Have had a bit of a crazy week this week! It has been my last week on the paediatric ward. On Monday during the ward round a mother started shouting and wailing so loudly and wouldn't stop for ages until she was sent off the ward, sadly her child had just passed away from 'breathing difficulties'. What I find so hard here is that so many people die unnecessarily simply due to a lack of equipment - there is no resuscitation equipment in the hospital and no monitors to detect when a person is deteriorating, and not enough staff to keep an eye on all the sick patients. There was hardly any response to this child passing away and ward round continued as normal, with staff seeing the mother as an inconvenience for disrupting the routine. Later that morning three children came in at the same time, all critically ill, and not enough was being done quickly enough as there is not really any sense of urgency so it can be very frustrating.
I spent Tuesday on the Neonatal Intensive Care Unit just for the day. There were 3 tiny very premature triplets all squeezed in one incubator, definitely adorable! Again the mortality rates for neonates are so much higher here in Ghana simply due to a lack of equipment and babies die from things which they would never die from in the UK.
Today was a really interesting day, I spent it on the delivery ward (infection control in England would have a field day) and saw 3 babies being born Africa-style. 2 of them had to be resuscitated as they were very blue and not breathing when they were born. The women in labour get NO pain relief whatsoever, and they are not allowed anyone with them until after the baby has been delivered, even the fathers. The women all are in labour in one room together, then when they are fully dilated they have to pick up their plastic sheet, walk through to the delivery room with no dignity at all, have their babies then walk back through to another room where they are later joined by their baby if it is well enough. The midwives slap the women if they make too much noise. I saw a few rather bloody procedures which they did without anaesthetic too, I honestly don't quite know how the women withstood it!!
This afternoon went to Egyam Orphanage with a few people from the WTW house, which was amazing. There are about 50 children there. We took toys and rice to donate. We played with the kids for a while, was so much fun! We took hula hoops but they didn't know what to do with them. Really puts into perspective how much we have and how fortunate we are.
Last weekend me and 7 other girls from the house spent the weekend at one of Ghana's favourite backpacker haunts called Green Turtle Lodge, about an house West along the coast from our base in Takoradi. We stayed in a round mud hut type thing about 30 meters away from the sea. It was so beautiful.
Am really enjoying my time here, it is going so quickly. Am missing home quite a bit too especially on days when bad stuff has happened at the hospital!
Hope you are all enjoying the World Cup - if England play Ghana I may have to stay indoors for a week.
Lots of love from Ella xxx
Thursday, June 24, 2010
Wednesday, June 16, 2010
Surgical wounds and Kumasi/Lake Botsumtwi
Today I spent the day on the female surgical ward at the hospital, just to see what it's like there and because there are children there too. The ward itself is pretty big with a huge variety of patients there, all women who either have had or need surgery, burns, wounds of any description or orthopaedic patients. I have never seen such awful wounds as today!! There are a lot of awful leg or foot ulcers due to diabetic patients which come about because diabetes is poorly controlled. These often end in amputations as the leg or foot becomes so gangrenous. Other common wounds are from fractures e.g. from people in car accidents which protrude through the skin. Procedures are done with mild sedation which in the UK would be done under general anaesthetic. The only dressings here are gauze and iodine and things tend not to heal very well so end up horrendously infected. Not for the faint hearted!
Every Tuesday all the students at the Work the World house have Fante lessons (the local language after English) from a teachers called Mr Atta. I had my third one yesterday and after we had a test, if we failed it we would have to repeat a class but luckily i passed and am now officially an intermediate! It's actually really useful having Fante lessons as it enables us to communicate with the patients at a basic level, as not all speak brilliant English. People here love it when you speak to them in Fante too. My favourite phrase is 'Mi ma wo ache' (good morning) and 'mintiase' (I don't understand)..does come in useful!
Last weekend me and 5 other girls from the house visited Kumasi, which is a big city about 4 hours inland of where I stay in Takoradi. We had an awful journey there on Friday night, as our tro tro (form of public transport) didn't leave for 3 hours and it took us 6 hours to drive there on bumpy crazy roads as there were huge crates of fish on top. So we got there at midnight and after a lot of hassle from people we managed to get in a taxi and the place where we stayed on Friday night was HORRIBLE!! But we left early on Saturday morning and visited Kejetia Market, largest open market in West Africa, which was definitely an experience but not particularly one I would want to repeat. It was HUGE, so so busy and because we stood out like a sore thumb we got a fair bit of hassle! But we explored a few other places in Kumasi on Saturday then got a tro tro to Lake Botsumtwi, about an hour further travel which was in the middle of nowhere and was absolutely stunning, a stark contrast to the big sprawling city.
