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We ended our stay in Ghana at an ocean-side resort in Cape Coast. We were all looking forward to a fun weekend of swimming, site-seeing, and relaxing. The ocean was refreshing, except for the plastic bags floating around that we would come in contact with once in a while. Our site-seeing consisted of touring two castles in which slave-trading was conducted many years ago. It was interesting but very sad to walk through the dungeons and cells that the slaves had to stay in. It gave me a little perspective on the complaining I’ve done when it was too hot, too smelly, the food was strange, etc. Hundreds of slaves stayed in these tiny dungeons that were dark, hot, uncomfortable, and smelly. They defecated, urinated, and menstruated on the floors that they lived on. We didn’t have things as rough as we thought.
I also went to a Catholic church service on Sunday. I was expecting it to be quite a bit different, but it ended up being pretty similar to the church I attend in Minnesota. The general flow of the mass was the same, the responsorials were identical, and the songs were similar. At the end of the mass they asked all the new members of the church to come up on the alter and introduce themelves. So myself and my fellow travelers went up, took the microphone, and told the congregation what we were doing in Ghana. The speaker then gave us each a rosary and the priest blessed them and us. The whole ordeal was right in line with the welcoming nature of the Ghanaian people. I never did meet a person that was not friendly and welcoming.
Now that I have been home for a couple days and the jetlag is wearing off, I am starting to realize everything I have learned about the Ghanaian culture, American culture, and myself. It is very obvious that most of the people in Ghana have much less than most of the people in the US, but one would never guess it after meeting a person from Ghana. They are all seem to be happy and content with what they have. I guess it’s true that one doesn’t need to have lots of money and assets to be happy. We came into this adventure thinking we were going to teach the Ghanaian nursing students a thing or two about how we do things in the United States. We did contribute some of our knowledge, but they ended up teaching us a much more important lesson about life and happiness.
I had such a wonderful experience in Ghana. I learned a lot and had some fun along the way. The things I have seen and experienced will always be in my memory, and I will be forever changed by them. I would like to thank the President’s Commission on Diversity and my friends and family for supporting me on my journey. I hope that our blogging has given you some insight into the Ghanaian culture, and maybe even a life lesson you can take with you.
Well, we made it home safely yesterday. Since the long travel and jet lag got to me, I didn’t get a chance to update from our last week in Ghana, so I will now.
On Saturday morning we boarded our bus for a 4.5 hour drive to Cape Coast. Our hotel was a resort on the ocean and we spent many of hours either jumping in the waves or just relaxing on the beach.
On Sunday, we visited the town of Elmina. For those of you who don’t know, this town, and specifically the castle located here, was one of the most important stops on the Atlantic Slave Trade Route. Africans were brought from the interior of the country , branded with a hot iron, and held captive in the dungeons, males seperated from females, roughly 150 persons in a room smaller than my living room. They were forced to remain there with no light, food or proper removal of bodily fluids until they were led out of the “Door of No Return” to board ships Sometimes, female slave captives were chosen by the govenors to be their “girlfriends”. They were then led upstairs to the governors bedroom. If it was found out that the women was pregnant she was either released back to the town or shipped for slavery after birth. Children remained in the country and were given English surnames. In all, about 30,000 slaves were shipped to North and South America by the 18th century. After this chilling tour we drove to the Cape Coast Castle. This had the same dungeouns and stories; it was just another stop on the slave trade route.
On Monday we got back to some of the medical stuff with a stop to Minneapolis based MicroClinics. Although it’s been built for 3 years, the building has been operational for just 3 months. This franchise is seperate from the government hospitals and clinics although it still works with the national health care. They are different because of their philosophy. They are really there for the patients . At the government hospitals we worked at it didn’t seem like hospital staff really cared about the patients. At the MicroClinic they really focus on communication with patients, treating the respectfully, hoping that their patients will not only come back again, but pass on the word of the clinic to others. The business is starting work on it’s second building and hopes to have many more in the coming years. If I were to work in Ghana, I think that this would be a good fit for me just because I agree with the philosophy. This same day we drove to Kakum National Park and walked the canopy of the rainforest. These rope bridges are about 130 feet above ground and spans about 1100 feet in distance. This was such a once-in-a-lifetime experience. The views were breathtaking, as was taking the first step onto a 10 inch board supported by ropes that bounces and sways with every step.
After a last swim in the ocean and the sharing of many memories at our last dinner, we fell asleep in Ghana for the last time. The next morning we made our way back to Accra, did a little shopping and had dinner and made our way to the airport for our long journey back to Minnesota.
This trip was truly amazing. I have made so many wonderful memories, experienced alot that I wouldn’t have, and learned more about who I am as a person. I have also enjoyed meeting all the friendly people in Ghana. I hope to stay in touch with a few of them and eventually make my way back there. Of all the places I have traveled abroad, this is the one I didn’t want to leave.
Thanks PCOD for your support that allowed me to experience diversity as it relates to nursing in another country.
