The Hospital

June 10th, 2018 by melindaroney

I have completed my first week in the hospital and clinic. I started out rounding with Dr. Tim Cahill. We start in one of the men’s wards and then proceed to the second men’s ward, the two female wards, then onto Peds if need be. The Ghanaian doctors would start in the pediatric or female wards and we would work toward each other so all of the patients are seen in a timely manner. Sometimes one or more of the doctors are doing C-sections or procedures. Most all of the deliveries are done by nurses who have trained as midwives so we have not been to OB.

 

The first male ward (as an example) is is a rectangular area around 20′ x 40′. It has 13 beds around the periphery. Sometimes there is a chart with an “x”, like 1-11x. That patient is located in the first ward and is on the floor next to bed 11. If the chart says “veranda-2” that means he is in the hallway. They do a good job of doing what is needed to accommodate all of the patients. The patients never complain and hardly ever express any sign of pain. Most patients bring 1.5 to 2 yards of fabric to serve as a sheet on the bed. Some (usually the men) just lie on the bare waterproof mattress. There are sheets on some beds but those may be limited as not everyone has those. If hospital linens are used on a bed, the next patient may use the same linens after that patient has been discharged. The patients on the floor are usually given a sheet of plastic or may even have a mattress on the floor. The room and the floor are clean and there are usually no odors. There is a small wooden bench for a family member to sit at most beds.

 

The family usually comes to stay at or near the hospital with the patient. There are courtyards and shelter where they can prepare food, get water, etc. Patient’s families supply their food. There is no cafeteria or food service here. There are no drinking fountains. There is of course no air conditioning, but with all of the windows open it is fairly comfortable. There is no shortage of nurses as there is a nursing school nearby.

 

There is an incredible sense of community that I have observed. If we are speaking to a patient with a translator and are not “getting it”, the patient in the next bed might jump in and help explain, especially if he speaks English. I was seeing a boy (children are often in the appropriate men’s and women’s wards as well) and the nurse could not find his parents, so our snakebite patient in the next bed got up to help. The patients and families do not seem to be concerned about privacy. One of our patients had hallucinations the day before and his sister was having trouble telling us what happened. The mom of the boy in the next bed chimed in and explained what she observed. I have observed the same sense of community in the clinic. In clinic 4, where I have seen clinic patients, we have had 4 providers and 4 patients at the same time. There is a desk in the middle and 3 providers sit at the desk with a chair for the patients next to each provider. One provider is against the wall. We all share one exam room. There is a staff translator at the desk. I had a patient who was there for her 6 week post-partum visit. Before entering the exam room, she handed her baby to a patient seeing one of the other doctors. This woman happily accepted her baby and held him while continuing to talk to her doctor. Those of us new to Ghana thought that was really neat!

Melinda Roney, MD

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