Ghana Elective Placement 2024

januar - februar 2024
  • Ellen Withers
One of the most amazing and rewarding trips of my life. Enabled by my amazing husband and the wonderful people who supported me to go I experienced things I never thought possible.
Faith was restored in human nature and help was provided to A&E!
Læs mere
  • Ellen Withers

Liste over lande

  • Ghana Ghana
  • England England
Kategorier
Ingen
  • 20,2krejste miles
Transportmidler
  • Flyvning-kilometer
  • Gåture-kilometer
  • Vandring-kilometer
  • Cykel-kilometer
  • Motorcykel-kilometer
  • Tuk Tuk-kilometer
  • Bil-kilometer
  • Tog-kilometer
  • Bus-kilometer
  • Campingvogn-kilometer
  • Campingvogn-kilometer
  • 4x4-kilometer
  • Svømning-kilometer
  • Padling/Roning-kilometer
  • Motorbåd-kilometer
  • Sejlads-kilometer
  • Husbåd-kilometer
  • Færge-kilometer
  • Krydstogtskib-kilometer
  • Hest-kilometer
  • Skiløb-kilometer
  • At blaffe-kilometer
  • Cable car-kilometer
  • Helikopter-kilometer
  • Barfodet-kilometer
  • 30fodaftryk
  • 29dage
  • 443fotos
  • 2kan lide
  • GHANA - DAY 10

    30. januar 2024, Ghana ⋅ ☀️ 32 °C

    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**
    Læs mere

  • GHANA - DAY 12

    1. februar 2024, Ghana ⋅ ⛅ 33 °C

    Sixth shift at the Effia Nkwanta Regional Hospital, death, frustration, advanced sepsis and BBQ and dancing.

    It was quiet when we arrived, but I quickly noticed that the patient with the abscess wound we cleaned yesterday had died and was awaiting collection. It felt like ages before he was taken away.

    Stock checking drugs and stocking trolleys led into the drug round and before I knew it there was another dead patient waiting to be picked up by the door!

    My next patient was brought in by an off duty doctor, who'd found them by the side of the road unconscious and seizing. He'd put him on a trolley and brought him in. I triaged him and he was definitely seizing and showed signs of advanced sepsis. I struggled to control my frustration at the fact that because there was a period of time where we didn't know who he was, we were unable to treat him. 💸

    The nurse and I were trying to convince him to allow us to give paracetamol to help with his 42 degree fever... But because it wasn't part of the emergency package they're allowed to give unknowns, but he did administer diazepam to stop the seizures. I ended up trying to actively cool with wet towels! They did eventually find his id and some money which meant with some organisation and a prescription from the doctor, we started antibiotics about 2 hours after he'd been brought in. But monitoring with one manual bp cuff (because all the electronic ones are now broken) and one pulse ox to go around the whole department was difficult!

    I left shift today certain he won't be alive when I arrive in the morning, and a little fatigued.

    To cheer myself up, I took a little trip to the mall and sourced more fabric for another outfit from the seamstress 🙂

    The BBQ and dancing was awesome tonight and we celebrated Eve's birthday (which is Saturday) and then once we'd all been dancing, we jumped in the pool and had a chill before finishing the day 😊

    **Photos taken and shared with permission**
    Læs mere

  • GHANA - DAY 13

    2. februar 2024, Ghana ⋅ ⛅ 29 °C

    Seventh and last shift at the Effia Nkwanta Regional Hospital A&E. More death, happy nurses, and travelling to Kakum National Park.

    Another quiet morning so we had time to chat with the nurses a little. Did some tidying and stocking and then two patients were pushed into triage in wheelchairs. The male nurse I was working with pointed to one and said you triage that one, and he did the other one. My lady was dead. So I did my checks and asked the doctor to pronounce, which he did. She'd died recently and probably on the way and her brother was distraught 😥

    During drug rounds there was some celebrations and sister Bernice called me over to join in! One of the nurses I'd getting married in march and had brought in an invitation for all the nurses in A&E!

    The rest of the shift was full of chatting and general activities. Then sister took me to get some supplies and we went out on the roof and I found the IT department, which made me laugh.

    After a quick turn around at the house we headed to Kakum, via dinner at Cape Coast (where I took the opportunity to get my feet in the water) to stay the night in a tree house!

    **Photos taken and shared with permission**
    Læs mere

  • GHANA - DAY 14

    3. februar 2024, Ghana ⋅ ⛅ 25 °C

    'sleeping' in a treehouse in Kakum National Park, canopy walk, Cape coast castle and batik workshop.

    The treehouse was super hot and the bugs were noisy. The canopy walk was great and I made some fabric which was cool.

