Friday, February 18, 2011

Tamale Teaching Hospital

Hello all! This is Maridel blogging from Tamale, Ghana. This is my first time using this particular blogger so if anything is off or not up to par, please forgive me. Several of the other students, including myself, have been blogging on our personal blog accounts which is why this blog has been somewhat neglected these past 3 weeks.

So far, the trip has been amazing and eye-opening. Words cannot describe what I have learned about the world, myself, other people and their health care system here. The following post is an entry I wrote on my personal blog ( about my first couple of days at Tamale Teaching Hospital. I hope you all enjoy it!

"Welcome to Tamale Teaching Hospital!"

Amaraba. That is the word you want to hear if you want to be at a certain ward in the hospital. To be allowed to work, you must first be introduced formally to the charge nurse and then welcomed. Amaraba means “You are Welcome” in Dagbani, the predominant Ghanaian dialect here in Tamale.

My first several days in the hospital have been spent on the Maternity Ward and the Neonatal Intensive Care Unit (NICU). The Maternity Ward at the Tamale is very busy. During my first 3 hours on the ward, at least 4 babies an hour were born. It serves as both a pre-delivery ward for patients with pregnancy induced hypertension or other complications, a pre-operation ward for patients awaiting an emergency cesarean section (c-section) and lastly, as a post-partum ward for all mothers, normal or with complications. An interesting thing to note is the fact mothers who deliver vaginally with no difficulties are often offered a mat on the floor while mothers with higher risk deliveries are offered a bed.

Nurses on the Maternity Ward care ONLY for the mothers (NICU nurses care for the babies, normal or not). I had the wonderful opportunity to work with a pregnant woman with Malaria. This was a once in a lifetime opportunity because Malaria does not exist in Canada and therefore, I may never have a Malaria patient ever again. To learn the principles and procedures of care was very fascinating. A blood test is performed to determine the level of Malaria parasite in the blood stream. In non-pregnant patients, a + means simple oral medication therapy while ++ or more requires Quinine Intravenous (IV) therapy. However, because this woman was at 20 weeks gestation, she received IV therapy despite only having a + malaria parasite blood level.

I spent most of the rest of my 6-hour shift (to all my fellow nursing students back home working 12-hour shifts: it’s because it gets too hot to continue working after 6 hours during the daytime) doing post c-section dressings. I was amazed at the amount of dehisced, infected wounds I saw on a Maternity ward. When I performed my dressing change, the nurse supervising me nearly had a heart attack when I threw away the guaze I was using after 1 swipe as I have been taught. He responded with the joke, “You are going to bankrupt the Ghanaian government”. There are limited amounts of resources so they must reuse each gauze to swipe the wound multiple times before discarding it. This increases the risk of infection significantly which in a downward spiral, increases the overall amount of resources used in order to combat the infection caused by reusing/saving resources. An unfortunate and very real cycle.

My experience in the NICU was also just as eye-opening. After the happy task of bathing babies all morning, I watched a baby struggle for every breath. She had been born with severe asphyxiation and as a result, all of her reflexes, including breathing and crying, were compromised. I spent the entire afternoon trying to find another point of resource to provide her (neonatal masks for higher flow oxygen, intubation). Unfortunately, the doctors and nurses had done everything they possibly could do – suction intermittently (her swallowing and sucking reflexes were also compromised) so she would not choke and provide oxygen. In speaking with the Doctor, he admitted that if this was a country like Japan (where he had worked for a month) or Canada, this baby would be intubated and on a ventilator. It’s chances of surviving would be greater than the 50/50. In addition, the lack of oxygen at birth has caused significant deficits. It was hard to watch this baby struggle but it was the best treatment the hospital had to offer.

The Doctors and the Nurses in this hospital have been very accommodating and humble. They all practice to the best of their abilities, their training and as much as their resources can take them. Ghana, more specifically Tamale, is lucky to have each and every single one of these health care professionals.

Today, I am thankful for Canada’s health care system despite the long surgical wait lists and overflowing emergency rooms. No one will really be able to appreciate it in all its abundance, technology and wealth until they see what much of the rest of the World has, far less. After my experiences on the Maternity Ward, I can say with conviction that every baby and mother in Ghana is a blessing indeed.