Everything's Rosy

Goats on the Street

The mornings are my favorite. The humid air settles in as we rub our sleepy eyes on the walk to the taxi stand. Its early in the morning but already the sounds of vendors selling their goods and the traffic of motorbikes, tro-tros, and goats overtakes the stillness. Its not often that we feel a pause from the continuous ambush of stimuli. The birds begin their songs, the Muslim call to prayer starts its circuit for the second time of five that day. We walk past a fabric shop filled with colors I never even thought imaginable. Another pause. The wind blows past the market and fills the air with the smell of fresh produce......or was it fish. Children hold hands as they attempt to navigate the unwritten rules of J-walking through the busy streets. I feel my senses being overloaded. I feel overwhelmed. I feel excited. Tamale is awake. The taxi honks it's horn behind us.

We arrive at Tamale Teaching Hospital and eagerly make our way to the pediatrics ward. Unease sets in as I imagine what I might see today. You don't have to be in Africa to know that there can be both really good days, and really bad days on the pediatrics ward.

As we are showed around by Peter, the head nurse, we do our best to understand his thick Ghanaian accent, as he tries to understand our thick Canadian ones. Our eyes rapidly switch back and forth as if we are dreaming, trying to take in all that is present on the unit. Our movement shifts and we see a platoon of beds made up in colorful cloths. Mothers hold their babies, some so small that they don’t even look human yet. The malnourished babes nestle into their mothers arms and we see each breath they take as their in-drawn breaths dissipate them into nothing, their recoiling breath bursting out through their rib-cage. Another section of the unit opens up and we see a wall of empty cribs. 

Empty Cribs

At first my thoughts are good, maybe this means that there are less sick babes today. I extend my lens. Maybe this means a lack of access or a resistance to care. The hospital is the last resort. When they come it is often too late. How do we change the perception of a place that brings death and misery. A bad experience for a family member or a treatment that didn’t work, why come back? How do we teach health promotion and prevention when their only access is inaccessible? If you think this is only a problem in Ghana, you may need to shake loose those rose colored glasses. 

 Peter receives a call and we are left alone. We speak none of the same languages as the families. We let our bodies speak for us as we attempt to communicate and provide relational practice. Our skin betrays us as the babies eyes open wide and their cries fill the room. We are a swarm of ghosts that were not invited to this Halloween party. This is going to take some work.

We fumble our way through the rest of the day trying to help where we can and cause the least amount of tears. Peter explains their values of family centered care as we see communication and collaboration take hold between families and staff. We see innovation and resourcefulness as the cuff off a rubber glove becomes a tourniquet for an IV start. It’s beautiful, it’s holistic, it’s inclusive. A doctor spots us drowning and asks if we are nurses. He takes us under his wing and immediately a comfort settles in. Healthcare, a universal language! Everything made sense again as we made our rounds. Each child with a different condition, some of them chronic.  I hear my pharmacology teacher yelling in my mind as she lists off all the symptoms of steroid side effects. My mind moves quickly as I get excited about the knowledge I share with this group of strangers. A common language, a link....but it’s time to check my privilege.

Tameka making Elephants

I have power. The English language has power. I have power over these patients. Just as I would back home, I must remind myself of my power relationship with both my colleagues and my patients. The rose glasses become clear again as I see that many of the patients and their families don’t even speak any of the same languages as some of the staff. In Ghana, healthcare is taught in English and each tribe and village typically has their own African dialect. So what do we do, how do we create balance in this ever present power relationship? We advocate. We ensure each patient and their family understands what is happening before a procedure and that consent is given. We make sure they are being provided teaching in their own language. We make sure a mother understands exactly all her options when she wants to sign an “against medical advice” form for her malnourished baby to leave because she is too poor to stay at the hospital and not be working. We check our ethics. We breathe. We share the language of laughter as we blow up our gloves and turn them into elephants for the kids to play with. We share the joy of playing hide and go seek with siblings as their mothers laugh along.

We worked alongside the staff helping with whatever we could, but often it was more relational than skills. After our three days of working on the unit the children’s wide eyes turned into giggles. Another pause from the ever present noise of Tamale. A breath. We see smiling faces staring back at us.

Posted by Michelle Epp 

UBCO 4th year BSN student