Daphne Thomas, an emergency physician at Inova Loudoun, examines a child in Ghana. (Commonwealth Emergency Physicians )
For one week at the end of May, Daphne Thomas and Edward Puccio, emergency physicians at Inova Loudoun Hospital, left one of the most affluent counties in the United States to care for thousands of people who had never seen a doctor before.
They were part of a team of six volunteers from Northern Virginia on a medical mission to Ghana, where they visited several remote villages to treat people who live without running water, sewers or electricity. The doctors distributed multivitamins and painkillers, administered anti-parasitic medicine, treated infected wounds and introduced practices to help improve the villagers’ health after the doctors had returned home.
Thomas and Puccio are founding partners of Commonwealth Emergency Physicians, a company that provides emergency services at Inova’s Lansdowne and Cornwall campuses. Although their company helps cover the cost of medicine and other supplies for the mission trip, they said, the volunteers pay most of their own expenses, including airfare, food and lodging.
Thomas has served on more than 10 medical missions to countries such as Cambodia, India, Tanzania, Nicaragua, Haiti and Laos. Puccio’s first mission trip was in 2007, to Cambodia. They try to go on a medical mission every year or two, they said, often serving on the same mission team.
“I went into medical school with the idea of one day going around the world and doing medical missions,” Thomas said. Being “an emergency physician is perfect for that, because you can take time off and really invest in the world,” she said.
The mission team’s center of operations in Ghana was Tamale, one of the West African country’s largest cities. From there, they drove an hour or two each day until they reached one of the country’s remote villages, where people typically live in mud huts with thatched roofs. Sometimes they visited more than one village a day. Thomas said they usually examined everybody in each village, “because they don’t know when they’re going to see another provider or another doctor again.”
She estimated that they examined about 600 people a day, with each exam lasting about two minutes. That was an adequate amount of time, Puccio said, because most of the villagers had similar health problems, and there was no need to ask questions about medical history, medications or drug allergies.
Many of the people they saw suffered from vitamin deficiencies and chronic pain brought on by hard labor, Puccio said, so the doctors gave them painkillers and multivitamins. Most also had chronic diarrhea from parasitic illnesses. “They don’t have good sanitation, so the water is contaminated,” he said. “So we would do deworming of everybody we saw.”
He said it is essential to have contacts in the places they visit who can help with logistics, such as arranging for translators. Some of the local contacts also follow up with people in the villages to encourage practices such as boiling water to kill parasites and help the villages get medicine and treatment after the mission team leaves.
“We can’t provide them with forever medication,” he said. “But we can give them a month of medication, hoping that in that month, they can get to the city” for more.
Thomas said that reading glasses are always a popular, if unfamiliar, item. “They’re like, ‘What is this for?’ And the moment that you show them something and they can [see] it, it’s amazing,” she said. “It’s like you’ve opened up the world for them. . . . So it’s a huge success wherever we go.”
The mission team also brings items such as coloring books and clothes to give to children, Thomas said. “We usually try to bring clothes, because these little kids will wait four or five hours to be seen for their worm pill,” she said. “If you can give them a T-shirt, that just lightens their face, whereas the worm pill doesn’t do it for them. It tastes nasty [and] they have to chew it.”
According to the doctors, one of the biggest challenges was educating people who had no understanding of bacteria or viruses. The cultural differences were also striking. The villagers didn’t understand the concept of waiting in line, and many could not say how old they were. “You ask them their age, they have no idea,” Thomas said. “They knew that they were born on a Tuesday. Not even the date.”
Never having been examined by a doctor before, the Ghanaians sometimes were puzzled by seemingly simple instructions. “When I say, ‘Take a deep breath,’ they don’t know what I’m doing,” Puccio said. “They don’t know that I’m listening to their lungs or to their heart, and they’ve never seen a stethoscope, so they’re wondering what this is.”
Puccio said that some of the patients they examined who had infections would have died without treatment.
“I do think we make a difference,” Thomas said. “I think we educate them, that at least there’s this possibility of being well. I think we make a difference in the young children. We expose them, so that maybe as they’re growing up, they’re going to change their ways and practices.”
The rewards come from the faces of the people they treat, she said. “They see that you really are there, you’re investing in them. I think that lights them up.”
Jim Barnes is a freelance writer.