As horrible as it sounds, today has been the first day of working in Ghana which I've enjoyed. The BBQ last night really cheered me up, and I went to Kwasimintim this morning with enthusiasm (and a slight hangover). A labouring woman came in and Ellyn and I looked after her. Her baby's heartbeat was a bit slow, and staff were willing to cannulate and start IV fluids. Short of starting a CTG (certainly not available at Kwasimintim!) their management of the situation was exactly as I would have done in the UK. Whether that's a positive reflection on them or a negative one on me is for you to decide. The baby came far quicker than any of us anticipated, and as I was the only one wearing gloves I delivered (#48, if you were wondering). As the baby came so quickly the woman had quite a nasty tear. Watching this being repaired was horrible - especially as it was being done with no anaesthetic. I could see a 10ml vial of 1% lidocaine, and tactfully suggested we used it. "Okay" said the midwife, "get me 1ml". Ordinarily I'd use 10ml, so I didn't expect this 1ml to go far. She infiltrated half of it, and commenced suturing again. Unsurprisingly 0.5ml of local didn't really touch the sides, and I persuaded the midwife to give the other half as it had already been drawn up, and couldn't be used on another patient. As awful as this was to watch, I knew it didn't happen because any member of staff was being deliberately cruel: it happened because that 10ml of lidocaine had to last for many other women too. Today, I felt everyone tried their hardest with the available resources - for the first time since I've been here.
The lack of effort and care in Ghanaian healthcare terrified me on a personal level. I was diagnosed with transverse myelitis in November 2014, and assumed cold British weather worsened my symptoms. As they improved as the weather became warmer I took this as causation and not correlation. Having been in Ghana for a while I've learned extremes of temperature - be it hot or cold - trigger pain. I hadn't expected to be needing analgesia stronger than codeine whilst I was out here, and got quite worried at the thought of needing morphine: from what I've seen of African hospitals so far, I'd rather return to the UK to get it. I mentioned this to Joe, our project manager, and he told me not to worry because there is a local hospital which will only treat ex-pats. Hearing this completely confirmed my opinion of Ghanaian healthcare: this is the place where staff sleep in front of patients, staff collect vague 'fees' at outpatient clinics which are then pocketed, and every ward has a staff television but can't provide bedding for patients.
I think the biggest lesson I can take from Ghana to my own midwifery practice is how not to do things.
Love Emily x
No comments:
Post a Comment