Tuesday, March 22, 2016

Tamale Teaching Hospital



Tamale Teaching Hospital

Our first week in practice was at the Tamale Teaching Hospital (TTH). TTH is a hub for both Ghanaian and international healthcare professionals and students willing to collaborate and learn from one another. We were divided into groups and placed in one of the following places: the OR, Emergency,  Labour & Delivery, the NICU, and pediatrics. We were dispersed throughout the hospital yet we found similarities on each ward. Although the resources were sparse, in comparison to Canada, we were impressed by the staff's ability to improvise and adapt. We admired the level of involvement that families and friends had in patient care.


Emergency
A&E Crew
Triage Sheet
We (Nicole, Kelsey, and Alyssa) were placed in emergency, also known as A&E (accidents and emergency).  It consisted of a triage area and  observation area (main department). The sheer volume of students in the department: med students, nursing students, community nursing students, and a variety of others, made for some interesting conversation.  Kelsey was put on the spot when asked to explain triage to a group of Ghanaian nursing students. From here we learned how to use their specific triage system. Cardiovascular disease and motor vehicle accidents were prominent, much like at home. Snake and scorpion bites however were something completely new to us.  After spending a couple of days in emergency, we moved to pediatrics to help on what seemed to be one of the busiest wards in the hospital. 
Pediatrics
A
 few of us had the pleasure of sharing a page in the health stories of 
our younger generation. Placed on the pediatric ward, we were excited to
 for the opportunity to build relationships with families and help 
little ones regain their health. We knew we would gain so much 
from this placement, but we had no idea what we were in store for. 
Our placement opened our eyes to the inside view of Global Health. 

One of the first things we noticed was that every child had at least one
 family member at the bedside. Without looking carefully and truly 
understanding their health care system, we would have thought of this as
 beautiful because we are seeing the children's support system. But in 
all truth, these children need their families with them. Families are 
responsible for providing personal care, feeding, washing, mobilizing 
and buying medications for the patients. These families have no choice 
but to drop everything in order to be there for their child.  They must leave their work, their village, their fields, get someone else to look
 after their other children, and sometimes even borrow money from others in 
order for their child to be in the hospital. We are so privileged in Canada to have the time 
and resources to care for our patients even when they do not have a 
support system with them. It was difficult to imagine the 
possibility of many children not being able to get medical attention 
because their families can't afford to get to the clinic or hospital.On
 a positive note, we saw so much strength in these parents. All week, 
they were by their little one's side, taking care of them, and promptly 
filling any prescription handed to them. They would sit there all day in
 the stifling heat of the ward just to make sure their loved one is never 
alone. 
 On pediatrics, we 
had to make do with minimal equipment. There were 4 vitals machines for a
 40 patients ward, and most were already attached to critically
 ill children. We became inspired as we saw nurses push through these 
gaps, and perform the best practice they could under such circumstances. 
 We had the opportunity to collaborate with the 
health care team by critically thinking through our client's health 
issues.  We became 
teachers. We had the pleasure of sharing the space with third year UDS students. Each shift, all of us would grab a new group of students and 
demonstrate to them how to do a thorough head to toe assessment, how to 
chart it, and what to do if your findings are out of the ordinary. 
When there were opportunities to do skills, or critically think about how 
we can help a patient, we would make sure to grab a student for a 
learning opportunity. What we found with teaching, is that we also learned from them.  Once we started to build relationships with the 
students, they would teach us their ways and vice versa. It became the 
perfect opportunity to truly leave our own mark in Tamale. We decided 
that if we can teach even just a few of these nursing students, how to 
do a thorough assessment and build relationship with patients, then they
 can start teaching each other.  
We hope that our school can further this
 partnership and build on what we have started by partnering with 
students again next year.
~ Mel Hameluk

Labour and Delivery
 This week we (Kath, Myrte, Paige and Mairi) got to spend four days working in labor and delivery. The staff welcomed us with open arms and made our experience awesome. Despite cultural differences, we appreciated the staff's willingness to talk about differing practices, and their openness to working alongside students.
The L&D Team
The labour and delivery ward here is much busier than in Canada. It seemed as though as soon as one baby was born, another was on its way.  For example, during a six hour shift, we saw 6 vaginal deliveries and 3 c-sections while another 4-8 women were completing their first stage of labour in the triage room... And this was considered slow, as birth rates increase with the upcoming rainy season. At times, it seemed as though there weren't enough hands to catch all the babies, but the staff were always there when they needed to be. 
Something that really stood out to us was the resilience of the patients. The strength and fight that these women and babes have are incredible in such a low resource environment. Mothers do not receive any pain medications throughout their labouring experience, and barely make any noise throughout the process (which from our experiences in Canada is rarely seen).
We are very thankful to the staff and patients at Tamale Teaching Hospital, for giving us the best crash course in labour and delivery we could have asked for. 

NICU

There are countless cultural differences between here and Canada, as would be expected, and some are challenging to adjust to. One of the most positive pieces we can take away from the NICU, other than the adorable babies, is the Ghanaian practices of Breast Feeding. As many of our readers know, breast feeding in public is often discouraged, or women are made to feel uncomfortable if feeding their babies in public.  Due to this outlook, my generation now faces the difficulty of breastfeeding our babies in public without comments and distasteful looks from onlookers.  Here in Ghana, the feelings around breastfeeding are the polar opposite. No one bats an eyelash when a woman removes her breast to feed her babe. She could be on a public street corner in the middle of a busy market, yet it is as if she is at home. By having such open practices surrounding breast feeding it allows mothers to preform the most natural of motherly tasks without fear of judgement.  While many Canadians have begun to change their views, we are still far from being as accepting as the Ghanaian people. 
~ Madi Phemister


We all enjoyed our experiences on the different wards. We learned a lot and hope we left behind new knowledge.

The Ghana Girls 2016

1 comment:

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