The past week has been really busy! At the leprosy camp, I dressed the wound of the young 3 year old named Majua. As soon as the old dressing came off, the wound bed began to weep and flies immediately covered the site. Volunteers had taken her to the local hospital the previous day because they are so infected. It's hard because we get only the equipment supplied to us by Projects Abroad, which clearly isn't the best quality nor does it include any kind of antibiotic ointment. I also wrapped an elderly man's foot. He has a club and such severe contractures on all his extremities that it is difficult for him to even walk. The pressure sore is open to about 3x4 in. It's on the bottom of his foot so obviously very sore when he walks so we placed extra gauze for padding. I met a 13 year old boy (Onasis) at the camp who has developmental delays. He is unable to speak and only understands a few words in Fante, the local dialect. Another volunteer gave him her juice box and he wasn't even able to drink from the straw. He is so small that I would've only guessed him to be around 9 years. He ironically wore only a torn blue special olympics shirt, so we plan to buy an outfit for our next visit. It really made me consider how the mentally ill are treated in Ghana. Everyday I pass a man who seems to live underneath the awning of a shop. He sits on a piece of cardboard practically all day. It's obvious he has some kind of mental illness. I see him in the same clothes day after day. It seems like every society puts a negative stigma around mental diseases but it's worse in developing countries because they don't have the resources to seek any kind of support. Instead they are left with no hope to succeed or be accepted in life. It's just really sad to think about living that way your entire life and being stared at everywhere you go. Onasis will never receive an education or be given the opportunity for friendship. He will forever be shunned by the community- the same people who are supposed to help him learn, grow, and feel loved. It was a wonderful feeling seeing him smile at us to play catch with him but heartbreaking to leave as all the kids fall into tears.
I completed my rotation through the pediatrics department. Near the end, I regularly gave medications and assisted with the doctor rounds. One patient was a 5 year old girl who had a boiling pot of soup accidentally spilled on her. She had 2nd degree burns covering the trunk of her body, splatter marks on her arms, and a significant amount of damage to the perineum. She was placed in a bath of cool water with antiseptic solution added. The old dressings were removed and her body lightly scrubbed. The poor thing was placed in her bed and was so cold but they didn't want to cover her due to the risk of infection from a non-sterile blanket. I assisted with opening packs of gauze with vaseline, soaking cotton in NS, and holding her while being treated. She doesn't get any pain medication other than something similar to tylenol. Her dark skin really put things into perspective for me. I could actually see skin peeling away, areas of white, some of pink, and all weeping yellow tinged fluid. Cape Coast doesn't have a burn unit but apparently the capital city of Accra does. I learned how to say it's ok and don't cry in fante- oye yay and men su respectively! This definitely comes in handy when working with the kids but you often get laughed at when trying to speak their language. I accidentally made a small mess of blood in one boy's bed after disconnecting his IV. I told them I would ask for a new bedsheet and change the linen while he was in the bathroom so he didn't have to come back and lay in a pile of blood. The older brother and patient were so grateful at my act and the staff seemed in awe like I was going out of my way. To us I was just doing something that would be expected. I don't think they get more than one pair of linen the entire stay in the hospital by the way things appeared. With the same patient, the IVP was so painful as I was giving it then I noticed it wasn't infusing any of the drip hanging. I concluded it likely had a blood clot forming inside as the hub of the catheter was filled with dry blood. I asked for the possibility of changing sites and maybe even getting new tubing but nobody really seemed to care. Some other volunteers don't seem to take work seriously and often leave early. I understand sometimes it does get boring and there isn't much to do, but afterall this is our purpose in being here. I actually felt bad because the charge nurse yelled at them in front of everyone saying, "Your colleague (meaning me) stays here everyday until 2 and helps with everything. As for you, you do nothing!" It did make me feel good and accepted but sorry for them.
A few things I have been able to assist with are NG tube placement (confirmed by placing the end in water- if it bubbles than it's in the lungs), interpreting urine dipstick results, and C&S of a sacral abscess. This was on a newborn baby and the MD stuck it with a needle, pulling about 4 cc of pus out into the syringe. He then proceeded to squeeze the pocket like a zit for about 5 minutes from all different angles, getting thick white discharge. The baby was crying the entire time and was being held down on her stomach by her mother. It wasn't until the very end that she was given any for of pain relief, which happened to by just a tylenol suppository.
Friday the 13th lived up to it's superstition if you believe. It was my worst experience yet... I was walking through the ward when I saw about 4 nursing students, one RN, and the MD standing around the crib of a baby who was in the private room. One of the students waved me in and then I saw the MD assembling an ambu bag and the nurse beginning compressions. As I entered, she just walked away and everyone else just sat there doing nothing. Not knowing how I would handle a critical situation, my instincts pulled off and I jumped in to continue compressions. In my head I kept repeating "one and two and three and breathe and, one and two and three and breathe and..." The worst of it was I knew the breaths by the MD were not effective as there was no chest rise and I could hear air leaking from around the mask. He was looking around as if it were a joke. We only did CPR for about 5 minutes and then they said let's STOP! It's no use! There's nothing more to be done. Well there was a lot more that could be done, at least where I come from. I couldn't believe what I was hearing, giving up after such a short time, especially for a child. In the end, the baby boy dies because of careless, uncoordinated attempts to resuscitate. I had to excuse myself from the room and had a few tears about the whole situation. It was my first time doing CPR on a real person and definitely not the successful ending I had hoped for. The nurses told me it was for the best. Apparently the child only had a grandmother remaining alive so to them he wouldn't have had much of a life. The entire scenario happened in the blink of an eye and the staff continued with morning rounds as if nothing had happened. I watched as the grandma entered the room, cleaned the body herself, and wrapped the baby on her back covering him with a drape so nobody would even know. The staff didn't say one word to her or even make eye contact. She had no support and had to live with the experience alone. Another volunteer who walked in and I told her what had happened and myself went and gave the grandma a hug, saying we were sorry for the loss. I don't think she understood the English, but she definitely could feel our empathy through the hug. The image of this helpless child and the woman walking out of the ward like nothing had happened will never leave my mind. On the positive, this was also my last day in the pediatric ward and I was able to hand out stickers, candy, and a pencil to the children. I also bought a thermometer to donate to the ward and wrote a thank you card. The nurse manager had me decorate a box that said, "funds for needy children" with some of the stickers. It was fun to watch as some children and their mothers said thanks, others God Bless, and some just smiling and immediately sorting through their present. Others were too weak to even care.
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