    Not my best day though. I'm really feeling like the odd one out 😞
    Læs mere

  • GHANA - DAY 15

    4. februar 2024, England ⋅ ☁️ 11 °C

    The past couple of weeks have caught up, so it's been a nice day of relaxing and looking at my literature review. I'm having to start again which is frustrating, but it was nice to think about something a little more 'normal' for a bit today.

    First day on theatre placement tomorrow. It'll be good to see another aspect of the hospital, but I'll miss A&E!
    Læs mere

  • GHANA - DAY 16

    5. februar 2024, Ghana ⋅ ⛅ 33 °C

    First shift at the Effia Nkwanta Regional Hospital general surgery department.

    Nothing, an argument at Takoradi mall (which I won) and a little progress on my dissertation.

    So, my first day in theatres involved being shown around and then a lot of sitting. The orthopaedic surgeon normally in on Mondays is off at the moment, so there was no list. Those that know me will know this won't have sat well. I'm a grafter, they joked about me in A&E because all I wanted to do was work 🤣.
    Anyway, the show around was really interesting (and eye opening).
    I went straight to the mall after my shift to take a power bank back that wasn't compatible with my phone, and when the manager in the shop was refusing to give my money back, insisting I could only replace it with something, I had to explain that all his alternatives had already been considered when I chose this one initially. My stubbornness paid off and eventually he muttered something like "I'm tired, and you need to go away, I'll give you your money back" 🤣🤣🤣

    So I went and bought a sammich and got a bolt back to the house and made a little progress on my literature review... Which is a really good thing because it was starting to really worry me.

    Nice dinner, and ice cream and a giggle with the girls outside before retiring for the night... All in all a good day 😀

    Apparently there will actually be a list tomorrow, and once I've observed one procedure and been shown what everything is, they'll let me scrub in (how fucked up is that?!! But I'm not complaining 🤣).

    The final note of the day... Thanks to my wonderful husband sharing the fundraiser at work and on his extensive LinkedIn network this morning, in a single day the donations more than doubled and we've smashed the target and I'm now planning what is going to be purchased for the A&E department here at the hospital. I couldn't be happier, it's going to make such a difference to both the nurses and doctors as well as the patient outcomes!

    Thank you all, from the bottom of my heart for all the support, kind words, encouragement and donations I had from you all in the last year. I am extremely humbled by the generosity and grateful for everything I've received x

    **Photos taken and shared with permission**
    Læs mere

  • GHANA - DAY 17

    6. februar 2024, Ghana ⋅ ☀️ 30 °C

    Second shift at the Effia Nkwanta Regional Hospital general surgery department. Three procedures, exam results and relaxing by the beach with a cocktail 😁.

    Second shift in theatres and today was much more busy. There were two planned (a hernia repair and bilateral lumpectomy) and one unplanned (a little boy with an impressive amount of puss in his hand!) procedures.

    Sister asked me if I wanted to scrub in, so I did!! I was a little nervous when I realised that it was the bilateral lumpectomy, as they were talking about potentially switching to a mastectomy, given my history. But it was fine, and super interesting. It's funny, because I notice the 'differences' between here and home much less. I'm kind of just accepting things as they are. Which I think is a good thing, it relieves some of the emotions and makes it a less bumpy ride.

    Towards the end of the shift our exam results came in, and these were the ones I was dreading, so was surprised and extremely relieved when I passed them both!

    We finished the list early so headed to the mall on the way back to the house, and after lunch I worked on my dissertation. I'm starting to get a bit of cabin fever so a couple of us went to Vienna City Beach for a cocktail (I had a sex on the beach... because there was no mojito!!) which was exactly what I needed.

    Tomorrow is orthopaedic day🤞🏻for a list, I'm excited to see some orthopaedic surgery 😊

    **Photos taken and shared with permission**
    Læs mere

  • GHANA - DAY 18

    7. februar 2024, Ghana ⋅ ☀️ 29 °C

    Third (and last) shift at the Effia Nkwanta Regional Hospital general surgery department. A closed comminuted tib/fib fracture, new clothes and a new job!

    There were 4 procedures on the orthopaedic list today. Three hips (of varying procedures) and a comminuted fracture repair. The first patient was supposed to be a hip repair (as demonstrated by the doctor when I asked him against the x-ray 🤣), but they hadn't organised blood in case of they need a transfusion.
    They were O- as well which is rare here too and so they were still waiting when I left at 1400.

    I watched the repair of a closed comminuted fracture (a bone broken in at least two places) of the right leg. Which had happened as a result of a car accident where they were driving. A tourniquet was applied to the leg (and preemptive TXA) given, to limit bleeding as much as possible. The surgeon cut on the lower leg and pushed the plate up to disconnect the muscle from the bone.
    This part was brutal! They then needed to take x-rays so he knew how well it was positioned (I think he might have taken about a thousand!! 🤣). Those of us without lead aprons were thrown out whilst this was happening. It was so interesting and after the surgery I chatted with the surgeon about the procedure and asked if he'd cut the whole leg open, would he have needed to use x-ray?. He said no, but that it's a matter of physiology. The technique is called MIPO (Minimally Invasive Plate Osteosynthesis). The idea is that the tissue surrounding a severe comminuted fracture like this would remain intact and serve to heal the bone faster and protect the site.

