Week two: Nsuto, Mole National Park, and Damongo

Under the direct supervision of local doctors and nurses, we spent three days working in the Mampong Government Hospital in the various wards. The Mampong Government Hospital is the only hospital in the area, serving a population of over 88,000 people. The hospital has 98 beds in the general wing and 56 beds in the maternity wing, with the most common patient admissions being for malaria, anemia, pneumonia, typhoid, hypertension, and diabetes. Many Ghanaians strongly believe in the powers of spiritual healers ("witch doctors"), and so for patients who are admitted to the hospital for a curable disease, by the time they come to the hospital, it is too late. The hospital also has a 14 bed emergency ward and a clean, modern surgical theatre and laboratory. We were surprised to find that even though the hospital supposedly has a back-up generator, the power still went out quite frequently in the general wings...causing the wards to get very hot and stuffy in the middle of the day.

The Mampong Government Hospital is staffed by four Ghanaian doctors, two Cuban doctors, anesthetists, medical assistants (PAs), nurses, nursing students, pharmacists and midwives. Interestingly, Ghana and Cuba have established a medical service and educational agreement: Cuban doctors work in Ghana for four years to support healthcare delivery in the country and Ghanaian medical students travel to Cuba to be trained as doctors. The two Cuban doctors we met at the Mampong Hospital, Dr. Anya and Dr. Eric, were both near the end of their four-year service. It was evident they were both extremely burnt out due to the immense work load they faced each day. Dr. Anya rounded on patients in the Children's and Men's ward, while Dr. Eric rounded on patients in the Women's ward. After rounds were finished, they both would see over 75 patients in the OPD (outpatient clinic) in a day. They both spoke broken English and Twi - so it was sometimes difficult to understand and follow their (very short) patient interactions. In the OPD, patients would come in to the room, be interviewed by the Cuban doctors (with the help of a translator), a physical exam may or may not be performed, something would be scribbled in the patient's chart, and the patient would be diagnosed and sent out with a list of medications, lab orders, or admission instructions. This entire ordeal lasted 2 minutes or less per patient.

Patient beds at the Mampong Government Hospital

Almost every patient we saw in the OPD had malaria. Or if their lab test showed they didn't have malaria, but they had the symptoms, they would still receive malaria treatment (quinine). Headache, stomachache, fever, cough = malaria. A test kit for malaria is available over the counter for the equivalent of $1, and the malaria medications cost around $10. Due to lack of education and lack of money, patients flood the hospital's OPD since they don't understand how to test themselves at home, or they simply cannot afford it. Anemia is another extremely common diagnosis in patients at the hospital due to their diet that is high in salt and lacks iron. Rounding in the Children's ward, we learned that anemia is diagnosed by inspecting the conjunctiva (inside of the eyelids) - it will appear white instead of a normal pink color - and by palpating the abdomen - the spleen is extremely enlarged. In fact, I remember back in Omaha in one of our physical exam lectures the MD said that she has never felt a spleen before and that it's very difficult to palpate properly. Well, in the children with severe anemia, you barely had to push on the abdomen before you could feel a rock hard spleen. In most cases, the treatment for severe anemia is a blood transfusion. Because of the unreliable electricity, the hospital's blood bank is in a constant shortage of blood. The way the hospital works in Mampong is that if a patient requires a blood transfusion, they will receive it, but they are not allowed to be discharged from the hospital until they "repay" what they were given. Thus, the patient (once fully recovered) or a family member is required to donate blood back before they leave the hospital.

We spent a lot of time in the maternity wing of the hospital, where most of us got to witness several Cesarian sections and vaginal deliveries. We practiced giving APGAR scores to the newborns, we learned about all the surgical instruments, we refreshed our female anatomy, and wore some cool outfits in the OR :)

Observing C-sections

Overall, the experience working at this hospital was, while at times very difficult, very rewarding. We were introduced to the Ghanaian healthcare system and how the hospital staff manages the enormous amount of patients every day. The hospital administrators welcomed our large donation of basic medical supplies, and I know they will be put to good use in the wards. The three days we spent on the wards opened our eyes to the incredible amount of need there is in this part of the world, and how important it is to serve an underserved population.

Before our time in Nsuto/Mampong was up, we squeezed in one more community health outreach. For this outreach, we visited three schools in Nsuto and screened children's vision. Thanks to First Sight, a non-profit organization in Omaha, we brought with us a vision screening kit that included 100 glasses frames and 200 lenses. Most of the children we examined had nearly perfect 20/20 vision! We ended up fitting around 20 children with glasses that corrected their myopia (nearsightedness). We took time to explain to the children how to take proper care of their new glasses, and we tried to show the kids that wearing glasses is cool!

Gary fitting a girl for glasses

After a fun goodbye party with our host family, we bid farewell to Nsuto. We all agreed that staying with a host family was a really great experience...we miss them already!! Our next stop was Mole National Park, a short break before we start our next two weeks in the West Gonja District Hospital in Damongo. The drive north from Nsuto to Mole National Park took around 6 hours. We broke up the long, bumpy journey with a stop at the impressive Kintampo Falls. According to the locals, the waterfall is home to a band of human dwarfs (whose existence has not yet been proven...) and a large aquatic snake. Needless to say, we did not see either of the two mysterious waterfall dwellers, but the falls were very beautiful!

Kintampo Falls

Mole (Mo-lay) National Park is Ghana's largest wildlife sanctuary, with significant populations of elephant, hippo, warthog, and antelope species. We stayed in Mole Motel, which is located inside the park's boundaries. Because of this, the hotel staff constantly has to shoo away wild baboons out of the restaurant and pool areas, and warthog families constantly graze at the grass right outside your hotel room! The hotel was located at the top of a cliff that overlooked a watering hole. From the viewing platform we could see for miles around the park. We spotted elephants bathing in the watering hole and herds of antelope grazing in the field. Our group set off for a guided safari on foot early in the morning. Almost immediately we encountered a group of elephants in the bush, making their way toward the watering hole. Our guide was very knowledgable about the elephants, and allowed us to get very close to them for taking pictures! The walking safari lasted around 2 hours. While the elephants were by far the coolest animals we saw, we also spotted lots of antelope and birds, and we saw buffalo tracks in the ground. Some of the group went on a night safari later that evening, where they ventured deeper into the park by jeep. 

Creighton takes Mole National Park

Our guide for the walking safari

After a restful few days in Mole, we packed up and made our way to Damongo, a small town just 30 minutes outside of the park. While in Damongo, we would be working at the West Gonja District Hospital and volunteering at the Redemption Children's Home Orphanage that is run by the same man who offered us a place to stay the two weeks. Redemption Children's Home was established by Pastor Abraham Saaka in 2004 and now he currently has over 50 children that range in age from small toddlers to teens. We spent many afternoons at the orphanage...at the beginning, I was expecting to feel heartbreak and sadness for these children, but every day we spent with the kids we saw them playing and running around with huge smiles on their faces. It was evident the way they clinged to us when we arrived for the afternoon that they all share the same need for attention and love. Pastor Abraham (or "daddy" to the children) and the aunties that work at the orphanage have the kindest hearts and treat the children with love, trust, and adoration. We spent a lot of time playing soccer (ahem, football) with the kids, letting the young ones braid our long hair, snapping pictures with our "sistahs", and so much more. 

Giving the girl's dorm a fresh coat of paint

Sistah let me braid your hair!