Septic Surgical Ward

We drove a couple hours to Mole (moe-lay) National Park this weekend to go on a Safari and we saw absolutely nothing! I was so disappointed that we didn't get to see elephants. The best part of the weekend (aside from the dirty pool) was when we were leaving the park and some baboons ran across the road. Lame.

Yesterday I was on the septic surgical floor here in Tamale. When I asked the nurses what their morning priorities were they told me that they spent the first couple hours dusting. Yes, I did just say they dust. For a couple hours. Every morning. It's very important. No patients were assisted until all the morning dusting was completed.

The next priority was dressing changes. The doctors usually come in sometime in the late morning to assess their patients, but this doesn't happen every day. And nurses do no assessments so the patients go without being assessed if the doctors don't show up. We saw nobody do any vitals and no medications were administered at all in the time we were on the floor (for six hours).

We watched many dressing changes and each one left us feeling physically ill. They were absolutely brutal - inhumane even. The patients are given no analgesic prior to wound care and the nurses are merciless. For starters, old dressings were torn off without being moistened so new granulation tissue was ripped off along with them. After the dressings were removed patients were instructed to soak their injured body part (most of them were feet and legs on this floor) in a bucket of water with laundry detergent added to it. They typically soak for 20 - 30 minutes, but if they are forgotten about it can be over an hour.

I just need to quickly say that wounds here are horrendous! They all started as simple surgeries, but they do not heal properly and they become large and deep. I cannot even begin to explain them. We did see bone and tendons in them though because they were so extensive. It was unbelievable! Many need to be cut open to allow for the swelling - they were gaping! One went all the way from the bottom of the foot to up past the knee and the entire leg was raw. They are so painful!!

Back to dressing changes though. After the laundry detergent, wounds are scraped dry with cotton balls. Patients were in unbelievable pain at this point, but none of them expressed it. They were all very stoic and were told to be strong. It was awful to watch!

Hydrogen peroxide was poured over the wounds to clean them. Hydrogen Peroxide. On a huge, gaping, deep, sore, open wound. On wounds that covered entire legs. Hydrogen peroxide. Hydrogen. Peroxide. It would fizz and sizzle and it was absolutely excruciating.

Next the wounds were again scraped dry. I use the word "scraped" intentionally because the Ghanaian nurses would push so hard on the wound. They would literally scrape it raw. I had a difficult time remaining quiet as I watched the patients writhe in agony. It was horrifying.

All the wounds were dressed the same way - gauzed soaked in iodine covered with dry gauze and taped.

I will never forget watching one man get his dressing changed. He was about my age and he injured his ankle playing soccer. I have never seen anyone in so much pain in my entire life -- it was traumatizing!  He was writhing in pain and trying to remain stoic, but it was impossible. The poor man was begging the nurse to stop pouring the hydrogen peroxide on his foot. He was desperately trying to control himself, but he could not sit still. He was beside himself and the nurse kept telling him to be a man. When the nurse began scraping out the hydrogen peroxide the man could barely contain himself. Kelsey moved to his side and rubbed his back and he just cried and shook in agony. His mouth was moving in a silent scream and he was forcing himself to not push the nurse's hands away. He kept grabbing his leg prepared to pull it away and then he would withdraw his hands and writhe. My heart ached and I had to crouch down and cover my gaping mouth. I had tears in my eyes as I silently prayed for him. It took all my self control to refrain from hitting the nurse's hands away and telling him off. I felt helpless and so frustrated with the health care system here. Words are not enough. I would have done anything to help that poor man. And things like this happen every day here in Ghana. That man gets his dressing changed every single day. It's unbearable.

There were some children on the surgical floor. One little girl had burns over most of her body. She was about 9 years old and Kelsey and I fell in love with her. She could not move her arms and her entire chest and abdomen were covered in burns. She was sweating profusely and she could not wipe her face so we did it for her. We gave her water and made her a puppet out of our gloves and stickers. She seemed to appreciate that. She thankfully spoke English so we were able to have a little conversation with her. She was absolutely beautiful.

I found the patients on the surgical floor to be the most friendly. There were 11 men at the back who made me laugh and made us feel so welcome. They asked me to take pictures of them and all smiled when I showed them the pictures afterward - it was a lot of fun.

We poked our head in again today because we were hoping to watch the dressing change of a man with burns on 90% of his body. They weren't doing his dressing today though, but they were doing a little boys dressing. He was three or four years old and he had burns on 50% of his body. That was difficult to watch as well. He had to stand up for most of the dressing change so I held his hands to support him as he cried and cried. It was awful! He was such a beautiful little boy! I don't know what the nurse was thinking, but he put a gauze dressing over the little boy's bum so he would be unable to defecate without soiling his dressing. I politely pointed this out and asked him to move the dressing aside so it would stay clean. The nurse looked frustrated with me and he said, "put on some gloves and do it yourself". I asked him if he could do it as I would be wasting a pair of gloves and he defiantly took his gloves off in front of me. I was so angry with him. I was furious!!! I could not believe he would care so little for his patient or that he would be so offended that I was just trying to help. Could you imagine feces all over a burn??? Stuck in the dressing? It would be absolutely awful! I grabbed a pair of gloves and moved the gauze over so there was a clear pathway. I asked the little boy's grandmother for her approval and she nodded and thanked me. The nurse then proceeded to put plaster (aka tape) directly onto the boy's burn to secure the gauze - and the poor boy howled! I almost lost my cool. But I didn't. I helped the boy lay back down and spoke softly to him even though he could not understand me. He calmed down quickly and his grandmother returned to his side.

My experiences in the hospital here have made me so outrageously thankful for health care in Canada. We are so blessed to have access to such fabulous care!

I hope you are all well.

Love Ashley