By Avigayil Kadesh
From a conference room at Jerusalem’s Herzog Hospital, nurse educator Ronni Suna is leading a class about diabetes for healthcare personnel at a Christian hospital in rural Ghana several time zones away.
About 25 doctors, nurses, midwives and the executive director of the facility sit at their computer screens, following the live class with the aid of visuals emailed in advance.
“I brought in a few slides to discuss the statistics in their own part of the world,” says Suna. “Diabetes has been dramatically increasing in Africa -- four million cases in Ghana and rising -- so they feel a need to learn general knowledge and practical aspects about treatment.”
It is not unusual for Israeli doctors and nurses to lend their expertise to African counterparts, but usually the training is done in person. Videoconferencing allows the information exchange to take place face to face without travel costs and without any need to take time off from work for a cross-continental visit.
A three-continent effort
Steve Schwartz, Herzog’s director of international resource development, explains that the institution was already participating in international videoconference “grand rounds” sponsored in part by Rotary International in Canada. This setup enables doctors in Israel, Jordan and the Palestinian Authority to share details of specific cases.
Rotary’s Jerusalem club and a partner club in North Carolina had helped the hospital set up its videoconferencing center.
Herzog also had initiated a program to retrain 250 Ethiopian immigrant women as nurses aides, Schwartz explains. He approached the Rotary Club in Windsor, Ontario – which does humanitarian work in Africa -- with the idea of combining the two programs to train African personnel in public health.
Dr. Godfrey Bacheyie, a Ghana-born Canadian Rotary leader and physician, helped put Herzog Hospital in touch with St. Joseph Hospital in Jirapa – a rural region serving a predominantly poor farming population near Ghana’s border with Burkina Faso.
The resulting Rotary Foundation Global Grant for the Tele-health Project is a partnership between Herzog Hospital and the Rotary Club of Jerusalem, the Jirapa Health Alliance and Rotary Club of Accra Ring Road Central in Ghana, and the Rotary Club of Windsor.
"This project will broaden the knowledge base of medical practitioners and allied health professionals and provide interaction between healthcare providers with counterparts in advanced and developed countries in a rural, resource-poor area where one doctor serves a population of 80,000," said Bacheyie.
Knowledge is power
Suna says the Ghana Health Service has been focusing its meager resources on preventing and fighting infectious diseases, another of the topics St. Joseph’s chose to learn about from the Israelis in a series of 10 lectures.
“A basic problem there is that they don’t have sterile equipment or sterilizers, so taking [infectious disease prevention] to the level we have is impossible,” says Shana Gottesman, the Herzog nurse who taught that segment.
“But at least I made them conscious about practices such as washing hands between patients, and procedures for isolating contagious patients. I tried to impress upon them that they can teach their patients, just as I am teaching them.”
Suna feels that even if her audience cannot implement all her suggestions, knowledge is power. “There are constant updates in diabetes and they should know what medication options and tests are available,” she says. “They can research how to do these things, just as they researched how to set up the video cameras for our sessions.”
The lectures are conducted in English, the official language of Ghana and the mother tongue of Schwartz, Suna and Gottesman. Schwartz and Suna were raised in New York, while Gottesman is a native of Savannah, Georgia.
“The beauty of the videoconference is the opportunity for questions and answers,” Schwartz says. “For instance, they asked how to deal with patient education and compliance.”
Though they are following a curriculum, there is a dynamic component to the program. The Africans expressed an interest in learning more about the connection between stress and physical ailments, so a Herzog neurologist with a holistic approach is scheduled to discuss how psychological stress affects the body.
Connectivity challenges
The Ghana participants are coming in with at least a basic level of knowledge on the topics, but they do not have access to the latest research and methods as do the Israelis.
Herzog, a 330-bed teaching hospital, has collaborated on African public health programs before with MASHAV, Israel’s Agency for International Development Cooperation at the Ministry of Foreign Affairs, but had not previously done any work in Ghana.
The technological aspects of the project can be challenging, Schwartz admits. Though St. Joseph’s Hospital has its own laptops and Rotary pays for the Internet connection, it took awhile to get all the pieces put together.
“One of the realities of getting this going was connectivity, because they are so rural,” he says.
But Schwartz is optimistic that the Ghana Tele-Health Project pilot may be extended to cover additional topics at St. Joseph’s and perhaps could be introduced to other African countries in need as well.
“They are always appreciative,” says Schwartz.