It has been 3 months since I arrived in Damongo. Thanks to MDA benefactors, Karlee, my companion & I were able to move into a renovated bungalow close to the hospital & St. Therese of the Child Jesus Church. We were previously staying at the Catholic guest house while awaiting permanent housing.
My time continues to be a time of patient waiting. We hit a snag with licensing. Ghana requires passing their licensing exam for long-term volunteers. Also, the NP role is being phased out. Those in their current program are being transitioned into the PA program. As it has been in the US, the debate continues on who shall govern the NP practice - Medicine or Nursing.
While I wait, I was granted a temporary 3-month RN license. To make use of the time of waiting, I rotate between the different departments in the hospital, including the outpatient department, observing their processes, learning the formulary, and their treatment guidelines.
I have come to admire the resourcefulness of the physicians and health care workers working in a low-resource environment. For example, the X-ray machine has been inoperable for months now. The only tech who is able to fix it is out of the country. Yet, patients with injuries from accidents, folks with pneumonia and TB continue to flood the A&E ( ER). Patients with infections are empirically treated with at least 2 antibiotics for comprehensive coverage of the offending organism. The lab does not have the capability to check for culture & sensitivity of samples. So, to the outsider looking in, it may seem callousness with stewardship of the use of antibiotics. I am reminded by the MDA veteran physicians in formation. “Observe. There is a reason for everything.” The provider here has to be very astute in their clinical skills. There are no CT’s, etc., and the availability of a variety of specialists on board for rapid consultations. Complicated cases have to be referred to the teaching hospital in Tamale, which is a 2-hour grueling road trip for those who can afford the fare.
Other than observing processes and trying to understand, I have mostly concentrated on how patients are able to communicate with their providers. I am reminded by the words of a wise mentor. “Sit & listen. Seventy percent of the time, the patient will tell you the diagnosis. Your best tools are your ears, eyes, nose, hands to touch & feel, and a good stethoscope.” Incidentally, he still used his stethoscope from medical school till the day he stopped seeing patients. May he rest in peace. He was greatly admired by his colleagues, students, and patients.
Language barrier is a big hindrance. No language line available here! Many tribal dialects are spoken. Often, the clinician has to search around for anyone to assist with interpretation. Yet, they continue to treat and care for those entrusted to them.
Meanwhile, I sit and pray while I observe, trusting in the Holy Spirit to guide us. “Where 2 or 3 of you are gathered in My name, there I AM with you.”
This is it for now. Hopefully, I will have my Ghanaian license at the next blog.
Thank you for your prayers and support as we continue our pilgrim journey as God’s children to make His Kingdom reality “ on earth, as it is in heaven.” We are all in this together.
Other than observing processes and trying to understand, I have mostly concentrated on how patients are able to communicate with their providers. I am reminded by the words of a wise mentor. “Sit & listen. Seventy percent of the time, the patient will tell you the diagnosis. Your best tools are your ears, eyes, nose, hands to touch & feel, and a good stethoscope.” Incidentally, he still used his stethoscope from medical school till the day he stopped seeing patients. May he rest in peace. He was greatly admired by his colleagues, students, and patients.
Language barrier is a big hindrance. No language line available here! Many tribal dialects are spoken. Often, the clinician has to search around for anyone to assist with interpretation. Yet, they continue to treat and care for those entrusted to them.
Meanwhile, I sit and pray while I observe, trusting in the Holy Spirit to guide us. “Where 2 or 3 of you are gathered in My name, there I AM with you.”
This is it for now. Hopefully, I will have my Ghanaian license at the next blog.
Thank you for your prayers and support as we continue our pilgrim journey as God’s children to make His Kingdom reality “ on earth, as it is in heaven.” We are all in this together.



