As promised, clinical is at the top of the order. Today we saw a 3 y.o. with sickle cell and a hgb of 8.2. This was up from a recent visit when it was only 7.3. So the little guy is making progress. He actually didn’t look as sick as this sounds! We had an unfortunate 8 y.o. that came in about 6:30 am from a motor vehicle accident. She was hit by an SUV type vehicle. She sustained a broken femur and a broken pelvis (quite clear on the x-rays). This little sweetheart went to the OR for casting (they call it POP, or plaster of paris), and then she went to paediatrics for traction. Of course we had various and sundry abdominal pains and food poisoning. There is an area nearby where there is apparently a lot of mining and many incidents of poisoning come in from there due to contaminated food and water. I think the poison is a phosphorus base. We treated malaria, first line drug used here is artemisinin followed by quinine. All of this is fascinating because so much of what we see here is so different than in the west.
It was interesting to find out today that about half of the nursing classes are men. It really shows in this hospital as there are so many more men on the staff than I would normally see in the states. General nursing education is 3 years. If a nurse wants to specialize in something, for instance emergency, they go on to another 15 months of school, 10 months of classroom followed by 5 months of clinical rotation. I have worked with two different providers in the last two days. The respect between providers and nursing staff is refreshing. All in all, the nursing staff has much autonomy here. Good to see.
In the midst of everything I am having lots of fun! The staff in the ED are great and they let me contribute in the care for whatever comes in the door. You name it, and it is different here, everything from IV supplies to many ampule vials for medications. Standard treatments for the region are becoming evident.
I wish I was a rich man and could provide much needed equipment for the hospital. There are so many items that we take for granted in the states in order to give standard of care for cardiac emergencies (defibrillator) and imaging (how about a portable x-ray machine). But the care these people get is excellent and I am so impressed with the talented staff. Perhaps modern medicine doesn’t need all the bells and whistles that we are so used to? Perhaps that just makes western healthcare out of reach from a financial standpoint? I will leave that to you to ponder.
Tomorrow I am in the operating theatre. Should be an awesome experience to see how surgery is done here in Ghana. I am getting to know providers and nursing staff alike. The ED has my phone number to call if something unique comes in. Going in is my choice but I will avail myself of new opportunities if I am able.