Name: Becky
Occupation: Student/Occassional Auxiliary Nurse/ABA Therapist/Serial traveller/owner of itchy feet
Home Towm: Bangor, North Wales
Current Location: Bangor
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| Saturday, May 24, 2008 |
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Why the Ghanaian Health Service isn't as good as it should be...
because I'm not running it. That and the education health workers receive isn't good enough or they forget it as soon as they leave. And they need to learn some bedside manners. Yesterday I spent in with the doctor (yes, only one!), Dr Mercy, which was very enlightening. The number of people that were diagnosed with malaria, or given anti-malarials 'just incase' was shocking. The worst case of this was a girl who came in with abnormal discharge for two months and a slight fever (I think she was about 37.5C- not very high really when you're in Africa) for the last two days so she was prescribe some. I realise that malaria is major problem here, but when it costs about twenty pence to do the blood film to test for malaria and about two quid to buy the medication then it's better to check before letting the patient waste money. The malaria parasite also builds up resistance to the drugs and as she give the same type to each patient, about 20+ each day, 5 days a week, they're going to be totally ineffective in the very near future! Most cases we saw were slight fevers, aches and pains, nearly all of whom got the malaria treatment. One baby who came she decided to leave me to see to as she wanted a break, and didn't question what I said at all which was a little worrying. Although it was very clear that she was very sick, she was very jaundiced looking, the inside of her mouth and eye rims were very pale (indicating anemia, often secondary to malaria) and she had a fever, a real one, about 39C, so we sent her to the regional hospital for treatment. Other cases which should have been treated with a similar urgency were almost ignored. A 16 year old came complaining of neck ache and a rash on her arms. Dr Mercy was going to give painkillers and educate her on personal hygiene for the rash, until I examined the rash and noticed that it didn't change when I put pressure on it, which combined with the neck pain should have screamed meningitis at her! I suggested that this was the case and that she should be referred. So Mercy spoke to her and sent her away, then told me she had asked the girl to return on Wednesday to be referred to the regional hospital to have a lumber puncture (the test they do for meningitis) as they only do them that day. Whether she will still be alive then is another question, there is a good chance she won't be if it is meningitis. And she was given no advice about what to do if her symptoms got worse or she developed a headache. I don't think Mercy is totally incompetent. Part of the problem is that she had around 50-60 patients to see and she was the only person to see them, so her time with each is very limited. She asks the patient for their symptoms, what if any treatment they've had already, and then prescribes some medication, or sends them to the lab if necessary (done very rarely, usually only if they've been treated already for malaria and symptoms have persisted, we also had a girl who might have been pregnant and a patient with HIV symptoms who both went for the relevant tests). She did no physical examinations, other than a quick glance at the rash or a wound that was brought in, even when a patient came complaining of chest pain and difficulty breathing she didn't listen to his chest! They all have blood pressure and temperature taken before they see the doc, but that only covers a tiny amount of what could be wrong (And most of the time those aren't accurate. The thermometer is left under the arm until the nurse gets bored of waiting, not until it bleeps, and the blood pressure is taken to the nearest 10, and is often wrong- one young girl was given a bp of 140/80 and I redid it and got 115/60 - quite a big difference!) Will update on the rest of my adventure when I remember to bring my note book to the cafe with me! 1:20 PM Comment (1) ... PermaLink |