Two Weeks in Ghana

Maureen Dodd

To celebrate my birthday this year, I decided to do something different. Since it was a milestone birthday, I needed to think outside the box . I have a nursing background and had always dreamed of participating in a medical volunteer project abroad. After considering several options, I signed on to work with Disaster Volunteers of Ghana (DIVOG) for two weeks in November 2008. Most of the planning was accomplished through email communications. The flight was expensive and took me via London so that I could visit my daughter who is working there.

Preparations included securing a Visa and receiving many vaccinations. They do not even let you into Ghana without proof that you have had a yellow fever vaccination. After spending a week in London with my husband and daughter, I was ready to travel to Ghana by myself.

Disaster Volunteers of Ghana had given me suggestions of gifts to bring for the children I would encounter during my visit. With the help of many generous members of the Goodell, DeVries, Leech and Dann law firm, I arrived in Ghana with a suitcase full of materials ranging from vitamins, to crayons, to calculators, to thermometers, to favorite books that included friendly messages inscribed in them by our children. I was able to personally give most of the presents to adults and children I encountered. The bulk of the materials went to 40 children in an Orphanage in the northern part of the Volta Region.

I had read that Ghana is the friendliest African country and could serve as a good introduction to the African continent. As I landed in Accra, the capital of Ghana, late on a Saturday, I was immediately struck by the wall of heat I encountered after leaving the airplane. Ghana is a third world country located in West Africa just north of the equator. It is about the size of Oregon and has a population in the range of 23 million. Life expectancy is less than 60 years of age. Agriculture and fishing are mainstays of the economy.

Although English is the official language, people in Ghana generally speak their local dialects. During my two weeks there, I ate all local food and took bucket showers in an outdoor room. I slept under a mosquito net in a house with no running water, but with electricity. Although everyone was friendly and I usually felt quite safe even traveling alone, the culture shock was hard to avoid especially when I was traveling, living and eating just as the Ghanaians do. The new sights and smells and experiences take awhile to assimilate, certainly more than the two weeks I had arranged.

My primary purpose in the DIVOG project was to be a medical volunteer for two weeks. I was assigned to help at the Ho Municipal Hospital in Ho, Volta Region of Ghana. Not being part of a specific, defined project (as usually occurs with the medical volunteer projects), I was expected to work with the hospital staff providing nursing care. I worked on a women’s ward and also had a chance to observe in their “Theatre” or operating room. While all the staff could speak English, the local tribal language (Ewe) was what people spoke during their routine interactions. The patients spoke varying degrees of English. Therefore, nonverbal language and the use of touch were an important part of my communication with the patients. The hospital did not have what we generally expect to see in our hospitals here. Basics like towels and linens were scarce. The fact that there was little to assist in resuscitative care meant that heroic efforts to save lives did not often occur. There were no crash carts. Somewhere in a closet there was an ambu bag.

The nursing staff seemed to be adequate in terms of numbers. They even had nursing students on the floor and they seemed to function like student nurses do here. After working with the nursing staff for two weeks, I discovered that an important part of patient care was lacking. Besides the absence or shortage of basic materials, there was also a gap in the focus of nursing care. When a patient was admitted, the nurses did not make an effort to conduct their own assessment of patients and develop a nursing plan to deal with real or potential problems. Efforts to introduce an assessment tool during the two weeks met with mixed success. The nurses were capable of performing such assessments and developing plans. They just did not do so and, in reality, had no template from which to work. For one patient this meant that no one made an effort to turn a partially-paralyzed, young woman. She quickly developed Stage III bed sores that were three inches in diameter.

In reviewing the patient charts, I saw that there were no nursing assessment or care plan forms that could be used to help focus nursing attention on basic patient needs. There was no medical library, no nursing journals or books in the hospital. There was no internet access for the staff to search for information. I came to realize that my "hands on" assistance was good during that two week period, but not as helpful as providing some additional resources for the staff to have on hand every day. Therefore, my two week medical volunteer project has not ended. I am contacting publishers of nursing journals and textbooks to ask them to donate materials that can be sent to the Ho Municipal Hospital for use by the nursing staff.

I have been surprised at the number of Americans who participate in volunteer projects in their own communities or in other countries. I have found them to be worthwhile and personally rewarding and would encourage anyone to participate in something no matter the size. My thanks to members of GDLD and their families for the support they provided for my own involvement for Two Weeks in Ghana.