University of Central Lancashire 2019

Medical, Ghana Takoradi

Onwuchekwa, UgonnaI chose to do my elective in Takoradi, Ghana for several reasons. 

Firstly, I wanted an experience in a rural setting. This was based on advice from doctors on placement, who advised me that electives in a rural setting are very good for improving examination skills. This is because cases usually present late, and hence they have more physical signs. 

Secondly, going with an organisation made planning the elective less stressful. The stressful parts of planning the elective were sorted out by Work the World. 

Furthermore, the cost of living is low in Ghana and therefore the elective was financially feasible. 

Finally, I knew Ghana had beautiful scenery, and I planned to visit these places over the weekend. 

For my elective, I chose emergency medicine because I wanted to see a variety of cases. Further, I wanted to have the opportunity to assist with a wide variety of clinical examinations and clinical skills such as CPRs.

They made me feel like part of the team. 

The hospital staff were amiable and willing to teach. They made me feel like part of the team. 

I shadowed doctors in the ED and had the opportunity to assist with taking histories and discussed management plans with the doctors. 

The experience was a steep learning curve for me. I noticed improvements in my cannulation and my abdominal examinations, as well as my clinical knowledge. 

Usually, I assisted with clerking in patients and examining them. I then discussed differential diagnoses, investigations and management with the supervising doctor. Also, if the patient needed any cannulation or bloods taken, I assisted with the task. 

I found that the process of caring for a single patient throughout their stay in ED helped me create rapport with the patients.  It was also a sort of lived out case-based discussion where I learnt a lot about that medical condition.

ED was always a place with exciting cases. One interesting case I assisted in was a patient who fell into a fire resulting in a burnt face. 

This patient was a known epileptic and had been told never to attempt cooking. On this fateful day, the patient’s sister gave him money to buy breakfast before she left for work. However, he decided to boil rice instead. Unfortunately, the patient had a seizure and fell face down into the fire. 

This patient was brought in with second-degree burns by neighbours. The patient responded well to treatment and by the fourth day, was stable enough to be transferred to the plastic surgeons. 

There was another case which had both an unusual presentation and resourceful management. An infant who came in with tachycardia, tachypnoea, grunting, noisy breathing and fever. 

However, on auscultating his chest, there was no wheeze or crackles. He was having respiratory distress due to malaria; this meant that he needed continuous positive airway pressure. 

There was no CPAP machine, but the doctor proved very resourceful. He used a water bottle and a three way connection tube to provide this positive ventilation for the baby.  The baby survived, and I was impressed.

Onwuchekwa, Ugonna

When comparing Ghana to the UK, Ghana still has a paternalistic system of medicine where patients are told what to do with no real room for negotiations. 

There are also limited resources, and hence much resourcefulness was needed to accomplish some tasks. For example, the case of the water bottle CPAP above is a good example. 

Another example was that instead of having designated urine sample bottles; the staff recycled empty medication vials for urine samples instead. 

doctors were well trained, very resourceful and knowledgeable.

There is a national health insurance scheme, but it does not cover some treatments and investigations. However, doctors were well trained, very resourceful and knowledgeable.

In the evenings I went out to the local restaurants to try the cuisines such as banku or I went to the various beach bars. The scenery was beautiful for walks and just to sit down and listen to the ocean. 

On Tuesday evenings we had language lessons in the local language called Fante. Thursday evenings were a great time to relax. We had a BBQ with local food and music. These were enjoyable nights.

On the weekend, I travelled to Nzulezu which is a village built on water. It also has a fascinating history. 

I had a great time in Ghana, and I learnt a lot. I would definitely encourage any student to take their elective in Takoradi.

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