Tuesday, March 3, 2009

All in a Day's Work for Project HOPE Volunteers in Ghana

Through life and death circumstances, Project HOPE volunteers find lots of opportunities to provide health education in Ghana
by Project HOPE Volunteer Gabreille (2-27-09)

Essikado clinic is the worksite for Marina (x-ray tech in the radiology department) JoAnne (RN who is primarily in the “gynae” or gynecology ward) Marilyn (midwife in labor and delivery), Michael (physician working with the clinic physicians), and myself (pediatric nurse practitioner ion the "causlutiy" or outpatient department).

The day was certainly a bit unusual compared to the rest of the week here. Early in the day we got word that a mother who was pregnant was going to have a c-section due to meconium (baby poo) in the amniotic fluid. JoAnne and I attended the delivery which sadly ended in the death of the infant. While it is troubling to see a delivery end this way and managed very differently than we are used to, it was also a starting point for many rich discussions between the volunteers and the Ghana staff regarding infant and child death, grieving, and delivery practices.

After the delivery, JoAnne headed to the gynecology ward. There are several nursing students doing their practicum there, and she has been an inspiration to these new nurses. Today a student came to her crying because the nurse was unable to get an IV in a woman with intrauterine fetal demise. JoAnne was able to quickly get the IV in place, then sat with the students and nurses to talk about IV insertion as well as gynecological anatomy. JoAnne has become a good friend to many of the staff in the clinic.

Marina was kept very busy in radiology working with her counterpart Prince. They had a friendly “competition” going throughout the day comparing their two methods for determining amount of radiation delivered vs outcome of the film quality. The radiology department stays happy and upbeat with the combination of Marina’s sense of humor and easy manner, Prince’s happy and easy attitude and eagerness to share and learn. The fact that this is the one air conditioned room in the clinic doesn’t hurt either. We all find ourselves going to check in with Marina often (honest – we’re just concerned about her….it has nothing to do with the air conditioning!).

Michael has a fantastic working relationship with Essikado physician Dr. Emanuel Darko. They see patients together, discussing the details of each case. There is an easy give and take of thoughts about diagnosis and treatment. Today was a particularly busy day as a local pier had a fire, and some people were trampled in the escape, including a 39-week gestation pregnant woman. Michael and Marina combined efforts to evaluate for possible pelvic fracture and the baby’s position. Michael has been able to teach on a variety of topics – including steroid injection into the joint for one patient, cardiac issues, and numerous other topics. Michael’s expertise was requested on a variety of other unusual radiologic issues today as well, including a case of Paget’s Disease with extreme complications.
Likewise, I and my counterparts, Tina and Elisabeth, have an incredible work dynamic. I am learning about malaria and local cultural approaches while teaching about physical assessment, lab value interpretations, and expanding the scope of possible diagnoses. The give and take of information benefits everyone and makes for a feeling of commradery. Today I was asked to teach the practitioners about nebulizer treatments, using a new nebulizer brought by Michael. The class started with three providers, but grew to include about 10. The practitioners are very excited to be able to offer this as a treatment option.

Marilyn returned to labor and delivery for a day with ups and downs. The reality of life in a developing country is that the birth outcomes are not what we enjoy in the U.S. Although two babies died today (including the baby born by c-section mentioned earlier), there were two healthy live births. Marilyn works with the midwives through these ups and downs, finding teaching points along the way – such as discussing the importance of a proper face mask seal when delivering oxygen resuscitation to a baby.

At the end of the long day, all the volunteers came together on the ship for a formal reception involving all groups involved in the African Partnership Station – including the community counterparts and the American Ambassador to Ghana. It was a special evening with local dancers, the Navy band playing, and wonderful interactions between volunteers and the diverse group involved in the African Partnership. It was a memorable way to celebrate the wide range of work being done in the area by so many groups.

1 comment:

  1. Thank you so much for the blogs. It is all very interesting. I am sooo proud of my mom, JoAnne RN, and it is wonderful to read about what you all are doing in Ghana!! Again, Thank you for all you do!