Volunteer Nurse Teaches and Learns in Ghana

Barbara Demman is a nurse and lecturer from the UCLA School of Nursing in Los Angeles, California. She is volunteering for Project HOPE on a three-week mission at the Komfo Anokye Teaching Hospital in Kumasi, Ghana as part of the Ghana Emergency Medicine Collaborative.  

There’s abundant colorful visual play everywhere in Ghana, from bright yellow cars to African patterned clothing.  Everyone, everywhere is carrying something on their head, from bags of water to live chickens… yes, live chickens! Tro tro’s, which are over packed minivans, speed through the city with people bulging out the entrances.

And of course, the heat is always a source of contention.  I am constantly dripping in sweat and within one minute of exiting my air-conditioned hotel room, my hair is up on my head in a ponytail. There is just no other way.

Power outages are as common as sneezes, men laugh like Eddy Murphy, and lizards scurry whenever you walk.  And in this sea of people thriving and working and pulsing, the streets are always full. I see lots of smiles, hear lots of laughter, and watch lots of dancing.

I am residing and working in the city of Kumasi and here, the Ashanti culture dominates.  Ashanti’s are beautiful, friendly, prideful people that can be identified by the crescent scar on their left cheek cut there by a ceremonial knife when they reach puberty.  So all in all, the vibe here is rich in culture, full of societal values and simultaneously light-hearted, fun and rhythmic.

As far as work here in the emergency unit, or “accident and emergency” unit as they call it, well, I don’t even know where to begin.  Each day brings more and more stories ranging from fascinating to depressing.

I do nursing lectures three days a week in the mornings.  Each class has about 30-40 rotating nurses, so within two weeks, I have taught 150 to 200 nurses.  I find the nurses very intelligent and thirsting for knowledge. The students are engaging, they are thinking, and they love to laugh. They are also full of gratitude for the opportunity to improve their nursing skills.

I have been invited to return, to teach again later this year and for that,  I am grateful and humbled.

When not lecturing, I’m working in the trauma/critical care area or the “RED ZONE” as it is called.  It is a continuous flow of patients that literally get dropped off with no report, no medical history and if there is a history it’s usually wrong.  Supplies are minimal and materials are quickly dipped in bleach and reused in emergencies.  Even scissors are nonexistent and everything is cut with dull razor blades.  People die from things they shouldn’t and sometimes people die because we are too busy resuscitating someone else dying and care was unable to be provided in time.

One day there was a community protest in Kumasi that turned violent and we cared for a seemingly endless stream of bloodied patients, one after another.

Many patients wait in the hallways for procedures until their families can manage to come up with enough money for treatment.  Even simple medical necessities, such as Tylenol, gauze or tape are not available and must be provided by the patient’s family.  The hospital just doesn’t have enough supplies.

The infrastructure is also testing.   Yesterday, the operating room had no running water so nothing could be sterilized and no surgeries could proceed.  There are no ID bands so it’s easy to misidentify patients. (I think I’ll resort to writings names on arms with sharpie markers for patients with altered level of consciousness starting this week.)

Despite being totally exhausting, the work has been very rewarding. At the clinical bedside, the nurses are always eager to learn, despite the many challenges they face due to the lack of medical resources.  When I see nurses perform procedures differently, because of new training they have received, well, my heart just sings.  It is one thing to teach nursing skills, but the application is totally up to the student.

The Ghanaian nurses have also taught me a lot, like the ability to take care of patients with minimal resources. I have also increased my medical/nursing skills by learning to diagnose through clinical presentation, without diagnostic resources.  Here, the x-ray and CT machines are often broken, lab results are extremely slow and get lost frequently.

Despite the needs, this facility is the best ER or really the only public teaching ER in all of West Africa. People come from many other African countries for treatment at this facility. There is a sense of pride and a knowledge that changes are happening. I can see this and feel this and I am proud to be working with Project HOPE, an organization dedicated to helping facilitate important and relevant system changes.

The environment is one full of hope and aspiration.  It’s lovely really.

Thanks for all the support.  If it wasn’t for people like you, and if I didn’t have such a strong foundation at home with friends and family and colleagues, who knows if I could muster up the strength to just go to Africa like this.

Thank you to all…. Full of gratitude

Barbie