~Joshua 24:17
It is on a daily basis that I pray to God for my safety and health while away from home. Every time I sit down in a taxi or tro tro, I realize I am putting my complete trust in the driver to get me where I need to go in one piece. So many times have there been close calls with those who go way too fast on curvy roads or pass cars with a mere margin of space between oncoming traffic. On top of transportation, there is always the issue of health. Thankfully, I have not fallen ill under the heat, had severe gastritis related to the change in food and water, or been sent to bed from malaria. It is by His guidance and protection I have made it through!
Even though I don't wish it upon children to get sick, I was quite happy when I entered into the pediatric ward this week to learn the pharmacy had reopened and patients were once again beginning to get admitted. We saw anything from malaria and gastritis to pneumonia, acute asthmatic attack, and osteomyelitis. The department has one nebulizer and face mask which is shared among all the patients after being soaked in chlorine solution. Like that is really good to be inhaling especially in an asthmatic! Some patients are admitted only to an observation room to receive day treatment. It's a very stale environment and lonely. One boy inside asked for a storybook to keep him company and the staff basically looked at him and laughed. Even though they have a designated playroom, it's empty so no kids are ever inside. As my donation to the unit, I gave five children's books, some stickers, balloons, and pencils. They were all so grateful.
I had the opportunity to go visit a volunteer in Lister Hospital- a top of the art private hospital in Accra. It was quite the interesting experience to compare those conditions of private rooms, air conditioning, flatscreen TV, hourly nursing rounds, and medical equipment to that of the hospital environment we are placed to work in. It actually took me off guard making me think twice about still being in Ghana. The nurses here are reserved a job by the government upon completion of school and must work at the allocated hospital to serve their time in national service. After they gain two years of experience, they are able to apply to work at the private hospitals where pay is better and the conditions are much improved. It is an odd concept that such vast conditions can exist within the same country, but then again, I guess it can be true for many places around the world. I questioned about how hospital bills work and supposedly there is not a flat rate per night that patients are charged but rather it is based on their admission diagnosis. It would then be the same whether they stay for one night or one week! There are different treatment sheets for every ward of the hospital. The national health insurance covers most costs other than some medications. New graduates are estimated to make between GHc 400-500 per month (about $250)!!!! This really doesn't seem like much at all to provide for a family by our standards but according to them, it's manageable!
One case happens to be very sad. A 9 year old boy was admitted with what was thought to be right orbital cellulitis. On further assessment, his eye was completely swollen shut, weeping tears, and felt like a dense mass. The parents waited a week before seeking attention as they are from a village very far from the main healthcare facilities. The doctor then began to consider retinal blastoma. After the eye specialist came, they were considering a corneal tumor. Either way, the family was referred to Korle Bu Teaching Hospital in Accra where specialized research is often conducted. The sad part being if it is cancer, by the time the tumor is as large as in his case, cells have likely metastasized throughout the body. Furthermore, chemotherapy is not accessible other than in some regional hospitals, is extremely expensive, and the family has no medical insurance. Thus according to the doctor basing his comment on a similar case, he will likely die within a couple of months. When the eye specialist was in, the boy was pinned down and the parents were sent out of the room. Anesthetic drops were instilled in the eye and a type of forceps were placed to keep the lid open. The boy was screaming in fear and pain and everyone just walked out of the room leaving him alone. I stayed behind to try to reassure him and distract him through asking generic questions, but as soon as he just kept saying yes to everything, I concluded he didn't know English. In the end though, amazingly nonverbal communication showed him I cared and he felt comforted by my touch and smile!
This specific case made me consider two services we have available in the states. The first is readily accessible, quality internet connection to research cases you are unsure of. I didn't even observe any medical textbooks available on the unit. The entire time I wanted to run to a computer and learn background knowledge on retinal blastomas to see if the physical assessment findings in this case matched. The doctor was made to base his entire diagnosis on memory from school and previous cases. Another service is the role of a childlife specialist to bring toys so the kids aren't afraid. Much of the time the parents do this role here but only though saying its ok and don't cry; not the fun things like books, pinwheels, or toys that light up and make sound. We truly are fortunate for the resources we have available everyday without a second thought.
My time in the pediatric OPD this week was much like any other day with familiar cases coming through the doors. The only exception is noticing many father's being the one to bring in their child which is really unheard of in Ghana. It's kind of comical though because they need walked through every step of the process and act clueless whereas mothers seem to naturally know the entire procedure. There was a father and son who were deaf and couldn't communicate with the staff. I noticed a lot of hand gestures going on before someone was smart enough to give him some paper and a pen. It is interesting to see how disabilities are dealt with in developing countries where resources are lacking. I know of a school for the blind and deaf but it's expensive. You often see the physically disabled left on the streets to fend for themselves. There was a 4 year old girl who came through with cerebral palsy. The first I've seen in Ghana. She is very fortunate to have parents who care as most end up in children's homes. There is a real sense of community upbringing when it comes to care and discipline of children. You can see parents look after another sick child while their own might run to the pharmacy. Then there are those who take discipline into their own hands and yell or hit a child if he or she misbehaves. It is not frowned upon but rather almost expected.
My final outreach day was a very good one at that! We were taken to a junction in the middle of nowhere where we were made to walk down a dirt trail with jungle like scenery on both sides, cross a wooden plank bridge, and head up a small hill before it opened into this beautiful landscape where the primary school was located. The building was just made of partially concrete walls with the sides open and only a tin roof on top. All the children began cheering when they saw us arrive. The kindergarten and class one students carried in their small wooden chairs into a common room while the older children were kept occupied by a few of the care volunteers who organized games. For the medical volunteers, we began with dressing wounds as always. I had a girl come with a piece of fabric wrapped around her finger. As I unraveled it, I realized it was a case of severe burn. She had dead skin hanging off her finger and the nail almost completely separated from the pad of her fingertip. Purple dye was covering the entire surface which I learned is a commonly used antiseptic solution. I felt so bad for her as I cleansed the wound with hydrogen peroxide and removed the dead skin. She was very brave and earned an entire tube of antibiotic cream to take home! Next was our lesson on how to brush your teeth. The children were surprisingly receptive according to Gifty when she asked them a question in Twi. When someone answered a question correctly, the entire class would clap and chant "A good show!" It was very cute! They were all so grateful to receive a toothbrush and sachet of toothpaste. Something so common for us is a wonderful gift to them.
I'm very sad that the day has come marking my last outreach with Projects Abroad. All of the experiences were well organized, providing for wonderful opportunities where I felt worthwhile and like I made a difference thanks to Gifty! It's difficult to think of all the places I have been yet how many more exist that suffer from the same conditions. There is so much need in the world, sometimes right in front of you, but in a sense you are made to put up blinders and block the harsh reality from your conscience. There is no way to help everybody but for those I have been able to serve through the outreach program, I feel blessed! This has opened my eyes to what my future could entail if I pursue further medical missions. Gaining a perspective of healthcare in third world countries in comparison to that of the westernized world really makes me appreciate every simple thing I have been given and taken for granted up to this point. I will never regret my decision to come as the people here are some of the most friendliest, welcoming, and thankful people despite their living conditions. They surely taught me what is important in life and to always have a smile on your face! THANK YOU PROJECTS ABROAD GHANA:)
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