Written by Editorial Team, DonateToday

Voluntary work in Ghana, improving Pathology services and healthcare, new surroundings and being a professional Muslim woman in Africa

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Dr Azra Khan working with a FREEDUK colleague in Nandom, Ghana

The charity organization Foundation for Rural Education, Empowerment and Development (FREEDUK) is based in Northampton, UK. Its team of professional volunteers from all walks of life includes surgeons, dentists, nurses, teachers, carpenters, football coaches and scientists. All are dedicated to providing healthcare and education to the deprived community of Nandom village in Ghana, West Africa.

A Lifetime of Hardship

The charity was started by Dr Dery Tuopar (an Oral & Maxillofacial Consultant Surgeon), after he returned from visiting a sick relative at Nandom Hospital in 2005. The failing health standards and lack of resources saddened him so much that, upon his return, he established the charity, together with his UK colleagues (Mr Andrew Camilleri – Consultant Surgeon, Sister Anne Hicks – Clinical Nurse Specialist, Dr Ambrose Ire – Dentist, and Ms Sue May – Dental Nurse) at Northampton General Hospital.

Dr Azra Khan (Operations Manager for Pathology Sciences for Sidra Medicine, Doha, Qatar) has travelled to Ghana regularly since the first FREEDUK visit in 2007 when she was asked to implement Microbiology culture techniques to provide more conclusive and relevant results for better patient management.

‘Since the earliest days of my career, I had ambitions to be involved in global healthcare especially in developing countries,’ Azra says, ‘So I was really excited when I was invited to be part of FREEDUK and had the opportunity to travel out to Ghana to use my skills and knowledge in helping those less fortunate than myself.

‘As a professional, my involvement with FREEDUK has been an invaluable experience working in such challenging conditions,’ she enthuses. ‘As a human being, it has been a very emotional, humbling and rewarding journey. At times, my interaction with the people of Nandom, whose lives were such a contrast compared to my own privileged lifestyle, was heart-breaking.

 ‘I know that for many it would be a lifetime of hardship, with little or no education at all,’ Azra explains. ‘It would be a lifetime of poverty, illnesses and daily struggle to merely survive. But at the same time, I have felt warmth and gratitude from people with very little but still find it in their hearts to speak to me – we don’t speak the same language, but their smile and sign language says it all!’

Exciting and Different

For some members of the FREEDUK team, travelling to West Africa was a completely novel experience. Azra, however, had already experienced that continent on numerous occasions.

‘I was born in Nairobi – although my family moved to England when I was four – and I have visited family in Harare and Pakistan on numerous occasions,’ she explains.

Goats and washing outside Nandom hospital in Ghana

‘So, to me, the surroundings, the culture and attitudes of a developing nation were not as alien as perhaps to the other team members, for whom this was a first visit to a developing country.

‘We landed in Accra, the capital of Ghana,’ she recalls of her first trip in 2007. ‘When the airplane doors opened, and we descended down the steps onto the airport tarmac the first thing to hit us was the heat and the humidity.

‘To me there was an immediate sense of change in the environment and atmosphere to that we are familiar with back in the UK,’ Azra goes on. ‘We were excited and looking forward to our challenging work of the next 10 days.

‘It took almost three days to reach Nandom village which gave us time to gradually acclimatize to our new surroundings, the people and the way things were done there, as we interacted with communities on our journey whilst staying overnight in guesthouses and conditions that would become our home for the next two weeks!’

Unhygienic Practice

On reaching their destination, it was time for Azra and the team to get to work. ‘From the first morning we walked through the courtyard to the hospital, we became aware of the differences between the healthcare establishments we have in the UK and this one in this developing country,’ she recalls.

‘We immediately saw the neglect of the buildings and surrounding areas, which were evidence of the burdened healthcare system in place. However, to the community, it was a facility providing vital medical care and that was what mattered to them, not the state of the hospital building,’ Azra admits. ‘Patients in the UK complain about the healthcare standards, but in comparison to this village hospital, we still have the privilege of care and treatment of a high standard. 

‘When we asked about the goats and other animals that were grazing on the grounds of the hospital, we were told that relatives of patients would bring their livestock with them for the duration of the time they were camped on the grounds whilst their relative was being treated. Inevitably, there were animal faeces in our pathway as we walked through the grounds of the hospital.

‘As we approached the wards, we saw patients’ relatives camping outside – cooking, washing and sleeping under the shade of the trees to escape the heat. To us, this seemed an extremely unhygienic practice because these relatives would go into the wards to take care of their relatives, possibly exposing the already immunocompromised patient to contamination and infections, but this was just accepted by the hospital staff as normal.

