Thursday, March 22, 2012

Starting off the day bright and early, we ventured off to our second day at Mpintsu. We started off by learning some sweet dance moves, like the robotic visor while waiting for the second van (thanks to Shayne). When we arrived at Mpintsu, we thought we would be able to get our stations set up very quickly since we had established a pretty good routine the day before. But once word got out that we were there, we were ambushed with a lot of people and had to quickly assemble order. Frank (the tank), a community worker that organizes everything for us, took the initiative to get everyone under control.

Yesterday we had a patient with an injury in his left knee down to his toes. When I first observed his leg, I would have guessed it was between 2-4 months old. He had been living with a swollen foot and a torn up lower leg for the past 10 years! We put him on our health insurance list and told him to return today to re-bandage the wounds. We were hoping to find out what the hospital said but his appointment was later in the week. Like any other person, he never wanted to go because he did not want his leg to be amputated.  Another follow up we had this morning was with a very sick little boy that was diagnosed with malaria on Monday. He had a fever of 102.5, an extremely high pulse and respirations, and was very lethargic. When he came for his follow-up, we were so happy to see his smiling face full of life. Just witnessing the 360 degree turn around in this little boy made this whole trip worth it. It was definitely a heartwarming moment.

Once we all arrived at the clinic and got the process started, we had to rush one guy to the hospital. He had the textbook definition of heart failure. His blood pressure was 210/150. He was out of breath when talking and said he had to sit up in order to sleep. Dr. Anthony (the local Ghanaian doctor who was helping us at the clinic) wrote him a referral to the hospital and we gave him cab fare so he could go right away. Today we were able to stay later at the clinic and ended up seeing almost 80 patients in 4 hours! Once we were all able to breathe again, Ben (one of our community workers) commented, “You guys are working so fast you are a machine!!”. During those 4 hours, my “adopted child” greeted me again 1 hour into the day. This little girl stayed by my side all day yesterday and today. Oh yoyo ah, how do you feel? She told me she had not eaten in 2 days and was extremely grateful for all the lollipops she was given. I wanted to go and buy her some food, but I was told that I needed to learn very quickly that we cannot help everyone. We wish we could stay for ever, but that is not possible with the amount of supplies we have. If this girl was given food, all the other kids would expect some and a mutiny would occur with this little girl. No matter how bad I wanted to buy her food, I had to learn where to draw the line. Unfortunately, it wasn’t realistic for us to provide food for that many children.

After another successful day at the clinic, we were invited to the chief’s home for a special ceremony. This was a very formal meeting. His wife started it by bringing out a goat fur chair (Akan ceremony chair) for her husband to sit on, along with two elders. The first elder’s job was to speak for the chief at all formal meetings (the linguist). The other elder was a kinman. It was an eye opening experience for the entire group to actually witness how everyone interacts with each other formally. What I really had to adjust to was interacting between the chief and an interpreter. The chief would talk for a good 5 minutes and then at one point we all laughed while the interpreter was coming up with the best way to explain it to us. The chief was asked through his linguist what his two main priorities for the community were.. In his response, he said the top two priorities were health care and education. While improving these two aspects, he said it is it very important that they maintain their community’s culture as well as Ghana’s. He is very proud of their culture and the way everything is run; it defines them and he would never want to change that. I agree with that completely because every community is defined by their culture and religion.

Later in the day we visited Effia Nkwanta Regional Hospital for a tour. When we arrived, I had no idea what to expect. We knew we would be greeted with excellent clinical skill, smiling faces and positive attitudes because that is what all the nurses brought to the table throughout the entire week. The first aspect that caught my eye was the names of every ward in the hospital. For instance, the operating room is called the “operating theatre” and they have male and female wards. I was very impressed with their resourceful to use what they have to their best abilities. For instance, in the U.S. everything is done electronically. If power was lost and the machines stopped working, a lot of the health care providers wouldn’t know how to manually test patients. On the other hand, the nurses here do not have the resources to save time and electronically do tests. They do everything by hand on their own and really understand what they need to do to treat each and every patient. If they do not have the proper supplies, they will find a way to create it. Another aspect of the hospital that I found to be very beneficial was the promotion of breast feeding. In the female/infant ward, there were a lot of posters explaining the proper way to breast feed and the importance of it. Posters were also in the male ward explaining the importance of emotionally supporting their wife throughout the period of breast feeding. They are not only involving the mothers-to-be and explaining the importance and proper way to breast feed but are also involving their husbands in order to provide support. Even with the lack of technology within the hospital, it is very impressive with how efficiently they use their resources to make up for it.

Once we left the hospital and made our way back to the church for dinner, Dr. Anthony joined us to give a talk about endemic disease in Ghana. He reminded us that not every fever is an indicator of malaria.  In actuality, they could very possibly have tuberculosis, typhoid fever, enteric fever, etc. He talked about each illness and how to tell each apart very easily. This ability allows him to make a quick but correct diagnosis’s and move on to the next patient very quickly. Another big issue is diabetes, which goes along side with hypertension. We noticed very quickly how everyone’s feet are really swollen. The majority of the people look like fluid is pooling in their feet. Something we did to help out those with diabetes is teach them proper dietary needs and exercise, making sure to take in their culture and everyday life into account. Suzanne really stepped up to the plate and did some research on how to incorporate their lifestyle with the proper requirements of diabetes. This way they will more likely to be compliant to treatment plans. Another issue we noticed quite frequently was numbness in the extremities. This symptom is usually caused by a vitamin b deficiency. A couple of us went up to Dr. Anthony and asked what he does for treatment. He said that vitamin b deficiency is quite common due to a fish tapeworm. Dr. Anthony is a very smart doctor and definitely works towards the long term well being and health of the people of Ghana. This all starts with promoting health education and healthcare prevention, as well as treating acute care that will prevent a lot of serious illnesses that do not need to be present. A great example of this is diabetes. A very popular side effect that is due to the lack of acute care of diabetes is kidney failure. By just walking up and down the streets of Sekondi, you can see how popular kidney side effects are. A lot of the Ghana health care providers want to start preventing chronic illnesses by providing and educating people on acute care. Jen Morton has acknowledged this act by providing knowledge and health care to the Ghanaian population twice a year for the last 14 years! By coming back over and over again, she has started a longitudinal trend that other health care providers are catching on to. Instead of catching diseases at the end when it is too late, we are now taking care of everything in the beginning phases to prevent chronic diseases. Hopefully today we have made at least the smallest of differences in our patients’ lives that will move them towards a better, healthier life.
-    Sarah Rheault

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