Reaching out to help and heal

Diasporian News of Sunday, 16 November 2003

Clevland, OH, USA -- Dr. Emmanuel Tuffuor has seen a lot of misery and suffering over much of the last half-century - in the torrid hinterlands of southern Ghana and the impoverished streets of East Cleveland.

But it's in these areas Tuffuor prefers to practice medicine, even though he could earn more money and distinction working elsewhere.

Prestige means little to Tuffuor, a native of the dusty village of Kumasi, Ghana. He works long hours each day and crisscrosses the Atlantic Ocean several times a year to assure that people in poor neighborhoods, jail or on society's fringes get quality health care.

"I see health care as a universal right," said Tuffuor, who attributes his approach to life and career to his grandmother, Aninwah, who raised him and his seven sisters.

The late Aninwah was an untraditional African woman, a matriarch who defied the rigors of a male-dominated society. She started a business to raise money for the children's education.

She told Tuffuor he had to become the man of the family after his father died when he was a child. And she instilled in him and his sisters the importance of a strong work ethic and the notion of helping those less fortunate.

Those lessons remain with Tuffuor. His pace is relentless.

Tuffuor runs full-time private medical practices in East Cleveland and Warrensville Heights, teaches a six-week course in international health each year at Case Western Reserve University and provides medical service twice weekly to inmates at the Cuyahoga County Jail.

In addition, he travels to Emena, Ghana, a half-dozen times a year to help oversee the Aninwah Medical Center - named after his grandmother - which he founded 12 years ago.

A magazine

Here at home, another project is under way. This fall, he will publish the first edition of a free monthly health-care magazine aimed at educating the black community about health issues.

The magazine initially will be distributed in East Cleveland, Warrensville Heights and parts of Cleveland in places including senior centers, grocery and convenience stores, and beauty parlors and barber shops, Tuffuor said.

"It will help them . . . engage their physicians [in discussion] about their conditions," he said.

It will cost the doctor about $1,500 a month to publish the magazine, tentatively titled The Foundation Health News. The publication will be produced with help from volunteers at the Glenville Health Foundation, a nonprofit group Tuffuor founded two years ago to educate African-Americans on health care.

With assistance from volunteers, including a handful of doctors who have agreed to periodically write articles, Tuffuor's latest project is not expected to cut too deeply into the time he spends with his family.

Tuffuor, who is married with three children, has not taken a real vacation in three years. His golf clubs and racquetball equipment are collecting dust.

"Trying to improve someone's life is the recreational part of my life," said Tuffuor, who went into private practice 20 years ago in East Cleveland.

"It seems like when I'm giving to people, in some ways I'm helping myself, too, because it brings me a lot of inner peace and joy and happiness," he said. "And in some ways it allows me to function in other aspects of life because of what I do."

Tuffuor's wife, Tanya McKnight-Tuffuor, colleagues and friends have watched the doctor keep up an unenviable work pace for years, although they say he is never frazzled or short with people.

"He has a lot of energy and doesn't need a lot of sleep," said McKnight-Tuffuor, a community care coordinator for the Visiting Nurse Association.

When pressed, she admits she would enjoy seeing more of the man with whom she has spent the last 20 years. But she understands and supports what he does for his family and people in need.

Tuffuor, 52, rises around 5:45 a.m. weekdays and spends as much time as possible with his wife and their youngest son, 14-year-old Matthew, before heading off to work. His daughter, Alli, is away at college; his oldest son, Osei, works in radio in Washington, D.C.

By 8 a.m. he is making rounds, visiting patients at South Pointe Hospital, St. Vincent Charity Hospital, Huron Hospital and University Hospitals. Around 10:30 a.m., he heads to his Warrensville Heights office for a good portion of the day. He usually arrives at the East Cleveland clinic by 3 p.m., leaving for home around 7 p.m., except when he works at the county jail. On those days, Thursday and Friday, he doesn't get home until 11 p.m. or later.

On one particular afternoon in his East Cleveland office, Tuffuor is in constant motion. He rushes from the lobby to the receptionist's office, from the medical table to the waiting room. His demeanor is one of concern.

The majority of his clients are black. But Tuffuor, who specializes in internal medicine, has cared for a diverse group of patients.