"If a life ends, that's just the way it is, which is really sad."

Dr Azra Khan

‘As I walked through the Outpatients waiting room on a daily basis, I saw the patients, many elderly and young children and babies, sitting or lying down in the waiting room and I just felt so sad.

‘Sadly, many who travel from near and far do not survive the journey to the hospital or even treatment as they are too weak or too sick. It feels to me that the loss of life to disease and inadequate healthcare provision in this area is insignificant and almost acceptable with no one taking responsibility or asking the question “why?”

'In developed countries, failure of health standards and care resulting in death or debilitated health would be investigated, questions asked and root cause highlighted, but in this developing country – if a life ends, that’s just the way it is, which is really sad.’

Challenges to Overcome

In 2010, Azra was joined by a UK colleague Marilena Ioannou to help her in developing and implementing culture techniques, as well as a number of other remits: teaching the Ghanaian hospital laboratory staff to carry out culture techniques, advising laboratory staff and hospital managers, and helping to acquire donations and equipment that may be used for other Pathology tests.

‘Both out-patients and in-patients with post-operative infections are routinely treated with a cocktail of antibiotics to cover all possible infections,' Azra explains. 'More often than not, the antibiotics are out-of-date or not appropriate resulting in antibiotic misuse which is more detrimental than giving antibiotics.'

‘With the help of our Ghanaian colleagues, we refurbished one of the rooms as a media preparation room and successfully prepared culture media plates – overcoming the potential risks of contamination, constant power cuts resulting in wasted media and time, and using makeshift equipment.

‘Our time in Nandom is very short and is mostly taken up with setting up the laboratory for culture methodology, leaving little time to give extensive teaching in Microbiology culture methods to the Ghanaian staff,’ Azra says. ‘Because of this, I strongly believe that the most useful tool for taking microbiology forwards in this remote village hospital laboratory would be if we could employ or support a volunteer microbiologist for a minimum of six months to work at the laboratory, to carry out teaching and to develop the staff skills so that they can confidently and independently carry out culture techniques.’

‘I have also been reaching out for the donation of an incubator in good working condition to be transported to the laboratory in Nandom. This is essential if we are to implement effective culture methodology, for more conclusive results and better patient management. As yet, I have not had any offers so if we could collect funds towards buying a reconditioned one, that would be great.’

Somebody to Look Up To

While there is undoubtedly still work to be done, Azra does look back on that first trip to Nandom with fondness – particularly as it included a completely unexpected surprise: as a Muslim lady, she attended Friday prayers at the local mosque, but never did she expect the welcome she received and to be asked to make a speech to the local community. This has now become a regular practice for her on every visit to the village and the mosque.

Dr Azra Khan and Marilena

'Their last parting shot was: "We see you as a professional woman; somebody to look up to for our children and our women; you're someone to model themselves on."'

Dr Azra Khan

Azra was also asked a number of questions by those present on topics such as her life in the UK as a Muslim professional woman; how she practiced her faith in line with her work and life in the UK; and her views on education for both boys and girls.

However, questions asked by the women who were sitting behind the curtain that segregated the men and women, as per Islamic custom, were relayed and interpreted in English by one of the male attendees.  ‘After several of these questions,’ Azra recalls, ‘I asked “if the women are asking, why aren’t they here to ask me themselves?”

'So, in break with tradition, the curtain was taken down for the very first time and I was surprised to be eagerly and affectionately greeted by the women and children who had been waiting patiently behind the curtain.’ 

The local Muslim community in Nandom seemingly came away from this meeting quite impressed and motivated. ‘Their last parting shot was “We see you as a professional woman, as someone to look up to for our children and our women: to model themselves on.” 

The FREEDUK team during their first trip to Nandom, Ghana in 2007

‘My dear late father was a teacher and always encouraged all of us to strive to achieve the highest education – it didn’t matter to him whether it was his daughters he was encouraging or his son – he supported us equally,’ Azra explains.

‘The words came from my heart and my own positive experience with my parents, and that message came across in what I was saying to the parents and the children at the mosque: regardless of whether you have a son or daughter, both should be encouraged to study in order to improve and secure their futures. Always work to improve your circumstances and, with the help of God, it shall be!'

The FREEDUK projects are funded by volunteers and families donating, organising fundraising events and Trustee financial support. The charity was set up in 2005 and, although has made significant impact on the services and the hospital staff, the lack of funds does not permit ongoing financial support and relies heavily on the generosity of both the charity’s trustees and members of the public. Please give what you can to help them continue their efforts to provide adequate healthcare and education to those who need it in Nandom.