About the International Health
Care Center (IHCC), a community clinic at Roman Ridge,
Since April 2003, I have been
working as a full time doctor at IHCC in Accra. My name
is Naa Ashiley Vanderpuye. I am 34 years of age.
I was born in the Volta region of Ghana. My father was
a Ghanaian and my mother a Dutch. We had a wonderful
simple life in Ghana untill my father suddenly died
of perforated appendicitis. My mother, left alone with
4 daughters and not working at the time, decided to
move back to Holland. All four children accompanied
Leaving Ghana so suddenly, at
the age of 14 and under those circumstances was not
easy. I had therefore promised myself that I would oneday
return to my motherland. The circumstances under which
my father died also motivated me. He, after being diagnosed
had to be operated upon immediately, but there wasnt
a surgeon around so he would have to wait for the next
day and that was just too long. He died in the early
hours of that morning.
My goal was to come back to my
country and help as much as I could. Medicine, before
then was what I was interested in, so I went on to do
just that. I was trained at the University of Nijmegen
in the Netherlands.
I completed my general medical course in 1998 and went
on to do tropical medicine, which I completed in 2001.
I then worked for a while in the Netherlands, as a senior
house officer at the department of surgery, then also
in Obstetrics and Gynecology and then in Pediatrics.
I visited Ghana frequently during
my school days and also during my working days and it
was in 2000 that I got in touch with Mr. Eddie Donton.
Mr. Eddie Donton, a Ghanaian by birth, left for the
States (California) at a very young age. He specialized
in Health administration and in 1996 he went fully on
his own when he started a Hospice called Care One Hospice
in Riverside California. Initially, this was for all
types of patients but it was at that time that the AIDS
pandemic was striking hard in the USA and so his Hospice
ended up receiving numerous numbers of AIDS patients
in the terminal stage. His work gave him a lot of experience
in the treatment and care of HIV/AIDS patients. During
his frequent visits to his family in Ghana he was continuously
confronted by the HIV/AIDS pandemic in Ghana. He therefore
decided to open up a similar Hospice as what he was
running in California. Initially his plan was to run
both places. During my days in Holland, I traveled to
Ghana once a year and on every trip, I tried to work
in different hospitals for the time I was in Ghana.
In 2000, I got in touch with Eddie and his work and
I was so fascinated by this that I promised him I would,
when I returned to Ghana, work with him.
In 2001 and 2002, I visited Ghana
again and I worked only with IHCC. I worked there full
time during my stay and it was then that we both noticed
that moving up and down between the States and Ghana
and the Netherlands and Ghana was not that easy. We
decided therefore to give our service full time to those
here in Ghana. Eddie closed down all he had in the States
and moved down to Ghana. In the meantime, my friendship
with Eddie kept on growing and we ended up getting married.
Since April 2003, when I came
down for good, we have been running both the Clinic
and the NGO. It all started with Eddies NGO, the West
Africa AIDS Foundation that deals with Educational issues
where HIV/AIDS is concerned. In the field of prevention
we were doing tremendous work but it did not take us
much too long to realize that we were also already dealing
with people with the HIV disease. There was not much
care and support for these people and that is when we
set up the clinic.
Because of stigmatization problem
in Ghana (all due to the fact that people have so little
knowledge about the disease), most of these people are
shunned by their communities and even so by people working
in the health sector. Getting the right care is a problem
for these people.
Our clinic therefore, was to give HIV/AIDS victims the
chance to get the right care. We have made it a community
clinic so it is open to the general public, but majorities
of our patients are HIV/AIDS victims.
Since my work here as a full
time doctor, I have encountered lots of challenges but
my motivation is the gratitude shown by my patients.
Although working here in Ghana cannot be compared to
what I was doing in Holland, the little I can do for
these people I am doing and the fact that they appreciate
it means a lot to me and keeps me going.
Currently, I am the only full
time doctor at the clinic. We have two other doctors
that work here parttime but because of financial constraints
and what they normally expect to be paid, we cannot
afford to have them work more than a certain amounts
of hours a week. The hours that we can also afford to
have nurses around is also limited, in the end meaning
that I do all the extra hours of the entire staff. I
have had my days that I stand there and feel very frustrated
and it has crossed my mind on several occasions then
to just run away, but then again the poor patients are
the ones that keep me going.
IHCC is now treating over 500
HIV/AIDS patients. These people are from the lowest
social ladder in our society and have very little or
no access to any kind of health care. Even transportation
fee is a problem. Many times, patients actually ask
us for some little money for them to be able to pay
their transportation back home. Food is also a serious
problem, financial constraints again being the main
reason. Most people cannot buy common fruits and a high
protein diet, what they do need is not part of their
diets. At our clinic we offer the in-patients free meals.
