Medicine & Healthcare, Nursing in Ghana by Kirsty Jane Poulter
I had just enrolled on a Return to Practice Nursing course following an 18 year career break to have my family when my son said he was thinking of going to Ghana, with Projects Abroad, to do a preuniversity medical project. It sounded a great opportunity to experience healthcare in a different country so I signed up also to do a nursing project.
We chose Ghana because it is only a 6 ½ hour direct flight away from the UK and English is a widely spoken language.
Arriving in Ghana
On arrival at Kotoka Airport we were met by Nyame, who very efficiently sorted out the issue that one of our checked in bags had not made it onto the flight. It was very reassuring to know that as soon as British Airways could get the bag to Ghana he would arrange for its collection and delivery to us at our host family in Cape Coast. All of which did duly happen.
Our first night was spent at the Pink Hostel in Accra. I hadn’t slept in a bunk bed in a girl’s dormitory for quite a number of years so it was quite an experience and home seemed a very long way away. The following morning we were escorted to Cape Coast on the tro tro and introduced to the local staff. Peter took us to meet our host family and drop off our bags before taking us on a very comprehensive tour of the town and a very nice lunch at The Castle Restaurant.
We returned to the host family having made arrangements that Bernard, the medical co-ordinator would collect us the following morning and take us to our placement at Cape Coast Regional Hospital. The host family were very welcoming and the host mother, Christina very keen to do all she could to make our stay comfortable. Unfortunately the other two volunteers in the house that were nearing the end of their placements were unwell, one with malaria. It emphasised the importance of taking our malaria tablets regularly, sleeping under a mosquito net and applying lots of mosquito repellent when out in the evenings. With treatment he soon recovered and was able to enjoy his final few days in Ghana.
On my placement
The next morning Bernard was there as promised and drove us to the hospital showing us on the way where we would get a line taxi from and the cost of getting to the hospital on future days. We were introduced to the Assistant Director of Nursing who discussed with us what areas we would like to work in. I opted to do most of my placement on the male surgical ward as this is the speciality I had previous experience in.
After a tour of the hospital and introductions to staff in various departments I arrived on the male surgical ward.
It was a 40 bedded ward divided into 4 bays and 4 single side rooms. My first impressions were that the beds were really close together with no curtains to screen in between them. I also noticed how a lot of the beds didn’t even have a sheet on them; often patients were lying on pieces of cloth that the family had provided. There was an acute shortage of clean bed linen in the hospital so when we arrived on a morning shift we often only had two clean sheets allocated to our ward. It was a tough decision as to who was the most deserving.
The morning shift was from 8am-3pm. The ward generally was quite short staffed so they were grateful for another pair of hands to administer medications & intravenous fluids, monitor & record the vital signs, follow the doctors on the ward rounds & implement requested changes and change wound dressings.
One particular patient had 58% burns to his body and his wound dressing took two members of staff over an hour to soak and cut away the old bandages and reapply new dressings. Sadly after 10 days of doing his dressings daily he became increasingly septic and passed away despite everyone’s best efforts to save him.
The surgical cases on the ward were very varied with a special interest of mine being the orthopaedic trauma cases. Some of the injuries were quite devastating and surgery could take a few days to arrange due to both booking a theatre slot and the patient finding funding. There were cases where the delay was so severe that limbs that were originally salvageable ended up requiring amputation. I felt very sad for these patients and wished I could have done something to speed up their surgery and chances of full recovery.
Activities on the weekend
Two days a week I went on the outreach programme with other volunteers. This varied from going to the leprosy camp at Ankaful, changing wound dressings to going to orphanages or special schools to do malaria testing and basic health care. We also went to a village Kaokram, where we did blood pressure monitoring, malaria testing, blood group testing and wound dressings. It was interesting to see what life was like in villages like this and what a great community spirit everyone seemed to have despite living in very challenging conditions. Quite a number of the children tested positive for malaria and we were able to give them medication for treatment but unfortunately very few had mosquito nets and we didn’t have any to give them.
During my free time I met with other volunteers in the evening at Oasis or our weekly Projects Abroad meeting at the office where we did activities such as learning to play Ghanaian games, dancing, cooking and making volleyball net out of recycled drinks packages for an orphanage. The National Park at Kakum to do the canopy walk is a nice day out and the castles at both Cape Coast and Elmina are a must to learn about the slave trade that was a big part of this areas history. I also enjoyed some relaxation at Elmina Bay Hotel that had a nice swimming pool to laze by.
My final thoughts
By the end of my 4 week stay I had made lots of new friends and really felt I had gained a lot from my experience. Ghanaians are very friendly hospitable people and Cape Coast is a great place to get an insight into life in Ghana. It is a very safe place and the large, regional, teaching hospital has a wide variety of opportunities for anyone with a nursing/medical interest.
I have come back to my job as a staff nurse on an orthopaedic ward in the UK and it has made me appreciate the NHS and the numerous resources we have available. The doctors & nurses in Ghana work under extreme difficulties due to lack of equipment and finances but do a fantastic job and I was proud to have been able to work as part of their team, if only for a short time.