Monday and Tuesday of this week I was in the female ward. The ward consists of a room each for general medicine, pediatrics, patients in labor, delivery, and postpartum. Take for instance the general medicine room. There are no partitions, just 10 beds lining the walls and one shared bathroom. The rooms are not air conditioned but do have fans. The patients wear their own clothes and often bring their own sheet. Their family members bring them food or they go buy it from the canteen. While they are being admitted, the patient or a family member goes to the pharmacy and buys the medication and fluids they will need during their stay. Any medications they can’t afford or that are not available they just don’t get. The hospital doesn’t seem to bill so much as to collect payment up front or at least before the patient leaves. There are no machines controlling IV flow rate, the blood pressure cuff used for vitals has real mercury in it, and there are no tvs. Well there is one tv in the peds room which the nurses watch sometimes when it is slow.
During my time there I hung out with the nurses and tried to help them with things. I took vitals, made beds, helped get meds ready, talked with patients and reviewed their charts. The general med room was pretty full while I was there. A number of the patients had hypertensive urgency/emergency, malaria, threatened/complete abortions. One patient had a diabetic foot ulcer. Another younger girl had fallen out of a moving car and possibly had a wrist fracture. A woman was admitted for GERD which didn’t make a whole lot of sense to me but she also as it turns out had malaria and was pregnant. There were a couple children in the peds room most with malaria along with other infections (UTI, URI, pneumonia). A couple of women were in the post partum room with their adorable newborns.
The doctor that is on night call rounds on the all the patients usually early in the morning. Since I hadn’t done much with any of the doctors I figured it would be a good opportunity and a chance to learn more about management. Tues I was on the ward at 5:15am and the doctor finally showed up an hour later. During that hour of waiting I was so tempted to just go back to bed. It was a good experience. The doctor is young and very nice. We rounded on all the patients and went next door to the male ward as well. It is much smaller and only had 2 patients at the time. I had gone to bed late the night before and the rest of the morning was a struggle. I would have to keep moving to prevent myself from falling asleep. I should probably go on rounds a couple more times before the end but it is hard for me to voluntarily wake up so early. If I do I am definitely going to bed early.
In the afternoon I got to watch a c-section on a term patient with premature rupture of membranes. It went much like the other c-sections I have seen but a lot of the equipment is older. Also they sterilize and reuse much of the stuff we throw away in the OR like caps, gowns, towels. I am still amazed by c-sections. The incision never seems big enough but they always manage to tug and pull the baby out. The baby looks like an alien rag doll and then minutes later when it is all clean and crying it is a soft, beautiful newborn.
One last brief wards story, one of the new admits was a very large woman with very high blood pressure. The nurses were trying to get an IV started on her but were having the hardest time. I think they must have stuck her 10 times. I totally could have tried to start the IV but felt so bad for her. I figured my one blood draw experience was much less helpful than the years of experience the nurses had starting IVs. They finally called in the doctor and he stuck her about 4 more times before he finally got it. By the way calling someone fat does not seem to be offensive in Ghana. Supposedly being fat means you are healthy and is preferable to being skinny. I wonder if this cultural preference is changing with the rampant spread of American culture.
Thanks for the comments! I really enjoy reading them. I have also been checking my yahoo mail but either comments here or email works for me. Things in the mission house have been going well. I have a bit of a routine now and the house doesn’t feel quite as big and lonely. The girls across the way are Ghanaians and work in the office at the hospital. I hang out at their place pretty much every night. They are very friendly and nice. We eat, watch tv, talk. They have taken me grocery shopping. I still would like to get out a little more and am going to work on making it happen. I hope all is well at home!