Wanderings of the lost boy – 6

My name is De-Graft. You can choose to call me Digi/DeGi/De-Ge/DeG…etc, whichever works for you. I am a medical student in my 5^th year of study. As part of our requirements for the medical school programme, in 5^th year we are posted to various districts to experience medicine outside the boundaries of the teaching hospital. We also collect data for our final year project work and thesis. I hope to take you along with me on my exciting trip with these memoires. Enjoy!

 

Episode 6 – Halfway!

 

1

 

It takes some reality check to admit to myself that I am already in my third week of the Community Health posting. During the period I have got progressively accustomed to the health system here in Pepease. The town is part of the Kwahu East district – the district I chose to do the posting in. However, so far I haven’t done the single most important thing I need to do here – data collection.

The essence of this community health posting is to experience the public health sector. But more important is for us to collect data for our final year project. I printed 400 questionnaire sheets to be filled by the senior high school students in the district and I haven’t yet got the approval I need to start. I was directed to the education director – the one to give me approval but for the whole of last week, she had traveled. And I was told that in her absence, there was no way I could get an approval letter to start with my data collection.

 

 

2

After my Kumasi trip, I resume work on Tuesday, 26^th March 2018. I returned to Abetifi yesterday and got the day off. After consulting room duties, we have home visits scheduled for the day.

There is something about health care in the communities I admire so much. The staff posted here are very interested in the welfare of the patients. And actually, from what I have seen the townsfolk have a better access to health care (even if not of the highest quality). There have been bed net distribution programs and malaria prevention programs and the health care personnel have ensured that the average household here has effective malaria prevention. Additionally, the health insurance scheme has been emphasized and the regular medication they need are usually provided by the insurance. There are outreaches for the smaller surrounding communities where medication is provided for the people in those villages and immunizations are done for the children there. Then there are these home visits, where the health personnel follow up on patients previously seen at the clinic who need some follow up care. Some of these do not return to the clinic as scheduled and others have medical conditions that make it difficult for them to visit the clinic.

Today we go on one and meet two clients who have what I suspect to be a form of chronic dermatitis linked to onchocerciasis. There is a large river that encircles the mountain range – The Afram river, beyond which are the Afram plains. And large rivers are notorious for breeding black flies, the vectors of onchocerciasis. Contrary to popular knowledge, onchocerciasis isn’t only river blindness but also chronic dermatitis and depigmentation of the skin. With this in mind, it is what I suspect of both patients we visit. According to recent research, there is some new medication which has been proven efficacious for treating the condition and I recommend that it be provided for the patients.

After the home visits, we head towards the education office to follow up on the letter we need for the approval to start data collection. Fortunately, after some few ups and downs and referrals, I get the approval I need to start the next day. Such relief!

 

3

 

Wednesday is supposed to be the first day of data collection. In the morning though, some mild anhedonia catches me and I get to work extra late (like 10am). My bag is extra packed today with 400 copies of the printed questionnaire (two sheets each). I plan to staple them before going to the school to administer them. For convenience, I decide to start off at the St. Dominic’s Secondary and Technical School in Pepease.

When I get to work, I am greeted with the pleasant sight of a large group of students in the local primary school who have volunteered to clean the health facility for us. They are accompanied by their teachers and a brass band. They are almost done by the time I get here and I watch them march off with music and dance!

 

I don’t plan to go to the consulting room today though and I decide to use the disease control office to staple my questionnaire while waiting for Bro. Sammy who has volunteered to accompany me to the school. Today he is the one doing consultation so we agree to go when he is done. After I have stapled about 50 copies, I am called by the midwife. She tells me there is a woman in labour and asks if I would like to assist the delivery. I am the kind of person who likes to jump at opportunities like these – I mean I want to live the community health experience to the fullest. But with me feeling under the weather and also not with the right attire to assist a delivery, I am moved to decline. So yeah, I decline. And I fix back my headset to continue with the music I was listening and with stapling my questionnaire.

