MediShare - Rotary International

Join in TEMA (Ghana) General Hospital Project

This project was not funded directly by MediShare International. It was funded by the Rotary Club of Palo Alto, California and two Rotary Clubs in Ghana, plus a Matching Grant from the Rotary International Foundation. However, since it utilized a number of important elements and processes developed for MediShare and since it was managed by MARCO MediShare Committee members, it is felt that it will be of great interest to MARCO members and therefore entirely appropriate that it be fully reported in the Newsletter. MediShare's influence has gone far beyond its previously more limited emphasis.

Dental Clinic Refurbishment

Tema Government General Hospital is located twenty-two miles east of Accra, the capital city of Ghana (click here for map), in the seaport city of Tema. It is described as a bustling industrial city and free enterprise zone. Thus the hospital handles industrial cases as well as accident-trauma cases.

Ghana Hospital The hospital serves 533,963 people according to the latest census, in the largest industrial and port city of Ghana. The hospital includes the sole public dental facility in that metropolis. Service has been increasingly limited by low budgets and equipment so obsolete (most over forty years old) it was no longer serviceable.

The Tema General Hospital Dental Clinic (see Exhibit of pictures) has facilities to accommodate two Dental Surgeons in two dental operatories. However it has only one partially functioning dental chair. The function is severely restricted inasmuch as the height only can be adjusted. The patient cannot be reclined which severely restricts - or prohibits - the performing of certain dental procedures requiring greater visibility of the oral cavity.

In recent times, a mobile dental unit was brought in to augment the capabilities of this one chair-unit. But it failed to meet expectations. Consequently dental services at the clinic currently comprises only of dental health education, some very limited emergency oral surgical procedures and the provision of some extremely limited dental prosthetics (dentures).

The clinic staff serves an average of five hundred (500) patients a month. An average of 60% of these patients require oral surgery, most frequently, dental extractions. These patients represent cases from a vast surrounding area, communities which include Ashiaman, Ningo, Prampram, Ada, Nunga, Teshie and Tema New Town.

Quite obviously the clinic had dire needs and challenges to overcome.

The immediate needs - - -

1. Two dental units (including chairs) to bring the clinic back into full usefulness.

2. Dental laboratory equipment to make it possible for a full-time dental technician to join the staff, and to be provided equipment with which to construct dental prostheses on site.

3. New and replacement dental instruments and supplies.

This will begin to solve the current problems and set the foundation for the clinic staff to extend their services into the surrounding communities.

In October 2000 a number of Rotarians from California visited Ghana to support the National Polio Immunization exercise. At a dinner held in their honor Rotarian Prosper Adamaley discussed with one of the delegates, a proposal to acquire some dental equipment for the dental clinic of the Tema General Hospital. The project details were brought to the writer's attention in California and were subsequently presented to the Palo Alto Rotary Club for possible funding support. The project was approved, after which sources of the needed dental equipment and instruments and supplies were identified.

Ghana Hospital Equipment As the (former) Managing Director of MediShare International, I have worked many years with non-profit organizations, which provide medical and hospital equipment to clinics and hospitals in Third World countries - principally in Africa. These include Direct Relief International (DRI) of Santa Barbara, CA.. Therefore I was aware that DRI frequently had access to surplus dental equipment as well as medical and hospital equipment. Ms. Kathy Poma, a staff member at DRI, examined the "needs" list and determined that the requested equipment, instruments and supplies could be provided and at a great saving, In this proposal, $4,500.00 delivered all of the carefully specified dental equipment which was valued on the wholesale US market of approximately $15, 000.00. In addition, Direct Relief International procured a USAID funding grant to cover all shipping and transportation costs, and import duty's significant additional cost that did not have to be borne by Rotary/MediShare International.

Note: DRI frequently is able to provide medical equipment, instruments, supplies and drugs at a leverage factor of from 10x to 20x, depending on availability of the equipment (i.e. $100 can provide from $1000 ­ $2000 worth of equipment as valued on the US wholesale market). In this project, some of the needed equipment had to be purchased from wholesale sources, and therefore the 'leverage' was somewhat lower - just over 3:1.

Rotarian Prosper Adamaley, Dr. Derek K. Larbi and Dr. Charity Brako, both of the Tema Hospital, and Ms. Kathy Poma of Direct Relief International, contributed to this final report.


Robert C. Smithwick, D.D.S.
Director Emeritus, MediShare International