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You can find fluffy lovely travel blogs everywhere online - I'm here to tell you the not so nice stuff starting with illness, death and burial in Northern Ghana.
No, I've not killed a volunteer off, everyone in Team Sarah is fighting fit after a couple of weeks in community and I've not had to take anyone to see a doctor yet which is almost unheard of. The first few weeks it's almost guaranteed that volunteers (usually the UK vols) will be broken down by the heat, the food, anxiety, malaria or all of the above.
The other team however have been dropping like flies so I have been helping out partially to have a nose about at the hospital in more depth and also for an excuse to head into town and find a cold soft drink… and for my caring nature of course.
This was my first visit to the hospital in a Team Leader capacity (rather than just a tour of the hospital pre-placement) and we were taking 2 poorly volunteers into hospital. This in itself is a complicated process of going to the records office to find your own patient record (luckily as all our volunteers are new and part of VSO they're kept in a separate easy to find place otherwise it can take hours), then depending on if you're from the UK or Ghana you go to the insurance desk to fill in a form and show your National Health Insurance Scheme card to prove that your payments are up to date and that your medical card is valid and up to date.
Then you go to a table with a nurse who weighs you, takes your temperature and prods you before you wait to see a medical assistant. I assume that this is the nearest thing to triage but there was no sense of urgency and no enquiry about what symptoms had bought us there and severity of illness.
There is usually only one actual doctor in the whole place so to see him you'd have to find him in his accommodation opposite or search the wards and drag him away from patients which he wouldn't likely do without good reason.
So instead you see the medical assistant who takes a decent medical history and checks symptoms. The first thing any of the staff are looking for is malaria which they can test for quickly using a scratch kit.
The result is not 100% especially if the malaria is mild and not yet in it's worse stages symptom-wise so then a blood test is needed to confirm so you take the slip, have your blood tested and then pray that it's before 2pm or they won't test any outpatient bloods until the next day.
Even if you're admitted then you have to sort your own paperwork and go to the lab and pay money for the sample tubes and stool pots that they want you to use and return to the lab which is far from a smooth process so being a patient is hard work if you're there on your own and not able to rush around sorting everything out in 35+ degree heat. (This is where I come in!)
If you are not seriously poorly, have up to date insurance it would be an okay system for an outpatient hospital or equivalent of a GP practice. The problem however is that people ARE seriously poorly and that the process is exactly the same for them.
When I arrived with my 2 poorly volunteers, I saw a young boy about 3 years old at most being carried out by a woman who I assume was his mother. He was foaming huge amounts from the mouth and nostrils in a way that I've never seen before and was clearly in a very bad way. A nurse calmly pushed a trolley towards him and put him on it - in no great rush - and then pushed the trolley outside through the walkway to take him somewhere. The nurse even stopped to apologise as they ran into someone's foot on the way out.
The whole time my reflexes were making me want to hit the emergency buzzer which at work in the UK mean qualified doctors and nurses with the skills and resources to give the patient every chance at survival will come bursting through the doors and take over.
But here it meant that after 5 minutes the young boy was bought back past me with a blanket covering him, the sheet stuck to his little mouth where the foam had been, his mother holding her broken shoe as they took her into a room and left him on the bed in the corridor where he remained until after I left hours later.
I know it must be tiring and cliché to hear this from every b***** who has ever left the UK but we are so unfathomably ridiculously lucky in the UK. If our relative is unwell then there is free care from trained staff and medicine to help them. The fact that our hospitals even have constant electricity and back-up generators and multiple theatres and on call doctors blows my mind.
This does not mean we should be complacent, be grateful and stop wanting more. It means I applaud all the people before me who have argued, protested and fought to create the NHS and who every day keep it going so that we can be in the position where we can be shocked when we see places that don't have the same.
Even death in the UK is handled as a matter of great importance. If the worst happens in the UK then there are peaceful viewing rooms in every hospital where again trained staff will have prepared the deceased sensitively for you to say goodbye and electric fridge's to keep them cool until funeral services of your choice has been arranged.
The practicalities of this is something that most people won't like to think about and you have the privilege of not having to think about it because it's all there for you and always has been. Imagine dealing with that same problem when your relative has died from a preventable cause, the hospital want you to take the body now even you own no transport and live miles and miles away and to top it off, instead of a cool mortuary there's a solid 35 degree heat to speed up decomposition while you try and come up with a solution.
These are all things that I thought about in the first hour of being in the hospital and this was just what I witnessed second hand in the waiting room.
In a bizarre twist of fate the exact scenario above happened the next day. I returned home and my host Dad told me that our next door neighbour, his relative aged 45 , had gone to hospital yesterday afternoon 'not feeling fine' and had died that morning. He did not know the cause of death as it seems no-one really investigates these things and the body was already back in the community in a clearing in the grassland next to our house.
I was invited to go and pay my respects which involved seeing the body sat in a chair on a 10 ft high platform (the height is increased in relation to how young the person as when they died) wearing his best outfit. He was to remain there outside in the heat for 24 hours while they dug the hold for his burial.
The women of the community wailed and walked around the body in a circle while the men played music. The noise of the women unnerved me the most. Some was genuine and tearful and the rest was almost like yodelling in its forced cries. Days later a women arrived and calmly got out of a van and then screamed and screamed and ran to the area where the body had been kept days earlier and screamed until early evening to show her grief and no-one batted an eyelid.
So folks, that's illness, death and burial in Northern Ghana!
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