His West African accent, which still filters through despite his 30 years in the United States, has been a curiosity to some. Others have been mildly intimidated by it.

Tuffuor came to Ohio from Ghana when he was 20 to attend Bowling Green State University. At first, his grandmother was paying the tuition.

But when Tuffuor saw fellow students from well-off American families toiling as dishwashers to help make ends meet, he knew the payment arrangement could not work.

"If I continued to let her do that, the gates of heaven would be permanently shut for me," he said.

So he worked odd jobs, got academic scholarships and paid his way. In 1974, he graduated with a bachelor's degree in biochemistry. And in 1976, he started medical school at Case.

Tuffuor met his wife in 1983 during his residency at the now-closed Mt. Sinai Medical Center. Tanya McKnight, a nurse, gave him a hand with a patient. They became friends, started dating and were married three years later.

They now live in Chagrin Falls, a community McKnight-Tuffuor has grown to fancy after living for years in Shaker Heights, which she loved. The lots are bigger out there, the houses farther apart.

It took a little longer to get to know people, but the Tuffuor family has settled in and made friends. One thing has remained the same - the doctor's unrelenting workdays.

Taking a break

He does "kick back" sometimes, she said, takes a snooze and manages to watch "60 Minutes" almost without fail each Sunday.

But his true relaxation comes when working on his projects in Ghana, she said.

"If he has a nickel and someone needs it," he will give it away, she said. "He had a grandmother and grandfather who worked very hard to bring him here, and he will do whatever it takes to make them proud."

McKnight-Tuffuor cherishes the health care field, too, but enjoys working part time to spend more time with her children and minding the demands of the house.

She is also Tuffuor's biggest supporter and biggest critic, cheering him on when he's right and putting him back on course when he veers.

"She helps me with balance, being a father and meeting the hard task of being a physician," Tuffuor said. "She is supportive and tolerant. Without her support, it would have been impossible for me to do what I have done for Ghana."

Ahmed Elghazawi, medical director for the Cuyahoga County Sheriff's Department, described Tuffuor as a superb physician. "He treats people with dignity and respect and provides the ultimate medical care."

David Miller, a former ambassador to Tanzania and Zimba- bwe, agrees. He and his wife, Patti, met Tuffuor many years ago and helped him raise money for the hospital in Ghana.

"When I think of the many people I have worked with over the years, he has to be one of the most caring," said Miller, who considers himself "half African" because of the years he served as ambassador.

In order to make hospital care affordable in Ghana, Tuffuor and the Millers set up a program in which natives of Ghana living abroad pay a small annual stipend for health-care insurance for their relatives back home.

The 75-bed hospital opened in spring 1991 and provides a wide range of medical services from general medicine to surgery.

It's situated about seven miles from Kumasi, which has a population of about 1,000. But residents of some 50 villages in the region use the hospital.

Residents of Tuffuor's village were offended that the doctor did not build the hospital in the village of his birth.

And some expected special treatment because they were from Kumasi.

Tuffuor was forced to travel back often to explain what he was doing and why.

Good health care must be spread to everyone, Tuffuor said, regardless of whether you are black or white, rich or poor.

"It's a joy to get them feeling better," Tuffuor said. "Some doctors love and command prestige . . . That is the least of my concerns."

Miller has teamed up with Tuffuor to help provide a medical relief aircraft to make it easier to get to people in remote areas of Ghana.

"For a man under as much pressure as he is, I have never seen him upset, short or curt with anyone," Miller said. "I'm not quite sure where that comes from."

Whether in Ghana or in East Cleveland, Tuffuor leaves the office or hospital each day hoping he has eased the pain for his patients, solved some problem. And he feels at ease.

"Health care is a partnership and there has to be give-and-take," he said.

"I feel there is a need to give back, not only to the communities I serve here, but also in the country where I came from. To share with others is an innate sort of thing I was raised with."

Mrs. Afranie Appiagyei, Administrator extraordinaire By Sebastian R. Freiku

The Chronicle, Tuesday, August 20, 2002, Page 7

There is one name that features prominently in the running of Aninwah Medical Centre (AMC), a private medical facility at Emena, near Kumasi in the Ashanti Region. The name is Mrs. Afranie Appiagyei. She is one person upon whose shoulders the administration of the centre arguably the biggest private hospital in Ashanti, rests.

