Ghana Trip 2023

  Friday June 23  We started the day at the weekly Friday morning meeting for all the doctors and staff. It was in a conference room and someone presented on sickle cell mothers and gave different statistics on neonatal deaths and different types of care for these mothers.  Today was some sort of world sickle cell awareness day and lots of staff were wearing T shirts and they had a banner for it. Today I wore my dress that I got at the market since on Fridays people wear traditional clothes (last week the doctors asked why I wasn't wearing that!) We went to another lecture in the conference room. It was a lecture on inpatient management of severe acute malnutrition (SAM).  For young children with malnutrition (under 6 months), the goal is to get them back to breastfeeding. But, the doctor explained to us all the considerations like twins with not enough supply so they need to supplement with formula, or mothers who are HIV+ so they need to weigh the risks.  Acut...

  Thursday June 22 Today I was in the malnutrition ward again. It is technically called the RC ward in the name of Reverend Campbell, although I’m not too sure what his role was and why it’s named after him. There is a plaque in the ward to Dr. Cicely Williams, a doctor here in the 1950s that did pioneering research on malnutrition and discovered and treated a protein malnutrition disease called Kwashiorkor.  We went to the ER and the dietician assessed a child who was in for respiratory distress but may qualify to be admitted to the malnutrition ward depending on how he does.  We observed the doctors doing rounds on the patients in the malnutrition ward, mainly checking heart and respiration rates. Each child is weighed every morning, some continue to fluctuate without much forward progress.  One of the resident doctors is a mother with two young children and schools just started their 8 week break. So, she showed us a workbook document she made to keep her kids ent...

  Wednesday June 21  There was tons of traffic on our way to the hospital today. There are certainly peak times for it but it’s sometimes randomly very slow. Today our Bolt driver was listening to a radio station where they were discussing “land guards”, which seem like privately hired guards that defend land, not so much in Accra but in rural areas. They sound controversial, most people who called in were saying that they are too lawless or violent and should be stopped by police, but one woman described her situation of her house being filled by squatters whom her landlord collected rent from and not being able to get them to leave for a year until she hired land guards.  Today I went to the family planning clinic. First-time patients can walk in but returners have appointments. The main nurse said that most women who come in already have children but some don’t have any yet and they do sometimes have teen girls come in.  Here are some posters that are on the wall ...

  Tuesday June 20  We lost power in the middle of the night but Roland our coordinator was able to turn it back on. Today was the dedicated HIV clinic day that took place in one of the outpatient rooms. Dr. Mensah, a doctor from Guyana, was the doctor running it. There were two other people in the room mainly doing paperwork and nurses came in and out. Dr. Mensah only speaks English so the nurse would have to sometimes translate for the patient.  The patients would come in and usually, it was a child and mother, the kids who were in today ranged from 4 years old to 14. Usually both the mother and child were HIV positive. The doctor mainly checked in with them about their meds and did a basic assessment. She would ask the kids how they’re doing in school and encouraged some to study harder. She would ask the moms if they’re married or have a boyfriend and if they’re using family planning. She would also ask if they’ve told their partner of their status; some said no and sh...

  Monday June 19  Today I was in the malnutrition ward. I’d heard it was slow with only one patient in previous weeks but today there were 6 patients who were admitted from the Friday weekly malnutrition clinic.  Most malnourished children have underlying issues, and when they’re in poor households, the families don’t get the care they need. So, most kids in this unit come into the ER or outpatient with other things (diarrhea, TB, malaria, really anything) and then get admitted to the malnutrition unit when they have certain measurements: weight, arm circumference, etc. They do a lipid test to see if the child is well enough to send them home with the feeding formula (to avoid them unnecessarily being exposed to other illness here) but if they can’t tolerate the formula well enough they are admitted. Malnutrition can make it hard for them to digest things so it is common for them to throw up the formula. They do a milk-based formula that has different dilution levels base...

  Saturday June 17 and Sunday June 18 We slept in a little then went to Kakun, a restaurant about 20 minutes away. I had a breakfast bagel and sweet potato fries and a ginger lemonade. We stayed there for about 2 hours then went to the Legon botanical gardens which were about 45 minutes away, The drive was very pretty and there was lots of lush greenery, it felt like we were out of the dense urban city for the first time. I also noticed tons of roadside shops selling potted plants and pots.  We also saw some groups of bulls with bumps on their backs which are apparently evolved for storing water.  The gardens weren’t as much “gardens” as a giant park with some attractions. Lots of people were sitting and hanging out in the open spaces and some even doing photo shoots.  We saw a monkey in a tree, a woman was giving it a banana.  We did the high ropes course which was only 5 US dollars. It felt really high up and I was definitely scared, there were some parts that...