Ghana's first respiratory therapy students learn at KU Medical Center
December 18, 2018
By Greg Peters
The mission to make respiratory therapy an officially recognized profession in the West African nation of Ghana rolled through America's Heartland recently with a month-long stopover at the University of Kansas Medical Center. Here, the first soon-to-be graduates of the bachelor's degree program in respiratory care at the University of Ghana spent four weeks alongside their American peers in an educational and cultural exchange.
The trip came at the invitation of faculty members Karen Schell and Lisa Trujillo, from the KU Department of Respiratory Care and Diagnostic Science. The two have been instrumental in establishing the first college degree program for respiratory care in Ghana, while also lobbying the country's government to make respiratory therapy a recognized medical profession. The nine students and their adviser arrived in the United States Nov. 3 and departed Nov. 30.
"It's mind-transforming," said student Josephine Ama Korang Osei-Tute, during a break from classes in KU Medical Center's Health Education Building. "We have been exposed to a lot of things, and we've met people and had encounters that have all shaped our mentality one way or another. The experiences we've had here, the interactions, it's all absolutely priceless. It's one in a million."
"Being pioneers in a new profession has its challenges, and among these challenges is gaining a vision of how respiratory therapists function as part of a health care team," Trujillo said. "Although the students have been educated by exceptional physicians and perfusionists in Ghana, they have not been exposed to respiratory therapists working at the bedside. Their trip was intended to fill this void and give them essential time working alongside respiratory therapists. They also participated in numerous respiratory therapy courses and lab experiences."
Taking a chance
The idea for a respiratory therapy program in Ghana began in earnest as early as 2011 when Schell joined Trujillo, who was then teaching at Weber State University, on a trip to Africa after meeting her via email. The next year on their trip to Ghana, they met a pulmonologist who convinced them the country was in great need for respiratory therapists. Fortunately, Trujillo had pitched a similar concept in China, so the framework was in place for taking a shot at creating something similar in Ghana. By 2013, a collaboration was formed and a curriculum had been approved by the Ministry of Health and the University of Ghana.
The next major hurdle was getting students to take a chance on a program and a profession that had little foundation or track record in the country. Everything basically would be starting from ground zero. Osei-Tute and her classmate, Emmanuella Maame Bemaa Oduro-Yeboah, were in their second year in the School of Allied Health at the University of Ghana when they heard about the new program and decided to take what many saw as a big risk by joining up sight unseen.
"It was a big decision," Oduro-Yeboah admitted. "I went online and read things about respiratory therapy in the States. I found it was very interesting because I've always liked studying the human body, I just didn't want to do surgery or be a medical student. I thought respiratory therapy would give me an opportunity in a very nice way. To me, even though it was a challenge when we had nothing, I believed something special could come out of it.
"People in Ghana were like, ‘something new is coming up, you don't even know what this country is going to treat it as," she continued. "It's a health profession, yes, but how is it going to thrive in this country? Nobody knows.' But I believed, especially since it was spearheaded by people who were in the industry."
More than pioneers
While these students are bravely carving out a path for those who follow, referring to them merely as pioneers is a bit of an understatement. The students have navigated numerous challenges and more lie ahead if the respiratory therapy gains a permanent place in the Ghanaian health system. The need for respiratory care is obvious. Currently, doctors and nurses take care of patients with respiratory needs in a system that sees doctors frequently tending to care beyond their specialties and patient-to-doctor ratios running as high as 10,000 to 1.
During his visit to KU Medical Center last year, Ghanaian doctor Alfred Aidoo noted that it would be a blessing to have respiratory therapists to take care of common conditions such as asthma, chronic obstructive pulmonary disease and children born with respiratory distress. Since meeting Schell and Trujillo, Aidoo has been their eyes and ears on the ground in Ghana as they worked to gain status for respiratory therapy from both the government and the medical community.
"Being pioneers is 100 percent important because we are fighting a system that doesn't understand or appreciate why we exist," Osei-Tute said. "We need to go back and explain it to them. You start from the fact that 11 percent of deaths are from respiratory-related infections."
At a time when these students are still gaining confidence in their own abilities as respiratory therapists and learning about its intricacies, these nine fresh faces will be called upon to not only define how respiratory therapy fits into the established health care system, but also to champion the cause of a medical discipline that is unfamiliar to much of Africa.
Because there is no set framework in place to guide the development of the profession from its infancy to a fully integrated part of the medical system, these first students can expect a lot of growing pains along the way. Many basic decisions will need to be made regarding medical regulations and practice procedures involving respiratory therapists, along with things like establishing working hours, treatment expectations and compensation. They also will need to convert critics who doubt the novice's abilities and those who might question why the profession is needed at all.
"Lisa told me, ‘people who work hard or make changes are recognized by other hard workers or change-makers, so all you have to do is excel at what you are doing, and the little groups that see your effort, your input, your progress will share your message,'" Osei-Tute said. "It will be like a telegraph wire spreading your message all over the place. Before you know it, somebody outside of Ghana will know about it, and their voice will be the one to send signals to the rest of the countries.
"Little drops of water make a mighty ocean."
In Kansas City, the Ghanaian students have worked alongside their American peers in the classrooms and labs learning information that will be vital to their practices in Africa. Because many modern respiratory machines and aids are not available in Ghana, the ability to improvise but still maintain quality patient care is one advantage the visitors have over their American counterparts.
"Back at home, we don't have all the equipment, and we don't have the protocol, so you have to think on your feet," Osei-Tute said. "You have to put things together fast, smart and efficient. At home, we learn how to do things without equipment, and the patients can still survive."
Snowballs, mac ‘n' cheese and change
It only took two years of training, a mountain of politicking and a 24-hour flight from Acara, Ghana, for the students to make it to KU Medical Center. New weather. New fashions. New food. Nothing was the same as at home, but it was all part of their big adventure.
In addition to witnessing their first blizzard and engaging in snowball fights, the trip included a a tour of the National World War I Museum, and a visit to Schell's family farm near Marysville, Kansas, where they learned about American agriculture. They concluded their visit by giving thanks to everyone involved during a meeting of the School of Health Professions faculty, serenading the group with a song.
"Snow is a fun thing now that we are used to the weather," said Oduro-Yeboah, who said her favorite American food is mac ‘n' cheese. "We went to the World War I Museum, and we now have a different perspective about civilization and the relevance of change and growth. It only takes a moment or a day to cause significant change in a nation or in somebody's life."
Change in the case of respiratory therapy will begin in Ghana with nine students who dared to take a chance on something new and unproven, but could someday soon improve the health of many people in their home country and perhaps all of Africa.