University of Edinburgh 2010

Medical, Ghana Takoradi

I had always wanted to travel to Ghana, and decided to go with Work the World as it was my first time travelling to Africa. I had heard that they were good at organising medical electives, and I wanted to make sure that I was supported at the hospital I was doing the placement at. It gave me the comfort of knowing that there were people who could help me if I needed it, and that there would be other students around for me to enjoy my experience with. And I am very glad I did, because I ended up having 4 of the best weeks of my life. It was an exciting travelling experience, where I gained a lot out of my hospital placement, and also made lots of friends.

General Medicine

I spent most of my time in the male and female wards with Dr. Fahmy. He loves to teach, you do ward rounds 3 times a week, as well as a general medical clinic, and a diabetes clinic. The ward rounds are relatively long and thorough, usually lasting from 9-12. There is a lot of malaria in Takoradi and you will get used to seeing patients present with fever and vague symptoms. Hepatomegaly and splenomegaly are very common. I hadn't really felt an enlarged spleen in my studies in Edinburgh, but in Takoradi there are plenty.

Many patients are HIV positive, and although you have to be careful when examining them, the range of rashes and symptoms these patients can present with, during end-stage disease is a huge learning opportunity.

What you will notice quickly, is that a lot of the medicine in Takoradi is financially dependent. Many investigations, such as CT scans are not available, and need to be requested in Accra, the capital. Many patients are not able to afford the travel to Accra, so cannot be fully investigated. Similarly, many patients cannot afford treatment.  Patients with chronic conditions, such as diabetes and asthma often present with worsening symptoms because they  can't afford to continue long-term treatment.

Casualty

People can present with anything, sometimes it feels more like an outpatient department compared to emergency medicine.  There are a lot of paediatric cases, which can vary from mild coughs to advanced meningococcal septicaemia. There is also a lot of trauma which keeps the department busy, particularly road traffic accidents. I got to see a lot of suturing, which is done by the triage nurses in the department.

General Surgery

I never intended to do any surgery on my elective. However, in my final week I thought I would go and spend a day observing the surgical practice. I shadowed a doctor, called Dr. Tawiah. He discussed a patient's x-ray findings with me, and asked me if I'd like to assist him. I subsequently assisted in all the operations on the list that morning. I felt good knowing that had I not been there, there would not have been another assistant. It can be challenging assisting in the humid conditions, and I had to leave during the final operation as I was feeling feint. They were very understanding, and any help is appreciated. I also assisted the following day with Dr. Teye. The general surgeons I met were happy to have you observe in the operating theatres. You can assist if you want to, and there is an amazing variety of things to see in theatre.

Travelling

Wli waterfalls

The most challenging, and my favourite exertion. I couldn't recommend it enough!  The journey from Takoradi can take up to 12 hours, so it's worth going for at least a couple of nights. The guided walk up to the top waterfall is a nice 2 hour hike through forest. The guide talks you through the wildlife and plants. Once you get to the top you can swim in the top waterfall pool. And then descend to the lower pool. The highlight of this trip is the natural beauty of the waterfalls, and the hike uphill over streams and along a small path. It's a little challenging but extremely worthwhile when you get to the top!

Green turtle lodge

This is a beach resort haven. The resort has a beautiful isolated large beach. You can play volleyball, beach football, table tennis, and there's a bar that stays open all day, and until late at night. You can put everything on individual tab, so you don't have to worry about paying until the end of your stay. The place also offers activities such as: late night turtle watching, and canoeing trips. I had such a fun and relaxing trip there, especially if you go with a big group, where you can play and relax on the beach in the day, and enjoy a few drinks and beach party at night.

Cape Coast, Kakoum canopy walk, Almena castle

These attractions are close to each other, and make for a culturally rich weekend. Cape Coast is a tourist-filled town, which has a slave castle that you can go visit. Almena castle is very similar, but is bigger (officially the biggest slave castle in the world). You get a moving and historical tour of the castle, where they show you where all the slaves were confined before being boarded into slave ships. The canopy walk is about 45 minutes away from the town. It is high up, but very safe and stable. You walk across the bridges above the trees, and see the beautiful landscape from high viewpoints.  

The Whole Package

As an elective experience, I couldn't have wished for much better than what I found with Work the World Ghana. My goals before leaving for my elective were to: have a lot of fun, experience medicine in Africa, and travel. After finishing my elective, I saw a lot of pathology in the hospital that you don't see in the UK. I had the weekends to travel and see areas of Ghana. And most importantly for me, I made a lot of friends at the house, who made the whole experience a lot safer and more fun.

The house in Takoradi is very welcoming. Ophelia is the house cook. She makes you feel at home and always asks about your day. If you have any opinions on food, she is very quick to amend her menu, she's lovely! The barbeques in the house every Wednesday are great fun. Al-Hassan, the house keeper prepares the food on the barbeque, people get dressed up, and there's a lot of dancing, including some traditional

Ghanaian dancing! 

There is a seamstress who owns a tailor shop only a few metres from the house. It was very popular when I was there to buy fabric from the market, and give it to the seamstress to make anything for you. I personally had African shorts and trousers made, and lots of the girls had dresses made too, for a very decent price.

One of the nurses in the paediatric ward called Max works for a local radio station called Good News FM. He invited a few of us to come onto his show, and also record some messages, including introducing shows. It was great fun! And interesting to see how a radio station actually worked.

We also went out to a couple of places in Takoradi. Ocean's bar is a pool bar, where they play mainly hip hop music. And there is a Scottish bar called Champs- they do Karaoke on Fridays!

Tips

My advice for working in the hospital would be to arrive with an open mind. The practice is nowhere near the standard you would expect in the UK. There are also mannerisms, and attitudes which you just have to accept. The hospital is not air conditioned and can get very hot. What we all did was wear scrubs all the time. Also, don't worry about committing to one department, there are lots of opportunities to see other wards if you want.  

And most importantly, embrace the culture, learn the local Fante language, and get to know the people. It's a great travelling experience, and I would love to do it again!

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