Occasionally it does happen that
we do not have certain medications and have to prescribe
these for the patients so they can buy it themselves
from the pharmacies in town. They mostly end up either
not buying these at all or buying just a few, at least
what the money they have can buy. This does not enhance
treatment and rather worsens it since in such cases
resistance easily builds up. Sometimes they show me
prescriptions they have been carrying for months, medications
that were prescribed by other doctors and what they
could not buy. People walk around with the same medical
problems for a long time because of this, only ending
up getting worse and even in certain cases dying.
At IHCC, most of our services
are free. Since we started our clinic, we have received
only one big funding solely for the treatment and care
of HIV/AIDS patients. This came from Barclays Bank Ghana.
In the proposal we estimated to treat about 200 people
with the disease with the money given, which was twenty
two thousand pounds but we ended up treating well over
400. With the funding, we are able to purchase medications
generally and frequently used in the treatment and care
of opportunistic infections, food supplements, which
is very essential, since most of the patients are malnourished
and cannot afford to buy the right food. We also use
part of the money in paying the staff and in buying
disposable items. We frequently have to squeeze here
and there but we manage to survive and carry on.
Our in-patient department is
the area that faces the most challenges. Most of the
patients admitted are either those with severe opportunistic
infections who have kept too long with consulting a
doctor or they are the terminally ill ones, shunned
mostly by their communities. Most of the time, these
people have had to take care of themselves and are brought
in when they are almost dead. For most of them, the
clinic is their last stop on their journey but at least
we try to give them a dignified death. It is mostly
palliative care with pain management and tender love
and care what we can offer them. Visits from family
members are a serious problem. Most of the time, the
family does not visit and take no part in caring for
these people. Many a time we have had to send corpses
to the mortuary without the family knowing this. They
are no where to be found. Also the families play no
part in giving advice in the management of the patients,
putting the whole responsibility on the clinic.
In some cases when the patients get better and have
to be discharged they do not want to go. Reasons being
that at the clinic, they have people to talk to, they
feel comfortable and at home they are going to end up
thinking too much and be shunned by the family.
Although stated on our brochure
we do not do surgery at the Clinic, one because we do
not have the right equipments in place and two we do
not have the right staff in place. It was initially
one of our plans and I think in future, being able to
operate at the clinic will be very beneficial. Since
my work here, I have lost three patients due to situations
like this. One patient fell and had a femur fracture
that needed to be operated. He eventually died. Another
woman with cholecystitis eventually died and another
with severe fibroids also eventually died. All three
never saw an operation table. Their HIV status being
the main reason. These were all young people, whose
lives could have been saved.
Problems we are facing now, are
the clinic lacks a lot:
Transportation: We are
very much in need of an ambulance and another extra
transport. The ambulance will enable us do our Home
based care programs, meaning visiting the people at
home. We are trying to encourage this as a means of
getting communities involved in the care of their loved
ones. It will also be used to transport patients from
the house to the clinic if necessary and from the clinic
to other hospitals for, for example, diagnostics and
also if we loose a patient to enable us send the body
to the mortuary. Currently, when we loose a patient,
we have to charter a taxi, which most of the times is
a burden. The taxi drivers charge a lot for this, if
they do agree to take the corpse and also getting some
of the bodies into a taxi is not an easy task and also
not a nice sight.
The other transport will be used to do our rounds. At
the moment we have to rely on only one car that is mostly
used for the NGO and charting cars every day is not
We also need help when it comes
to our laboratory, which is not functioning at
the moment. On the out-patient basis it is not a problem
for I have them do their tests (if they can afford)
at other laboratories. The in-patients are the problems.
The are too sick to be transported and we do not even
have the right vehicles to transport them and drawing
the blood here and having it analyzed elsewhere, we
have discovered is also not cost effective.
We also need funding to be able
to get one of the other doctors to work for some
more hours a day and a nurse for the night hours.
We also need a ward assistant who will be able to assist
the patients with the washing of their clothes and bowls
and also if necessary with the feeding. Then we need
to get at least one permanent cleaner for the
I am a hard working person, very
devoted to my job and who does not need much in life,
just a comfortable place to live and to be able to have
some small time for my family (we have a 1 year old
Currently, the workload is very high and it is because
I bare a lot on my shoulders. I am currently a doctor,
nurse, cleaner, all at the same time. I do not even
have a home. At the back of the clinic, we have a small
building, which is currently used partly for office
purposes and partly as a temporary home. I am therefore
around my patients 24 hours. I am doing my best,
but I believe, getting more hands to assist me, will
definitely improve services in the clinic and will also
enable us broaden our services to our patients.
No help is too small and I thank you in advance.
This is a short description of
the Clinic. We are also engaged in many other things,
which I will let, you have in due course.
Dr. Naa Ashiley Vanderpuye.