Jumping Hurdles On Hump Day

I woke up well rested after a long emotional day yesterday. I haven’t mentioned much about my interactions with the patients and their families since I plan to recap my week at the hospital in a future post. However, my increased interaction with Patient 8 and his family the past two days will provide meaningful insight into life in this Ghana ER from a loved one or caretaker's perspective.

Patient 8 was admitted on 8.22.19 after experiencing severe chest pain.  On Monday when I arrived in the ER, one of the first things I noticed was his wife sobbing next to his bedside and I’ve seen her there every min I’ve been there the past 3 days.  While shadowing Dr. Moro on his rounds Monday I learned he is suffering from heart failure, pulmonary edema and was receiving Furosemide via IV to reduce the fluid in his lungs. His oxygen level was 8 LPM. Dr. Moro ordered a chest x-ray since the patient was in a lot of pain.  

When I arrived on Tuesday I noticed Patient 8 had his wife, his daughter who was noticeably distressed and one of the pharmacists I had chatted with briefly the previous day at his bedside. While shadowing Dr. Moro he discovered the chest x-ray he ordered the previous day wasn’t done since Patient 8 is on oxygen and they couldn’t find the portable oxygen unit. Dr. Moro ordered a normal lab work up and labs to check his kidney function as a work around.  The patient was having trouble breathing so the nurses increased his oxygen level to the highest setting of 10 LPM. Throughout the morning Patient 8 had visits from Priests and what I thought were relatives. I noticed the pharmacist resembled Patient 8 and I figured that was his uncle since he was doing more consoling than grieving. After chatting with him, he confirmed he was indeed his nephew and that Patient 8 is a pastor.

Today I walked in to see Patient 8 with his wife at his bedside and learned one of the gentlemen I’ve seen hovering around the ER waiting area is his son.  During rounds with Dr. Moro he had me walk over to the ER computer with him to look up the labs he ordered the previous day.  The kidney labs were missing and he informed me if the patients don’t pay in advance the labs won’t be completed. The family was able to show proof of payment for both sets of labs but the key labs weren’t in the system.  I let Dr. Moro know Patient 8 was a pastor which he confirmed from his address on his folder [I need a whole blog to talk about these patient folders], the pharmacist was his nephew and told him he should loop him in to track down the labs. He couldn’t reach him on the phone and luckily I spent time in the pharmacy this AM so knew exactly where | how to get into the pharmacy to find him.  The pharmacist was unsuccessful his first trip to the lab since they wouldn’t print out the record [SMH] so I walked back to the lab with him and told them Dr. Moro needed a printout [he didn't actually request it but I saved us a trip because I knew they weren't in the system]. The labs confirmed his kidneys are failing, Dr. Moro recommended dialysis which is a cash only option not covered by insurance and cost 2500 Ghana cedes [$500] for the first round and 1500 Ghana cedes [$300] for each subsequent weekly round. The pharmacist asked me to walk with him to break the news to the son of Patient 8. When I left the hospital today, the family was trying to figure out how to come up with the money for dialysis and his wife graciously thanked me for helping a bit today.

[side note] The herbal “dispensary” consists of what we’d consider over the counter drugs that wouldn’t fill up 1/8 of a shelf at Whole Foods. 

Thankfully I got to spend the afternoon at the rainforest!  The Wli rainforest is 2 hours away from Ho and there was thunderstorm with significant rain when we arrived.  Kaufi and I waited for the rain to settle a bit, she put a plastic bag on her head since her hair was pressed [it's currently styled by rainforest humidity] and we thugged out the 90 min hike thru the rainforest while getting drenched. It was worth every raindrop and muddy step to get there. I spotted this chill lil guy and this crab our tour guide caught so I could get a photo [he released him in safe waters so he wouldn't be Kaufi's late night snack] in route to the waterfall.

Kaufi was smart and covered herself with a towel, I was a clown as usual and unsuccessfully tried to improvise.

[side note 2] The plumbing has failed in the home base so I’ve been bathing from a bucket the past two days.  This volunteer life abroad isn’t for everyone, but the rewards significantly outweigh the inconveniences that come up for me.