October 29, 2013

So –what was I actually doing in Ghana?


I volunteered at GA West Municipal Hospital through the organisation Volunteer Partnerships for West Africa (VPWA). They are a locally run NGO who offer a range of different placements from microfinance, to teaching, to the Street Library and of course the hospital. My choice to go through them was very much influenced by the price, which at 100€ a week was much better value than what the generic gap year companies can offer. You also know that the money is being used to develop the NGO and actually staying in Ghana. In addition this is one of the only companies I found which would let me volunteer in a hospital without already being a medical or nursing student.


Amasaman Hospital Ghana


I sort of decided to go on a whim. I wasn’t particularly enjoying my job and thought it was about time I mixed things up a bit. Best decision I ever made. Not only did I gain a lot of experience working in the hospital, but I met a lot of amazing volunteers who I enjoyed the most epic nights out and perfect weekends away with (work hard, play harder).


I volunteered in the hospital for 7 weeks, each morning between around 9am and 2pm (Ghana time allows a lot of leeway with when you actually arrive). Each week I would go and see Grace the training coordinator and tell her which department I would like to go to and for how long. As I was there for a while I managed to see a lot. I started off in the ART clinic where they test for HIV. This is done by a simple prick test which I was actually allowed to conduct myself. It was pretty scary doing this at first –the nurses kept telling me I needed to prick the patients harder because the blood was coming out a bit slowly. I just felt so guilty when they winced in pain. It was a great opportunity to get some hands on experience though.


From the ART clinic I moved to the Gynae ward (pregnant ladies and newborn babies). Here I was taught to take vitals –blood pressure, heart rate, breathing rate, temperature. I really struggled with the manual BP monitor at first and generally finding people’s pulses (I still can’t find it in my own wrist :s) but I did get the hang of the noises I had to listen for eventually. It was a bit embarrassing having to take multiple attempts to take the patients blood pressure but they were all really nice about it. I also helped changed the dressings of caesarean wounds and even got to go to surgery and watch a caesarean! I had never seen any surgery before so I was a little wary of how I was going to cope. Honestly it is kind of gross (fat on the inside is actually horrendous) but it was very interesting and I was pretty pleased that I didn’t feel like I was going to faint or anything!)


After a week in Gynae I spent a couple of days on the Buruli Ulcer ward. Buruli ulcers are one of the neglected tropical diseases which are relatively rare but have huge effects on those who are infected. For some unknown reason (a lot more research needs to be done in the area to determine the actual cause) Amasaman (the area the hospital was in) had a particularly high incidence of the disease. I saw children with huge wounds on their faces, amputees and wounds that had eaten the flesh away right down to the bone. I would share a picture here but it doesn’t seem fair to unexpectedly launch that upon you. I helped to take off the old dressings so that the nurses could clean the wounds and redress them. This was a fairly shocking job as you just didn’t know how bad it was going to be when you took the dressing off. I felt so sad for the patients, especially when the treatment seems so limited and the disease has progressed at such a high degree that amputations would be necessary. This was the area where I thought most improvement could be made. Dressings were only changed Mondays, Wednesdays and Fridays and there seemed to be very limited doctor involvement. I believe the patient’s could really have benefitted from their dressings being changed more often and increased doctor review of wounds (this seemed fairly non-existent with this ward being almost completely nurse led). Hopefully one day researchers will actually be able to determine the cause and discover new treatment options…


The next week I spent in labour ward where I saw natural birth for the first time. I was very impressed with how the mothers coped without pain relief, only clicking their fingers to help them through their contractions. The reality of childbirth makes me pretty scared for it to ever happen to me though –that does not look enjoyable! As well as birth I saw circumcisions and 1 emergency case where a girl had tried to abort at home. This seems to be a major issue in Ghana with their traditional views on sex after marriage meaning that many abortions occur at home in secrecy, often with dangerous consequences for the girl involved. I saw further evidence of this when I spent a day in the ultrasound clinic where there was 1 young girl who was heavily pregnant but had travelled to a different part of Ghana for an attempted abortion. The family were very upset that there was still a baby but at this stage (about 6 months) it was far too late and could not be allowed.


Problems surrounding birth control are not limited to young girls. Spending time in the family planning clinic enlightened me to the fact that this is an area surrounded with much secrecy. Many women would come without their husbands knowledge, using Depo Provera (the contraceptive injection) as it could not be discovered. The head nurse told me how some women don’t even want to be seen in the clinic and so they have community volunteers who the women can go to, to purchase birth control discreetly. I saw this first hand when I went to volunteer at the street library in a local school one Saturday  and the headmaster took us around the community to try and persuade more of the local children to come to school. We saw huge families and very young mothers who are seemingly completely unaware of the birth control options available to them. We spent a lot of time discussing this issue and I helped to put together a proposal for a community health initiative that could include the promotion of family planning.


The rest of my time in the hospital was spent with a few days in each of the clinics or smaller departments. I attended the ear, nose and throat clinic, the emergency room, child welfare, the gynae consultation room, a paediatric consultation room and the eye clinic. One of my favourite things I saw was the children in the child welfare clinic literally being hung up by their onesies on a scale to be weighed. They looked so bemused and cute just hanging there. In contrast I saw a really sad case in the eye clinic. A girl (probably about 12 or 13) came in with a bruised and inflamed eye that was as a result of her mother hitting her in the face with a cane. I was pretty shocked about this and the consulting nurse just asked me if we didn’t hit our children and laughed at my reaction. It’s pretty horrifying that that is normality there. In the face, of all places.


I also spent a day helping with the measles and rubella vaccination programme filling out the vaccination certificates. It was pretty amusing to see the nurses accosting the unaware local school children and telling them they need to be vaccinated as they innocently walked past. In Ghana there is literally none of the drama surrounding vaccination that we have in the West. Everyone is happy for their child to be vaccinated and pleased that they are being protected from disease therefore preventing the potential issues we have with poor herd immunity here.


So that is a pretty epic essay on the time I spent in the hospital there. Next time I’ll talk about the fun shenanigans I got up to at the weekends :).



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