This blog is extremely long, I know! But I’ve been able to get on the internet for a total of maybe 45 minutes in the last two and a half weeks so I wanted to catch everyone up. The internet situation is not great here.
Nkrumah Monument
For one of our seminars, our teacher took us on a little field trip to the Nkrumah Monument which is in downtown Accra. It is basically a gigantic monument in a park where, Kwame Nkrumah’s body is barried. Kwame Nkrumah was the first Prime Minister of Ghana and led the country to total independence in 1960. He also helped some other African countries gain their independence. His legacy and dream was to create a “United States of Africa”. He has written several books about African liberation and will remain one of the most influential people in history. This was really something to see, what a good field trip!
Orphans and Disadvantaged Children’s NGO
We all went to an NGO which is managed by one of the nursing instructors at the University of Ghana. On the first Saturday of every month, several families and orphan children come to the NGO and they receive wheat fortified with soy (15 kg per family for one month), education about HIV and other diseases (many of the children had HIV), and we handed out some toys and diapers that we had brought from Canada. This turned out to be a chaotic free-for-all, as everyone wanted something and unfortunately we didn’t have enough. The kids were all so happy to have us there though. We played so many games with them and even did the chicken dance!
Weekend on the Coast
This was our first weekend away from Accra. We headed west along the coast to a small fishing town called El Mina. Here we went to El Mina Castle, which was originally used as a fortress to trade goods and gold in the 17th century by the British and the Dutch. Later it was used to trade and store slaves. What an eerie place this was. The slaves were packed into dark, overcrowded and unsanitary dungeons for weeks and months at a time, and if they survived this they were led out of the castle to waiting ships through the Door of No Return.
Later that night, we went to Hans Cottage Botel which was a restaurant in the middle of a pond of crocodiles.
On Sunday we went to Kakum National Park. This park protects 357 sq km of diverse and dense vegetation. It’s also the home of 40 different species of large mammals like elephants, monkeys and antelopes. Unfortunately we didn’t see any wildlife, I guess the best time to see them is early morning or evening. We did, however, get to take the canopy walk over the park. It was about 350m of rope and cable strung up about 30-50m above the park. They were really flimsy and several people were feeling a little light headed from the height. I decided to run across one just for fun, but then I got in trouble from our tour guide. Haha….
Trauma/Surgical Department at Military 37 hospital
If you’re interested in nursing/health care read this section, if not this section may bore you.
So I just complete three weeks on the trauma ward at Military 37. What an eye opener this has been. There are sooooo many accidents or RTA’s (road traffic accidents) as they are called here. I’m not surprised I guess, the traffic here is ridiculous and people are weaving in and out of traffic constantly. I’ve never seen so many blood transfusions in my life. At Military 37 if a patient receives blood from the blood bank, the family is expected to donate their own blood back to the hospital. Kind of a good idea actually. This ward is really short of supplies. The trauma ward takes on a functional type of nursing. So one person does dressing changes, another does medications etc. Dressing changes are done daily and “sterile” technique is basically non existent. They clean wounds with cotton, hydrogen peroxide and normal saline which is hand made and put into used water bottles. Iodine soaked gauze is then put on the wound and taped on with “plaster” which is their word for tape (not clear tape like we’re used to, but soft cotton tape, very annoying for checking IV sites). Patients usually wait until they get really bad before they come in to trauma. Here are some interesting cases…
A 40 yr old women came into trauma with the worst case of breast cancer I have ever seen or even heard of. Her right breast was about four times the size of her left and the tumor was so large that her skin had split open and was infected. This open skin bled so much that she needed a blood transfusion. Apparently she had been to a “traditional healer” for herbal treatments (this is very common here) and that is why it was so bad when she came in to trauma.
A middle aged man came in with pretty severe cellulitis. His leg was about three times the size of the other leg. This man also went to see a traditional healer. The traditional healer told him that he stepped in some “evil” at a funeral and that is why his leg was swelling. The healer then cut the man’s leg open and put in some herbs. Then his leg got really swollen and infected and that is why he came in to trauma.
A 10 yr old girl was rushed in to trauma after she was hit by an ambulance. She was totally unresponsive when she came in and was intubated. They had to use adult sized equipment to intubate this girl and they ended up ripping her cheek open. The girl was then sent to ICU, where she died several hours later.
A woman came with a compound fracture of the tibia. Her bone was completely severed and was sticking straight out of her skin. This woman stayed in the trauma unit for about a week and a half waiting to get into surgery. This may have been the most disturbing case I’ve ever seen. Every day the dressing change was done on this poor woman and she was in complete agony every time. One person would lift her knee and one would lift her foot and the middle would just sag into the bed. The splint she had was a folded up cardboard box with gauze wrapped around it. She was given no pain medications even though she had bought some and it was sitting next to her bed. The nurses kept saying that she should just bare the pain and that they didn’t want her to get used to having pain medications before every dressing change. I helped with the dressing once and I was so disturbed by it, I felt like I was being part of some kind of human torture. The next day I refused to be a part of this dressing change unless this woman was given pain medications. I had to really fight with the nurse but finally she let me give the patient something for pain, in the middle of the dressing change I might add. (By the way narcotics are rarely used here for pain... Pain control is not really a priority here). I just held this lady’s hands through the whole thing while she yelled and prayed in agony. Really horrible experience.
For the most part, things are pretty much the same as Canada. They are pretty smart in trauma, they just have very little to work with. They will use old IV tubing as tourniquets, reuse a needle on the same patient, fill gloves with water and use them to prevent pressure sores etc… Trauma was a really great experience, next week Public Health!
