearheaded a physician education effort that now includes specialty training at the University of Ghana Medical School and the Kwame Nkrumah University of Science and Technology.

Since 2004, up to four students have been exchanged between the University of Michigan Medical School and the two schools in Ghana. In 2008, 12 medical students a year from both schools began to do senior clerkships in Michigan. Over 60 Ghanaian students have been trained in Ghana, with nearly all of them opting to remain in the country after completing their residencies.e

The initiative began in 1986 after the Carnegie Corporation invested funds there in an effort to build international medical capacity and improve maternal medicine.

Multiple organizations, including the Carnegie Corporation, the Royal College of Obstetricians and Gynaecologists, the American College of Obstetricians and Gynecologists, the Ghana Management Committee, and the University of Michigan, established specialty training programs in Ghanain the mid-80s to improve health conditions there.

Another of the health initiative's goal is to raise educational standards in Ghana and implement a better system of teaching.

"Medicine in Ghana, even though it's very different, it's still good medicine," Johnson says. "However, their education system needs to catch up to ours. In Ghana, we're trying to change the old system of trying to fail as many students as possible, to a current system where we hold teachers more accountable for the mistakes that are made."

Other areas that need to be improved include pediatrics, family medicine and urology, he adds. Johnson believes bringing visitors to Ghana will expose them to conditions they may not be familiar with.

"You see diseases you'd never see here, consequences of lack of resources, mothers dying every day from childbirth, women dying from illegal abortions, pediatric cancers advanced to a stage you'd never see here," Johnson adds. "People come back with a different view of the world."

Bringing visitors on this trip will help show the improvements in health care that have resulted from U-M's work and generate interest in future projects.

"(U-M President) Mary Sue Coleman went to Ghana with us two years ago and described her trip as a transformative experience," says Jennifer Edwards, U-M Children's and Women's Health Senior Gift Officer. "We want to get people excited about our efforts, to see the partnerships we've formed with the people of Ghana."

U-M alumni and other community members that will travel to Ghana are paying their own way. Many are participating because they are interested in learning more about U-M's commitment and impact on global and women's health.

"We reached out to some of them, while others volunteered to participate in this experience," Edwards says. "We're trying to recruit ambassadors in the hopes that their passionate testimonies will help break new ground. Developing networks can help us meet our objective of growing this program."

Johnson hopes that increased enthusiasm about the project will lead to more funding for endeavors in Ghana.

"Our goal is to develop an endowment so exchanges can be permanent," he says. "If we get an endowment, we can keep sending medical students from the U.S. to Ghana on a regular basis and continue to build the program."

Timothy R. B. Johnson, M.D., chair of the University of Michigan Department of Obstetrics and Gynecology:

Written by Margarita Bauza and Thad Green

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