Erin in Ghana: April 2010

And here we are for our final week of nursing. For five days we stayed in a small village called Apemanim, which is about an hour’s drive from Kumasi, the second largest city in Ghana in the Ashanti Region. They say this region is the cultural heartland of Ghana. There is a lot of history with the Ashanti, one of the most powerful nations in West Africa in the middle of the nineteenth century. There is a lot of royalty in this region including the Ashanti King and Queen Mother. There have also been quite a few wars between some of the various tribes. A few people were actually killed not too long ago in one of these tribal wars.

Kejetia Market in Kumasi, the biggest market in West Africa.... very easy to get lost here!!!

The chief of Apemanim, Nana, actually lived in Edmonton and has a degree from the U of A. This village does not have a clinic and most people have to travel very long distances, usually on foot, to seek health care. Public transportation rarely passes through this village and the condition of the roads are very, very poor. They are currently building a clinic but financial and political restraints have really slowed the process down. Our job was to do a community assessment to find out what the greatest health care needs of this village were. We broke up into three small groups. One group was to find out about maternal care and childbirth, one group for school-aged children and one group for geriatrics. We all went out into the village with a translator (very important!) and just started questioning the people. I was with the geriatric group, so we talked to a few of the elderly people (there weren’t many). We found out that the main health concerns of this group was hypertension, poor vision, poor hearing and chronic pain (similar to home). The maternity group found that access to a clinic for prenatal care was very difficult for the women that lived here and most mothers gave birth in their home with the help of a traditional birth attendant. The children’s group found that poor nutrition and malaria were big issues.

Nana, the village chief

So after spending a couple of days with the people of Apemanim, we learned that a clinic would really be beneficial to this community, so we decided to try to get one started. We all donated some money and went out and bought some basic supplies that could be used to get a clinic started. We used one of the rooms of the guest house we were staying at as the site of our new clinic. We scrubbed it from top to bottom and then filled all the cupboards with donations that we brought from home and with our newly purchased supplies. By the end of our fifth day at the village we were actually able to get a clinic up and running, and the community nurse, Jaelle, was able to start seeing patients on the same day!!! We are going to continue fundraising for this clinic when we get home. We all had such a good time at the village and found everyone to be very welcoming. And we are now officially nurses!!!! What a good way to end it!

My trip has now come to an end... I am hoping to post one more blog when I get home so everyone can see pictures of my travels, which was the best part of the trip! Wish I could have done that before leaving Africa, but the internet is so awful here!!!

See you all back in Canada, hopefully the volcano doesn't get angry again, or I'll be stuck here!!

Our new clinic... only took like 3 hours to set up!

Jaelle, the community health nurse

This baby is not too pleased with my backpacking skills!

The traditional birth attendant

These are all coffins!!! Can you imagine being barried inside a fish???

Mole National Park

This monkey was responsible for stealing several of our sugar cubes, luckily Erica was able to wack it with her water bottle before it stole are toast!

This was the blog I was hoping to post two weeks ago before we left for the village but that didn't end up happening. So here it is. And hopefully in the next couple of days I can post what I've been doing in the last two weeks... if the internet works that is.

We have now finished our two weeks at Mamprobi Polyclinic. The polyclinic is sort of like a mini hospital. There are several different clinics within Mamprobi including STI, Labour and Delivery, Antenatal, Post-natal, Nutrition, Recovery, Community Psychiatric, Community Health and Family Planning.

Thanks for the dresses mom!!!

Day 1: Community Psychiatric: Mondays is when patients come to the clinic for counseling. The most common psychiatric illnesses are alcohol induced psychosis, schizophrenia, tension headaches, and epilepsy (which is a little strange that they would treat that as a mental illness). These are just a few, there are a lot actually. Counseling is done quite a bit differently than in Canada. There is no privacy for the patient. I sat in a small room with the counselor, 6 nursing students and two nurses and the patient. The counselor was actually a reverend at a Pentecostal church and he also does spiritual healing. He is also a registered psychiatric nurse. Quite the combo.

Day 2: STI Clinic: Today I was put in the STI clinic. In a span of 20 minutes two pregnant women were diagnosed with HIV, one of whom has been married for 10 years and has three children. The nurse called her husband and told him that his wife was HIV positive and that he and the children should come to the clinic right away for testing. The nurse was really excellent with these patients. This was a really hard day for me actually. I had a huge lump in my throat while the nurses were telling these women their results. But I guess that’s just reality here.

Day 3: Psychiatric Home Visit: Today we did what is called “home tracing”. This is where the psych team will go out into the community and try to figure out where their patient’s live from some very obscure directions they were given by the patient. The directions are usually along the lines of “drive to the corner store, turn right at the green fence, turn left down the alley with the three black goats, then turn right at the garbage pile”. It is very tricky finding these places. Also patients will usually give out fake address because mental illness has such a stigma here.

Day 4: Labour and Delivery: Busy day on the ward today. We got there just in time to see a placenta being delivered and then we got to watch a birth right after. It seemed quite a bit different than at home. There were about 8 nursing students watching the birth and two mid-wives delivering the baby. No one really talked to the mother the entire time this was happening. After the baby was born they immediately gave him a bath. They pretty much scrubbed that baby raw. After about an hour, the mother was finally able to hold her baby.

Day 5: Child-Welfare Clinic: Today I went out into the community with the nurses and we set up a little baby clinic, outside under a tree. We vaccinated and weighed the babies. The nurses even let me do some of the vaccinations and also the teaching about nutrition. They also made me read out everyone’s name, I’m pretty sure they did this just to laugh at me trying to pronounce them.

Administering oral Polio vaccine

Day 6: Child-Welfare Clinic: Today I went with the nurses to a very poor area of Accra for a baby clinic. We first had to go into the community to let the people know that we were running the clinic. The nurses just knocked on everyone’s door because they said there would be at least one baby in every home. There is a lot of polygamy in this area and many of the mothers have around 10 children each. The people here tend to use a lot of traditional medicine and their overall health is very poor. The conditions of this community were the worst I’ve seen. Everyone lives in such close quarters. None of the adults were at work and none of the kids were at school. The nurses said that this is their most challenging area. They say that the mothers always say they’ll come to the clinic, but then they never show up. A lot of the babies at this clinic were not gaining or they were loosing weight. This community definitely needs a lot of education.

Pictures taken while visiting community

Day 7: Childwelfare Clinic: Today was a very busy day. Laurie and I went to do a baby clinic with the community nurses. We powered through 72 babies in about three hours. It was crazy, but the nurses have a very efficient system.

Impitego: Common skin condition in children here

Day 8: School Health: Me and three other students went to a school where we assessed around 400 kids with only the help of a couple more nurses. There were a lot of dental carries, rashes, ringworm and boyles on the kids. They were soooo cute! And so excited for us to be there.

And that’s it for Mamprobi, March 27 we head out to a village for a week to do a community assessment.

Random Pictures

How can I come to Africa and not golf?? Here we are at the Achimota Golf Course in Accra, the most prestigious course in Ghana. It wasn't quite as nice as our courses at home. The greens were usually covered in sand, which made it tough to putt. We felt like starts though, as we had two caddies that did everything for us! And yes I realize our outfits are kinda funny, we were scrambling around our rez the night before looking for collared shirts!