adventures in Lom, Togo Audrey Coventry Le Togolais chante quand il - - PowerPoint PPT Presentation

Clinical Shadowing and other adventures in Lomé, Togo

Audrey Coventry

Fast facts:

Capital: Lomé Population: 7,756,937 (40% urban) Languages:

• French (official)
• Ewe and Mina (in the south)
• Kabye/Kabiye and Dagomba (in the north)

Religions: Christian 29%, Muslim 20%, indigenous beliefs 51% Physician density: 0.05 physicians/1,000 population Fertility rate: 4.43 children born/woman Median age: 19.7 years Literacy (age 15+): 66.5% (male 78.3%, female 55.3%)

https://www.africaguide.com/afmap.htm http://www.operationworld.org/country/to go/owtext.html

“Le Togolais chante quand il est content, alors il chante toujours”

• The Togolese sings when he is happy, so he is always singing

Recent government history in brief

• Gen. Gnassingbe EYADEMA ruled Togo as a military dictator for ~40yrs
• After his death in 2005, his son took his place
• In 2007, democratic progress led to the first relatively fair election
• Faure Gnassingbe remains president of the presidential republic today

Togo is a developing nation, and is a safe and stable country compared to many of its neighbors in sub-Saharan Africa

https://commons.wikimedia.org/wiki/File:Flag_of_Togo.svg

Polyclinique Saint-Joseph

~100 beds (KU has 713) 3 stories, 7000 m2 Laboratory services:

• Biology
• Hematology
• Parasitology
• Pathology
• Bacteriology

The nicest (and most expensive) hospital in Togo

Medical services:

• Surgery
• Pediatrics
• Emergency medicine
• OB-GYN
• Ophthalmology
• Internal Medicine
• Dermatology
• Neurology
• Nephrology
• Medical Imaging
• Kinesiotherapy

Why Lomé?

• Personal interest in international medicine
• Personal desire to travel somewhere new
• Family connections in Lomé
• My uncle Franck teaches at the French high school in

Lomé

Why Polyclnique Saint Joseph?

“Ce n’est pas la réalité” (It’s not reality)

• Closer to American hospital standards
• The doctors didn’t want to scar me by going

straight to the CHU

My 2-week experience

1 week of shadowing

• Surgeries
• Laminectomy
• Hematoma resection
• Hospital rounds
• Pediatric office
• Neurosurgery office

Tour of the CHU Sylvanus Olympio

• Largest public hospital in Togo
• The teaching hospital of Togo

1 week of Togo tourism

Unexpected clinical realizations

Provided at KUMC Provided at PSJ

Hand sanitizer

 

IV bags and tubes

 

Drinking water

 

Food and patient meals

 

Blankets

 

Procedure gloves

 

• Everything is BYO at Polyclinique

Saint Joseph

• IV bags, vaccines, etc. are

bought at the pharmacy, then taken to clinic/hospital

• The doctors administer shots,

IVs, etc due to insufficient nursing staff

• Families of patients provide all

food, water, and other essentials

• Patients are billed for

everything, including gloves and wipes

Double-take moments

• “I’ve had the same IV for 5 days, can I get a new one?”
• “We’re out of mosquito nets, why didn’t you order more?”

“People steal them”

• The doctor called to a random guy on the street from the balcony to

fetch me a bottle of water

• One of the rooms with 4 beds: No curtains, one topless female patient,
• ne male patient on dialysis getting fed by a nurse using her fingers for

silverware

• No hand-washing between rooms on rounds

Touring the CHU (public and teaching hospital)

“If you learn here, the rest is easy” “we have every specialty and good doctors, we just don’t have enough equipment”

• Largest and arguably best public hospital in Togo
• The teaching hospital for Togolese medical students
• All medical specialties represented
• Extremely dirty and run-down by our standards
• Dozens of beds per room in the pediatric ward
• Doors to the OR didn’t shut properly
• Trash everywhere between buildings
• Not enough linens
• Most window screens broken
• Much of the equipment old and rusted and/or malfunctioning

https://maximedomegni.wordpress.com/tag/chu-sylvanus-olympio/

The CHU

http://renaudossavi.mondoblog.org/2015/02/16/greve-au-chu-sylvanus-olympio-la-determination-des- grevistes-le-desespoir-des-familles/ http://www.freiwilligendienste-afrika.de/big_photo_gallery/ http://www.27avril.com/blog/culture-societe/sante/chu-sylvanus-olympio-maternite-les-femmes-obligees- daccoucher-a-meme-le-sol-faute-de-lits

Pregnant women sleeping on the floor in the maternity ward Crowded beds Representative of the state of much of the equipment and infrastructure

Cool cultural things: Tamberma village

• UNESCO World Heritage site
• They have kept the same style of hut

and village complex for thousands of years

• The first

ancestor of the village Presumably lived in a hollow Baobab tree

Top: Children of the Tamberma village with 2 of the many huts Left: Me inside of a hollow Baobab tree

Cool cultural things: Peuls nomads

• Nomadic people that live

throughout sub-Saharan Africa

• Ethnically, linguistically,

culturally unique distinct from the Togolese and other tribal groups

• The Togolese believe they can

do magic

Cool cultural things: Lots of villages

Young boy helping sift his flour at the village mill

Cool cultural things: artisans, Obama, and terrifying road adventures

Cool cultural things: Religious diversity in harmony

Christianity, Islam, and the world’s largest Fetish market

http://www.flyingfourchette.com/2013/12/23/lome-togo/

References

• https://www.cia.gov/library/publications/the-world-

factbook/geos/to.html

• http://www.countryreports.org/country/Togo.htm
• http://mtn-togo.org/?p=1438

My sincere thanks to my aunt and uncle for hosting me, to Dr. Jacques Amegnito and the medical staff at Saint Joseph for their kindness and unparalleled hospitality, to Dr. Theo for giving me a tour of the CHU, and to Anatole and Corrine for providing the opportunity for this once- in-a-lifetime cultural adventure