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Ghana Elective Placement 2024
  • Ellen Withers
jan. – feb. 2024

Ghana Elective Placement 2024

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! Les mer
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  • Reisens start
    21. januar 2024
  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 1

    21. januar 2024, Ghana ⋅ 🌙 26 °C

    Takoradi rest day

    We ventured out briefly to the market, but as it was Sunday it was super quiet. The tiredness was oppressive so I was in bed and snoring (literally apparently) by 2020 (I'm SO rock and roll!!!).Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 2

    22. januar 2024, Ghana ⋅ ☀️ 32 °C

    Effia Nkwanta Regional Hospital introductions and Takoradi city tour

    A little more refreshed after my sleep, I started to feel more positive this morning. We had our briefing first thing followed by a hospital tour and then the city tour. We are lucky enough to have a Tro-tro which will take us to our placement shifts and back again... But it was funny, it looks in much better condition than it actually is!

    Everything is different, and the heat is oppressive. Simple things become much harder in the heat, so I'm looking forward to acclimatising a bit so I struggle less with that. Everyone is so friendly, both inside the student house and outside. All the nurses and doctors we were introduced to were glad to see us and made us feel welcome!

    Ghana bear (Honey as Oscar named her) visited the hospital with us, but decided to stay at he house for the city tour. Shame, she missed out on a lovely dip in the warm gulf of Guinea 😍

    My placement starts tomorrow and I am in A&E. Very excited but also very nervous.    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 3

    23. januar 2024, Ghana ⋅ ⛅ 25 °C

    First shift at the Effia Nkwanta Regional Hospital, Fante lesson and Mole trip planning.

    Humbled.

    It'll take me a few days to fully process my first day, but humbled is how I feel. NHS, you are amazing!

    Irrigating an 8 year old girl's open tib-fib fracture, opened my eyes to how strong these people are. Watching a chest drain being inserted for a haemothorax with only lidocaine on board made me wince! It's really hard to describe the atmosphere, but it's an experience I feel honoured to be having!

    Observing the culture and learning from the way they do things is so interesting.

    An added bonus was that I met an ambulance crew towards the end of the shift and had a chat with them, and a look at their ambulance! I'm hoping to get a day with them at some point 😊

    My Fante is terrible, but I try! Their faces genuinely light up when we try to use their language... It really does help us to build relationships with them.

    I'm looking forward to seeing what tomorrow brings.

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 4

    24. januar 2024, Ghana ⋅ ☀️ 26 °C

    Second shift at the Effia Nkwanta Regional Hospital, fabric selection for tailor and washing!

    Another humbling shift at the hospital. We arrived this morning to find that the 5 year old with meningitis secondary to malaria had died. Primarily due to a delay in antibiotics 😞

    We felt short staffed this morning, confirmed by the fact that Sister Irene was working and when I asked why she wasn't in scrubs she replied that she was actually off duty, but had stayed to help out ❤️

    Today's cases included a bradycardia patient with a heart rate of 28, another patient with suspected DKA, secondary to an infection and a 1 year old with severe bronchiolitis.

    On a lighter note I took a candid picture of the one of the nurses doing some paperwork and when the others saw it they all wanted one of themselves, so there was a little photo shoot 🤣🤣🤣

    Today was also an exciting day because we went to buy fabric to take to a tailor in Takoradi to make us outfits! Having (badly) described what I want, I'm looking forward to seeing the finished products! 🤣

    Today felt like a lighter day, slowly finding my feet and figuring out how I fit in and feel useful. I'm acclimatising to the weather making the heat less tiring, so it's a better day again. With all this in mind I decided to celebrate by doing some washing this evening, before chilling and heading to bed!

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 5

    25. januar 2024, Ghana ⋅ ☀️ 31 °C

    Third shift at the Effia Nkwanta Regional Hospital, a visit to the mortuary and BBQ with dancing at the house!

    It was super hot today, and although there were fewer patients in A&E, I didn't stop.

    My day started with the biggest, deepest necrotic ulcer I've ever seen. The patient was triaged and assigned a bed, he was very poorly and before he could be taken to his bed he needed to be cleaned due to the smell. My instinct is ALWAYS to help. Here the majority of the non medical healthcare is undertaken by the family. They bring food, drink, sheets for the bed (to go over the plastic sheet they need to pay 10 cedis for) and anything else the patient may need. Including medicine that the doctor prescribes on the rounds and the family have to go and get. So this cleaning (not wound cleaning) was to be done by the patients wife. Who looked worn out and upset. So I helped her. And the nurse looked at me like I had two heads!

