Hello from Ghana. I have now been in Takoradi, Ghana for 10 days and I can’t quite believe how fast the time has gone and how much I have seen and experienced.
I arrived in Accra late Saturday night and was met by a Work the World representative Alhaassan, we took a short taxi ride to a local hotel to stay in before our long journey to the house in Takoradi the next day. The hotel was basic and adequate, I was exhausted from the travelling and managed to get a good night’s sleep even though everything was so unfamiliar to me.
The next morning myself Alhaassan set off to Takoradi, being in and amongst the local people while getting on the bus made me feel like this was going to defiantly be an adventure. After 5 hours on the bus I arrived at the Work the World house, the house can sleep up to 32 students so as you can imagine is a huge house. I initially met two of the girls who are from the Netherlands, with my tour of the house complete I was ready to relax. My room sleeps 4 people in 2 sets of bunk beds with an ensuite bathroom, I have this room to myself for the 4 weeks as there are so few of us here. All the beds have mosquito nets over them and a ceiling fan. The other three girls returned from their weekend away at the beach and I soon got to know them. Two British girls and a girl from Canada. It is just myself and one other who are student nurses, the others are student doctors.
My 1st day was an orientation of the hospital in the morning to meet the staff I would be working with while I am in Ghana. The hospital is much bigger than I had expected and I was introduced to many members the nursing team on various wards including the children’s ward and Neonatal intensive care unit, My first impression was that everyone was very friendly towards me. I had a briefing and a tour of the local area later that day, there are some beautiful spots in Takoradi and also some extreme poverty. In my briefing I was told about the local culture and how to great people, this is something I have found very important, ensuring that you great everyone you meet with a good morning. I was also told to keep an open mind about that I will see on the wards and that the ‘caring’ side of nursing is very different to the culture of home. You should never wave with your left hand as it is considered as a person’s dirty hand.
My 1st day on the children’s ward was quite daunting, as with any 1st day on a new placement there is the anxiety of being new and not knowing anyone, this was on another level. The nursing staff don’t teach in Ghana, it will be the doctors that I will learn from, but I also feel that by observing and asking questions the nurses have grown to like me and see me as a part of their team. Out of respect I am to address the female staff as Aunty or Sister and they call foreign people ‘Oburoni’, this isn’t meant as an insult and I have quickly learnt to respond to this when they call me to assist. The ward had capacity for approximately 40 children with two isolation rooms, there are normally two sister’s and two nurses on shift at one time, I did speak to a nurse who told that that when you are newly qualified you can be responsible for up to 30 patients. The nursing staff do not have patients assigned to them, I’m still trying to understand who takes responsibly for what, as there doesn’t seem to be much structure or delegation. I will say that team work is very strong and they do work together well. Many of the cases I have seen have been malaria, with a few cases of sickle cell and meningitis. The healthcare system is very different and the lack of money is very obvious by the lack of equipment in the hospital. When I child is admitted onto the ward they are then prescided the medication needed and the parent has to take the patient folder to the pharmacy to collect the medication to bring back to the nurses who then administer it, This can be at the nurses station, the patient bedside or just wherever the patient is.
The hardest part so far is when a child has blood taken or they are canulated, this is done by the nurses mainly and is an example of how we at home do things very differently, the needle size depends on what is available and the cuff of the gloves is used as a torneque, the parent is asked to hold the child down and squeeze the arm or leg to assist the nurse, a child can be screaming and kicking and this is deemed normal, they will have many attempts with the same needle and I have seen them try up to 15 times on one child. This is when I realised during my training at Staffordshire University and while on placement at home I have learnt best practice and distraction techniques, it makes me appreciate the resources and specialist staff we have to ensure a child is at ease as they can be, it is also something I have stayed true to. Over here I am still the person who comforts a child and wipes their tears, reassuring them and trying to care as much as I can, I believe that the 6 C’s are running through my veins are are truly a part of who I am. This does not mean how the staff her do things are bad practice, this is how in their culture they have and will continue to do things their way, all I can do is be myself and let them see how I carry myself as a student nurse and represent Staffordshire university, we recognise bad practice but who is to say that over here things are being done incorrectly?
The level of treatment and care that is given all depends on how much money a patient and their family has, for example a CT scan can cost up to £100 and in Ghana that is a lot of money, if a family cannot afford it they will not get the treatment.
All medical notes are written in English and one thing that is very similar to how we write at home is the terminology, if someone was to read the nursing or doctors notes here you could be mistaken to reading notes from home, this does make me wonder is the level of treatment and care down to lack of money and resources?
So far my experiences have made me greatly appreciate what I have learnt so far in my nurse training and it has also made me realise that I have learnt a great deal already, without thinking about it I can recognise a deteriorating child, I always have best practice in the back of my mind and I am constantly aware of what is going on around me including correct documentation.
I am enjoying this experience and I am looking forward to what comes next, with a trip to the mourge planned and time in the mother and baby HIV clinic I am sure there is a lot more to learn.
On a final note I am grateful for this opportunity and how the nurses and doctors have allowed me to interrogate into their team on the ward and answering my questions honeslty and professionally.
Until next time I thank you for taking the time to read my blog.