title: Experience of collaboration between a Dutch surgical team in a Ghanaian Orthopaedic Teaching Hospital.
abstract: BACKGROUND
  Surgery is an indivisible, indispensable part of healthcare. In Africa, surgery may be thought of as the neglected stepchild of global public health. We describe our experience over a 3-year period of intensive collaboration between specialized teams from a Dutch hospital and local teams of an orthopaedic hospital in Effiduase-Koforidua, Ghana.
  
  
  METHODS
  During 2010-2012, medical teams from our hospital were deployed to St. Joseph's Hospital. These teams were completely self-supporting. They were encouraged to work together with the local-staff. Apart from clinical work, effort was also spent on education/ teaching operation techniques/ regional anaesthesia techniques/ scrubbing techniques/ and principles around sterility.
  
  
  RESULTS
  Knowledge and quality of care has improved. Nevertheless, the overall level of quality of care still lags behind compared to what we see in the Western world. This is mainly due to financial constraints; restricting the capacity to purchase good equipment, maintaining it, and providing regular education.
  
  
  CONCLUSIONS
  The relief provided by institutions like Care-to-Move is very valuable and essential to improve the level of healthcare. The hospital has evolved to such a high level that general European teams have become redundant. Focused and dedicated teams should be the next step of support within the nearby future.
authors.affiliation: University Medical Center Utrecht, Department of Surgery/Trauma-surgery. P.O.-box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: T K
authors.initials: TK
authors.lastname: Timmers
authors.affiliation: University Medical Center Utrecht, Department of Anaesthesiology.
authors.forename: E
authors.initials: E
authors.lastname: Kortekaas
authors.affiliation: University Medical Center Utrecht, Department of Vital Functions and Theatre Managment.
authors.forename: Bpc
authors.initials: B
authors.lastname: Beyer
authors.affiliation: University Medical Center Utrecht, Department of Surgery/Trauma-surgery. P.O.-box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Huizinga
authors.affiliation: University Medical Center Utrecht, Department of Vital Functions and Theatre Managment.
authors.forename: S M
authors.initials: SM
authors.lastname: V Hezik van
authors.affiliation: St. Joseph's Hospital, Department of Orthopaedic Surgery Effiduase-Koforidua, Ghana.
authors.forename: E
authors.initials: E
authors.lastname: Twagirayezu
authors.affiliation: University Medical Center Utrecht, Department of Surgery/Trauma-surgery. P.O.-box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Bemelman
mesh_terms: D003299:Cooperative Behavior; D005551:Foreign Professional Personnel; D005869:Ghana; D006784:Hospitals, Teaching; D006801:Humans; D009426:Netherlands; D009985:Orthopedics; D010348:Patient Care Team
keywords: Dutch; Ghana; Orthopaedic; collaboration; improvement