Merel Stevens 2019 ENG

Necessities for the hospital in Ghana

I brought my own stethoscope, saturation meter, eye lamp, and reflex hammer. Besides, notebooks are convenient. About clothing: closed shoes or sandals are fine and decent clothes are appropriate.

Description of the activities

Every morning I started at the accident & emergency department with the visits. I would see mainly new patients then. I saw the patient independently, after which one or multiple doctors would come for teaching rounds. This is where I would present my case, ask questions and a lot was explained. Furthermore, there were a lot of other Dutch and Ghanaian students present with whom I could discuss things. Afterwards, I would go to my department. You were allowed to make your own schedule and the doctors are very flexible in this. I did the female ward for 7 weeks and after that 10 weeks at the maternity ward. I would do the visits alone sometimes and sometimes together with a doctor who was present at my department. It depended on this doctor how much responsibilities you would get. If no doctor was present, I was always able to call for advice or supervision by call. The afternoons were quite free of choice for me. I went to visit new patients at the emergency, or reviewed my patients from the morning, and I always had something to do on the department. At the maternity ward I have spent a lot of time with the midwives, did labour assessments, deliveries and curettages. You also do the antenatal clinic daily, which is where pregnant women will come with complaints or divergent lab results. Moreover, there is an outpatient department where you can see patients. You can have yourself scheduled, but only in the afternoons and not in combination with maternity. This is because you usually don’t have time in the mornings. I have been at outreach too with the public health department. As a student you cannot contribute a lot here, but it is very interesting and useful to have seen. 

Supervision

The supervision was good. The doctors are education-minded and aware of the fact that you are a student and that you are in the hospital to learn things. This is something I enjoyed a lot. Because there were some problems in the hospital, in the final period I experienced a bit less well-organized education. However, supervision was always available. There are some cases where no one picks up or it takes a long time for a doctor to arrive, but this is something you need to get used to. 

EPASS feedback

Dr. Vitalis is responsible for this and was quite fast and adequate in filling in and validating my EPASS forms. You can take the EPASS forms with you printed, so employees in the hospital can fill it in for you. Everyone is willing to do this. Ghanaian people are a bit less direct compared to Dutch people, therefore you will not receive negative feedback quickly. Thus, in my opinion, the quality of the feedback wasn’t always contributing. You have to be very specific when asking feedback. 

Practical skills

Because I worked at the maternity ward for almost three months, I mainly gained practical skills there, like vaginal examination, examining pregnant women, curettages, deliveries and doing echo’s and stitches sometimes. At the emergency department there are a lot of possibilities to learn skills like stitching, ascites drainage, inserting a NG tube etc. If you are interested it is also possible to assist at the theatres on Tuesdays.

Language barrier

The employees of the hospital speak English, a big part of the patients don’t. About five languages are spoken by the patients, therefore it is impossible to learn the language. The employees, however, are always willing to translate for you. The downside of this is that you don’t have a lot of direct contact with patients and you are forced to ask closed questions. The communication with the patients is, thus, very different compared to in the Netherlands. 

Culture, ethnicity, religion, food

There is a strong hierarchy in the hospital, and it is a good learning process to gain insight in this gradually and also to find your own spot in the hierarchy. Some nurses do see you as a doctor, others know that you are still a student and treat you more like a co-assistant. It occurs sometimes that the same supervisor acts very casual to you and very strict to a Ghanaian student. This was something I found difficult and really needed to get used to. 

Ghanaians are very religious. This did not influence my work in the hospital directly, besides the way they dealt with death and palliative care, which is not only influenced by religion. I was asked often if I was religious. I have been very open about this and this was accepted well. I went to church with some colleagues sometimes. 

Trips

Mole national park is half an hour drive from Damongo, where you can go on safari or go swimming. There is also a nice restaurant in Damongo named Eco. Yosta van der Heiden, an old GEZP student lives in Damongo together with her husband James since September. She enjoys meeting and chatting with the Mustangh students and making clothes from beautiful Ghanaian fabrics. Unfortunately, there isn’t a lot of time to explore the rest of Ghana, because you only have weekend for 1.5 days. I would advise to travel through Ghana before or after your internship. 

What stayed with you the most

I really enjoyed my time with the midwives and nurses at the maternity ward and really felt a part of the team. Sometimes I did run the ward independently and noticed that my colleagues gave me this responsibility and trusted me. This was a very nice experience.