    I completely take for granted getting a piece of tissue for a spillage, a glass of water for a thirsty patient and food for when they've spent a few hours with us and must be hungry. At home I think nothing of grabbing an extra mineral water incase they finish the first one, and winding off far too much paper roll when said water ends up on the floor of the truck! 🤦🏻‍♀️ These people get NOTHING for free. They arrive so sick they cannot walk/breathe/talk as they've waited so long and then have to basically pay their way through treatment that is delivered in less than ideal conditions and timescales. It is heartbreaking to see.

    As I walk back to triage, two patients have been brought in. Both in wheelchairs. As I approach the patient nearest me I have a fleeting thought that there isn't anything we can do, but start forward to check... The nurse I'm working with grabs my arm and nods towards the other patient "triage him, what do you think is wrong with this one?".... I reply "I think they might be dead..." And she nods. Simple as that. I move to the next one and she asks the family to move their dead relative to the gurney in the corner and someone gets one of the screens. I triage the other patient with the student nurses at the hospital on their first ever placement and life goes on around the dead body.

    When I enquired as to where the body would be taken I was told the mortuary. So I asked if I could go and see... They looked shocked that I'd asked, but were happy for me to go. It was an experience that I'll never forget. One where you're not entirely sure what to expect, not completely surprised by what you see, but still blown away (not in a good way). It is the only place I have been asked not to photograph since being here, so there are none of the inside. The primitive setting and lack of resources again shows. There is a system they follow, a process the dead go through before the family receive the body of their loves one... But not before they've paid. The most profound thing I've seen is many, many bodies which are waiting to be collected and are identified by a ripped piece of cardboard with a number written on it. I'll process this for a while as yet.

    The remainder of the shift was filled with lovely interactions with amazing clinicians, doing the best they can with the resources they have and after the drug round I headed out to the Tro-tro. As I left the hospital the 'ulcer patient's' wife said "are you going home?" I said I was and that I was back Tuesday... She replied "my lovely doctor lady, you were wonderful to us, thank you...".
    Just about finished me off!!! 😭🤣

    Tomorrow we're heading towards Mole for our weekend safari trip and so we needed to pack and organise for that. After spending some time in the pool, we had the Thursday night BBQ and dancing. It was good fun, and got us all ready for a quick meeting regarding getting packed for tomorrow.

    I'm going to bed a little subdued. Today I saw a lot, I realised a lot and I'll take all that forward with me. It showed me that a little kindness, in a cruel world can actually make a massive difference to those people. Such a small amount of effort on my part helped her feel a little less overwhelmed by the whole thing. I'll think of them often.

    Mole tomorrow!! Excited much 😊

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA DAY 9 - Mole Weekend

    29. januar 2024, Ghana ⋅ ☀️ 25 °C

    Day 6, 7, 8 and 9 - Ghana elective placement

    TLDR: the weekend was brilliant! Look at the pictures 😉

    Mole national park trip: Lake Bosomtwe, horse riding, trauma dump, monkey sanctuary, infinity pool, a gorgeous hotel, safari, village tour, night safari and a waterfall!!

    WOW! what a weekend. It's been an absolute blast! Having spent time in the hospital during the week it was time to soak up some of Ghana and wind down a bit. This weekend was the Mole national park trip! It's a lot of travelling and so other stops are included on the way and on the way back to break the 15 hour drive up a bit.

    We took a boat on Lake Bosomtwe to get to the riding stables. We rode part way round the lake and back to the centre through the villages. It was really authentic, really basic and they didn't have much.... But they were all so happy. The little people love having their photos taken. Then as we took the (very) small boat back the sun was going down making it a very pretty ride!

    We carried on to the hotel we were staying at for the first night and had some food, drink and a bit of a trauma dump 🤣

    On the road at 0530 we headed towards Mole National park via the monkey sanctuary. I have to say, I wasn't particularly bothered about this one... But it was brilliant and I'm glad I went on the tour. It was interesting to see how the colonies were arranged and how they applied boundaries to each other. The most interesting thing was that there is a monkey cemetary, apparently when the monkeys are going to die, they go to a place they'll be found easily and whoever is looking after them collects the body. A little coffin is made and the monkey is buried with honour. They are worshipped here.

    We arrived at Zaina lodge and OMG!! SO gorgeous. They're doing quite a lot of refurbishment at the moment, but they still let us in the infinity pool so we enjoyed a cocktail in there! Rounding the evening off with dinner and a few games of cards we all went to bed excited for the morning safari!
    I've always wanted to do a safari, and this morning didn't disappoint. We saw lots of wildlife, stopped for coffee and biscuits in a clearing and then had a close encounter with some elephants, and as a bonus a crocodile as well!

