Kathryn is a 3rd year Adult Nursing student at Portsmouth University. She spent two weeks in a Ghanaian hospital to see the differences between the delivery of care in Ghana and the UK, and below diarises her experience.
The Diary of a student nurse in Ghana
In January, Daisy (my lovely university buddy) and I will be flying out to Takoradi in Ghana, where we will undertake a nursing placement in one of the local hospitals. I will be spending one week in A&E and one week in paediatrics. Being the emotional wreck that I am, I fully expect to find this a really difficult but rewarding experience. We have been pre-warned by Work the World we will encounter situations that we would never experience here in the UK, and that people will die of what we would class easily treatable conditions.
It was the night before Ghana when all through the house, not a creature was stirring not even…joking - I am WIDE awake. My cases are packed, I’m sure I have forgotten something really important. I have been out to the shops 3 times since yesterday; last time was for Marmite. I feel better knowing I have that at least. Now for SLEEP… hope! Next time I update you, I should be there!
We’re in Ghana
On arrival last night, we were met by the very enthusiast Work the World staff member. We left the big city of Accra and drove through deserted roads and little pop up villages (which is exactly what they look like really, shacks, huts and small buildings built up to form communities) men, women and children standing at the sides of the roads selling anything from bread to cuts of fabric. And yes, they all carry everything on their heads, big heavy loads. And finally we arrived at the big blue Work the World house in Takoradi.
6:20am my alarm went off up and ready for breakfast at 7.am. I didn’t sleep well… it is SO hot at night. The plan for today was both the hospital and local area induction.
After another bumpy ride we arrived at the hospital, a crowd of us walking along like a sea of blue. We visited the different departments and were introduced to the hospital staff, from the minute we walked in it was completely obvious this was going to be nothing like home.
The hospital is old with limited equipment. We were shown the orthopaedic ward. The nurse invited us to walk through. Privacy does not really exist here. Two of the men we encountered were not orthopaedic patients but had sustained head injuries, she explained that actually they should be intensive care patients but seeing as they don’t have one, they will have to stay there. No fancy equipment, just a bed and a drip.
Next stop A&E… there seem to be people everywhere, a lot just hanging about waiting for others, patients sitting outside, lying outside, waiting on trolleys outside, being carried out of a car outside. Inside, the beds are virtually on top of each other.
I have to say the one thing the hospital staff beat us on in Ghana is their uniforms. The nurses wear beautiful green and white fitted dresses, with a band on the sleeve to indicate if they are qualified or which year of training they are in. The head nurses wear pristine white dresses, white socks and white shoes. Every one of them looked like the dresses had been made to measure.
My first day on placement
Today I was placed alongside Hayley, one of my university friends. First stop was the paediatric ward. We arrived at 8;00am to find the ward quiet with only 4 patients. One was an 8-year-old girl with sickle cell, the nurse explained that she urgently needed a blood transfusion.
They had given her half of what she needed but could not get anymore. To be able to receive blood, a family/friend has to donate the same type back to replace it. The girl was a rare blood type and there was nobody available to donate for her. If she doesn’t get it, she will most likely die. It’s such a hard concept to grasp when we think nothing of things like this at home. We take for granted that what we need is readily available when we are sick.
At around 10:30am we moved up to neonatal intensive care (NICU). There is no aircon in the hospital, so the working conditions are very difficult. But in NICU it’s hitched up a notch as the room is kept even warmer due to the babies in incubators. The nurse was watching over a baby boy who was less than 24 hours old. He had a pulse oximeter (measures pulse and oxygen levels) on his foot and his oxygen levels were very low, dangerously low. He had a make shift CPAP in place administering oxygen, this had been put together using an old water bottle with tubing in.
They just do not have the equipment, like we do back home. What I wanted to do was wrap him up and hold him until he peacefully went to sleep. He had been through so much. We left at 3:00pm, emotionally and physically drained.
As placement is Monday to Friday so the weekends are free for us to explore Ghana. This morning we set off for a journey down to Cape coast and then onto Kakum National Park.
We arrived at Cape Coast to visit the Cape Coast castle. This is one of the many castles and forts built along the Gold coast by European traders. Originally it was used to trade timber and gold but by 1653 it was used to harbour slaves for the Trans-Atlantic slave trade. We had a guided tour of the castle grounds and stories of the living conditions that the slaves endured whilst they were being held captive. It is an emotion evoking tour and I have to admit I did shed a tear.
So here I am doing something I am completely not comfortable with… spending the night in a tree house in the middle of a forest in Kakum National Park. It really is as basic as they come. We trekked in with our guide who laid out mattresses, gave us each a sheet and then said he would be back later to spend the night with us. We have a mosquito net each which we have tied up and tucked under the mattress. It’s hot, loud with the sounds of nature and quite honestly a bit scary... mostly at the thought of spiders. The plan is we get up at 4:30am with our guide and set off for a canopy walk to watch the sunrise and hopefully catch all the wild animals before the park opens.
04:19 am – I did not really sleep. The alarm is set for 04:30am. Hurry up - I want everyone to wake up so we can get going. The canopy walk was amazing, it consists of 7 rope style bridges, suspended over the treetops at 30m high. Usually I don’t like heights but after the night I just had, it really was a piece of cake. We stood up there at the top of the trees and watched the African sunrise into place. It was peaceful, beautiful, and made the whole night worthwhile.
A&E is not A&E as we know it, no fancy equipment and a very small room. There is a triage area as you walk in the door, which basically translates to a couple of chairs and a table. Patients present themselves directly to this point where they are triaged pretty much straight away. This involves a brief history and a set of observations. Anyone suspected of having anything contagious is put outside on beds/chairs. Blood glucose is also done but the patient must pay 5 Cedis (less than £1) for this. There is an insurance system here in Ghana, it costs only £4 for the year. Not everyone takes it out though, and if you don’t have it, you don’t get any treatment unless you pay, and sadly many people cannot afford to pay.
Time to go home
Where have the last two weeks gone?
I’m torn between wanting to get back to my loved ones and home comforts, yet never wanting to leave Ghana life. I am a complete creature of comfort, hate change and try to avoid venturing too far from what I know.
But I can honestly say Ghana has been the most amazing and humbling experience of my life. The things I have seen really have made me question what is this life I’m living? One thing I have taken from all this is I want to encourage my children to travel, as much as they can. To meet people, experience different cultures, see those who aren’t as us fortunate as us and to realise there really is a beautiful BIG wide world out there. When people say the world is your oyster... it really is.
Big shout out to ALL the lovely people I met at the Work the World house. The doctors, nurses and the physiotherapist…what a trip of a lifetime!