But I am not the kind of person you can trust to resist temptations like these and almost immediately I settle down, I get up again and rush to the labour ward. I have to assist the delivery in the clothes I brought to work – with no scrubs or even with an apron but I am not deterred. I take off my headset and place it on the shelf around and I ask what to do to assist.

The lady in labour is a young lady in her late teens who is already in stage two – the stage just before delivery. From what I gather later, her labour pains started three days ago. But like almost all others like her in labour, they wait till the baby is just about coming before reporting to a health facility. And the reason amazes me. For nulliparous women (those who have not delivered a baby before), they have to deliver in a District hospital where they can offer specialized care to the client. But they say going to the government hospital is too expensive. Hence, if they come to the health centre at a stage like this, the midwife here would have no option but to allow them to deliver here, instead of referring them to the district hospital which is quite a distance from here.

 

4

 

The first thing I’m told to do is to set a line for her and I’m given a cannula to get that done. It is quite a simple procedure to me now and I get that done soon – only that the cork of the cannula I am given is faulty and the lady starts to bleed when I take the needle out. My instincts move me to cover over the opening with my fingers as I call for help. When we finally sort her out, the gloves I am wearing are all covered with blood and the floor is fairly stained.

The pain she is experiencing is at its peak and she keeps screaming when the contractions are taking place. To move her to the labour table, I have to time when she isn’t having a contraction and hence not in too much pain and rush her to the ward. That is done soon and we get her on the labour table to get started. The labour is not prolonged – actually it is so fast that, the midwife is barely able to change into her scrubs and to do an episiotomy when the baby’s head starts to pop out. We have got gloves at least and the baby is delivered safely. This baby cries well too and I help to clean it up and leave it on her mum’s belly so they can have some bonding.

The lady has quite an extensive tear though and the birth canal has to be repaired. That takes quite a while and eventually, after about an hour and half, we are all done and can weigh the baby and take some pictures.

 

It’s past midday and Bro. Sammy has been done with the consulting room duties for a while now and has been doing some stapling for me.

Right after I join him, we move through the lungulungus to the secondary school. We are directed first to the headmaster, then he asks us to see the senior housemaster. We have to wait for the break to end before we get started.

After going to three classrooms, it’s time for them to close and I have quite a good number of questionnaires filled.

 

 

5

 

The next morning (on Thursday), I return to the school to do some top up to reach the target number respondents I have set for that school.

I return to the clinic afterwards and they (the clinic staff) mention to me that the next day (Friday) will be for an outreach and they will visit five villages. They will be riding on a motorcycle and the possibility of the thrill and experience excites me. I talk up the possibility of joining them on Friday but nothing is concluded.

 

I am up and all dressed up by 6am on the Friday morning and I call Bro. Sammy asking if I can join them.

I would really want to go but they don’t seem they’d like me to go along with them – and understandably so. It’s only one motorcycle and if I join them, there will be three of us. Besides they are concerned about my safety and comfort also highlighting that the trip is extremely tiring. With all the reasoning, they quench my fire and I have no option but to go to clinic on that day for my regular duties.

 

6

 

Today is especially exciting as Uncle Gideon and Paa Joe have scheduled to pay me a visit at Abetifi. They are here by 5pm – well after I have closed work and the lighted up weekend starts. We visit Nkwatia and I get the chance to see St. Peter’s school.

 

The next day (Saturday) is field service and there is the chance to see Abene, Hweehwee, Yaw Tenkorang, Bonyan Kan and Bonyan Kyiri. Bonyan Kan is totally uninhabited though since the inhabitants were forced to abandon the village due to threats and violence from Fulani Herdsmen.

 

After field service, we head towards Kumasi to visit the family.

En route, I think of how fast these three weeks have passed. After this, I only have two weeks more and the thought of returning to school saddens me for a bit.

 

But in the meantime, in-between time, the future is exciting and… um.. And yeah! It’s exciting! 😉

De-Graft. 2019