It has taken me some time to get used to my new living conditions but now the reality has set in that my time is already over halfway over and I will be finished working with Projects Abroad at the end of the month. The one thing I wish you could prevent from happening while living in a developing country is becoming desensitized to the life around you. I feel I have to almost force myself to look at what I am experiencing as sad circumstances instead of just passing by as if it is completely normal. I have just started to feel that this is my normal life too- having to fetch a bucket of ice cold water to shower every night, not think of it when the power goes out (even during a surgical procedure!), taking taxis or tro tros everywhere, buying goods out the window of a car, sleeping under a mosquito net, watching people urinate on the side of the street or children bathe off the main road, transportation breaking down only part way to your destination, and food taking hours to receive after ordering. It all is so normal to me to see now that it doesn't touch me emotionally as it did in the beginning. This is my life for now at least...
I am really enjoying my time working at Tetteh Quarshie Memorial Hospital. The staff is so friendly and I have been able to see and do a lot compared to my time in Cape Coast. After every birth, I get to weigh, measure, give a bath, clean the cord, instill prophylactic eye drops, and bring the newborn to his/her mother. The vitamin K has been finished for a few days now so I am curious of the effects this will have on the babies not to receive the injection? I get to watch the entire labor process, watch cesarean sections and other gynecologic procedures i.e. total abdominal hysterectomies or bilateral tubal ligation, be the one who monitors the patients post-op as in taking and recording vital signs and fluid, initiate IV drips, and just follow along during doctor rounds. During surgery, as mentioned, the power went out for a few minutes. This means that the monitor, air conditioning, and suction all turned off. Good thing the surgical light is on its own electical box so the doctor could still see what he was doing! The suction is very ancient. It's a 5 L glass jar that sits inside a machine with a dial pressure gauge and tubing that is rinsed with hot water between patients. The anesthetist uses conscious sedation instead of general anesthesia so no intubation was performed. The role of one staff member was just to wipe the face of the surgeon as he was dripping with sweat. At least they had the common sense to prevent droplets from entering the open wound. I was happy to learn a form of time out occurs to count needles and gauze before suturing up the clients. My final experience in the OR was the concept of infection control. I was made to change my scrubs and shoes even though they all walk around the ward and in and out of the theater wearing the same clothes. They all wear crocs with holes in the top so your feet aren't completely protected and then the surgeon and surgical techs each have a pair of knee high rubber rainboots! It's quite the sight to see. Concerning the mask, it really does no good as 50% of the people in the room only wear it to cover their mouths so they can still breathe through their noses. Maybe a bit more education is indicated... Tonight I will be working my last shift on the maternity ward before changing over to pediatrics for my final two weeks in the hospital.
Last week the ward had no working thermometers. I watched as each patient had a temperature recorded into their chart to the tenth of a degree! I confronted the nurses on their findings and they said it called the hand thermometer, by touching the patient... told them I was quite impressed they could feel to the tenth of a degree lol. Luckily a working thermometer was available the following day. There was one case of a baby born with severe meconium aspiration. He came out completely lifeless with the cord around his neck too. It definitely wasn't treated as an urgent situation as the suction (which I was surprised they had) wasn't even set up. It seemed like forever before attempting resuscitation and the baby began to cry. They actually held him upside down for a minute vigorously rubbing his back to stimulate him. They didn't even allow time to recover before giving him a bath and bringing him to his mother. She was HIV and sickle cell positive. To ensure my protection, they told me only to watch and not touch anything. They said the biggest issue is breasfeeding because the virus can be transmitted through the mother's milk to the baby. Although all women know it's advised not to breastfeed, they really have no choice as formula is expensive and not readily available. Two cases on the same day required the women to receive an episiotomy. It looked like the most painful process as they just cut the perineum as the patient is pushing without giving any kind of local anesthetic. Upon suturing, they did inject a small dose of lidocaine but with each pierce of the skin with the hook, I cringed in empathy for the patient. To make matters worse, one of their hemoglobin was already low, the incision was actively bleeding on top of the normal blood loss after birth, and an inexperienced midwife was doing the repair with a smile on her face, taking her sweet time. Meanwhile, six people gathered to look at the damage. I felt so bad for her. One day a primary school girl age 6 showed up on the ward. Supposedly she belonged to the nurse. She came around the ward with us, pushing the trolley with files on it, watching injections be given, running around doing small tasks, and even entering into the delivery room to watch a birth! I was shocked that anyone and everyone just walks in and out freely to catch a glimpse of any action.
Last weekends trip was to almost the Ghana-Togo border along the coastline. The first night was in Ada Foah and the second night in Keta. We slept right on the beach, ran around with no shoes on, laid underneath the stars, and cooled off in the ocean. The transportation to and from is always an adventure in itself. On the way, we were suck in a minibus with five people across and maybe twelve rows of seats. The traffic was horrible coming out of Accra and you could barely move or stretch your legs. Obviously it took longer than expected but our tro driver was so nice and took us right to our destination even though it was out of his way. By the time we got there, the kitchen was closed. The manager could see by our faces we were so hungry so he offered to make us pasta with pesto sauce which hit the spot! On the way to the next resort, the only public transportation was a motorcycle taxi. No helmet, holding on while grasping my bag, and putting all my trust in the driver to get me along the pot hole filled, dirt road safely. Fortunately it wasn't too far of a ride to get to the main station and I made it safely. We hired a private tro since we were a group of 7 traveling and made it along the beautiful route to Emancipation Beach. The accommodation was traditional thatch huts with beds inside, bucket showers, flushing a toilet by fetching water to fill the tank first, and a bar which served local name beverages. For food, you had to order in advance as staff went to the market to buy fresh ingredients to prepare your meal. They played local and western music and the beach was spotless of other tourists and garbage- a rare find in Ghana! The drive back our tro tro completely broke down in this random village where I am positive we were the first white people to ever step foot on the land. We waited for almost two hours before another tro came by that could fit us all. It's what makes the experience though and you just have to take a deep breath, be patient, and know you can't do anything about the situation.
This week is a local festival in Akropong so there has been a lot of people and music. There is also a crew that has been working to clean the streets and drains which actually looks really nice. It's the first time I have seen such an effort to keep the environment cleaner here. Over the past week, family members have come to take both Eva and Belinda away to live in another village. There was no preparation or goodbyes. I just came home from work on two separate occasions to learn they had gone. Now we are left with Kweku and Jessica who do basically all the chores around the house including preparing our meals. They are just ages 12 and 9 respectively. All the kids here work so hard. In the morning they are usually up before me to begin chores before going to school. After they return home, there is more sweeping to be done, clothes to wash, or errands to run for the grandma or Dina before sitting down to study and complete homework for just a minute. I give them a lot of credit! Jessica came to ask me this morning when I will leave and gave me a big hug when I said in two weeks. I didn't know I've had any sort of impact on her as it seems we all keep to ourselves for the most part. The family has been really welcoming though:)
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