GHANA - DAY 10

Fourth shift at the Effia Nkwanta Regional Hospital, a visit to x-ray, CT and ultrasound, more fabric shopping and yet more washing!

Today's shift was crazy. Having stock checked the drugs and stocked the trolleys up I caught doctor Irene and asked her to go through the patients and next steps. She is really good at going through what they're presenting with and then covering her thinking around management. It's so useful to hear this, and we had a really good conversation about they way they manage sickle cell anaemia here, and how that's different based on whether the crisis presents in the joints or pulmonary circulation! Comparing that to our management was really interesting, and will inform my management in future, within guidelines of course.

Just clear of that as we're walking over to triage a man is pushed in on a trolley with his foot dangling off the end and a killer graze down his torso and was in masses of pain.

Dealing with him was such a contrast! In the truck we'd reach for the entonox, get a line in and administer paracetamol, followed by morphine and we'd splint the dangling foot with a box splint designed for this purpose. What actually happened was he got morphine, then we made do with a cardboard box cut up to splint the ankle. 3 oxygen tanks were found to be dodgy before he eventually got oxygen. The scissors we managed to find barely cut anything and bandages are always in short supply. Everything is difficult to get hold of because it's all shared between them all, so you have to track stuff down.

The doctor sent him for x-ray, CT and ultrasound to confirm what was going on... And while she's ordering these, another patient is pushed in, in a wheelchair seizing. Suddenly all hell breaks loose and the throng looking after the trauma patient needed to divide to deal with them both. I stayed with the trauma patient and asked if I could go to his scans with him.

His colleagues were all running around sorting things. They had to go and buy what he needed immediately, then go and pay for the scans so that they could be done. To take patients to x-ray, you have to go out the front door of A&E and walk round the hospital to go back in another entrance. I chatted to his colleagues as we walked about the impact these injuries will have on the patient's life and financial implications. They did say he was lucky as his company would sort the hospital fees and wages whilst recovering. He's more lucky than most here.

Unsurprisingly, the CT machine has been broken since last year when it was moved to the new location and so they're limited to CT head and neck. The x-ray machine was old technology and definitely showed it's age, but they all did the job and confirmed the distal tib/fib fracture and also showed a full set of broken ribs!

Heading back he was made comfortable in A&E and waited for the orthopaedic doctors to review him. After the drug round it was time to leave and we headed out to the Tro-tro... As we walked across the trauma patient's colleagues all said good bye and thanked me for my support. Always nice to hear!

A quick turn around at the house before heading to the mall to select fabric for my dress and I got enough to get a matching shirt made for hubby 🙂 and after dinner it was time to do more washing! Weirdly it's actually quite therapeutic!!

**Photos taken and shared with permission**Leer más