Just a Small-Town Girl Nursing in Rural Ghana

Let me ask some hypothetical questions to get your minds’ going:

You work ten-hour days farming, seven days a week in rural Ghana. Your one-year-old child hasn’t been sleeping well and you’ve noticed that their skin has been hot and sweaty.

What do you do?

Lately, you’ve noticed that you’ve been getting constant headaches while working, you can feel your heart beating through your chest at times, and often your eyes have been going blurry.

What do you do?

The closest city is an hour away by vehicle and you do not own one, nor does anyone else in your village.

What do you do?

This is a very vague idea of what men and women face on a daily basis in rural Ghana regarding access to healthcare. Fortunately, there are health clinics that are available in rural villages so that people can receive healthcare. We had the opportunity to work at four rural health clinics: Nangodi, Nyobok, Pelongu, and Sakote. These clinics offer a variety of services from health screenings, child health screenings, antenatal care, and laboratory testing; however, not all the clinics offer all these services as some of the clinics are still in the process of growing.

Us and the team at the Okanagan Community
Clinic in Nyobok

I had the opportunity to work at the Okanagan-Nyobok clinic, which has been operating for four years. The staff consists of two nurses, Vincent and Abraham, as well a few volunteers. The environment at Nyobok was very welcoming and positive, and their patients were treated with the utmost respect. A group of colleagues and I were able to run health screenings, as well as one simultaneous child health screening. With the help of translators, we were able to ask questions about patients’ health concerns and figure out solutions to their problems.

We also had the chance to go to two different schools to complete general health teaching to grade 3’s and grade 6’s. The Nyobok clinic often has a community healthcare nurse, Nancy, come and teach at the local village schools about a variety of health topics. We did a presentation on handwashing as children often don’t wash their hands properly, or even at all. After we taught the students to sing their ABC’s while washing their hands, we also taught them basic hygiene practices such as bathing daily and brushing their teeth. Finally, we focused on teaching what malaria is, what the signs and symptoms are, and what to do if they feel this way, or a family member does.

Grade 3 & 6 students writing in their books to give to the
students at Aberdeen Hall in Kelowna

Now that you have an idea of what some of these clinics offer, I would like to ask a few more questions:

You know the Nyobok clinic is 5km away from your village and you are prepared to walk it in 40-degree heat with your one-year-old infant on your back, but you don’t have a healthcare card.

What do you do?

Your child appears to be sicker.

Can you afford to pay for medications?

What if you have to go to another clinic for further testing, can you afford the ambulance drive there?

Can you afford the additional tests?

What do you do?

Healthcare isn’t black or white, it is layers of mixed colours on top of each other. It’s a puzzle. It’s sometimes a “this is the best we can do, but let’s make it work”.  Interestingly enough, these questions I have asked you are not unfamiliar. We ask them at home in Canada as well. It is just a different context. What I appreciate about Nyobok, and the rest of these rural clinics, is the mentality of “let’s make it work”. There was a patient who was left with us unconscious. Long story short it turns out this patient’s medications had run out and was having seizures. Vincent (bless his heart), made sure this patient was able to get more medications, and set up a daily “check-in” routine every morning at the clinic before the patient went about their day. What I also appreciate about these clinics is how they value education. I believe that education is imperative to growth and change. When we taught about malaria, we emphasized how important it is to prevent it by using mosquito nets while sleeping, how to recognize the signs and symptoms, and to go to the clinic if there is a possibility that you have it.

I have asked a lot of questions, and fortunately I have some answers:

The sick woman with the sick child did come into Nyobok clinic. She walked the 5km with her babe strapped to her back in 40-degree heat. We assessed her and her infant and decided to test her babe for malaria; the test came back positive. Since the mom had health insurance, she was covered for the antimalarial medication. After the babe had the first dose along with some Paracetamol, we also assessed the mom. Both the mom and her infant needed follow up, so we completed our appropriate teaching, and the mom agreed to come in for the next four days to be reviewed.

So, what did we do as almost Registered Nurses to ensure that the patients in the rural villages continue to access healthcare?

Frank, the "clinic baby" as they call him.
Our volunteer Dokas' son.

In the Nyobok clinic we assessed patients thoroughly, critically examined their situations, advocated when necessary, and did a lot of teaching. We can only hope that we addressed the patient’s health concerns, as well established a trusting professional relationship with them to ensure that they continue to use the health clinics. Entering into my own nursing career, I will always remember Nyobok clinic for what it taught me; sometimes healthcare is “this is the best we can do, but let’s make it work”, and most importantly how education is key to growth and change.  


Blog post written by: Shannon Marken, 4th year 
UBCO BSN student