Anything is Possible
May 11th, 2022 by Cecile Dinh
Posted in Uncategorized|
My first day at Ankaase Methodist Faith Healing Hospital was spent in the emergency department as I awaited further instructions on an orientation. In talking with the nursing staff while there, a phrase that one of them used has remained in my mind and likely will for the rest of my time here: “Anything is possible.”
One afternoon, the emergency department admitted a 67-year-old gentleman who was complaining of acute onset of severe abdominal pain that first occurred three days ago while he was out tending to his crops, and was worsening. He had since been unable to pass stool or eat without nausea and vomiting. He had a past medical history of hypertension and diabetes mellitus. The diagnosis of acute abdomen was made with a differential of mesenteric ischemia or complete bowel obstruction, among others. Given the hospital is a district hospital without resources such as CT scanners / MRI machine, or on-call surgeons, the decision was made to transfer him to the larger regional teaching hospital about an hour away for further management. However, I learned the following morning that he passed overnight while awaiting the transfer (which probably wouldn’t have happened for at least 24 hours after initial contact with the receiving hospital). Out here in rural Ghana, anything is possible, in the sense that literally anything could happen, for the better or for the worse.
While working in the antenatal clinic and labor ward, we encountered a patient who was referred to the hospital at early term due to size measuring smaller than dates and an ultrasound revealing oligohydramnios. A repeat ultrasound continued to show severe oligo with a total AFI of about 3. The patient was placed on the following day’s schedule for an “elective cesarean,” which I was able to assist with. Upon entering the uterine cavity, thick meconium fluid spilled out. Apgars were 5 and 6, and the baby was quickly whisked to the neonatal unit for further resuscitation. Had the hospital had the capabilities of health facilities comparable to the United States, an “urgent cesarean” would have been called with likely delivery that same day. The baby survived despite the circumstances, and it amazes me how much they are able to do with so little. Again, anything is possible here.
A few days after I arrived in Ankaase, I was stricken with gastroenteritis (presumably from some street food) on top of what I now believe was heat exhaustion/dehydration. I guess my body was shocked by going from dreary, cold Washington to the tropics. The weather is unbelievably stifling, even worse than New Orleans’ humid heat due to the lack of air conditioning, and I failed to keep up with drinking enough water. Thank goodness for working in healthcare, as I quickly was able to receive 3.5L of IV fluids and am slowly improving after having started ciprofloxacin that my PCP pushed on me before I left home. A blood test also confirmed that I did not have malaria. I finished a 20-gallon container of water by myself over 5 days and am happy to report that my urine is now pale yellow. Though miserable in the midst of my illness, I survived. No longer can I say that I have an iron stomach – really, I have not had more than a day of abdominal cramping here and there despite my years of international travel and eating whatever I wanted – but I guess here in Ghana anything is possible.