-Brandi
We completed our last day in the hospital yesterday. It’s crazy how fast time has gone and I can’t believe that the trip is coming to an end.
After doing 7 shifts at Suntreso, I got the opportunity to be at the teaching hospital with everyone else. After a game of paper-rock-scissors, I got to be in the red unit (Kayla talked about this in last post). This somewhat resembled our emergency rooms back home, but I only saw the most severe cases. The first one was a very elderly woman with a chest tube. The second patient was a 19 year old that had been referred to the hospital for possible meningitis with cerebral abscesses. He didn’t look too well and the staff didn’t really have a plan for him. They couldn’t drain the abscesses until they knew where they were by CT scan, but the CT scanner was broken so that was out of the question. A little later, my classmates and I were standing around him with some of the students from the University here. They began asking Kayla what they should do to bring the blood pressure up (it was like 50/30). Sometimes they quiz us to see what we know, but this was actually asking us what to do. Kayla recommended running fluids faster, checking hemoglobin, giving blood and vasopressors. They also didn’t understand the ventilator to which he was hooked up too. We got the fluids running and that was about it. Finally his BP started to increase to 70/30, but as soon as the fluid bag was empty, they hung another at a slower rate and I watched as his BP once again, made it’s way back to 50/30. We came to the conclusion that they had really just given up on this case and moved on to the next.
My day at the teaching hospital was great; I wish I would have had the opportunity to spend a couple more days there – maybe on my next visit.
Overall, I have been left with these impressions:
1. I am amazed what they can do, despite the limited resources. One of my classmates when to an STI clinic, which ran from morning til about noon because then the sun moved to the other side of the building. They used the sunlight to examine the patients and once it was gone, they had to close up shop. While trying to resuscitate a baby on Thursday, the midwife needed suction. She got a suction catheter and attached a cut off end of a needle cap and used the cap to wedge it into the suction hose because there was no way to connect the two.
2. The pace in the hospitals is very cultural. We are always go go go back in the states and rarely have time to sit down and take a break. On our first day at Suntreso, they didn’t want all 5 of us in one ward because there was no place for us to rest. An emergency c-section the other day for fetal distress took about 45 minutes. Me and another classmate decided to work the overnight shift on Monday and when I asked the midwives what they do when no one is in labor, they said they rest and literally we rested, I mean slept, from 1030 pm to 430 am. Nothing here gets done in a hurry and that suprised me. I guess for us, the faster we get patients in and out of the door, the faster we can get new patients in and this results in more money.
3. I truely enjoyed my experience in the hospitals. It’s easy to find the faults in everything, but that’s just because we don’t know any other way than how we do it. Over 2 short weeks we had gotten to know the nursing students and shared stories from our lives and showed pictures of our loved ones. We became one of them – doing the menial work of opening and closing suitcases when the person asking is standing right there, fetching someone a pair of shoes or apron, sorting a huge stack of papers and then stapling them into packets, being a part of the student group as the doctors ask you why and what causes this. The people we met and the experiences we had are what will stick with me as I age. I am grateful for the opportunity to practice nursing in Ghana.
Well, we are headed to Cape Coast in a couple hours. While there we will enjoy laying on the beach, going to the slave forts, climbing through the jungle on rope bridges and visiting a Minnesota based micro-clinic. And just in a few days we will be back home.
-Brandi
Hello all,
As Brandi said, we are in our second and final week of clinicals here in Ghana, and I am now in the teaching hospital. There are currently five of us there; two in the yellow ward, two in the orange ward, and one in the red ward. These three wards are the branches of the emergency department. How this system works is when a patient comes in, the triage nurse scores them on a multitude of categories; such as mobility, level of consciousness, etc. She then totals the score (maximum of 10, minimum of 0) and sends the patient to the appropriate ward. The yellow ward gets the least severe patients (0-3), the orange ward gets the moderately severe patients (4-7), and the red ward gets the most severe clients (8-10).
Today and yesterday I have been in the yellow ward. Things we have seen in this ward are broken bones, stomach pain, blisters, etc.; nothing extremely emergent. We will be rotating through all three of the wards this week, so tomorrow and Thursday I will be in the orange ward, and then Friday I will spend the day in the red ward.
Yesterday was mainly orientation to the building and unit. This hospital is very comparable, physically, to the hospitals we have back in the US. It is multiple stories high, very clean and spacious, and has actual patient rooms in many of the units. However, there still seems to be a shortage of supplies, as the units have several sinks around, but don’t have any soap or paper towels.
Today we shadowed a nurse as she checked in on her patients and made sure that their tests and procedures were scheduled. It is still crazy to me that the nurses don’t do assessments on the patients. If we were back home, we would probably be doing continuous assessments. But here they simply do not have the resources. Another thing that is strange to me is that patients can stay in the emergency room for days because the units they should be transferring to are full. In the US, patients are either sent up to an appropriate unit or sent home once they are stabilized.
