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IN COUNTRIES WHERE MALNUTRITION, measles and diarrhea rank among the top five causes of children's deaths, there are still lessons Americans can learn to improve their own health-care system. It's a hard pill to swallow in the U.S., where such conditions are tucked in overlooked corners, but seeing is humbly believing.

When Dr. Daniel Van Durme, a practicing physician and professor and chair of the Department of Family Medicine and Rural Health in Florida State's College of Medicine, first visited Ghana in 2006, the high quality of medical education impressed him.

The small West African country of about 23 million people-where a third of the workforce makes less than a dollar a day-maintains high standards of health care relative to its financial circumstances, he said.

Most of Ghana's medical facilities and equipment don't measure up to U.S. technological standards in health care, but when it comes to Ghanaians' philosophy of care, Van Durme said, Americans should pay attention. "They do a good job, better than some places in the U.S., of recognizing the need to treat the whole patient, not just the disease," he said.

Ghanaian doctors, Van Durme added, are taught to weigh the realities of poverty, lack of transportation or conflicts with traditional beliefs or medicine, for example, that can interfere with a person's ability to receive care in the modern, "Western" way. Asking these questions specific to poverty might seem irrelevant to U.S. doctors, many of whom come from middle-class families that don't confront the same challenges, but dismissing them would ignore America's own reality. The problems many of Ghana's patients face are, in fact, similar to many rural patients' circumstances in the U.S. Still, many physicians in the U.S. are pushed by an impersonal system to spend as little time as possible with patients in assembly-line-like fashion.

To expose future docs to a more caring approach to care, on his trip last year Van Durme traveled with members of a campus group of medical students, called Students Interested in Global Health, to Ghana for a two-and-one-half week tour of the country's medical network, including trips to rural clinics, urban hospitals and a medical school. This summer, associate professor and medical doctor Robert Campbell went with the student group on the excursion.

Clearly, Ghanaian physicians struggle with formidable obstacles in providing care for an impoverished populace that don't face their U.S. counterparts. But Americans can still benefit from studying others' diverse approaches to health care, and in return, U.S. medical professionals can share their own expertise as well.

The value of this kind of exchange is something Van Durme learned years ago. Ghana is the latest global destination for the professor, who also continues to practice medicine in clinics in and around Tallahassee. Among other countries, Van Durme has made the rounds for humanitarian as well as educational purposes to Azerbaijan, Russia, Vietnam, Panama and Mexico in the past decade. —C.S.


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