by Joe Jamieson

Clinical Experience

The example below is based on a nursing student undertaking a 4-week elective placement in a teaching hospital in Ghana. But please note that the example below is only there to demonstrate the structure of an elective and the kinds of things you could see and experience. Your elective will be tailored to your skills and interests and, therefore, unique. You choose the duration, the destination, and the departments you want to get experience in.

What happens when you get there?

You’ll have gone through our comprehensive pre-departure preparation by the time you arrive at your chosen destination. So, when you arrive in your chosen destination, you’ll have a good idea of what to expect.

But let’s say you’ve decided to travel on your own. When you first land, you feel a bit nervous in the hustle and bustle of the airport. But a Work the World team member meets you on arrival and takes you back to your exclusive private accommodation in the Work the World house.

Once you unpack and meet some of your housemates — other students who have already been in the country for a while — you settle right in.

Your city orientation

Claire Finlay (FINLAY23939)

The next day, you get a welcome briefing from the Work the World team. The locally hired team explains that they support you throughout your placement. Their office is based in the house, and the team are available to you day and night.

The team shows you and the other new arrivals around Takoradi — the Ghanaian city you’ll live in for the next four weeks. You get a local SIM card to stay connected while you’re overseas, visit local markets, exchange money, see a few sights, and try some of the local food… You get a good feel for the place and what you can expect.

Your hospital introduction

You head to your placement hospital with the Work the World team that afternoon.

The teaching hospital makes a striking first impression — it’s noticeably different from what you’re used to back home. You see patients sharing beds, a member of staff hand-washing latex gloves ready to be reused, and the lack of staff is immediately apparent.

The Work the World team takes you around the rest of the hospital, and you start to get your bearings. You then see the departments you chose before travelling — A&E, OBG and NICU —  meeting your supervisors and their department staff.

You quickly realise that your English-speaking supervisors have already been briefed about you as they bring up interesting points about your clinical experience and studies at home.

Just to let you know, the Work the World team has close professional relationships with our partner hospitals. You feel confident they will support you throughout your time in the hospital, should you need them to.

Week 1: A&E

You start your placement in A&E. You see one patient who had been in a bad car crash three days before he finally came to the hospital. He is seriously unwell. He doesn’t have the money to be able to afford treatment, which is why he held off coming into the hospital. He is turned away without treatment.

This is the first time you see how dramatically different things can be when a healthcare system isn’t free at the point of care.

You see plenty of other patients with extremely advanced conditions and start to understand why they present so late.

After placement

 

After placement each day, you get to know your housemates better. Some nights, you talk about the things you’ve seen over dinner cooked by the chefs in the house. Some nights, you go for a few drinks at a nearby hotel bar.

You have regular debriefs with the Work the World team to discuss your placement progress. You also discuss the differences between what you’ve seen in Ghana and what you’re used to at home.

Thursday is your first BBQ night. Everyone in the house (including staff) gets together for an evening of food and drink. Traditional drummers and dancers come along to provide entertainment.

Weekend 1: Mole National Park

The weekend is suddenly upon you. It’s time for your first big weekend trip, and you and your housemates have decided to go on a safari in Mole National Park.

The experience is incredible. You hop in a Jeep and travel around the park, spotting various animals, including wild elephants.

You stay in a beautiful lodge in the park. The rooms are incredible, and so is the food. And when you’re in the hotel’s infinity pool, you’re right above an elephant watering hole to see them all drinking below.

Week 2: Community nursing

You have a change of pace during your second week. You’ve chosen to head out with the community nursing team. The nursing team are welcoming and eager to talk to you about how nursing differs between your two countries.

You travel out to a village to care for villagers who can’t get to the hospital, like the elderly and those who can’t afford the transport.

Like your time in A&E, you see a lot of patients with advanced conditions, which helps you connect the dots between a lack of primary care in the community and late presentation in the hospital. 

You spend time with many different patients, offering advice and assessments under supervision. You become more confident taking blood pressure manually — not something you have to do much of back home.

After placement:

DAR ES SALAAM HOUSE

You’ve been throwing yourself into the twice-weekly local language lessons in the house. You learn some basic phrases and some clinical terms to help you get by in the hospital. You notice that if you try to speak to people in their language — even if that means you do so clumsily. Doors begin to open for you based on your efforts.

Your elective experience isn’t just about learning about the Ghanaian healthcare system. Your housemates are from all over the world and all different disciplines (medics, nurses, midwives…), so you chat with them about their experiences in the Dutch, American, and Australian healthcare systems, too. 

Weekend 2: Cape Coast

Jake Melvin (MELVIN25479)

It’s the weekend again, and you and your housemates decided to dig into Ghana’s rich culture and history. You take a trip to Cape Coast, which has incredible historical significance.

You visit the Ghana National Museum on Slavery and Freedom, learn about Ghana's role in the slave trade, and more generally explore Cape Coast’s history. You also visit the massive fort along the coast that was at the centre of the atrocities.

In the afternoon, you head to the coast’s white sand beaches to decompress, then return to your hotel for a meal and a few drinks.

Week 3: OBG

You spend week 3 in OBG. The experience opens your eyes to the resilience of local patients, especially given the minimal pain relief they have available.

One highlight is observing procedures in theatre. You even sit in on C-sections, several of which take place in the same room at the same time. The consultant is passionate about his work and is willing to answer any of your questions.

You’re surprised by how resourceful the local staff are. They sterilise almost everything for reuse, from IV bottles to dressings. It makes you contemplate how comparatively wasteful we are back at home.

After placement:

DIGITAL CAMERA

You’ve had a busy couple of weeks, so you decide to spend some of your evenings chilling out at the house this week.

You sit by the pool on the Work the World house grounds in the afternoons. You take some time out to read the book you brought with you. In the evenings you put the TV on and watch films with your housemates.

Weekend 3: Kakum

Canopy walkway in Kakum National Park

You spend your third weekend at Kakum National Park. Unlike Mole, Kakum is located in the middle of the rainforest. You go on early morning canopy walks with amazing views and spend the night in a treehouse under the stars.

Spending weekends like this with your housemates has allowed you to get to know each other and experience the adventures Ghana offers. It’s clear that you’ve all become friends and will stay in touch when you go your separate ways.

Week 4: NICU

It’s your final week, and you’re in the NICU. You know you have total flexibility regarding shifts, so you add a couple of night shifts to get a different perspective. You see a lot of cases of malnutrition and malaria while you’re here, which is not something you usually see back at home. The experience here is eye-opening.

You see a vast number of reasons for admission here — HIV prophylaxis, broken bones, sepsis, complicated or prolonged delivery, birth asphyxia, heart defects, genetic disorders… It’s a breadth of cases you have never seen before.

But the most significant difference you notice is the much higher infant mortality rate in premature babies. You ask why, and your department team explains that this is primarily due to a lack of resources.

And that sums up your elective placement experience here in Ghana. There are significant differences in practices, resources and staff levels, but it’s the memory of the impact these issues have on the lives of patients that stays with you.

Get complete flexibility

Remember: The above is just one possible elective experience. On a Work the World trip, you pick the destination, the departments, and the duration of your stay.

Want to start building your dream elective? Start here by choosing your discipline.

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