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Peter G. Trafton, MD, and R. Richard Coughlin, MD, with KATH’s Christopher Akandobnaab.


Published 6/1/2011
Lynne Dowling; Nancy Kelly

AAOS, OTA, OO launch West Africa trauma training program

New volunteer opportunities available

After years of planning, disappointments, and fits and starts, a long-standing vision recently became reality with the establishment of the first official orthopaedic specialty training program in the West African nation of Ghana.

Originally part of an AAOS-funded initiative, the Africa Cooperative Education Program, this new training program is the result of years of cooperative effort by the Academy, the Orthopaedic Trauma Association (OTA), and Orthopaedics Overseas (OO), the largest division of Health Volunteers Overseas (HVO). The American Orthopaedic Foot & Ankle Society and the Institute for Global Orthopaedics and Traumatology, in cooperation with the Ghana College of Physicians and Surgeons and Ghana Ministry of Health, also joined in to establish the new orthopaedic specialty and training program.

The primary training site is located in the new, multimillion dollar Accident and Emergency Center adjacent to the Komfo Anokye Teaching Hospital (KATH), in Kumasi, Ghana. The program is managed and administered by OO under the oversight of program directors Peter G. Trafton, MD, and R. Richard Coughlin, MD. Dr. Trafton oversees volunteer selection and preparation for teaching and surgical service assignments; Dr. Coughlin oversees U.S. and West African residency training and various research components of the program.

A new facility
The new Accident and Emergency Center at KATH opened in May 2009. Adjacent to the KATH, it is a state-of-the-art facility equipped with a triage area, minor and major treatment facilities, a resuscitation ward, three subacute wards (for men, women, and children), an intensive care unit, four operating rooms, and a helipad. Office space, conference rooms, and classrooms are also available.

Dr. Ralph Kumah is in charge of the orthopaedics and trauma service. A trained traumatologist, Dr. Kumah completed his orthopaedic residency training program in Germany following his full medical and surgical training in Ghana. He was recently joined by trauma surgeons Drs. Dominic Awarijah and Peter Komado, who also trained in Germany. Each directs a functional orthopaedic service, and each service is on call every 3 days.

Caseload and burden of disease
Recently, Dr. Kumah participated in the AAOS Orthopaedic Educators Course. In discussing musculoskeletal conditions in Ghana, he noted that the major burden of disease is trauma-related, mostly due to road traffic accidents and industrial accidents. Multitrauma patients are numerous and often have pelvic and acetabular injuries.

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Peter G. Trafton, MD, and R. Richard Coughlin, MD, with KATH’s Christopher Akandobnaab.
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A view of the new facility at KATH, in Kumasi, Ghana.

On average, one mass casualty event—usually a multipassenger minibus vehicle accident involving 20 to 25 people—occurs every week. As a result of this trauma burden, elective and subacute cases such as adult reconstruction and pediatric issues are repeatedly postponed, creating a backlog in surgery. Tumor patients often arrive too late to receive any definitive care.

Qualified physician and allied healthcare providers are in short supply, and the level of burn-out is high. Further, because the burden of disease is disproportionate to the number of available personnel, research must constantly be put aside due to lack of time and resources.

The new training program will help develop more qualified personnel, so that, over time, the quality of care provided will improve and can be extended to elective and subacute care.

Call for volunteers
Ghana is situated in the heart of West Africa, just north of the Equator. It has a stable, democratically elected government and a population of 23 million. Kumasi, with one million people, is the second-largest city. The official language is English, and it is widely spoken.

Volunteer assignments may last from 2 to 4 weeks; 4-week assignments are preferred. Housing, local transportation, and some meal service is provided nearby. Volunteers should be either board certified or eligible. Volunteers need an active license to practice medicine unless they are retired. Volunteers will be expected to teach and to participate in live surgeries during their stay.

For more information or to volunteer for this program, contact Andrea Moody, HVO, at (202) 296-0928 or visit the Web site at

Lynne Dowling is director of the AAOS international department; Nancy Kelly is executive director of HVO.

OO program sites
Orthopaedics Overseas also has programs in Bhutan, Cambodia, Cameroon, China, Costa Rica, Malawi, Moldova, Mongolia, Nicaragua, Peru, St. Lucia, South Africa, Tanzania, and Uganda. For more information, visit