April 23rd, 2019 by Galit Rudelson

I have arrived to Ankaase. To get here I had to take a bus from Accra to Kumasi, about a 4 hour trip. It was a typical charter bus, and I got a window seat! The entire path on the bus was paved, without many potholes, which surprised me. Everyone was warning me how hard the bus ride was going to be. The country side was very pretty. I passed a lot of small villages. I saw many houses made of sticks, or pieces of metal. There were many children outside playing with each other. Woman were selling water and snacks along the road the whole way. They would carry these things on their heads. The road was a 2 way, but cars passed each other often, honking to let the other car know they are coming. I saw a couple of places where children were carrying water back to their houses.
In Ankaase I am living in a house provided by the hospital. One other woman lives here, Dorcas. Dorcas is a nurse in the operating theater. She is from a town a little ways away, but moved here for the job. She has been living in this house for 5 months. The house has a kitchen, an enormous living room (with many chairs in it, a social place). There are 3 bedrooms, Dorcas in one, me in another, and one empty. I arranged my room kind of funny. I put the bed in the middle of the room, right under the fan, and then my dresser right next to it (in the middle of the room). This way I made a makeshift wall by my bed, which is how I like to sleep!
Yesterday I also met Rachael, who is helping with my hospitality while I am here. She is also a nurse in the operating theater. She helped me set up my room and spray it for mosquitos. While we waited for the spray to settle she took me to her house, up the street. I met her three children, who were incredibly cute. We played several games together, and they showed me their handstands and bike and toys.
Today was my first day at the hospital. I will tell about the actual hospital later, since I will have my official tour tomorrow. But today I worked on the Antepartum outpatient clinic. This is mostly run by the midwives, with 2 doctors also present. The midwives were very helpful, and had me spend some time at every place the patient goes to. First I helped with taking vitals (blood pressure and weight), as well as spot checking the urine for protein and glucose. Each patient gets checked everytime. They do not do a gestational diabetes check unless there is an indication, because of price (so large baby, history of diabetes, ect). Then I spent some time in the midwife consultation, where they get the patients pregnancy history. Then palpation. This is where I need to practice the most. They measure the fundal height (which I have done in America). But they also listen for fetal heart tones with a fetoscope. The midwife showing me said she could hear all the babies heart tones very loud. But I struggled to hear most of them, I could only clearly hear a couple. I will be sure to practice more tomorrow. Then you check if the baby is head down. Finally I worked with the doctor. He was a very good teacher. Much of the conversation happened in Twi (the local language), but he made sure to translate for me. We saw all sorts of pregnancy problems, including “fever, body aches, fatigue” which was often treated symptomatically as Malaria, even without confirmatory tests.
We saw two women with miscarriage (one who had a molar pregnancy). It was interesting to see the difference in interactions between patients and doctors. The doctor very plainly told the women they were no longer pregnant, and the woman said thank you and left. There was much less consolation than there would have been in the US. But the woman seem to be comfortable with this as well.
Well I have written much too much for now. I will try to only pick a couple of stories in the future, and tell them in detail, as opposed to briefly telling about my whole day!