    We were all on a high! We moved onto the Mole Motel and checked in. A far cry from Zaina with rooms that looked like army barracks 🤣 but their viewpoint allowed us to see some elephants frolicking in the watering hole below.

    Next we were taken to the village and shown one of their main business ventures, Shea butter. It's absolutely gorgeous and so pure it'll last for years! They use it for so much here. Walking around the village was again (isn't everything this week!) Humbling. They use the income from the Shea butter they make to support the orphanage and some goes towards the school. The children are overpowering, little hands grabbing you and asking for things!
    Thankfully there are quite a few in our group that loved the attention from the children and spent time with them, so I could sneak around and take some candid shots of everyone. I love the 'real-life' view, what I always try to do when I take pictures.

    Most of these communities are similar, extremely basic facilities, dusty, houses that look like shacks and happy people. This particular village is quite self sufficient and also has a church, mosque, businesses and a school (which they are refurbishing, with money given to them by tourists and students)... However for water they still all have to go to the edge of the village!

    Once we'd procured some Shea butter and been shown round we headed back to the Mole Motel to get ready for the night safari. We didn't see much, we were all hoping for a sighting of a leopard, but nothing.
    0430 start this morning, and it is a 15 hour journey back to the student house in Takoradi. Hell of a slog. Not convinced many of us slept well, and some of us (including me) have woken up with colds, coughs and sore throats. So when we arrived at the waterfall, having travelled just under 4 hours without breakfast, the atmosphere in the van was 'frosty' 🤣🤣🤣

    The waterfall soon changed that!! It was awesome and everyone had a great time 😊 and breakfast had been booked on the way up so we just collected it and carried on for the mammoth trek home.

    I've had the best weekend! Loved being with my 'children', I've adopted the girls and am oddly protective of them 🤣 the more I get to know them the more in awe of them all I am ❤️

    Back to A&E tomorrow. I'm looking forward to it, with a little trepidation, so an early night to prepare I think!!    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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 😞    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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!    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    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**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 20

    9. februar 2024, Ghana ⋅ ☀️ 32 °C

    Second (and last) shift at The National Ambulance Service (NAS), Takoradi. Nothing and market circle.

    I went back to the ambulance station today in the hope that we'd get a call. We didn't. I had preempted this and taken my laptop so I got some uni work done.
    But I'm frustrated with the entire wasted day! But I'd have regretted not going...

    I finally went to market circle this afternoon. It's not a tourist destination, much more a central location for locals to buy their food, clothes, shoes and household items. The centre (where the market is normally) is being revamped and so all the traders have migrated out to the surrounding streets, so it was carnage. It was hot and smelly! But I've been now 🤣

    Chilling tonight and stilt village tomorrow, which I'm looking forward to.

    I miss home.

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 21

    10. februar 2024, Ghana ⋅ ☀️ 33 °C

    Day at Busua beach.

    No stilt village because we left too late and wouldn't be able to fit it all in. It was a much needed relaxing day and was awesome to swim in the sea (which was WARM!!).

    I also got a backpack made by one of the men that sew in the village. It cost so little and I got to keep the leftover fabric... But bless him, it wasn't great. I'll have to fix it when I get home. I love that he tried to make it for me though.

    I'm SO sunburnt... Suspect I'll suffer for a while. I got back to a very special delivery! I'll sort through it and confirm I have everything I need in the morning.

    I spent the evening showering, applying after sun and packing for my week in the village. I'm going to princess village to do a clinical placement there. It'll be another view of healthcare here.

    I'm looking forward to it... Better practice my manual BP taking 🤣

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 22

    11. februar 2024, Ghana ⋅ ☀️ 32 °C

    'Village Week - stock check of donation items, travel to Princess Town, town orientation.

    After my chilled day on the beach yesterday, today was about getting organised and heading to Princess Town, for the final part of my Ghana elective placement.

    This week staying in Princess Town, which is located in the Ahanta West District and the majority of the working population are subsistence farmers and fishermen although some commercial activities do exist. Crops such as maize, cocoa and coconut are farmed. Other commercial activities include gari making (local food), oil preparation, alcohol distillation and several craftworks.

    The village has access to electricity but not pipe-borne water so bore holes are used to draw water and has a population of about 2,500.

    I'm going to be 'working' in the Princess Health Centre which is a government-managed facility and serves the 8 small communities around Princess Town, as well as Princess Town itself. It should be interesting to see what might come through the doors!

