One of my coaching clients is Accra Medical Centre; Moses and Cynthia are building a network of hospitals here in Ghana. Health care is radically underserved here – Ghana is a poor country – and the demand for better facilities (By folks who can pay) is enormous.
Moses trained as a accountant and Cynthia as an anesthesiologist and both have had ample opportunities to move to the UK, Canada or the U.S., which is the classic career path of educated, ambitious folks from this part of the world. Mose and Cynthia spent several years in Bermuda but opted to return to their home country to try and improve the healthcare system. Moses is short, compact and energy; his eyes sparkle about his greying beard and he is constantly thinking about what is next. Cynthia is a thoughtful, caring physician and displays that care gently but with a discipline that has been honed building a practice in a difficult market.
Moses took me on a tour of a large public hospital that serves the greater Accra area where Cynthia trained. Korle Bu Teaching hospital occupies a large campus in the City that clearly has grown organically and a little haphazardly since the British built is first structure in 1923; as you would expect it was crowded with patients carrying large jumbled files (Patients take care of their own medical files), had an emergency area – they had recently instituted a triage process – and large wards with multiple beds populated by patients in various states of health. The hospital does have some new equipment – much more than you might see in a public hospital in South Asia – and performs serious procedures (e.g. transplants) but, as some its occupied buildings dated from when the British were here, and has a worn, tired feel like an old sweater that should have been retired a while ago but is still in use.
Middle class Ghanaians have access to good health care and often carry health insurance and many have spent time overseas, so there is demand for better quality care in new facilities. Moses and Cynthia run a clinic now here in the City, manage a hospital that serves a large gold mining community in the West of the country (They contract with the mining company), are in the middle of constructing their first hospital here in the City and have a second one planned. These hospitals are very small by our standards – less than 50 beds – but will have operating theatres, laboratories and MRIs.
I’ll help Moses and Cynthia develop a marketing program to generate patient flow for the hospital they are building now, which is supposed to open in March, and help them move from being “Do everything” entrepreneurs to managers that can delegate. This will be no small task – it is difficult to get entrepreneurs anywhere to begin to let go of some of their organization but all the more so here in Africa, where businesses are often family run and ties to family trump all sorts of other exigencies.
Moses and Cynthia have two daughters who are both close to entering college, one of whom has Sickle Cell Anemia, an inherited disease found mostly in Africa and India and sometimes in Central and South America and amongst those diasporas.
Sickle Cell Anemia
Sickle Cell Anemia occurs when someone inherits genes from their mother and father that result in improperly formed red blood cells – these cells have a sickle shape, hence the name. Healthy red blood cells are flexible and can move through organs and capillaries easily – sickle cells cannot. As a result of their shape, sickle cells get stuck, causing intense pain, damaging the spleen and other organs, affecting vision, reducing energy and increasing susceptibility to infection. Sickle Cell Anemia can also slow growth and delay puberty.
Other than bone marrow transplants when an individual is young, or stem cell transplants that are experimental (Both prohibitively expensive here), there is no cure for the disease but Moses and Cynthia tell me that their daughter is on some meds that help manage the symptoms and have enabled her to live a pretty normal life.
Interestingly, carrying the Sickle Cell traits makes you less prone to getting Malaria so one sees more carriers in places where Malaria is endemic; this has resulted in much lower prevalence of Sickle Cell amongst in African Americans (We eradicated Malaria 70 years ago) than amongst Africans here on the continent, where the mosquito-borne disease is still a factor. Still, about 1 in 13 African Americans are born with the Sickle Cell trait, a high enough prevalence to be concerning.