Today, all 66 of us ran our clinic right on the NEA compound for the many, many, many villages that surround the Carpenter area. We were shocked by the crowd already gathered outside the gate as we walked to breakfast at 0615 today.
It was so lovely for all of us to be working so closely together on the compound with the luxuries of bathrooms, hand washing sinks and improved crowd control due to the fence around the NEA compound.
Preliminary numbers from yesterday indicated that today was the largest clinic ever run in the history of our Ghana Health Team with approximately 750 patients being cared for by our medical, surgical, dental, eye and laser team. At 3:30 pm I snuck away from my workstation to pay a little visit to tall our teams. I’m hoping I can take you all on a little tour.
Our triage and weights and temp team were packing up for the day when Dave pulled a very sick little girl out of the crowd. Her temperature was 39 degrees and she had severe malaria. Thank God that mom got Dave’s attention and his tender heart insisted we add just one more.
Our diagnostics station was humming. This station, led by our lab technician Tracey, has run like a finely oiled machine this year as they dealt with a constant stream of testing for malaria and HIV as well as urine, pregnancy and glucose tests. These tests, often ordered by triage nurses before seeing the physicians, allow us to get to our diagnoses so quickly. It is an invaluable tool to help us provide the best care to large volumes of patients. Tracey and Elena had a thermometer propped up on their table. It was actually 40 degrees under her canopy today!
The physicians were spoiled as our consultation room was the large, air-conditioned training centre. We felt so guilty (well.. kind of) as we worked so comfortably. Our translators were not comfortable at all. It was far too cold in there for them!
The big NEA gazebo was our nursing station today and once again our nursing team were busy dressing many terrible wounds and skin ulcers, giving oral rehydration to sick babies and IV lines were hanging once again from the rafters.
I then popped into the eye clinic. Their home base is the peanut storage facility which we like to call the ‘nut house.’ This eye team was processing patients at top efficiency it was a joy to watch.
Meanwhile, Dr. Toylin and Dr. Angela were busy restoring sight to 35 glaucoma patients in Margaret’s well run laser clinic. To finish off their day with a bang, Dr. Toylin talked the surgeons into giving her one OR and 2 nurses and together they performed a bilateral ectropion surgery with the assistance of Dr. Stephen.
Pharmacy was cheerfully in very high gear today. On the wall of the pharmacy there is a big poster containing the list the drugs we have run out of and those that we are getting low on. With only one day left to go, there were only 4 non-essential drugs on that list and a small handful of drugs we are getting low on. This confounds me that after the numbers of patients we have seen, our pharmacy still has everything we need. It feels a bit like the Bible story of the loaves and fishes. Way to go Sherry! As soon as clinic ends, we have an “all hands on deck” rule that everyone helps everyone prepare for the next day. After such a gruelling day I was touched to see our team docs and even our Team Leader Abraham helping pharmacy pack pills for our final day.
The dental team had a constant stream of patients under the mango tree and it appears that Francois received his first marriage proposal. In medicine we have a term called “last case syndrome” meaning that just when you think you are done for the day, your most serious case arrives. Well the last case syndrome hit the dental team today when Garrett pointed out a man “with an unusually big face” to his dentists. Sure enough, a serious dental abscess needed to be dealt with. Way to go Garrett!
Our surgeons too were hit with a last case syndrome as a small child needed surgery right at the end of the day. He had a rocky recovery but thanks to our incredible anaesthetic and recovery room team all was well.
The team broke the 250 procedure mark and a large of number of children received operations today.
Dr. David Hunter, Aaron and Emilia stayed late to drain two serious finger infections that were seen by the medical team.
One of the funniest stories of the day requires a small explanation. When a surgeon is examining a groin hernia, they place their hands on the patients’s groin and they ask the patient to cough. This manoeuvre pushes the intestines down through the hernia opening so that the surgeon can determine the true size of the hernia and type of operation required. Because this is done over and over again in the preop clinic, our surgeons quickly learn the word for “cough” which is “boa.” Today it was pointed out by a translator that for the past two weeks, while examining their patients, the surgeons have inadvertently been adding an “a” to boa. When they have been place their hands on the groin hernia and saying “ABOA!” they have been actually been saying “ANIMAL!” David Mensah was almost on the floor with laughter when he heard about this.
As darkness fell, Soale and I left the operating theatres and he repeated, “There are no cowards in this place; there are no cowards in this place.” It was a profound statement that I had never really processed before. Soale is right. It takes a special kind of health professional who is courageous enough to work in this place. It is one thing to care for patients with all of the resources of our health care systems back home but working in a low resource setting with all the challenges I have written about over the last fortnight takes a lot of guts. I believe that the courage that we have been able to muster up comes from the constant support and collaboration we receive from this multidisciplinary team and from God himself.
One of our 3pm quotes today was Joshua 1:9:
Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord God will be with you wherever you go.
Despite all that happened today, we were so happy to join one other for dinner by 7:00 pm, and I’m sure you have realized by the title of this blog what was on the menu. That’s right. One of the emus who many of us love to visit regularly “took one for the team.”
We felt bad for the poor guy until we tasted how delicious he was — as was the carrot and ginger soup, whole wheat rolls, chicken stir fry with rice, salad garnished with beets, beans and carrots, french fries, roast potatoes and fresh watermelon. Teams of NEA kitchen staff are essentially working around the clock to prepare our food every day.
Although today was an amazing day for me, it was also very difficult. Some of the cases I saw involved so much suffering. After consulting on a group of women who had very serious but easily treatable conditions that they had been suffering with for years, I needed to take a minute to compose myself. Even my translator was rocked. “The women really suffer in this place,” he said to me. He is right. I’m beginning to understand why so many of NEA’s programs focus on the women, as the suffering they endure is beyond my comprehension at times.
As we walked out of the main gates to our residence tonight, many men and women and children were already sleeping on mats by the front gate, trying to secure a place in our last clinic tomorrow. It seems a good part of the country knows tomorrow is our last day and my prayer, as this day ends, is that tomorrow we will finish well and our hands will get to those who really need our care.