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





August 5, 2010

Today I started at the Central Regional hospital (Figure 28), where I will be finishing off my medical internship in Ghana. The regional hospital is larger, more modern, and contains patients with more difficult cases than the district hospital.
Figure 28. Central Regional Hospital.
I started in the Accidents and Emergency ward.  I knew the house director (doctor fresh out of medical school, but who still does the work of a normal doctor), Dr. Yamba, from a previous orientation day, so I followed him around.  He was extremely informative.  He used the patient cases to teach and test me on clinical knowledge. 
 
Dr. Yamba led me through the diagnosis of a pregnant woman with pneumonia, urinary tract infection (UTI), and hypoglycaemia.  We diagnosed the pneumonia by listening to her lungs with a stethoscope (the right lower lobe had diminished air volume).  UTI was diagnosed from complaints of painful urination combined with the fact that UTI often occurs in pregnant women.  Hypoglycemia was diagnosed based on complaints of faintness and the womans report that she had not eaten in a long time.

There were also some actual “emergency” cases, which were very interesting to observe.  One man had a perforated intestine (hole in the intestine) and was awaiting surgery.  Intestinal perforations can be very dangerous because intestinal contents begin to leak into the normally sterile peritoneal cavity causing bacterial infection of the peritoneal cavity.  Unfortunately, the emergency surgical theatre was not operational, so the man had to wait for the only other theatre to become free.  The man was still waiting by the time I left about 4 hours later.  In the mean time, doctors pumped the man’s stomach with a nasl-gastric (NG) tube to avoid further leakage of stomach contents into the peritoneal cavity through the perforated intestine.

I also saw a man with suspected early stage hypertension-induced subarachnoid brain hemorrhage.  Due to the hypertension, an aneurism (weakening of the blood vessel walls) had formed and blood was now leaking through the weakened vessel into the subarachnoid space around the brain.  Blood in the subarachoid space was increasing intercranial pressure, which caused a hematoma (blood pool outside the vessels) to form underneath the sclera (white part) of one of the man’s eyes.  The man was becoming confused and losing motor abilities as blood flow to certain areas of his brain diminished. The man's wife and son were with him and seemed very scared.

A 17 year old girl in labour was also admitted.  It turned out the girl had not attended any antenatal (during pregnancy) clinics to check her or the babies health.  It turned out the girl was HIV positive and had a bacterial infection of the amniotic fluid.  It was now too late for the mother to take prophylactics to stop the baby from acquiring HIV.  By now the baby had also likely contracted a bacterial infection from the contaminated amniotic fluid.  There was a good chance the baby would not survive long.  Doctor Yamba was furious that the girl had not attended an antenatal clinic and the baby’s life was now at risk.
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