Tuesday, June 17, 2014

First Week in an African Mission Hospital

            Our prayers were finally answered regarding my Ghanaian medical license. Praise Jesus! I was granted my license last Friday, and I began work at the hospital on Saturday morning. It has been a steep learning curve. I begin my rounds most days in the isolation ward, where there are several patients with chronic wounds, a couple patients being treated for or ruled out for tuberculosis, and a smattering of other patients with infectious diseases. After finishing there, I usually go to either the pediatrics ward (children <5yo) or Ward 5 (mostly older children/adolescents, but occasionally there will be adults if the other adult wards are full). After I have seen those patients, I go to make sure that there are no more patients to be seen in the other wards. I start rounds around 7:30 AM Monday through Friday and 8 AM on Saturday and Sunday. Monday, Wednesday, and Friday are clinic days (where clinic starts around 10 AM), and Tuesday and Thursday are procedure/surgery days.

            There are a total of 8 wards in the hospital: maternity, men's medical, men's surgical, women's medical, women's surgical, Ward 5 (as I described above), pediatrics, and isolation. The hospital administration had just brought two new doctors onto the staff a couple days before I started, one Ghanaian surgeon and one Nigerian ER doctor. They then added another two Ghanaian doctors a couple days ago. There is also one American OB/Gyn that has been here for almost a year. That brings the doctor count to 6 now, which is much better than what I thought that it was going to be, which was 2. It helps out tremendously on morning rounds when we have to see all of the patients in the hospital, which can potentially be around 120 patients when all beds are full. Not all of the beds are full right now, but they are starting to fill up as we enter rainy season and the cases of severe malaria start to increase.

            Just to give you all a sense of what working at the hospital is like, I will share about a few of the cases that I have seen this week. I saw a teenager present to clinic with elevated blood pressure (180s/130s; normal is 120/80), anasarca (whole body swelling), including fluid in the lungs (pulmonary edema) and shortness of breath. We gave her some oxygen and some medicine to decrease the amount of fluid in her body and to help her breath better. Then after some basic workup, including a heart ultrasound and urine analysis (blood tests are very limited here), it appeared that she had a condition called acute glomerulonephritis (essentially injury to the kidneys) in addition to heart failure. I placed her on all of the medicines to help treat these conditions, and she has improved greatly. She is no longer on oxygen, her lungs are clear, her blood pressure has normalized, and her swelling has almost gone completely away. Thank you God for your healing of this woman! Please pray for her continued healing and recovery, as she has some residual right-sided weakness that started before she came to the hospital, probably secondary to her severely elevated blood pressures.

            I have also assisted on a couple C-sections and a bowel perforation (hole in the intestines) from a typhoid infection (a common infection in this area that comes from consuming contaminated water). I have done a few paracenteses (draining fluid from the abdomen of people with liver disease) and lumbar punctures (collecting samples of the fluid around the spinal cord to look for infections like meningitis). Additionally, there was a young man who presented with an abscess of his thigh, but this was no ordinary abscess. It was as big as half of his thigh, and after cutting into it to drain the infection, it appeared that the abscess had actually spread between different layers of his muscles (a condition called pyomyositis).

            Lastly, the most memorable experience of the first week of work at Baptist Medical Centre was getting to be an anesthetist for an emergency surgery. There was a pregnant woman that had come in with a ruptured uterus and had blood in her abdomen, so she needed to go to surgery right away. The Ob/Gyn approached me on rounds that morning and told me that the anesthetist on-call was not available and asked if I could be the anesthetist for the surgery. We agreed to use ketamine (a type of anesthetic) so that the patient did not have to be intubated (tube placed in her windpipe for breathing). Plus, if she were intubated, I was going to have to manage the anesthetic gases, with which I practically have no experience. I read up quickly on ketamine use, prayed, and then went to the operating room. Everyone worked together as a team, the surgery went well, and the patient did well. All glory to God!

            Those are just a few of the cases that I saw this week that I wanted to share. Please continue to pray for the hospital, healing for the patients, wisdom for the doctors and medical assistants, endurance and joy for all workers at the hospital, and that Christ would be glorified through all of the work being done here.


  1. Hi Cahills!! I forgot this blog existed until today, so I'm reading through all of it throughout the evening. I'm looking forward to catching up on what has been going on during your first months in Ghana. We love y'all so much and will continue to pray for you. MISS YOU!! ~~Caitlin Hines

  2. Praying for you and the hospital staff that God will fill you with wisdom, joy, grace, and strength! Praying for patients healing and to come to the knowledge of our Lord and Savior! I so appreciate your heart for these people!

    " Now to Him who is able to do far more abundantly beyond all that we ask or think, according to the power that works within us, 21 to Him be the glory in the church and in Christ Jesus to all generations[n]forever and ever. Amen." Ephesians 3:20-21