Next we watched the doctor suture a little boy’s leg, and after that we got the opportunity to go up to the theater (the operating room) and watch the surgeons put pins in a patient’s broken ankle. It was pretty much exactly like any operating room one would find in the US. A few differences that I noticed was there were way more people in the room than would probably be allowed back home, and people were allowed to use their cell phones.
-Kayla
 Second Stage/Labor Ward, Suntreso Government Hospital Laboring bed against wall with sterile tray in front. They actually had the curtain hanging down for privacy for other bed, this isn’t always the case. What you can’t see is a rusting paint chipped bed.
 Florence This is Florence, one of the 3rd year nursing students at KNUST (the partnering school). She is a great student and knows her stuff and is willing to get us involved and translate for us.
 Progression of Wheelchair Wheel chairs used at Suntreso. Plastic chair bolted to frame with bicycle wheels. And another wheel chair more common to us.
 Wards Although this picture was taken at Psychiatric Hospital in Accra, the conditions are much the same at the Government Hospital. Beds right next to each other and even mattresses on the floor.
Well after a long week in clinicals at the hospital, we were all ready for a little break. Chapter 3 as Jonathan called it consisted of a 4.5 hour bus ride to Akosombo, a cruise-trip on the Volta Lake and the ride back to Kumasi.
When we got into town, we took a tour of the Akosombo Hydroelectric Dam. The energy gained in the dam is changed to electricity which helps to supply a lot of the country, as well as Western countries Togo and Benin, with electricity. 3 Volta Rivers meet at this site and then fall into the man-made Volta Lake.
After the short tour we made our way to the hotel. The place was like a resort – nice swimming pool, right on the river, zoo animals (monkeys, birds, crocodiles, snakes) and very colorful.
The next morning we got up early (again) for our boat cruis of the Volta Lake. The 6 hour cruise on the Dodi Princess was great. We had a lot of fun dancing and singing, playing games and just relaxing in the sun. Half way through the cruise, we stopped at Dodi Island. This was nothing like I was expecting. I thought there would be a market and people hawking things. Instead, you get off the boat and there are native people singing, dancing and playing instruments. All they wanted from us was money. The elders all pushed the younger ones to go and ask for money. As you walk the 5 minutes to the other side of the island, little children are set up next to the walkway with their plastic bins and sticks and bamboo drums with a little collection bowl in front. If you stopped too long to watch, they expected you to give money. A few of my classmates got to dancing with some of the elders so I took pictures; midway through, they asked for money and they asked for money from my classmates that were dancing. After a short stay on the island we got back on the boat and headed back to dock.
After this long day we still had our 4.5 hour drive back to Kumasi (in the dark). The Ghanain Latex Foam Beds have never felt so great as I was just exhausted.
Today, we are back to clinicals. Half the group left this morning to tour the teaching hospital. I think they have been looking forward to this as the government hospital has been getting a bit boring. Hopefully Kayla will update later on the conditions in the teaching hospital and how it compares to the government hospital.
-Brandi
The past couple days have been spent at the hospital. We split up in to two groups; the morning group and the evening group. The morning group works from 7:30-1:30, and the evening group works from 1:30-7:30. The first two days we had a couple of us go to the Mother Baby Unit on each shift, and the others go to either labor and delivery or post-partum care. The Mother Baby Unit ended up not being very exciting because the nurses don’t really do a whole lot. The nurses told us that they had a routine that they followed, consisting of assessments every 4 hours, but we never ended up seeing a single assessment. What it seemed like the nurses did the most was teach the clients what they need to know when they discharge. This would be great for us to listen to, but they were not speaking English, so even this was not very fun for us to experience.
So now we have everyone going to labor and delivery, postpartum care, or any other unit that has something interesting going on that day. For example, one of our classmates went to the HIV/AIDS counceling clinic that was going on only today. I (Kayla) was in the labor and delivery ward. This was very interesting and exciting. I got to see two births and insert a couple IV’s. The labor process occurs in a room with three beds in it. The women labor here until the doctor says that they are ready to start pushing. The women then get up and walk themselves over the birthing table. They then get up onto the table, and without any medication, start the birthing process. It sounds extremely painful, but the two women I saw were very stoic, and hardly screamed at all.
One of the babies had stooled inside the mother, so it was considered “critical” because it may not be able to breathe very well if it inhaled any of this stool. When you and I hear critical, it means something needs to be done quickly. To the nurses here, it means something needs to happen in the next 30 minutes. It took them over five minutes to start dealing with the baby’s airway. They first paid attention to cutting the cord and cleaning the baby off. I was getting very anxious because I knew that the baby was not breathing well when it came out. Eventually they took the baby over to a special area where they suctioned out any stool that the baby had swallowed, and it was fine. It is interesting to see the difference in “urgent situations” between here and home.
After clinical we went to the Cultural Marketplace. Everything there was crafted by hand. It is so amazing to me how creative people here are. In one store, there were purses made out of old candy wrappers; now that is what I call recycling.
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