    The main advantage of MIPO is that it does not interfere with the fracture site and so provides improved biological healing, and the plate has better angular stability. If opened up fully, the small pieces of bone become dislodged and it's essentially a puzzle, which is harder for the surgeon, and more detrimental to the patient and their outcome. However, the obvious disadvantage is the almost excessive use of x-ray to check placement and position for inserting the screws. There is no cast applied after the surgery. The patient is advised not weight-bear for 6-8 weeks.

    I also asked how long the limit is for the tourniquet to be on, he replied that for the type used this morning around 2 hours because we're unable to control the pressure or know about the perfusion. He described systems that could have been used to allow us to know what the pressure was, and also to be able to ease the pressure off and then back on again after 2 hours to allow perfusion.

    During the procedure the anaesthetist asked my name... When I told her she said "are you Tuesday born?" (😲WTF🤣) I nodded yes and she said "your Fante name is Abena". I really rather like it too 😁 I'm still wondering what made her say Tuesday 🤷🏻‍♀️

    After bidding a fond farewell to the lovely sisters in the main theatres I headed back to the house and a few of us headed back to the sea stress to collect some clothes... I keep accidentally getting clothes made 🤣🤣🤣 I love these as much as I loved the last outfit too!!!

    When we got back the lovely ladies that make our food had made kokonte (like fufu, they're both made from cassava) and palmnut soup for themselves (it's a traditional Ghanaian dish) and because when I'd asked for fufu this morning they'd said next week, and I won't be here (I'm at the village) they saved me some especially! ❤️ It was very nice!!

    Then, the best news of the day? I have a job!!! I applied for an NQP (newly qualified paramedic) role within SNEE (Suffolk and North East Essex) and I got it! I still can't quite believe it. It'll take a minute to sink in. But I couldn't be more pleased, or proud of myself! My dream has almost come true!!

    I'm going to bed, very content and thankful. For so much.

    **Photos taken and shared with permission**
    Læs mere

  • GHANA - DAY 19

    8. februar 2024, Ghana ⋅ ☀️ 33 °C

    First shift at The National Ambulance Service (NAS), Takoradi. CPD, donation order and some chill time.

    Today I went to the NAS. I felt so at home, I got a massive amount of comfort from being in and near the ambulance 😁 I hadn't realised how much I'd missed it. Everyone was so welcoming and really happy we'd joined them.

    They were really keen to learn from us about our trucks and processes and what we do on the road. Despite the fact that their equipment, in some ways is actually better than ours!

    There are 20 ambulances in the western region. There are 3 levels of ambulance crew. Basic trained (which takes 1 year), EMT (2 years training) and paramedics (2 years training in North Dakota!). The Takoradi station houses the Control room / dispatch centre. There are 2 dispatchers for the whole region and they work 24 hour shifts. They take an average of 15 to 20 calls per day and decide whether an ambulance is needed.

    The government funds the ambulance being used for accidents, taking women in labour to hospital, but the patient must pay for fuel if they're being transferred between hospitals.

    The inside of the ambulance has lots of features and things that may be better than ours:
    ➡️ The spinal board slides under the stretcher.
    ➡️ The carry chair is bigger, more comfortable and doubles as a stretcher.
    ➡️ There is a ventilator on board.
    ➡️ Vacuum splints are standard.
    ➡️ Foetal monitoring on board.
    ➡️ The stretcher mechanism is purely mechanical, less likely to go wrong and easy to use.

    Interesting points:
    ➡️ Not as many drugs (only carry diazepam, TXA, oxygen, dextrose and normal saline).
    ➡️ No drugs are locked away, the diazepam was on a little shelf next to the stretcher 🤣.
    ➡️ They carry diazepam to pacify aggressive patients!

    We went through everything in the truck and s we were doing it one of their managers came out and told them they may as well use it as CPD!! So we went into full SIM mode 🤣 it was brilliant. We didn't get a job unfortunately, but we did get a lift back to the big blue house in the truck (all of us in the front 🤣).

    They invited me back tomorrow, and it would be rude to refuse!! Here's hoping for a call 😊.

    The order went in for the donation to ENRH A&E. It's very exciting. I'll update that separately.

    Finally... It's BBQ night, food was lovely, and now my social battery is low... So I came up to chill, had a shower and now feel much brighter and ready for tomorrow!

    **Photos taken and shared with permission**
    Læs mere