Wednesday, March 24, 2010

Need for Pre-hospital and Emergency Medical Protocols

It was only 9:30 a.m. as we walked into the Accident and Emergency Center located on the far end of Tema General Hospital (TGH) campus, but the air was thick with humidity. Seven of the eleven beds were already filled with patients that had come in over the previous days and additional patients lined the wooden benches waiting to be seen.

One of the patients, Joseph, a 35-year-old male who suffered an open fracture and dislocation of the left ankle, lay in the corner staring out the window, with a small black bible in his hand. When we went to talk to him, he greeted us warmly and explained that a metal bar had swung out and hit his leg while he worked three days ago. He had been taken to TGH where he received initial treatment including splinting and pain management. But, with no orthopedic surgeon on staff at TGH, Joseph was now awaiting transfer to the 37th Precinct Trauma Hospital in Accra, where he would receive the necessary definitive management that his injury required.

Unfortunately, Joseph's story is not unique. In a country where OSHA laws do not exist to protect workers, occupational injuries are a daily hazard in this port town. Health insurance is not offered through most employers in the region, so the patients themselves are burdened with the cost of their medical care including transfer to a higher level of care. As Dr. Charles Annan, the head of the Emergency and Accident Center at TGH explained, one of the area’s vital needs is appropriate pre-hospital protocols and proper trauma facility designation. Joseph's story highlights one of the many facets of pre-hospital and emergency medical protocols that the Project HOPE team is evaluating during our two week assessment of TGH.

Thanks for reading - Elise Chamberlain and Marley Gevanthor

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