    I started the day early, heading down to stock check the donations that had been delivered. The rep was already there, building a screen... There parts missing. We spent almost 3 hours going through it all, and deciding what to do next... But now the final order is finally in, it's paid for and she said it'll be all sorted and ready for Thursday when I get back so we can take the donations to A&E Friday before heading home on Saturday.

    As soon as this was done, we headed to Princess Town. As ever an experience on the road, and now the bridge is broken near the town, we could only be taken as far as there and picked up from the other side (having crossed a walking bridge).

    We had a super warm welcome by the family that are hosting us this week when we got here and we're then shown around the town by our guide and he explained the format of the next few days. It's quite a large town, and we walked for a while whilst he showed us where everything was. The beach was particularly beautiful and we'll get a canoe ride down one of the rivers on Tuesday afternoon after placement!

    We returned to the family home where our tea had been prepared and after an interesting experience of 'bucket shower' and 'drop toilet' complete with a MILLION cockroaches I've headed to bed to try and get some rest ready for my first shift at the clinic tomorrow morning.

    I do hope I figure out the drop toilet... 😕

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 23

    12. februar 2024, Ghana ⋅ ☀️ 31 °C

    First shift at the Princess Town Health centre - RCH, palm wine distillery and carrying water on our heads!.

    This week is fully mapped out. We have something planned each day until we go, so there is always something to talk about 😊

    We didn't have a great sleep last night, but after breakfast and a freshen up we were taken to the health centre where we'll be based for the next 4 days. We spent time with Doctor Eric who was really good at talking to us about the common conditions they see here, and how they manage them. It was really interesting to see how they test foraleria, it looks a lot like a COVID test!!

    We went out with the Reproductive and child health clinic. They essentially take a bag out with them and do blood pressure of people they come across....
    They're doing an vaccination drive at the moment so we were giving vitamin A to al children we dcpme across under 5 too. It was so nice walking around with them and meeting people in the community. We were invited to educate people when we were with them as well. For example making them aware of the implications of hypertension, poor diet and even por hygiene.

    I even did some breast feeding support!! One of the mums had managed to exclusively breast feeding her son for 6 months on only one boob as he refused to feed from the other one from the start!! Kudos!!!

    When this was done we headed back to the family home to have lunch and get ready for our afternoon activity. We visited a palm wine distillery. Which was rudimental, but really interesting. They essentially produce the alcohol content (it's about 400% apparently!!) For company's to used when. Producing their alcoholic beverages. 😊

    Lastly, before tea we took our buckets to one of the town''s 9 wells to get our own 'bucket shower' water to wash in later... And we had to carry it back on our heads!!

    I might have accidentally bought some more fabric 😳🤣

    Tea was lovely and because we can't face sleeping in our disgustingly hot rooms, we've decided to sleep on the roof, where it is much cooler 😊. I'll let you how it goes!

    **Photos taken and shared with permission**    Les mer

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  • Ellen WithersGhana Elective Placement 2024Reisende

    GHANA - DAY 24

    13. februar 2024, Ghana ⋅ ☀️ 30 °C

    Second shift at the Princess Town Health centre - a district performance meeting, a baby girl and the fort with rocks and waves!!

    Today was the 2023 Annual Sub Municipal Review for the clinic and others associated. It's designed to discuss progress and improvement in 2023. It was a 2.5 hour meeting and representatives from the other clinics came to share their figures and discuss challenges too. It was eye opening to hear of the issues from everyone. I got the impression that the princess clinic is the largest, and despite this, they have the same challenges. They included the state of the roads, the bridge being broken, teenage pregnancy, no oxygen, power outages, low staff levels and lack of space. Dr Eric pointed out that the government will give them a grant in order to improve the services, have a lab and extend... But they weren't going to because there is a lack of space!

    Currently there is a community project to build another hospital, next to the clinic and this is being done purely by the community. 🤞🏻 It helps them get what they need... Imagine a clinic that cannot administer oxygen!!!

    The primary complaint here remains malaria, they are all frustrated as this a preventable disease and the fact that it is so rife is predominantly because people refuse to sleep under nets!!

    After the meeting we put the clinic back together and I got my first paediatric cannula... I've been putting it off for months, so glad it got it finally 😊 then we had a catch-up with Dr Eric and went home. As we're eating lunch our guide came to say a baby was imminent at the clinic... So we headed back to the clinic to witness a baby girl born.

    We visited a fort, and I wasn't sure what to expect, but it was really cool, and the best bit was the rocks with a view!! We spent a while there and then walked back through the market and tasted kokonte prepared by one of the locals. It was nice!

    **Photos taken and shared with permission**    Les mer

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