I want to mention something about what I have been doing the past few weeks in Ghana. I have been privileged to work at Mount Sinai Hospital, a small, year-old hospital between the villages of Akropong and Koforidua. Below is a picture of the Out-Patient Delivery, the entrance to the hospital. The building looks unfinished, because it is. This is how most building projects in Ghana work. They build some and continue building as they use it. The plan is to have a three-story hospital at its completion. The wing to the left of OPD extends beyond the boundary of the photo and contains all four wards as well as the nurse's station.
I don’t know what I expected at the beginning of this project… When I initially met with Dr. Essien and his wife (who is also a doctor, not currently in practice) they explained to me briefly about the hospital and asked me about my resume. Imagine me sitting in an air-conditioned office room in Africa with two Ghanaian doctors and two other Ghanaian men, one of which I had met that morning and one two days prior. Honestly, I was very intimidated in my new environment. After reviewing my resume, Dr. Essien explained that since I am not yet a medical student, his knowledge base and my own do not overlap. Also, unbeknownst to me, I would have to pick up some basic Twi because that is the primary language of most, if not all, of the patients that come to the hospital. Patient interaction would be nil if I was not willing to learn the local language.To sum it up, my first contact with the hospital left me humbled and wondering what I had gotten myself into.
That very morning, I was ushered to Consulting Room 2, where “Captain” Richard was seeing patients. I was able to sit with him for most of the morning and watch him gently speak to patients in Twi, diagnose their condition, and prescribe the due medications. Between seeing patients and during lunch, he taught me some basic Twi words and we got to know each other a bit. His kindness gave me a spark of reassurance that I was in the right place for the summer. Below is Richard setting up for surgery.
Since then, I have spent two weeks in the Males Ward and I am currently serving in the Childrens Ward. Below is a picture of sweet girl Jennifer, whom I got to know and practice my Twi with throughout the day, and nurse Lydia.
While working in the wards, I have been acquiring some basic nursing skills ranging from cleaning the windows to administering medicines and setting an IV. Today was my first time successfully finding a vein and setting an IV on my first go-around. I got my Certified Nurses Aid (CNA) certificate last summer, which I thought would have prepared me for working at Mount Sinai. Basically, most of the technical things that were taught for the CNA certification are useless to me here. Here I don’t need to know that supine is a 30-45 degree angle—most of the beds are rarely raised. It’s not necessary to know the perfect way to fold a bedsheet—many times the patients don’t even use one. Who cares what side or at what angle you’re to stand at when walking a patient to the toilet—if they can’t do it themselves here, a family member is typically standing by to help. Many of the basic things that we consider a “necessity” in the States are not even thought of here. Surgical, sanitation (of drug administration), and certain clinical procedures seem to be universally similar but beyond that, healthcare here is much less formal than it seems to be in the States. Unfortunately, I haven’t spent this kind of time in a hospital back home, which leaves me quite unqualified to contrast the two settings of healthcare.
I have found a few terms humorous in respect to how I initially perceived them…
-In the States we use “Isopropyl Alcohol” with cotton to sanitize something. Here, they use “Spirits.” If you think about it, it makes a lot of sense. When you drink the alcohol, you have a lot of spirits. This seems to be their reasoning for calling it this. From patients to doctors, this is the term they use.
- The nurses and Dr. Essien kept mentioning to me that they’ll be in the “Theatre” on Friday, asking me if I wanted to attend. Every time I would walk by the room labeled “Theatre” I would think to myself: Why in the world would they put money toward a theatre in a newly established hospital?? Perhaps I am just naïve, but I finally asked Richard why Mount Sinai had a Theatre, and that gave him a good laugh. He explained to me that the Theatre is the surgical room/OR. Since then, I’ve been able to stand in on all of the surgeries including a few C-Sections, an appendectomy, and a herniorrhaphy. Tomorrow is another hernia repair and Friday another CS.
In regards to the surgical procedure, it is almost identical to what I have seen in the U.S. The scrubbing in, the washing hands, sanitizing instruments, etc. all seems to be the same. Two things are drastically different, however. One, music is always playing during surgery. The anesthesiologist brings his mp3 player and dock and plays tunes ranging from “Heart of Worship” to African hip-hop. During surgery, it’s not surprising to find someone singing along or dancing to the beat. The other thing that caught me off guard but which I admire is that someone—either an individual of the surgical team, the patient, or me—prays before and after the surgery. They usually pray in Twi, so I don’t generally understand what is being said, but Dr. Essien seems to hold true to the mission statement of the hospital (of which I will try to take a picture in the next few days). I have been asked to pray for the surgery once, and I appreciated that they offered me that opportunity to talk to our Father in their presence.
In regards to the surgical procedure, it is almost identical to what I have seen in the U.S. The scrubbing in, the washing hands, sanitizing instruments, etc. all seems to be the same. Two things are drastically different, however. One, music is always playing during surgery. The anesthesiologist brings his mp3 player and dock and plays tunes ranging from “Heart of Worship” to African hip-hop. During surgery, it’s not surprising to find someone singing along or dancing to the beat. The other thing that caught me off guard but which I admire is that someone—either an individual of the surgical team, the patient, or me—prays before and after the surgery. They usually pray in Twi, so I don’t generally understand what is being said, but Dr. Essien seems to hold true to the mission statement of the hospital (of which I will try to take a picture in the next few days). I have been asked to pray for the surgery once, and I appreciated that they offered me that opportunity to talk to our Father in their presence.
I think I will add a few Twi words that I have picked up. Twi does not seem an easy language to learn. Perhaps if I had a book that taught it to me it would seem more structured, but I can’t pick up on any patterns or “rules” that the language follows. Below are some basic words that we use almost every day. -
- Akwaaba = You are welcome (a greeting)
- Responses to Akwaaba:
- Yaa Agya (“Yah eh chuh”) = I accept you (to an elder man)
- Yaa Ena (“Yah en uh”) = I accept you (to an elder woman)
- Yaa Nua (“Yah new-uh”) = I accept you (to someone your age)
- Me daa wo ase (“May dah wo see” or “Medassi”) = Thank you
- Obruni = white person
- Ete sEn? (“ehh tay sen”) = How are you?
- Response to above: Eye (A yuh) = I’m fine.
- Bra ha = come here
- Ko = go
- Didi = eat
- Ye twa sue [don’t know spelling] = Continue treatment
- Bra ha = come here
- Ko = go
- Didi = eat
- Ye twa sue [don’t know spelling] = Continue treatment
