American College of Emergency Physicians

A Mission of Mercy, Hope and Love

How three months in Africa changed one physician forever

"You can watch the movies about Africa and the poor, but nothing can take the place of being there in person. Until you actually travel overseas, you cannot fully comprehend the vast differences between their world and ours."

Reflecting on his recent three-month mission trip to Ghana and Benin in west Africa, ACEP member Dr. W. Craig Sanford says that his experience was both challenging and life-changing. Serving for a few weeks each in three different locations, he treated hundreds of patients with conditions ranging from malaria to HIV.

After an initial orientation and training in tropical medicine at Manna Mission Hospital in Accra, Dr. Sanford acted as a crew physician on the Youth With A Mission Mercy Ship Anastasis docked at Cotonou, Benin. Along with over 400 other volunteers from around the world, he helped care for many seriously ill patients who would have otherwise gone without critical medical attention. (Mercy Ships primarily provide head and neck surgeries such as tumor and cataract removal, cleft palate repairs, and skin grafts for severe burn victims, as well as on-shore medical and dental clinics and education.)

Lastly, Dr. Sanford's skills were fully put to the test when he served as the sole physician at the Africa Christian Mission (ACM) clinic in Amedzofe, Ghana. With the assistance of only one nurse and an interpreter, he frequently had to rely almost entirely on clinical observation for diagnosis. Despite the lack of x-rays, lab, phone, FAX, or even an otoscope, Dr. Sanford found the work extremely satisfying, as he saw many patients make major turnarounds:

Physicians interested in medical outreach through Africa Christian Mission should contact Dr. Seth Anyomi, president of ACM, at kofiwinfred@yahoo.com. For information about Mercy Ships, go to www.mercyships.org.

"One four-year-old boy who was comatose and having seizures when I arrived responded rapidly to antibiotics and antimalarials and quickly recovered. I successfully treated numerous cases of acute undifferentiated febrile illness, many of which were probably malaria." ( Malaria remains a major cause of pediatric mortality worldwide, claiming the lives of approximately one million children per year.)

In addition to deficiencies in basic health care, there are no emergency medical training programs in Ghana or Benin and not a single neurosurgeon or CT scan in Benin. Consequently, the treatments, surgeries, dental care, and education provided through such organizations as the Mercy Ships and ACM literally save dozens of lives and drastically improve the quality of others.

Dr. Sanford vividly recalls one of his patients on the Anastasis: "Brigette had come to the medical screening near death due to a massive tumor distorting her face and almost totally blocking her airway. It's hard to imagine how such a growth could progress so far until you are there and realize the limitations of the health care system. Death is common, especially among children, and expectations are not that high."

In Brigette's case, surgeons were able to remove the tumor after a 14-hour operation.

"Amazingly, despite the tremendous odds against this little girl, she remained cheerful and appreciative throughout her stay on the ship and made all of us conscious of how much we take for granted," said Dr. Sanford. " Brigette represents just one of many patients who are grateful simply to have the chance to live."

Less fortunate patients included a six-month-old baby named Prudence who came to the Mercy Ship with an encephalocele. Extremely underweight and sick with an undifferentiated febrile illness, Prudence could not be admitted onboard until she gained sufficient weight to have surgery, said Dr. Sanford.

"Although I treated her for malaria and her family obtained free formula through a local charity, she still remained emaciated after five weeks of outpatient visits, and I do not know her outcome," he said. "Such cases underscore the tremendous need for comprehensive health care in this and many other parts of the world."

Despite the almost constant demands for his attention, Dr. Sanford did have a little time for relaxation. "I brought my trombone along and played for patients in Accra, Amedzofe, the villages of Benin, and on the Anastasis. Music is truly the universal language, and it provided another avenue for relating to the people, especially the children."

Dr. Sanford has some clear-cut advice for those desiring to share their skills overseas.

"Go with a reputable and experienced group. But go," Dr. Sanford said. "Get outside of the box of your workaday world, even if it's only for one week. Your perspective on life and on the practice of medicine will change dramatically. Afterwards, the materialism and petty concerns we have in America will seem-well, petty.

"Caring for seriously ill patients in a remote jungle environment stretched me both personally and professionally," he said. "I learned how other health care systems work, and became highly appreciative of the many advantages we have here in the United States. Basically, however, I found that people's needs are the same wherever you go. Before I went, Africa seemed very distant. Now it doesn't seem far away at all.

"Most importantly, I believe that I made a significant difference in a number of people's lives. I look forward to going back in the future and would recommend overseas medical missions to anyone."

Scientific Assembly 2002