In late 2009, a number of GPs and practicing nurses working in Amsterdam South East went on an educational trip to Ghana. This trip inspired us to see if we can put a collaborative project together. From the very beginning, our idea was to focus our attention on two aspects of care: firstly, how can we help Ghanaians achieve their healthcare objectives, and on the other hand, what can we learn from the Ghanaians. During the trip we came in contact with a regional hospital, which is well organized but needed support in setting up a care program for chronic illnesses (diabetes and hypertension). Hypertension and diabetes are a major and growing health problem. A disease such as hypertension not only found in prosperity countries, but is also prevalent among the poor people in developing countries. The WHO is paying increasing attention to this problem.

In Ghana, however, the care is more focused on infectious diseases and much less on chronic diseases. There are many obstacles preventing care for the chronically to take root. These obstacles include: the shortage of doctors, responsible for the care of  hypertension and diabetic patients. The distance to the regional hospital, where control and treatment takes place, is also a problem.

We have devised a plan partners in Ghana, whereby the care of patients with diabetes and hypertension will be delegated to the nurses in the health centers and posts in the villages. This is in line with how the care for things like contraception, pregnancy, infectious diseases, etc. is organized. Much is being done by the nurses themselves, there are protocols and clear agreements on delegated care and referral criteria.

For chronic diseases, there is no system yet.

A small group of us went for a second time to Ghana. This plan was devised based on the discussions we had with the various stakeholders. At this moment we are negotiating with organizations to get financing backing for the project. At the moment we are in talks professional school for general Practitioners of the AMC to explore the possibility of cooperation with them and social medicine.