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Hoping for a domino effect

A physician has a challenging first day on the job in Ghana

GregBasura2

Greg Basura, M.D., Ph.D., remembers the first time he examined patients in an ear, nose and throat clinic in the West African nation of Ghana.

The examination room was crowded with 10 to 15 nurses, doctors, residents and other people. He was trying to figure out the set-up and the workflow. What instruments were available? How did the patient’s chair work? What did the medical records say?

He began screening patients and discussing his findings with a resident. As he worked, he started to notice that one of the Ghanaian doctors seemed to be growing impatient. Finally, the physician tapped Basura on the shoulder and led him outside into the hallway.

“There was a line of patients all the way down the hallway and around the corner. It kept going and going,” said Basura, a U-M neurotologist in the Department of Otolaryngology-Head and Neck Surgery. “I could see about 30 to 40 people, but I couldn’t see the line once it turned the corner. We had to get through all these people.”

That happened last March when Basura traveled to Ghana to help establish a new training program for physicians in otolaryngology at Komfo Anokye Teaching Hospital in Kumasi, the second-biggest city in Ghana. He and the U-M team of otolaryngologists brought drills and microscopes for a new “temporal bone lab,” where surgeons could practice their skills drilling through the skull to operate on the middle and inner ear.

Basura also performed a few surgeries. The dilemma he faced was that his Ghanaian partners wanted to make the best use of his skills and have him operate on some extremely complex cases. But Basura preferred focusing on more basic cases that would be better teaching opportunities for the young Ghanaian physicians.

In October, Basura returned to the country for a week of screening patients and operating with his Ghanaian colleagues. The new collaboration’s goal is to train two physicians so that they can teach their residents. Eventually, the center will train doctors from across West Africa.

“We’re banking on their interests, their motivation and dedication. We’re investing in them so that they will invest in everyone else,” Basura said. “You hope it becomes like a domino effect. You kick a couple dominos over and they all start tumbling.”

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