An opportunity to volunteer in a hospital abroad
For most medical students, the highlight of med school is their medical elective. An opportunity to plan a project anywhere in the world doing anything they want to (so long as it benefits their medical training.) Struck by the travel bug aged 17 on a school trip to Belize, I couldn’t wait to go exploring again and it was just brilliant to be able to combine this with volunteering in a hospital in Ghana. I chose Ghana as it would be my first solo adventure so I wanted somewhere relatively safe, friendly and where English was the main lingo. Ghana fit the bill perfectly.
An experience that will stay with me
I expected to have my eyes opened, to be shocked at times, saddened at others, but nothing could prepare me for life volunteering in a rural Ghanaian hospital. Ghana is considered a wealthy country by African standards, so what I saw was probably tame compared with other electives. But for me, the experience was life changing and has left me with memories – both good and bad – that will last a lifetime.
I quickly fell in love with Ghana. It’s delightfully chaotic, always colourful and vibrant. Men stroll past with suitcases balanced on their heads, chickens roam free EVERYWHERE, children dance with insane innate rhythm in the streets and I received daily wedding proposals – for 10 goats you say?!
Volunteering in an urban hospital in Ghana
After 3 weeks of travel and getting my bearings, I started my volunteer project in the city. Working alongside a team of Ghanaian medical students in a teaching hospital to learn as much about tropical medicine in 2 weeks as was insanely possible. Once I arrived at my rural destination, I would not always have the support of a medical team behind me so I needed to learn and learn fast.
A Culture Shock
Whilst the hospital where I was based in was large and not dissimilar to a UK hospital in terms of amenities, it was still a huge culture shock. The wards were filthy and when a patient vomited, staff just stepped over it leaving the smell to filter through the entire ward. Patients were left naked, incontinent and confused with absolute zero privacy on a mixed gender ward. Clinic were heavily oversubscribed and patients presented so late there was often little that could be done – such as the patient who had a parotid tumour stretching from his ear to the tip of his shoulder! Senior doctors referred to me as “You! Obruni!” Yes, Obruni means white person. How was this ok in 2008?!
An opportunity to work with talented doctors
Whilst the sanitary conditions and privacy were definitely not up to the standard I had come to expect, what I did realise was just how knowledgeable and talented the doctors were. The medical students would go home at 3 am, after we’d danced the night away, and open their textbooks working until the sun came up. When asked questions on ward rounds they would produce detailed answers that could have been lifted from a book. I however, loitered at the back cringing and hoping they wouldn’t ask me anything!
Volunteering in a rural hospital in Ghana
After my 2 weeks were up, I headed to a village, north of Accra and settled into the little hut that would be home for the next 2 months. It was bug central and we only had freezing cold bucket baths but it was nice to have somewhere to call home after moving about so much prior to this.
Initially, I shadowed one of the three doctors who ran the tiny community hospital, learning loads from them. But after a few days of shadowing, it was my turn to step up and play doctor in the emergency department. At this point I had 1 year left of med school. I was perhaps more knowledgable that the ‘medical officers’ who staffed the emergency department and had just 1 or 2 years of training. But I was the first to admit that there were HUGE gaps in my knowledge. Fortunately, I was there with some other medical students and together we did the very best we could with limited knowledge, limited resources, a pile of textbooks and very occasional contact with the doctors who rarely answered their phones!
Working with a lack of hospital resources
Not only did we have gaps in our medical knowledge to contend with but also lack of facilities and a lack of money to deal with as well. For example, I saw a child who had seizures. Initially I presumed they were actually just febrile convulsions where a young child fits with a fever – pretty common. However after seeing the child have an absence seizure I realised the 3-year-old probably had a form of Epilepsy. Now in the UK, the child would definitely get a CT brain scan for their first real seizure. They would then be observed overnight, closely monitored then followed up in outpatient clinic. If it happened a 2nd time, anti-epileptic treatment would likely get initiated. Here however, there would be no scan. The family couldn’t afford to have their child admitted for observation and quite frankly, it was unlikely there would be space anyway. All we could do was educate the family about first aid and advise them to come back if it happened again. We couldn’t even get hold of the doctors to discuss initiating treatment.The sub standard care we were able to give was incredibly frustrating and something we never really got used to!
Chaos in the operating theatre
We spent some time in theatre which again was a real shocker! Minor (or not-so-minor) operations were conducted in the corridor. Tools were ‘sterilised’ by scrubbing with a toothbrush and sometimes the water supply cut out entirely. The anaethetist had 18 months training and no formal medical qualification. He would often turn off the anesthetics too early to conserve funds. This meant it wasn’t uncommon for a patient to start coming around whilst the last sutures were going in. Staff would just hold them down whilst they thrashed about. It was barbaric and incredibly distressing to see.
