ENDOMETRIOSIS IN GHANA – A Gynecologist’s Perspective.
(An interview with Dr S.K Gumanga, M.D, FWACS)
Written By:Fareeda Serwaa Brobbey, B.Pharm, MPSGH
The doctor to patient ratio in Ghana is approximately 1: 10,000. This put women with several gynaecological disorders that are considered “normal” by virtue of our cultural beliefs at a disadvantage – an example of such disorders is dysmenorrhoea. Such women are likely to be managed with over-the-counter painkillers and may not get past the GP to see a specialist. When they do meet the specialist, they may be turned away for not having a serious gynaecological illness. However, there are always some doctors willing to listen to their patients and ensure that all the necessary investigations are carried. One of such doctors is Dr Solomon Kwabena Gumanga.
Dr Gumanga is a gynaecologist at the Obstetrics and Gynaecology Department of the Tamale Teaching Hospital in the Northern Region. He is considered as one doctor, who shows empathy for his patients (mostly women) and always seems to understand what they are going through. He completed the St Petersburg I.P Pavlov State Medical University in Russia in 1997. From there he pursued his Housemanship at the Korle Bu Teaching Hospital in Accra, Ghana from 1997 to 1998. He proceeded to pursue his postgraduate studies in Obstetrics and Gynaecology at Korle Bu Teaching Hospital. Dr Gumanga graduated with Fellowship in Obstetrics and Gynaecology at the West African College of Surgeons in 2008. After his fellowship, he worked in Korle Bu Teaching Hospital for a year and proceeded to Tamale Teaching Hospital in the Northern Region. He was one of only four (4) Obstetrics and Gynaecology specialists at that time who were working in Tamale and attending to patients from the Northern, Upper East, Upper West Regions and also parts of Burkina Faso, since the Tamale Teaching Hospital is the only tertiary referral point in Northern Ghana. The number of Obstetrics and Gynaecology specialists in the hospital has since increased to seven (7) in 2016.
When asked about his experience with ENDOMETRIOSIS, Dr Gumanga disclosed that several women he diagnosed presented with clinical symptoms. For others, endometrial tissues were discovered through surgical findings for a different condition (for instance, some were discovered while he was performing myomectomy to remove uterine fibroids). Some cases of infertility have also been discovered to be caused by endometriosis. Most of the common cases of endometriosis he has managed so far were Pelvic Endometriosis and Umbilical Endometriosis. He has also managed Thoracic Endometriosis. His major concern was that there are a lot of under diagnoses of Pelvic and Extra pelvic Endometriosis in Ghana because Laparoscopy is not performed routinely as part of investigations especially in women with chronic pelvic pain, infertility, dysmenorrhoea and dyspareunia.
Dr Gumanga believes Endometriosis may be occurring at the same rate as uterine fibroids especially in young women of reproductive age in Ghana. His challenge with the management of Endometriosis is having access to the right diagnostic tool (Laparoscope) to properly diagnose and also to offer a better long term management especially for young women. For now, he can only offer management using hormonal therapy and pain medications.
Dr Gumanga hopes that there will improvement in the diagnosis and management of Endometriosis in Ghana and that requires the attention of his colleague gynaecologists, to the problem.