Adjustments to Ghanaian Health Care

I have spent two weeks on the Yeboah Ward now - which is the maternity/labor and delivery unit. It has taken a bit to get used to the unit and the staff, as everything is so different, but am beginning to feel much more comfortable. I have been able to watch several caesarean sections and then assist the midwife with the infant care and treatment after. This has been an amazing experience, as I feel like I am finally able to do something hands-on. I have also been getting to know the midwives and doctors! They are such great sources of knowledge and experience. And furthermore the cases we see are so different than from what one would see in Canada, some with diagnoses that I’ve only ever read about in text books.

While things have gone fairly well, my last shift on Thursday was particularly difficult. A patient was rushed in for an emergency c-section, which did not go as planned. To make a long story short, the infant and the mother were not in very good condition, each being taken to the NICU and ICU. That experience left me feeling overwhelmed and powerless. The frustrating thing was that although they had all the expertise and knowledge there (with anesthetists, surgeons, midwives and nurses), they did not have the resources needed. It was impossible to find the right size of equipment to intubate the infant - and in fact they never found it. Intubation had to be done with an ET tube far too large for a neonate and the oxygen hose had a leak in it making me wonder if it was even effective.

I wonder how many lives suffer and are lost due to this lack of resources. I think back to Canadian health centers, where every size of resuscitation equipment is neatly color-coded and ready, within reach. The disparities are enormous. I am beginning to realize that while Ghanaian health care does not lack any knowledge or skill, it is extremely limited by the scarcity of resources. Nurses and midwives often tell me, “We are doing our best”… “We do it right here.” At first I had a difficult time believing this as I watched a procedure which should be sterile become contaminated because the midwife could not change her sterile gloves. Now I am gaining a different perspective…and am seeing how much I have to learn from this country.

Next week I was supposed to switch to the Trauma Emergency Ward, but am choosing to stay at Yeboah for at least two more days with hopes of seeing a few normal deliveries (I’ve only seen one thus far). Of course all of the deliveries occur right before or after I am on shift!