Blog Description

This past summer I went on a 6 week medical observational internship in Ghana, Africa with the Abusua Foundation (an NGO run out of Ghana). I went to gain experience in a hospital and see if medicine is really what I want to do with my life. I lived in the small village of Kwaprow, in the coastal fishing town of Cape Coast. I worked in two hospitals: Cape Coast District (smaller, less modern)and Central Regional (larger, more modern). I also taught English and Science to young children of my village at the BCL after-school program.

While there, I wrote a journal about my experiences in the hospital, teaching at the after-school program, and general life in Ghana. Since being home, some people have expressed an interest in reading the journal, so I figured the easiest thing to do was to post the journal here for anyone who is interested in reading it. Any patient names mentioned have been changed to ensure confidentiality.

It should be noted that because this is a blog site, the postings are in reverse order of when they occurred (which I can't change). So, to read the entries in order you should start from the oldest posts at the bottom of this page.

About Ghana
Ghana is a coastal country in West Africa. The national language of Ghana is English. The capital of Ghana is Accra. Ghana is considered the safest country in Africa (according to global peace index; see Global Peace Index map at the bottom). In terms of development, Ghana is ranked in the middle tier of African countries and 152 out of 182 in the world by the Human Development Index.

Monetary exchange:
$1.40 CAN = 1 Cedi, 1 Cedi = 100 Pesewas





July 16, 2010


Today I was able to observe a C-section surgery.  This was performed by Dr. Kwarteng, the doctor for the female ward.  Dr. Kwarteng told me that all doctors in Ghana are trained in basic surgical procedures, which they routinely perform.   The surgery went off without a hitch, and a beautiful baby boy was born.  
For a C-section, the patient is anaesthetized by a spinal tap and the abdominal area is sterilized.  The surgeon makes a small (approximately14 cm) horizontal incision through the integument (skin), underlying adipose (fat) tissue, and abdominal wall to expose the uterus.  Any blood vessels are clamped shut to stop bleeding.  The aforementioned tissues are stretched to accommodate the size of a typical baby (this is done very forcefully!).  Tissues are stretched as opposed to making a larger incision because stretching avoids cutting of blood vessels.  The uterus is raised out of the abdominal cavity, then cut open and the baby removed head first.  The umbilical cord is clamped on both the mother’s and baby’s end, then cut in the middle.  The placenta is removed from the uterus, and the uterus is sutured up and put back in the abdominal cavity.  The surgeon ensures there is no sustained internal bleeding, then the abdominal wall, adipose tissue, and integument are sutured back together.  
All in all the procedure took about 30 minutes.  I was surprised at how short it was.  I was also very surprised at how rough the surgeon can be on the patient’s body (stretching skin, stuffing the uterus back in the abdominal cavity), without causing damage.   
C-sections are much more common in Ghana than Canada. Dr. Kwarteng explains that this is because in some younger woman, the birth canal is too small for the child to pass through.  Since pregnancy commonly occurs in younger girls in Ghana compared to Canada, higher rates of C-sections are performed in Ghana compared to Canada.
Nothing too exciting was occurring in the male ward, so I went to visit Rob in the female ward as Dr. Kwarteng did his rounds.  Dr. Kwarteng and Rob showed me a snake bite victim who was in bad condition.  The lady had been bitten on the leg last Friday, but did not come to the hospital till Monday, by which time her condition had worsened significantly and treatment was not being effective.  When the lady was first brought in, her leg was swollen and discoloured, but she was otherwise alright.  By Friday, she was in a coma and struggling to breathe.  Dr. Kwarteng suspected the snake venom was acting as a neurotoxin, causing the woman to fall into a coma, as her brain systems became impaired.  Dr. Kwarteng predicted that the woman would die shortly, as the venom inhibited the woman’s vital brain systems (temperature regulation, respiration, cardiac function).  The women died two days later, as Dr. Kwarteng predicted.
Dr. Kwarteng and Rob also showed me two patients who were HIV positive and suffering from secondary infections due to their weakened immune systems.  This was the first time I had seen HIV patients.  The girls looked extremely weak and disoriented.  Dr. Kwarteng ordered a CD4 count to be performed to determine the stage of HIV of each girl.  He suspected they were in stage 4, the stage just before full blown AIDS. Dr. Kwarteng said the treatment course for the girls would be to send them to HIV clinics, where they would be placed on ant-retro viral drugs for a time, until their symptoms became manageable. Dr. Kwarteng said HIV positive patients were sent to a separate clinic because there is still a large social stigma surrounding HIV positive people.
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