Since taking over the administration of the 75-bed capacity hospital in April 1999, three years after its establishment, Mrs. Appiagyei has turned the hospital into a viable proposition and erased the initial fears of his US based brother proprietor, Dr. Emmanuel Tuffour, that the hospital project could be a flop.

Mrs. Appiagyei, 47 and mother of four, made the most sacrifice ever and returned to Ghana from Toronto to take charge of his brother’s dream and served as full time administrator. She graduated from McMaster University in Hamilton, Canada, with a double major in Psychology and Sociology. She has a six years experience as a Social worker/ Counsellor with the Ontario Social Office and as an Assistant Customer Services manager with the Canadian Imperial Bank of Commerce, Toronto, for nine years.

With this rich academic background, the former social worker has expanded the hospital radically. The poor management systems, general financial loopholes, rampant stealing and the poor business culture which characterized the running of the place initially are no more. The transfer of funds from the USA for operations at the hospital ceased shortly after she took over.
A wind of change has actually blown at the place to the admiration of the chairman, Board of Directors and staff. This feat has earned her the accolade of “Iron Lady.”

The question is how did Mrs. Appiagyei do it. How has she successfully handled a portfolio generally perceived as the preserve of men, particularly when she is a non-medical professional.
The origins of her leadership qualities and managerial skills are not farfetched. As a pioneer of the Akosombo International Secondary School, she was the Girls’ Prefect for the entire five-year period.

She enrolled at the Elmwood High School, Ohio, in the United States, between 1973 and 1974 before entering the McMaster University for her Bachelor of Arts degree.

She was also the first African to be part of the Miss Black Ontario, Canada in 1985 and emerged the first runner-up in the said beauty pageant. Such is the character who would want to work, work and work until results and a positive one at that.

She has no fixed working hours, a quality which has inspired the entire staff to constitute themselves into a driving force for the promotion of the Primary Health Care program. In fact, she is committed to what she does.

“My prime concern is to assist in providing healthcare and other related services to all classes of consumers on the most competitive terms possible,” she stressed.

Her secret is hard work. There is no better life outside idleness, she believes. She actually takes pleasure in the work she does. No doubt she has condemned the Ghanaian work ethics which she says is not healthy for development. According to her, salaries are earned and not dashed to people and that it is real work that provides pay.

She is guided by what she calls the four challenges in human endeavour. The maxim she explains in the 4R’s, namely the right systems, the right caliber of personnel, the right training and the right facility. These principles she has effectively adopted to transform AMC into a leading medical center of excellence these few years.

Notwithstanding the level of success, Mrs. Appiagyei is no longer content with just delivering healthcare. Today, her aspirations are different from the initial objectives in the setting up of AMC. She is adopting a cultural revolution to get almost all 53 communities in and around the Kumasi metropolis to support the running of the hospital.

Guided by AMC’s objective to provide healthcare, she has since 1995 introduced six different options of Health insurance schemes, namely the Ghana Care and the Company on Credit schemes for Ghanaians abroad who buy health insurance for their loved ones back at home and employees of companies respectively.

The pay per service scheme for individual families was introduced in 1996. Then in 1999 the Community Health Insurance Scheme (CHIS) was established for the benefit of communities, market women, associations, small business concerns and small micro enterprises.

The latest of the schemes introduced this year (2002) is the Susu Scheme for pregnant women and mothers with babies under which AMC sensitizes the target groups to finance healthcare through the payment of premiums.

Lately AMC, as a service provider and partner with Micro Care Ghana, an NGO, also under the Executive Directorship of Mrs. Appiagyei, has setup research centers and developed community outreach programmes (four times a week, including Sundays) counseling on HIV/AIDS, teenage pregnancies and STD’s.

Under this partnership, AMC and Micro Ghana Care promote quality accessible healthcare for PLWHA and provide appropriate information on HIV/AIDS.

That is Mrs. Afranie Appiagyei for you – a woman whose principle in life hinges on “responsibility and accountability.”

