Monday, November 14, 2005

MUSTANGH : Now, Why Didn't We Think Of That?

The story of MUSTANGH is another story of young people showing the way. In this case, it is a group of medical students from Maastricht University in the Netherlands who have initiated a program to partner with the West Gonja District Hospital (WGHD) in the Northern Region of Ghana.

To be more specific, it is a partnering between the Maastricht University Faculty of Medicine (UMFdG) and WGHD.

This all got started when an investigation was made into the possibilities of a cooperative effort between Maastricht University and a rural hospital in Ghana. This is termed as a "Twinning Project." The MUSTANGH web site says that this initiative was: "Driven by interest in Development Cooperation and triggered by the international mindset of Maastricht University."

A search was made for a "deprived hospital in need of financial and material support" that could also provide "a good educational environment for medical students to fulfil parts of their medical curriculum."

The West Gonja District Hospital (WGHD) in the Northern Region of Ghana, a needy though well managed mission hospital that is functioning relatively well was thought to meet those requirements.

An organizational diagnosis was made of WGHD and it was determined that this chould be the target hospital. The results of the daignosis were presented to both Ghana and Maastricht University and both parties became extremely interested in the potential that was shown to be possible if a partnership was undertaken

All of this was motivated by two students, Gaël Pennings and Noëmi Nijsten who initiated MUSTANGH Foundation and made possible the opportunity for Maastricht University Students to make a difference in the word by Twinning a North Ghanaian Hospital.

The mission of MUSTANGH is to "offer Maastricht medical students the possibility to do parts of their education (e.g. electives and research programmes) in a North Ghanaian rural hospital and its surrounding communities. The presence of these medical students can be seen as development assistance. To make this contribution in aid complete, it shall be expanded by financial and material support to WGDH and its surrounding communities." MUSTANGH set out to create an organisational, financial and educational structure from which they could guarantee quality and sustainability of the project.

Additionally, MUSTANGH aims to realize improvements in health care delivered by the hospital and its surrounding facilities. This will be accomplished by "providing well-coordinated financial and material donations, provided that this support meets the local needs and conforms to national and international standards." The organisation insists that the "improvements aimed at, must be as sustainable as possible." And they plan to achieve this by creating a better professional environment for doctors and nurses at WGDH, so to diminish the current braindrain towards the south of Ghana. Not only will doctors benefit from renovating the hospital and supplying the needed equipment, but Ghanaian medical students will be able to fulfil parts of their curriculum in this hospital, as well while learning to work in rural areas. This initiative will eventually result in more medical staff for the northern parts of Ghana, but in the interim the West Gonja population will receive more proper health care than was previously available.

MUSTANGH is a student run non-profit organisation that is led by a board comprised of 7 students from the Maastricht University Faculties of Medicine and Health Sciences. Guidance for the student board is provided by one of the organisation's co-founders, Noëmi Nijstenm M.D., who now also functions as the board chair and project manager. Additional support is also available to the student board from a Council of Advice, consisting of professionals with expertise in different fields and by several prominent professionals at Maastricht University and in Ghana.

The decision making capabilities of the board are enhanced by a commission for PR/Acquisition. A commission for education is currently being composed. Like many other organizations that arise from a university community, MUSTANGH operates independently of Maastricht University Faculties of Medicine and Health Sciences but is firmly linked to the Institute for Medical Education at Maastricht University.

The educational component of the twinning project provides manpower to WGDH by organizing an educational program for 6th year medical students. These students provide patient care, under supervision, as junior doctors in WGDH and its surrounding communities. The superintendent at WGDH acts as "external tutor" for the UMFdG / MUSTANGH students and Dr. N. Nijsten is the "internal tutor". It is anticipated that later on students will be guided by a staff member from the Department of General Practice at UMFdG.

MUSTANGH lists many reasons why medical students should study in developing nations such as Ghana. Besides the general benefits such as developing independence and problem solving skills, but there are many other reasons as well. The organisation says that students that participate in their program:

- become acquainted with a health care system in a developing country

- become acquainted with health care and its limitations in a developing country

- experience and evaluate the role of foreign medical practitioners in a developing country

- become acquainted with tropical medicine, both practically and theoretically

- practice medicine providing both cure and care

- gain basic experience in organisational tasks related to health care provision in developing countries

- as well as having an unforgettable experience in a country other than their own.

The West Gonja District, where WGDH is located, is the largest district in Ghana and is one of the thirteen administrative districts in which the Northern Region of the country is divided. The MUSTANGH web site states that Gonja's total land area is more than 2/5 of the Netherlands. The district has an estimated population of 150,000 living in approximately 318 communities. And Damongo, a town 130 km west of Tamale, serves as the administrative capital of West Gonja District.

The West Gonja District Hospital is located at Damongo. It serves as a referral centre for the health centres in the district and is run by the Catholic Church with a subvention from the Government of Ghana. Approximately 125.000 people depend on WGDH.

The hospital contains 160 beds, an outpatient department, an emergency ward, an X-ray room and a small laboratory. There is also a shortage of staff, and the state of the hospital buildings and medical equipment is far from satisfactory.

In West Gonja District there are 8 Health Centers in the surrounding communities, which have no doctors. And the students spend some of their time at these Centers.