There are now 21 medical and nursing students in the house which is a bit maniac sometimes (especially in the mornings when we are fighting for the bathrooms...) but really fun. Feels like I have been here a lot longer than 3 weeks now.
Lots of African love from Ella xx
Every Tuesday all the students at the Work the World house have Fante lessons (the local language after English) from a teachers called Mr Atta. I had my third one yesterday and after we had a test, if we failed it we would have to repeat a class but luckily i passed and am now officially an intermediate! It's actually really useful having Fante lessons as it enables us to communicate with the patients at a basic level, as not all speak brilliant English. People here love it when you speak to them in Fante too. My favourite phrase is 'Mi ma wo ache' (good morning) and 'mintiase' (I don't understand)..does come in useful!
Last weekend me and 5 other girls from the house visited Kumasi, which is a big city about 4 hours inland of where I stay in Takoradi. We had an awful journey there on Friday night, as our tro tro (form of public transport) didn't leave for 3 hours and it took us 6 hours to drive there on bumpy crazy roads as there were huge crates of fish on top. So we got there at midnight and after a lot of hassle from people we managed to get in a taxi and the place where we stayed on Friday night was HORRIBLE!! But we left early on Saturday morning and visited Kejetia Market, largest open market in West Africa, which was definitely an experience but not particularly one I would want to repeat. It was HUGE, so so busy and because we stood out like a sore thumb we got a fair bit of hassle! But we explored a few other places in Kumasi on Saturday then got a tro tro to Lake Botsumtwi, about an hour further travel which was in the middle of nowhere and was absolutely stunning, a stark contrast to the big sprawling city.
There are now 21 medical and nursing students in the house which is a bit maniac sometimes (especially in the mornings when we are fighting for the bathrooms...) but really fun. Feels like I have been here a lot longer than 3 weeks now.
Lots of African love from Ella xx
Thursday, June 10, 2010
Second week at Effia Nkwanta and Nzulezo Stilt Village
This week has gone so fast! It has been my second week on the paediatric ward at the hospital. Today there were 3 critically ill children all rushed in from A+E, all 3 with cerebral malaria with convulsions and i honestly didn't think they were going to survive the morning but they were still there when I left to go home. I have come across a few cases of where parents use 'herbal remedies' or go to 'medical healers' to cure their children of coughs, colds etc and end up having to bring their child to hospital as a result of this, for example one mother gave her child an enema of ginger, another child had very strange cuts all over from a 'healer' and another child had been given garlic to stop him convulsing...
There are also quite a few children who come in with infections and is is discovered through blood tests that they have HIV, it is heartbreaking when the parents are told. I am starting to learn a lot about malaria, TB, typhoid, and sickle cell disease, all of which are so common here in children. The consultant, Dr Eghan has really taken me under his wing and teaching me so much. Basic things are in such short supply here but they really do improvise, for example plastic tubing for tourniquets to take blood, folded cardboard boxes for splints etc.
Last weekend me and 4 other students from the house traveled 3 hours West along the coast to the most secluded village called Beyin, where we stayed at a beautiful beach resort. It was so nice to sit in the sun and relax and admire the picture perfect beach! On the Saturday we visited Nzulezo Village, which is a village literally build on stilts in the middle of this HUGE lake, it was amazing! Took an hour canoe ride to get there, in the middle of absolutely nowhere. Was such an experience to see though, so hard to think people actually lived in these wooden huts on the water. It was a really good weekend and although had a slightly hairy journey back on sunday evening (our tro tro didn't turn up so we ended up getting a lift from this very strange but obviously hugely rich lebanese man, from the resort to a nearby town (30 mins drive along the WORST road ever) then a tro tro from there back to our house which went so fast it was terrifying. Never been so pleased to see our house!
Hope you are all having a good week.
Lots of love from ella xx
There are also quite a few children who come in with infections and is is discovered through blood tests that they have HIV, it is heartbreaking when the parents are told. I am starting to learn a lot about malaria, TB, typhoid, and sickle cell disease, all of which are so common here in children. The consultant, Dr Eghan has really taken me under his wing and teaching me so much. Basic things are in such short supply here but they really do improvise, for example plastic tubing for tourniquets to take blood, folded cardboard boxes for splints etc.