"Doctor discovers the right medicine for Ghana"

Howard W. French, NYT 8 De 95, A4 talks about the good and bad experiences of Emmanuel Tuffour, who returned to Ghana to open a modern clinic after being a doctor in Cleveland, USA. A major problem was encounter with ancestral values and Ghana's old socialist ideas. He believes in individual responsibility and effort but has been swarmed on by relatives, long lost kin and others demanding jobs or free care. And well off people have come to his clinic demanding treatment for which they refuse to pay.

“A Wise Investment to save the Health and Life of your Relatives in Ghana”

The Executives of GhanaCare Ltd. from Cleveland, Ohio made GhanaCare health care program presentations in a “Town Hall” meeting at Presbyterian Church of Ghana and The Ghanaian Catholic Community at St. Andrews Parish both in Etobicoke recently.

The Executive Vice President, Mr. John Pokryfki outlined the immediate and future goals of GhanaCare – a unique initiative of health care delivery service in Ghana. Mr. Pokryfki said the goals of GhanaCare affiliated to HealthAfrica Inc. are to make quality, affordable health care services available to all Ghanaians living in Ghana by promoting cost effective care in the private sector in Ghana using a managed care model and other innovative financing arrangement.

Mr. Pokryfki said the GhanaCare program is designed so that Ghanaians living abroad would help finance health care for their loved ones in Ghana by sponsoring them through model annual fees ranging from $100.00 to $420.00 US. An individual member and family dependents are entitled to annual physicals, routine office visits to the family doctor, the first seven (7) days in the hospital and physical therapy all at no charge. GhanaCare, Mr. Pokryfki, continued, is also designed to eliminate financial barriers to care and thus encourage early and frequent visits by members to the doctor, avoiding costly care after the onset of serious illness or disease. GhanaCare provider established a ‘health profile’ for each new member so that the doctor can develop a health promotion plan or treatment plan if illness already exists.

GhanaCare have negotiated agreements with twenty three (23) hospitals and clinics serving all regions in Ghana. The individual agreement between the hospitals and GhanaCare provides, both individual and collective, for efficient patient care and continuous quality improvement.

Mr. Pokryfki said that it is also GhanaCare goal to implement a health care model that encourages self-reliance among Ghanaian nationals and indigenous Ghanaians and which is financially and structurally sustainable over the long run.

Mr. Pokryfki told the congregation that this model of health care delivery which is the first of its kind in Africa, however the parent company HealthAfrica Inc. is working to propagate the concept in other parts of Africa. He also said that The United Nations, the World Bank and other parties have expressed interest in GhanaCare and would like to become more involved with them.

Dr. Emmanuel Tuffuor, a board certified general internal medicine physician the architect of GhanaCare gave a brief account of his all-consumed desire to create financially sustainable health care for his fellow Ghanaians left behind in Ghana. The Aniwah Medical Centre (AMC), opened by Dr. Tuffuor, thrives in the rural village of Emena, just a few miles outside the regional capital of Kumasi in great measure due to the dedicated physicians, nurses and other professionals committed to serving the health care needs of Ghanaians. AMC employs more than eighty (80) people in the community and has become the economic basis for further growth in the area. Its reputation and popularity, he said, have even lead it to be fondly called the “American” hospital.

Dr. Tuffuor, envisioning the need to be creative in financing health care in Ghana, especially as it related to AMC, created a company called Complete Basic Health 2000 (CBH) to be the organizational conduit for financial and technology transfer from the United States and other western countries to Ghana. Stated concisely, CBH 2000 was a mechanism to secure hard currency from Ghanaians having a higher standard of living in the western countries and to make those funds available to the hospital and or clinic in Ghana on a “capitated” basis. The idea of financing health care at AMC through Complete Basic Health 2000 (CBH 2000) is the forerunner of GhanaCare Ltd.

Dr. Tuffuor and his team of experts are on extensive and resource-consuming communication campaign to get “GhanaCare” message to Ghanaians nationals living in the United States, Canada and Europe to provide them with the information necessary to sponsor a loved one in Ghana. Without the knowledge of the program, Dr. Tuffuor said, Ghanaians will miss an opportunity to take responsibility for the health of their loved ones in Ghana.

For more information about GhanaCare Ltd. call, toll free 1-888-505-6566 or in Toronto region 416-299-9611. Address requests for free brochure and application to: GhanaCare Ltd. P.O.Box 20298, Shaker Heights, Ohio 44120