Ghana, Healthcare Delivery, And Sustainable Philanthropy

As many of our readers know, Cumberland Advisors is a proud sponsor of the Global Interdependence Center (GIC – www.interdependence.org), the not-for-profit organization headquartered in the Federal Reserve Building in Philadelphia. GIC is a neutral convener of dialogue around the world on global trade, economics, finance and markets, and other important issues related to world citizenship.

Last week we had the opportunity to attend GIC’s conference in Accra, Ghana in partnership with Sanford Health, the largest rural healthcare provider in the US, with headquarters in Sioux Falls, South Dakota. Sanford Health is a not-for-profit system that operates over 37 hospitals, clinics, and services in the North Dakota, South Dakota, western Minnesota, northwest Iowa, and northeast Nebraska geographical area. Sanford Health has also launched its Sanford World Clinics effort, to provide primary-care services in multiple locations around the globe.

Issues of health and wellness can be profound and truly impactful to individuals and nations. The conference was specifically focused on the issue of providing a sustainable model for permanent healthcare infrastructure. The intent of the organizers and the participants was to discuss specific and real methods for alleviating human suffering, to improve the human condition, and to do good in the world. Featured speakers at the conference included representatives from the Ghana Ministry of Health (www.moh-ghana.org), the Ghana National Health Insurance Scheme (NHIS – www.nhis.gov.gh), the Women’s World Health Initiative (WWHI – focuses on maternal health, with emphasis in Senegal; www.wwhi.org), USAID in Ghana (http://ghana.usaid.gov), DocuTap (a provider of electronic medical records (www.docutap.com), and Sanford Health (www.sanfordhealth.org). Attendees included GIC members, American Chamber of Commerce in Ghana personnel, local business owners, church officials, and other Ghanaian citizens and organizations interested in healthcare issues. We encourage readers to explore these organizations’ websites to see the interesting and varied work they do.

The dialogue was vigorous as various approaches and topics were explored. It was clear that a need exists to regularly convene such dialogues among the stakeholders, both regionally and beyond. Providing sustainable healthcare and building permanent infrastructure are fraught with potential complications, particularly and most importantly the specific health needs of the people being served, with challenges arising from the mixing of cultural expectations and norms, differing standards, differing models of delivery, the resources available, the openness of officials to new participants, the political and legal stability of the nations involved, and of course the actual issues on the ground.

As in politics in general, healthcare delivery around the world is local, local, local. This presents a challenge to anybody seeking to provide a model of sustainable healthcare delivery. The facts are that this is really hard to do in a way that is both effective and replicable; hence, the need for a venue and a host to facilitate a healthy exchange of ideas. In many ways, the conference turned into a working session, as the participants and attendees questioned and sought to understand and resolve concerns.

The tour portion prior to the conference focused on the Sanford World Clinics initiative as it relates to a hub and spoke network of ten primary-care clinics being built in Ghana (see http://www.sanfordhealth.org/initiatives/worldclinic and, specific to Ghana, http://www.sanfordhealth.org/Initiatives/WorldClinic/Ghana). The Cape Coast clinic began operation at the beginning of the year, with other clinics in Mankessim, Adenta, Kojokrom, and Kasoa to open in the next several months.

The tour began by driving to the Mankessim facility, which is still under construction. It will be an outpost of positivity and newness amid a backdrop of somewhat rough conditions. The participants then continued on to Cape Coast to view the hub facility that is functioning and seeing patients. It was wonderful to see the innovations, modern-looking pharmacy, people waiting to see the doctor, and electronic records systems. The clinic itself is a “light on the hill”: well-painted, clean, and inviting. The clinic sees about 1400 patients per week, adults as well as children. A majority of the patients are presenting with malaria and are being treated. These are real people, with real and treatable maladies, receiving appropriate care.

The memorable moment for me at the Cape Coast clinic was gazing into the male recovery room. There was a small boy getting a drip IV who was shaking under his sheet, obviously in discomfort. It is a very simple, mundane, and profound thing to offer a basic human remedy to another. That quiet little miracle of health and life is all that really matters. Basic access to care for that young boy, who might otherwise have gone untreated (with the attendant mortality considerations that would follow), is a miracle in its plainness and simplicity. To the degree that others in various parts of the world do not have access to treatable maladies, this is part of the human tragedy.

Many good things came from this mixing of people—hosts, speakers and attendees—and the conference certainly could be viewed as a resounding success. What a fantastic opportunity to make a meaningful difference in individual lives – doing the right things, hopefully in the right ways, for the right reasons. For people who think often and long about how to make the world a better place and help people to flourish in both theory and practice, this conference on tangible healthcare infrastructure and delivery seemed particularly noble. Practical and consistent application of good intentions is where the rubber meets the road; and the convening of the conference, with the working clinics as a tangible product for investigation, provides hope. Of course, sustainability is the key and the Holy Grail. Having interesting discussions and also seeing people on the ground meeting the practical needs of patients who come in the door was truly invigorating. It was inspirational to see the opportunities, challenges, and complexities that might present themselves going forward in these endeavors.

A hearty thanks to the Global Interdependence Center and Sanford Health for convening and hosting such a worthwhile event.


BY Michael McNiven