A different way of life
It was often difficult to reason with the medical team. After all this was the way they had been doing things forever and they saw no reason to change. Life in general is a lot tougher than back home and the patients seemed to tolerate things without question even when we couldn’t believe our eyes! I remember on labor ward, pleading with a doctor to give a lady a c-section. She’d been pushing for hours with a breech twin and it was clear she was exhausted. The response? “She is fine, she is just LAZY!”
Chaos on the labour ward
After babies were born on the labor ward they would be wrapped in a single thin blanket and placed in buckets at the end of the bed! Our requests for more blankets fell on silent ears. Most distressing of all was the lady who had stillborn twins. She lay in a ward surrounded by women with their babies whilst she gazed silently at the ceiling.
Volunteering with the rural outreach programme
After a few weeks at the base hospital, I headed out with the rural outreach team in an old ambulance each morning, providing care in the most rural deprived areas. In these clinics there were no doctors. There were dedicated midwives, medical officers and sometimes just a disease surveillance officer doing the absolute best they could with minimal training. I would see 30 or so patients a morning with everything from Malaria to typhoid to TB all whilst trying to pass on as much of my limited knowledge as possible to the existing staff. They listened attentively soaking up any knowledge I could impart and together we worked to provide as much care as possible in some heavily deprived areas.
Frustrating cultural and financial barriers
Again we battled with cultural and financial barriers. I remember a 10 year old who came in with malaria. Now there is malaria and then there is Malaria with a capital M. Different strains of it determine how badly affected the person will be, whether they will need hospital admission and whether it could endanger their lives. Now this kid I suspected, had the capital M Malaria. He desperately needed admission. However his sister who he was with could not afford to take the day off work to get him to hospital. I knew from similar cases that the doctors at the hospital would probably make an exception and treat him for free but I had absolutely no way to get him there, There was no ambulance in these parts and try as I might, I don’t think his sister could really comprehend how ill her little brother actually was. After lot’s of arguing and pleading, we did the best we could. We hooked him up to a drip, pumped him full of fluids over a few hours and gave him the oral medication which would treat the milder form of malaria without needing hospital admission. I doubted it would be enough and I only hope they sought further help if and when he deteriorated.
Volunteering in the community
In addition to helping to run the rural clinics, I also got involved with community life – probably my favourite aspect of this volunteer work. This involved doing house visits to little mud huts where a whole family slept in one bed, providing health and nutrition classes to primary school children and sex-ed lessons to the teenagers. We also gave the children quick health checks, gave some immunisations and offered free HIV testing for staff and the teenage students.
Volunteering at the baby clinic
Baby clinic was always fun. I’d get involved giving advice to the mothers, vaccinating the babies and helping to weigh them. The technique being to hang the baby in a one size fits all nappy seat and hope the baby didn’t fall through the leg hole and trying to catch them if they did! I loved being part of the community and helping these women in whatever way I could.
Reflecting on volunteering in a hospital in Ghana
Whilst I was often shocked and appalled by the conditions in these hospitals and rural clinics, one thing I would say is that the staff were incredibly hard-working and dedicated. They did the absolute best they could with very minimal resources. Where they could, they showed compassion and treated patients even when they could not afford it – much to our relief! Attitudes are different, people are tougher, priorities not the same. It was a huge learning curve for me. I developed so much in my short time volunteering there. I went back a more confident, self-assured medical student relieved to be working in the NHS.
Maybe the NHS isn’t so bad?!
Now the NHS is a long way from perfect. Under-funded with waiting lists that no one thinks are acceptable. Don’t even get me started on Jeremy Hunt the UK health minister. But volunteering in a hospital in Ghana really did put things in perspective. Our patients are treated with dignity, allowed privacy and have access to all the investigations and treatments when they need them most and at no cost to them. Patients don’t need to choose if to put food on the table for their family or allow one child to get medical treatment. When they attend to see their GP, they know their doctor will be full qualified and will have had training for a minimum of 8 years. So when I get frustrated with the lack of funding, lack of staff, the huge waiting lists, I think back to my time volunteering in Ghana and feel lucky – sometimes we just don’t know how good we really have it.
If you are thinking of volunteering in Africa, why not search for ideas here
Have you volunteered abroad before? Or are you thinking about doing it? I’d love to hear your experiences! please leave comments below. And if you enjoyed this article, I would really appreciate if you could share it with your friends and family!