Returning to Ghana on a solo humanitarian mission

Hannah Jefferson is a recent Nursing graduate from the University of Manchester who is currently working as an A&E Nurse at a busy hospital in Manchester. As part of her studies at Manchester she conducted a placement in Ghana and became so touched by the Ghanaian people that she made it her aim to return once she was a qualified nurse. Here, she explains just why she was so compelled to return and outlines some of her personal highlights from the Ghanaian experience…

Background

Unlike most Nursing graduates, my first job after leaving university was not within the NHS, but in a hospital in Ghana. After spending seven weeks in Ghana in 2017 through the University’s elective placement, I was inspired to return  as a qualified nurse, on a solo humanitarian mission.

My experience from 2017 was something that had stayed with me, and I felt compelled to return and help as much as possible. My personal mission was to provide the emergency department with a defibrillator (there wasn’t one in the entire hospital) and as many medical resources as I could.  I achieved this as a result of a gofundme.com page and the generous donations from friends, family, colleagues and strangers.

I chose to go to Ghana to challenge myself, gain experience working in an alternative culture, climate and environment, and to learn about the epidemiological differences. I spent the majority of my time working in the emergency department of a city hospital. Returning as a registered nurse was an empowering experience, I felt more confident in my abilities and more aware of how I could help.

The Emergency Department

The Emergency Department is just one room, with five beds and three chairs – the lack of resources and equipment is shocking and takes some getting used to. There was a broken defibrillator, no ventilators, and an ECG machine with no electrodes. The only diagnostic equipment available was one thermometer, one pulse oximeter, one tattered blood pressure cuff and a malaria test (which only tests for one of the four malaria types). In 2017, there were no emergency ambulances, and on my visit this time, there was just one ambulance that had been commissioned for the whole city, except it did not get called out because no one was aware of its existence.

On top of the lack of resources, there is no running water, and the temperature is around > 30 degrees centigrade. Patients have to wait sometimes days to be seen, even in cases of trauma. A lot of the time patients cannot afford treatment, and can die because of this.  Being in such a poorly equipped hospital really brings to light what a privilege it is to have our NHS system in place.

Highlights

On both occasions I absolutely loved working there, even though the challenges were the most extreme and most difficult experiences I’ve ever had to deal with – both in my career and in my life. I learnt how to treat injuries that I would never likely come across in the UK – machete injuries, explosion burns, snake/spider bites and scorpion stings to name a few! I also treated a number of tropical infectious diseases; as Ghana is in a sub-Saharan tropical climate, mosquitos are abundant and this makes Malaria one of the biggest killers in the region. Other prevalent diseases in Ghana are typhoid, yellow fever, TB, hepatitis, HIV and cholera.

The whole experience was a mutual transfer of knowledge between myself and my Ghanaian co-workers. Whilst I learnt how to treat diseases and injuries that I wouldn’t normally have to contend with in the UK, I was able to teach the most up-to-date methods of Basic Life Support to the nurses there.

My biggest moment was probably resuscitating a new-born – having had quite a traumatic experience the previous year dealing with new-borns who had passed away (a devastatingly common occurrence in Ghana), I was determined to get back in and do everything I could to keep this baby alive. After forty minutes of resuscitation, he took his first breath and I was overwhelmed with joy and relief. It was amazing to see the family’s response – as it’s common to lose new-borns in Ghana, they had quietly resigned themselves to their grief.

Another highlight was appearing on local radio in support of Breast Cancer Awareness and donating boxes of condoms to the HIV clinic, kindly donated from the University of Manchester’s Occupational Health service.

Advice for other students working in developing countries

You will need compassion, advocacy, and most importantly the willingness to ADAPT to your surroundings. My biggest piece of advice would be to remember why you came. At times it can get very difficult and overwhelming, especially when we have been trained to work a certain way in the UK or are used to having certain resources available. Frustration is a common emotion, so to recall why you came in the first place really helps put everything into perspective.

It is also absolutely essential to recognise and respect the culture of your host country and hospital. Comparing two countries with vastly different histories, problems and environments does no good, so it is important to embrace the different attitudes and cultural norms rather than criticise.

I would also recommend that you use the time to grow as a person. I have learnt the value of patience and flexibility so much more since working in Ghana and have gained a thicker skin when it comes to dealing with loss and the more extreme sights of emergency care. It’s a good time to learn to look after yourself in a foreign environment, and learn a different language – it’s much easier getting stuck into the job when you can communicate with your patients directly.

Finally, I would say embrace the change of living environment (you are unlikely to have hot running water and regular access to the internet), embrace the culture and explore. Eat local food and make new friends – they will always show you the best parts of the country, not just the tourist hot spots.