The recent transfer of a mammogram machine from Sanford Worthington Medical Center in Minnesota to a clinic near Accra, Ghana – a trek of about 6,000 miles involving several modes of transportation – reminds us that Sanford Health’s impact in this West African country does not sit still.
In terms of patients cared for and services offered, it is an evolving legacy.
Sanford facilities in Ghana now go well beyond a conventional definition of what we know as clinics. More accurately, Sanford Health offers outpatient and specialty services designed and maintained to meet the needs of the communities they serve.
With the updated mammogram machine, Sanford is now providing access to early detection services with diagnostic imaging, a crucial addition in a region where late-stage diagnoses are common.
In a very real way, it is aligning with part of the Sanford value of courage. The Ghana initiative continues to be an opportunity about “having the strength to persevere, problem solve and take action.”
A little history
The Sanford World Clinic initiative started in 2007 through a transformational gift from Denny Sanford with the goal to provide sustainable health care infrastructure that would last for generations.
In 2012, Sanford Health established a presence in Ghana and formed a relationship with the Ghana Ministry of Health.
The alliance continues in this country of more than 35 million people with a key piece being that, unlike many of the private health care options in Ghana, these Sanford locations do not turn anyone away based on ability to pay.
Photo by Lonnie Nichols, Sanford Health
Sanford locations have served more than two million patients in the years since then in Ghana.
“Sanford Health offers quality care in very clean environments,” said Kwaku Darkwa, M.D., the vice president/country director and chief medical officer at Sanford World Clinic. “Our people are poor and the health care system overall has a lot of inefficiencies and gaps, but the quality of care is similar to what we offer here in the United States. It’s not exactly the same, but it is similar. I think that is really comforting.”
Sanford’s presence in Ghana took a paradigm-shifting step in 2019 to add labor and delivery suites as a service.
Since 2012, Sanford Health’s ability to reach people in need of care has included these major additions:
- Specialty and support services, including ophthalmology, internal medicine, retail pharmacy, and expanded laboratory services.
- Transition from daytime to 24/7 outpatient care with overnight stays.
- Launch of surgical services, including a surgical theatre, pre- and post-op areas, and private and shared inpatient rooms.
- Strengthened public health partnerships that have led to robust vaccination efforts.
“We’re technically not a ‘hospital’ because you need to have certain criteria locally to meet hospital status, but we can have patients stay overnight,” said Karoliina Slack, vice president of World Clinic. “Our locations in Ghana are more than clinics. More accurately, I’d call them ‘outpatient centers.’”
Mammogram donation
The addition of the mammogram machine is an example of seeing a need and addressing it. Gaps in care are being filled. Lives are being saved.
“About 50% of the women who get diagnosed with breast cancer in Ghana end up dying because it was discovered too late,” Slack said.
At a recent fundraiser in Sioux Falls, South Dakota, Slack spoke with a woman from Ghana who works at Sanford. She and her sister told Slack about how they had lost their mother because she had advanced to stage 4 cancer before she was diagnosed.
“It’s something that is hard for many of us to understand,” Slack said. “How is that even possible in today’s world?”
There are less than two dozen mammogram machines in the whole country, Slack explained, and many of them are not functioning much of the time due to breakdowns brought on by climate and infrastructure challenges.
Photo by Lonnie Nichols, Sanford Health
The machine from Worthington was launched at the Sanford Adenta Clinic, enabling mammogram screenings, diagnostic imaging, and biopsy services. It is helping to catch cancers earlier.
“There have been a lot of screenings in this short number of months that we’ve had the mammogram machine,” Dr. Darkwa said. “October was a Breast Cancer Awareness Month, and you should see the traffic that turned out to Sanford because the mammogram machine is there. It’s been beneficial because some of the cases have proven to be cancerous, and referrals have been made to higher centers. The impact is already being seen.”
The presence of the mammogram machine fits in well with Sanford’s continued efforts in expanding its scope from primary care to a more comprehensive health system. What we would view as essential supplies in health care here in the U.S. are sometimes in short supply in Ghana. When made available, they make a dramatic impact.
A case in point: Sanford spearheaded an HPV vaccine effort with the help of philanthropic donors. They then combined that with Samaritan’s Feet International distributing shoes.
“We went to the schools and provided education for the teachers, with the government sector, and with the parents,” Slack said. “We created a model where pretty much all the kids showed up to school on the days that we were there to give them the HPV vaccine, along with Samaritan’s Feet giving out shoes. This model was a sort of a pilot. … We paved the way for them and the government is now taking it to a bigger scale.”
The addition of midwife services continues to post success stories on behalf of the people of Ghana. Sanford facilities deliver more than 800 babies a year now with the expectation that total will continue to increase with the presence of a surgical theatre at the medical center in Adenta.
Surgical theatres
When Sanford began delivering babies in Ghana, it became apparent there was a need for some of these births to be accompanied by specialized care.
Hence the arrival of “surgical theatres,” where specialists and their teams could perform C-sections. These rooms work primarily in helping deliver babies but can be used for other procedures as well. It is part of a long-range plan for the clinics to become self-sufficient as a health care system in the region.
“By adding surgical services, we are adding the hospital piece,” Dr. Darkwa said. “The reality is that Ghana can someday become its own market within Sanford like Bemidji or Bismarck or Sioux Falls. We need to grow, though, and offer all the integrated services to get to that point.”
Photo by Lonnie Nichols
Darkwa sees a day when Sanford Health would become a hub in Ghana for advanced care of cancer and stroke. Cancer patients often leave the country now to seek treatment, and stroke is the No. 1 cause of death in the country.
“It’s all about meeting a need,” Dr. Darkwa said. “We are growing in Adenta – the numbers are increasing. So far, we are getting to about 20 surgical cases a month. It’s still small, but I think we have come a long way, and we’ve been around for just about 12 months. We are hoping to replicate this at a second facility in Kasoa and serve more people.”
Continued development of the workforce will be a huge piece of the future. Initiatives involving nurse mentorship, physician exchanges, establishing residency programs and conducting research have great potential to foster cross-cultural learning.
“The Global Nurse Mentorship has been a huge benefit for our Sanford employees as an opportunity for them to get experience in Ghana and the work they do,” said Kim Martens, Sanford Health nursing and clinical services consultant. “The last two years we’ve had global nurse mentors who have really been instrumental in helping us get the Adenta surgical theatre up and going. Because we have such a small team with world clinic, we need help from the experts in those fields in order to push things across.”
It’s clear that Sanford’s involvement in Ghana has mutual benefits. In this case, the premier rural health care provider in the U.S. also has a significant global footprint.
“We are delivering high-quality care in a rural, low-resource country,” Slack said. “It really elevates our brand because there is a lot of learning that can be taken back and forth.”
Learn more
- Sanford World Clinic depends on local providers in Ghana
- ‘Global nurses’ revel in personal, professional growth
- Medical residents go global with Sanford World Clinic
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Posted In Cancer, Cancer Screenings, Pregnancy, Women's, World Clinic