Last weekend me and 4 other students from the house traveled 3 hours West along the coast to the most secluded village called Beyin, where we stayed at a beautiful beach resort. It was so nice to sit in the sun and relax and admire the picture perfect beach! On the Saturday we visited Nzulezo Village, which is a village literally build on stilts in the middle of this HUGE lake, it was amazing! Took an hour canoe ride to get there, in the middle of absolutely nowhere. Was such an experience to see though, so hard to think people actually lived in these wooden huts on the water. It was a really good weekend and although had a slightly hairy journey back on sunday evening (our tro tro didn't turn up so we ended up getting a lift from this very strange but obviously hugely rich lebanese man, from the resort to a nearby town (30 mins drive along the WORST road ever) then a tro tro from there back to our house which went so fast it was terrifying. Never been so pleased to see our house!
Hope you are all having a good week.
Lots of love from ella xx
Wednesday, June 2, 2010
Start of placement..
So i started my placement yesterday and thought i would add a blog to write about it as there is so much to say!
At the moment i am on the children's ward. it has about 40 beds and is constantly busy, there is only 3 nurses on each shift. There are two main rooms (almost like small village halls is the best way of describing it) and a few other side rooms for 'isolation' cases (no infection control whatsoever though so definitely not isolation rooms!). There is no monitoring equipment at all and the most advanced equipment is a drip stand.. the whole children's area is very open, no privacy at all, beds crowded close to each other, patient toilets are so smelly and disgusting, the whole place is quite dirty, and was a bit of a shock the first time i walked in but i have sort of got used to it already!
About 70% of the children admitted are for cases of severe malaria, often with complications e.g. anaemia. Other cases include typhoid, TB, malnourishment and dehydration, and a few cases that I would see in the UK e.g. kidney problems, high fevers etc. I asked one of the consultants about the provision of mosquito nets and he said everyone can easily and cheaply get them here as so many are donated through aid organisations, but people apparently do not like using them as they are too hot and irritating...
The attitude of the nurses in particular is so different to the UK and to be honest, they often seem very aloof and 'not caring' towards patients and families but this is just the culture and how they do things here. In particular the attitude to a child dying is so different - for instance when i got in this morning one of the doctors told me a child had died over night rather unnecessarily, as they had needed a blood transfusion as they had severe malaria but no one had bothered to pick it up from the blood bank as it was late evening so the child died overnight. One of my friends also from the UK is on the neonatal unit and on her first day a baby died in her arms...there again was no monitoring equipment and so no one had noticed the baby deteriorating and then when resuscitation was started there was no oxygen in the cannisters. So it is frustrating in situations like that but just have to get on with it and accept that is how it is here; I am not here to change the whole system but to learn how they do things in a place with such limited resources.
Better go now as slow internet...
love ella xx
At the moment i am on the children's ward. it has about 40 beds and is constantly busy, there is only 3 nurses on each shift. There are two main rooms (almost like small village halls is the best way of describing it) and a few other side rooms for 'isolation' cases (no infection control whatsoever though so definitely not isolation rooms!). There is no monitoring equipment at all and the most advanced equipment is a drip stand.. the whole children's area is very open, no privacy at all, beds crowded close to each other, patient toilets are so smelly and disgusting, the whole place is quite dirty, and was a bit of a shock the first time i walked in but i have sort of got used to it already!
About 70% of the children admitted are for cases of severe malaria, often with complications e.g. anaemia. Other cases include typhoid, TB, malnourishment and dehydration, and a few cases that I would see in the UK e.g. kidney problems, high fevers etc. I asked one of the consultants about the provision of mosquito nets and he said everyone can easily and cheaply get them here as so many are donated through aid organisations, but people apparently do not like using them as they are too hot and irritating...
The attitude of the nurses in particular is so different to the UK and to be honest, they often seem very aloof and 'not caring' towards patients and families but this is just the culture and how they do things here. In particular the attitude to a child dying is so different - for instance when i got in this morning one of the doctors told me a child had died over night rather unnecessarily, as they had needed a blood transfusion as they had severe malaria but no one had bothered to pick it up from the blood bank as it was late evening so the child died overnight. One of my friends also from the UK is on the neonatal unit and on her first day a baby died in her arms...there again was no monitoring equipment and so no one had noticed the baby deteriorating and then when resuscitation was started there was no oxygen in the cannisters. So it is frustrating in situations like that but just have to get on with it and accept that is how it is here; I am not here to change the whole system but to learn how they do things in a place with such limited resources.
Better go now as slow internet...
love ella xx
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