We (Myrte, Nicole, Kelsey, Dawn, and Kath) were warmly welcomed into Sakote by the Chief and the staff at the clinic. We were surprised to learn that there were 10 staff members working at the clinic, including a midwife, community health nurses and general nurses. The staff all live right at the health centre and are able to provide services in emergencies after hours.
Firstly, we learned how to run the consultation room. The practice of the consulting nurse differs from our scope of practice because they are responsible for diagnosing and prescribing medications. They make their decisions based upon algorithms that they follow. Larger clinics will have a Nurse Practitioner or Physican Assistant for consulting, but in these smaller rural clinics, consulting is the responsibility of the nursing staff. The scale of conditions that could be diagnosed and treated was minimal as the centre was only equipped to treat a handful of diseases, most commonly malaria and respiratory infections. The HIV and malaria test kits are effective because they are quick and easy to use. In the case that a diagnosis could not be treated at the clinic, the nurse referred the patient to a larger clinic or hospital. The nearest larger centre, the Nangodi Health Centre, is about 12 km down a rough gravel road. The nearest hospital is in Bolgatanga, another hour drive on rough roads. Many patients do not have access to transportation to the larger centres and they must walk. Unfortunately, many are unable to follow through with the referral.
One of the biggest challenges we faced was communication. Due to the high number of dialects throughout Ghana, this can even be challenging for nurses working in clinics. Luckily, some of the staff were able to translate our assessment questions, followed by recommendations and teachings.
The clinic also provided routine checkups which included an HIV test and blood pressure. Vida spread the word that we were doing health screening, and the number of people seeking routine checkups was encouraging, even the Chief and his wife came out to show their support of the screening program.
Sylvia, the midwife, was knowledgeable in teaching us about antenatal assessments. She sees patients both at the clinic and in the community. We were fortunate to be there on the day the "ultrasound medic" traveled to the clinic with a portable ultrasound machine (this only happens once a month).
Our collaboration with Ghanaian healthcare workers was an invaluable tool during this experience. We feel even more immersed into Ghanaian culture as they taught us how to eat banku and pump water from the well!