MUSTANGH states that the "north of Ghana still is an unattractive environment for doctors to work in. A braindrain occurs; Ghanaian doctors leave the north of Ghana after finishing their education to work either in the south of Ghana or in the western world. The hospital therefore, has shortage of manpower."

The MUSTANGH web site has much, much more information about the project, the West Gonja District Hospital and a great deal of background information. But I want to spend a little time giving accolades to MUSTANGH and asking the following question:

"What is everyone else waiting for?"

MUSTANGH has shown that it can be done; and that it is an enriching experience for both the client hospital and for the students who go there to provide assistance. Many medical schools in developed nations have the ability to do the very same thing that MUSTANGH is doing. But so few of them are doing it.

I would like to make a request of the health care professionals that read this Blog. And I would like to make a request of all of those individuals who are interested in health care in developing nations that read this Blog. That request is that they send this article to medical schools and teaching hospitals in developed nations and ask them when they are going to follow MUSTANGH's lead?

Every Teaching Hospital and Medical University in the developed nations should consider following MUSTANGH's example.

Three Cheers for MUSTANGH!

Three Cheers for Maastricht University Faculty of Medicine!

Three Cheers for The Netherlands!

Read more about Visit MUSTANGH here.

1 comment:

denisotika said...



Ngora Health Sub- District (HSD) is one of the two HSD'S that constitute Kumi district. The other HSD is kumi. Ngora HSD has four sub- counties viz: Ngora, Kapir, Mukura and Kobwin. The HSD is bordered by Katakwi district in the north (across Lake Bisina); Soroti district in the west (a cross Kyoga tributary); Pallisa district in the south (a cross lake Nyaguo) and Kumi HSD to the East.

The HSD has an area of 715.95 square kilometers of which 538.51 is land area and the rest water surface (lakes, rivers, swamps)

The climate is modified equatorial characterized by hot and wet weather conditions. First rainy season starts around mid-March till September but broken by dry spell in June. The first rainy season has medical significance because incidence of malaria goes high a month after the rains.
Dry weather conditions charaterised by hot, windy and dusty atmosphere prevail from October to March. However, due to unexplained meteorological phenomena, rain pattern and dry spell are unpredictable these years.

The main socio – economic activities are trade (large and small scale), agriculture, local brew (Ajon) selling, brick making, quarrying (sand, aggregates and hard core) private medical and traditional health practices, employment in the formal and informal sector etc.

The HSD has a total population of 125,736 (projected from 2002 census using a factor of 0.043). Out of this population females are 66,514 (52.9%) and males 59,222 (47.1%). The population growth rate is 4.3% and fertility rate is 7.2% one of the highest in the Country. The literacy rates for males stand at 65% and females 35%. The life expentary for males is 42% and females 48%. The mortality rates are as follows:-

•Infant mortality rate(IMR-122/1000 live births
•Lender five mortality rate (<5MR) – 205/1000
•Crudedeathrate - 19.1%
•Maternal mortality rate (MMR) - 700/100,000, one of the highest in the Uganda.

The infant population is 4.3% of the total population; under fives 20.5%, women of child bearing age 23%, pregnant mothers 5% and expected deliveries 4.85%.

Ngora Health Sub-District has II functional health Units. Nine of these are government-owned and two NGO-owned.
The nine Government owned health units are:-
Kapir Health centre III, Mukura Health centre III, Ajeluk Health centre III, Ngora Health centre III, Ngora maternity unit Health
centre III, Kobwin Health centre III giving a total of six Health Centre IIIs.

The other three government owned health units are health centre 2s and they are:-
Omiito, Agu and Atoot. The two NGO facilities are Ngora Freda carr Hospital owned by church of Uganda and St. Anthony Health centre II owned by the catholic church.

Ngora Sub-County alone has five health facilities i.e. Ngora Hospital, Ngora Health centre, Agu, Ngora maternity unit( average 200 deliveries /month ) and St.Anthony. The other three Sub-counties have two health facilities i.e. Health centre 3 and 2. In addition to the above facilities which provide the minimal Health care package (M.H.C.P), communities seek for health services from private drug shops which are numerous in all trading centres and also from traditional healers and drug distributors (CORPS).
Ngora Hospital is the referral health facility providing all health services – curative, promotive, preventive and rehabilitative. Because of its level, it is the headquarters for Ngora HSD.
Ngora Hospital had been a leading provider of quality health services since it was founded by the missionaries. It was vandalised during the civil wars that rocked Uganda when Idi Amin was toppled in 1979, and in 1985 and 1989 respectively during the rebel insurgency that was concentrated in this region.
Currently the hospital lacks major diagnostic facilities and has a pressing problem of lack of an Ambulance. The old Ambulance is grounded and this makes referral difficult which partly contributes to the high maternal mortality since many mothers who are distant from the Hospital prefer to deliver in the hands of Traditional Birth Attendants.This is not to mention the lack of Doctors in the Hospital. Only one Doctor apparently runs the hospital who also doubles as the Medical Superintendent.
I look forward to a fruitful discussion with anybody willing to aid this hospital that at one time was served by Professor Omaswa, a reknowned Ugandan Cardiologist who has been Uganda's Director General of Health Services and most recenlty Director of Global Workforce Health Alliance(GWHA) based in Geneva, Switzerland.
Please get in touch with:
Tel: +256772454995
Tel: +256772191365