Bethany Marsden

I am sitting in the small office in Takoradi, Ghana on the final day of my trip. The Work the World programme manager sits across from me, we are conducting our final meeting to discuss my trip and he says to me ‘You are one of the strongest people I have met,’ Little do I know at this point how often these words will echo in my head and provide me with strength, even on the toughest of days.

In August 2017, at the end of my first year of my nursing training, I boarded a plane bound for Ghana. My placement lasted for three weeks and rotated between the emergency department, the labour ward and a week on the village healthcare experience.

To say that this trip was transformative would be an understatement. 

My first week was spent in the Emergency Department of the hospital located in the city of Takoradi in the Western region of Ghana. It was an eye-opening experience to say the least. The department itself is very small and patients wait to be seen under the hot sun.

Unlike in the UK, the patients often presented in the far more advanced stages of their illness. As patients are obliged to pay for treatment, quite often they delay seeing a doctor until they can afford the whole cost.

Throughout the week spent in the emergency department I witnessed a variety of cases, a number of which you would be unlikely to come across in England.

Many patients were brought in after suffering car accidents, either as pedestrians or in cars. A man and woman were brought in after they were hit by a taxi as they were crossing the road; the same taxi then brought them to the hospital. This quite a common occurrence in Ghana as people are obliged to pay for ambulance transportation in addition to the treatment they require. There are often delays in acquiring ambulances, therefore private transportation is frequently used.

The other types of cases I saw were malaria, gastroenteritis and HIV and AIDS. The other students and I also witnessed a case of complications arising from the practising of witchcraft. A woman had been told she was being possessed by the devil, and therefore must undergo an exorcism which involved cutting her leg and putting in a concoction of herbs to rid the evil spirits. This had caused a severe infection and her leg was likely septic.

A particularly sad case was a man and his young son who had been cooking on a gas stove when it fell over and caused severe burns to the pair of them.

Whilst it is heart breaking to see cases such as these, both the doctors and nurses with whom I was lucky enough to work with were so talented it was a privilege to work alongside them.

My advice would be to attach yourself to some of the local nursing and medical students, not only is it very interesting to compare differences and similarities in your training, but they will be happy to translate and help you to communicate with your patients.

During my second week I was lucky enough to spend my time in the labour ward. This was truly special for me because as an adult nurse, I had never witnessed a live birth before, and I did not have long to wait. I had scarcely arrived on the ward for my first day before one of the midwives took me by the hand and pulled me into the theatres to observe a caesarean section.

Later on that same day, I was lucky enough to witness a standard delivery. The moment when the baby was born was extraordinary and brought tears to my eyes.

During this week I was also accompanied by another student nurse and a student midwife who was so happy to share her knowledge and wisdom.

As a side note, one of my favourite things about Work the World placements is being around nursing and medical students who are just as zealous about their own disciplines as you are. This thirst for knowledge and dedication to our respective fields results in instant bonding and friendships as you share a mutual understanding and enthusiasm for the caring professions. One of my favourite parts of every day was gathering around the lunch table and swapping stories about our mornings at the hospital.

During my final week in Ghana, I travelled to a village to spend a week living with a family and working in the local health clinic. This week was undoubtedly my favourite week. The family with whom we stayed were delightful; so welcoming and kind despite not speaking very much English. Our guide was one of the kindest, most humble and downright wonderful people I have ever met.

We went to the clinic every day and saw a whole host of different cases. We worked the triage desk which involved doing vital observations, taking patient histories, reason for attendance and current complaints.

Throughout the week we honed our skills and by the end of the week we made the perfect team. It was necessary to test many of the children who were attending for malaria, there is a quick and simple test that can be done. Unfortunately, many of the tests were positive, in some cases the children were able to go on the malaria treatment and would make a full recovery. However, tragically despite the whole medication regime costing little more than £10-£15, some families were unable to afford this, and consequently their children would be unlikely to recover.

After delicious lunches cooked by our host mother, our guide came to collect us for our scheduled afternoon activities. My highlight was on Thursday night, we walked down to the beach where a fire had been lit. There were drummers and singers and we all danced and sang at the top of our voices until the fire had burnt out completely. This was a moment of pure freedom and bliss.

I could fill many, many pages with the lessons I learnt during my time in Ghana, however that which has stayed with me even a year after my trip is to value what I have. Never have I appreciated the NHS more. Even with its many shortfalls and staff shortages it is an institution which continues to run 24/7.

On returning from Ghana, you may find yourself wanting to grab those complaining about the NHS by the lapels and say to them "Do you know how lucky you are?”