|
Ghana - Atibie - Kwahu Government Hospital |
|
|
|
Contributed by Geetika - USA
|
|
Sunday, 19 April 2009 |
|
The hospital
Kwahu was a good size hospital…small enough to get to know my way around and the people quickly, but not too small. People were very friendly and welcoming (though that was true for most places I went in the country). The hospital has 3 doctors that work there full-time and one that is there about 2 days a week. They are all very good and essentially run the hospital…doing everything from surgeries to pediatrics, medicine, ob/gyn. The resources are fairly limited. We could get basic labwork on patients, renal function tests on Wednesdays and Fridays, and plain x-rays. We could however, refer patients to another hospital if they needed further diagnostic work-up (if they could afford to pay for it). It is in a really pretty location in the mountains.
The specialty I rotated through all of the departments at the hospital, which worked out well.
The tasks We usually started by rounding on one of the wards in the morning, beginning 8:30am. This was supposed to be with one of the doctors, but many times we were not sure when the doctor was going to show up, so we would round on our own and get to know the patients in the ward, especially if we could get one of the nurses to help translate. This was also helpful because once the doctor came, it was nice to be able to ask questions about the patients (which would be difficult to do if I did not know anything about the patient ahead of time). With the doctors, ward rounds usually ran quickly, but I always felt like I could slow them down and ask questions and they were willing to answer them. After this, sometimes I went to the outpatient clinic for the rest of the morning until lunchtime (usually around 1pm or so) and sat in with one of the doctors or occasionally ran my own clinic (maybe with another med student). After lunch, I went to casualty (their emergency department), which we ran on our own with one of the nurses helping to translate. I went to the operating theater one day a week.
The teaching I definitely wish there had been more teaching at Kwahu than there was. Most of the teaching I got was during ward rounds. It helped if I was familiar with the patients beforehand and could ask questions about the management decisions being made. There were no formal teaching at all. It would have been nice to have 1-2 short lectures a weeks from one of the doctors, but they were all obviously very busy as well.
Language difficulties- Twi was a tough language for me to learn much of beyond basic greetings. I would ask people how to say certain phrases and write them down, but it was still difficult to pick up. There were usually people to translate for me when I needed it, but I found it to be frustrating sometimes because I felt like I was losing information in the translation. The quality of the translators also varied quite a lot and some did not know English very well, so it was difficult to interview patients with them. It just required a good deal of patience and persistence sometimes to get detailed histories and do proper exams.
Furthering medical studies I learned a lot about malaria and its complications and the way it is managed. I also saw many patients with complications of diabetes and hypertension, which is not so common in the USA. There were also many women with pregnancy complications. I felt like I got a decent amount of experience with common tropical diseases.
Social life There was not a whole lot to do in Atibie, but I actually preferred the quieter location compared to what it may have been like in Accra. I was at the hospital most mornings and many afternoons on weekdays, sometimes until pretty late in the evening, so when I came home on those days, I was happy just to eat dinner and stay inside. We would watch movies/tv shows (there is a dvd player at the house), read, play random games, talk. On the weekends, we would usually be traveling somewhere. On my afternoons off, I would take a taxi to the nearby town of Nkawkaw and use the internet or explore. I rarely felt like I was missing out on a nightlife (but I guess that partly had to do with my idea of a good time). It was nice to be able to get to know the other people in the house and spend as much time at the hospital as I could. But if you like to go out at night (to eat, bars, clubs, etc.), you may feel bored sometimes in Atibie.
Difficulties The language barrier was one of the big frustrations. Waiting around in the morning for the doctor to come in to start ward rounds also made me impatient sometimes, as we were never sure when they were going to come in. Since the hospital is in the mountains, we had to travel up or down the mountain in order to leave/enter the hospital, which could be kind of scary at night…but I just tried to avoid doing this at night if I could. Sometimes the way the doctors and nurses there talk to and treat patients can be rougher than we do in the USA, so this could be disturbing to watch. There was not as much teaching as I would have liked overall.
Good things One of the best parts of the elective was the independence and responsibility we got. This was scary in the beginning and challenging throughout, but at least it got less scary as time went on. The afternoons that I was on Casualty (the emergency department), I saw patients on my own (usually another medical student was there as well) and made treatment decisions/prescribed medications. There was also a medical assistant there seeing patients in a different room that I could ask questions of if I needed to. One of the doctors was on call everyday and could theoretically be called if I needed to discuss a patient. So there was help if I needed it, but otherwise it was pretty much on our own. Then my last week, I went to one of the community clinics (about 40 min away from the hospital) and ran a outpatient clinic there. There was less help available that week, but a good chance to be able to take the reigns. The food at Kwahu was delicious!!...we got lunch and dinner everyday during the week made at the hospital kitchen and it was filling and very very good. They were very flexible as well with special dietary restrictions (I am vegetarian and that was not a problem). The doctors were all very good at what they did.
Improvements It would be nice to have a few formal teaching sessions to go over the basics of tropical diseases.
Advice If you are waiting for ward rounds to begin in the morning, you can check to see if the doctors have arrived by looking for their car in the parking lot. It is a good idea to follow-up on patients that you admit from Casualty the next day and until they are discharged to see what their diagnosis is and how they are managed. Try to familiarize yourself with the patients before ward rounds begins and ask lots of questions…that is probably the only way you will get much out of ward rounds.
Organization of the trip The organization was great..everything went very smoothly. Sefa came to get me at the airport and accompanied me the same day all the way to Atibie. He was easily reachable at all times during my stay in Ghana and very helpful. He’s a really nice and fun to hang out with person. I would recommend asking him for help in organizing this elective for anyone interested in heading to Ghana! |
|
Last Updated ( Sunday, 19 April 2009 )
|
Plan Your Elective 
