de-I in Wonderland - A Ghana Hospital System Adventure

 One thing I DID NOT plan to do this trip was learn how to navigate the Ghanaian Hospital system. But learn to navigate it I did.

One of our Participants had been complaining of a pain in her right side. It was preventing her from lying on her side when she slept. By Tuesday morning the pain was acute and she was barely able to move. It's hard for a middle class or higher strata person in a developed country to conceptualize the what those in less developed countries who are not in the upper strata deal with medical issues. Our Participants, people who have fallen through the rather wide cracks of society here, have little to do with doctors or hospitals. 

This Participant does my local scheduling so we were scheduled to meet the first thing that morning and go to the office. She shows up at the apartment just about ready to collapse. Of course she doesn't know a thing about her own hospital system. First thing I do is go online and search for hospitals and emergency rooms. The search comes up dry. I find hospitals but none even mention having an emergency room. 

I call one my local board member who has been most closely working with our team. She tells me to call 112, the Ghana equivalent of 911. There is no answer, despite numerous tries. She tells me the hospitals that are close by. I look them up and call. No answer. By this time my Participant is in severe pain. My driver shows up. Another contact I reached out to tells me the closest hospital to me is the 37 Military Hospital and it has an emergency room. They didn't even show up on my search! I find out later they are considered one of the best in the city.

We arrive. Of course the emergency room looks nothing like anything I've seen. Even finding a reception person is a task. My colleague shows up to help me (she is a godsend). We are told we need a 'card' that registers our Participant. We are given vague directions of where to get said card. It takes waiting in three different lines to get the 'card'. Back to the emergency room. Wait. In the heat. No air conditioning. No chairs for any but patients. 

Finally, our young woman is seen. They tell us to get an ultrasound. This requires us to walk outside to another building. It takes an hour to navigate who to see, how to get in the queue, how to pay for said ultrasound (I will find you have to pay for each and every item you get for the process as you go along), then finally get the test done. We are told to come back in an hour and pick up the results. It is the patient's family or representative that has the responsibility to get the results back to the medical staff. Finally our young woman is entered into the emergency ward.

Now we are asked to by pharmaceuticals for our patient. Off we go again (some other Participants have shown up now to help with the process) to the Pharmacy to get the needed drugs. Again the three step process of checking in, paying, then getting what is needed. Blood work is needed. We carry the vials of blood to the lab where again we wander around trying to figure out where to drop things off only to find there is a check-in, pay, then drop off process...in this case all at different places. At each there is a crowd of people and no specific line. So you have to exert yourself. 

We finally get the ultrasound. We started this all by arriving at the hospital at 8am. It is now early afternoon. We are told they want to watch and observe our Participant. We come back in the early evening. They need us to buy more pharmaceuticals. At least we know what to do now. They want to observe her longer. We are told that at 5:30 to 6:30am the next day, they will either release her or have her enter the hospital proper. It is around 7:30pm and my driver is taking me back to my apartment. We get a call from one of our other women who was helping us. They want another blood test done. And because the hospital lab is closed we need to drive it to a 24 hour lab. And we have to pick it up and bring it back to the hospital. 

We get to the lab. They are noncommittal about when it will be ready. My driver ends up going back three times and it is only finally ready at 3pm the next day. Now they have admitted our Participant into the hospital proper. With us getting the final blood work, they have confirmed a diagnosis - acute pancreatitis. This is nothing to sneeze at. We are fortunate to have been able to get her taken care of. The care now is in line with what one would find in the the U.S. as far as the medical treatment. Except that the patient's family/representatives have to take care of all the non-medical needs. 

As of this writing, she is still in the hospital but improving visibly. She reports she feels much better but is weary of the hospital. The treatment for this condition is no food or external fluids, only intravenous. So she is hungry. We are hopeful that she will be released tomorrow, Friday. Keeping my fingers crossed.

Has been very stressful.