My Medical Elective Placement in India – Alvin Katumba
In July I travelled to India to carry out my month long medical elective in Trivandrum, Kerala. During my stay, I was based in the Global Medical Projects house and worked in various hospitals around the district.
Our House in India
The house was nice and comfortable and accommodated up to 12 other students. It was located away from the busy main roads which provided the house with a relaxed, quiet atmosphere to return home to after a long day of placement. In the house there were two main housekeepers that cooked and cleaned for us every day and the elective director, Babu, who was always around to help with any queries or questions I would have. They were all really friendly and helped the house feel like a home very quickly. The front courtyard was secured by a large gate which made the house feel extra safe. Each bedroom was spacious and most importantly had a fan which helped us keep cool in the sweltering Indian heat. The house also had wifi which helped us keep in contact with friends and family.
Sree Gokulam Hospital
During the weekdays I spent most of my time in one of three medical institutions; St Joseph’s Hospital, Sree Gokulam Medical College and Shneha hospital and during the weekends I would have free time to travel and experience other parts of India.
During my elective I rotated through a number of specialities as the staff were very flexible and accommodating. I spent time in many specialities including orthopaedics, cardiology, haematology, gastroenterology, neurology, ophthalmology, obstetrics and gynaecology, paediatrics, geriatrics and palliative care. This gave me the opportunity to experience as many specialties as possible and therefore work with, speak to and learn from as many doctors and nurses as possible. There were also many Indian medical students around who were friendly and easy to talk to.
In addition to the common conditions seen worldwide, I saw many interesting cases that I would not normally have had the opportunity of seeing in England. I saw patients with leprosy, tuberculosis and HIV and learned how these patients are diagnosed, investigated and managed in India. When seeing these patients, I also gained a better understanding of the stigma and social factors surrounding HIV and leprosy in India which was interesting to compare with what I had seen and experienced during my previous four years as a medical student in the UK.
Inside the hospital
My time on placement was a once in a lifetime experience as I saw and learnt a lot. Each of the hospitals I worked in offered a different unique learning experience. The Sneha hospital was a primary health care clinic so dealt with patients with minor illnesses and injuries. Here the most common things I saw were patients who had been in road traffic accidents or had non-specific coughs, aches or pains, similar to what is seen in a normal GP practice in England. Sometimes these patients would need to be referred to a bigger, more equipped hospital for more specific investigations and treatment options. Gokulam Medical College and St Joseph’s Hospital were larger hospitals that took care of these patients and it was in these hospitals where I spent most of my time in surgery, inpatients departments or outpatient’s clinics.
During the weekends, I travelled with the other students and volunteers to various cities and towns around southern India. The weekend trips were a chance to relax and enjoy as much of India as possible with my new friends. These trips involved sightseeing, guided tours, boat rides, elephant riding, relaxing on the beaches, watching the sun set, exploring the market stalls and eating the amazing traditional dishes from around the area.
Watching the sunset
Overall, I gained everything I hoped to achieve by going to India. I gained hands on clinical experience in a developing country that I had never been to before, I saw conditions that would not normally see in the UK and learnt a lot by living in a different culture for a month and meeting so many new people. The doctors, nurses and other healthcare professionals, as well as all the organisers, housekeepers and other students made it an enjoyable experience that I would recommend to anyone hoping to do their elective in India.
As a second year Children’s nursing student I undertook a four week nursing placement in India based at Sree Gokulam Nursing College, Kerala, organised through Global Medical Projects. For my Professional Development Experience (PDE) I wanted to have the opportunity to explore nursing in a developing country rich in culture and traditions. My aim was to gain an understanding of how acute and community care of children differs between India and the UK through observing and participating in care in different health settings.
From the moment I arrived in India, all the staff and students at the Nursing College were very hospitable making me feel welcome and like one of their own students. Everyone was so friendly, happy to help, answer my numerous questions and organise a nursing placement specific to my interests and objectives. It was inspirational seeing how the professor at the college is trying to inspire passion into her students as she fights to make nursing more highly regarded, in India it is not seen as a profession.
Sophie with her Indian colleagues
I spent two weeks in the community with the second year student Nurses from Sree Gokulam. Every morning we explored a different aspect of community nursing in Kerala and were able to experiences healthcare in the rural areas and how the way people live has a direct influence on health. Visits included; home visits, Anganwadis (Children’s Centres), administrative centers, women’s self help groups and rural hospital with immunisation clinic. It is fantastic to see the determination that these women have to increase people’s qualities of life..it could well be said that the women of Kerela will eliminate poverty in time. With India’s aim to become a developed country by 2020 the influence that these women have is inspirational.
Sophie on the Children’s ward
For my next two weeks I was based on the Paediatric ward at the Private Sree Gokulam hospital where I also got the opportunity to experience Paediatric out patients and neonatal intensive care. Although the principles were the same, intervention methods and ward routine differed. I was able to observe and participate in some basic nursing procedures becoming confident in the ward routine, admission/discharge process and help with drug and fluid administration.
Kerala is the most developed state in India and therefore the hospital was very advanced compared to many in the country. Despite this and the hospital’s large elaborate outside appearance the wards were very plain and bleak with 30 beds all packed closely together, nowhere for the family to sit and no curtains for dignity. The children lay on the beds all day with no toys or distraction and were expected to ‘rest’ while their families brought in all of their meals wrapped in newspaper. The Nurses did little in the way of distraction during procedures and I found it hard not to say anything when I was told to help hold down a screaming twelve year old along with four other nurses while blood was being taken and her mother waited anxiously outside. Despite policy being evident this was not always implemented and infection control seemed very inconsistent with the Nurses never washing their hands unless visually dirty, no sign of gloves or aprons and open access to the diarrhoea ward. Medicines and IV’s were prepared at the Nurses station and the ward was hot and stuffy with frequent power cuts. The Nursing process and interventions were much the same as in the UK. With no NHS it was sad to hear the doctors telling you that they often could not prescribe the most appropriate medicines as the people could not afford them, delaying recovery times.
Sophie Outside Sree Gokulam
In India Nurses train for four years to be general nurses of all branches, specialising at masters level. They are taught a range of modules including biochemistry, microbiology, physiology, nutrition, medical, surgical and community health nursing in the form of lessons with classes of seventy students. The students attend college Monday – Saturday 9am – 4pm with clinical/community postings in the morning and theory lessons/labs in the afternoon. The Nurses were extremely hard working and worked nine hour shifts with only four days off a month. The Nurses were very helpful and I interacted with them, exchanging nursing, cultural and personal experiences. Many of the Nurses questioned my choice for wanting to be a Nurse as Nursing had been their parents choice, one particular Nurse had desperately wanted to be a teacher. This really saddened me as there was no passion, although they said they had ‘adapted to Nursing and now enjoyed it’ and that it was a job with financial security.
Sophie on the Children’s ward
Through completing this experience it has not only aided my professional but also my personal development. I was able to improve my communication and listening skills through interacting with the nurses, doctors and students. The placement was fantastic providing me with many opportunities to engage in nursing interventions while comparing the differences in healthcare, nursing training, common illnesses and nursing practice between that of the UK and India. It also improved my confidence. I had to be open minded and flexible with my time, constantly pushing myself in order to gain the most out of the opportunities available. Through observing the effects of hospitalisation on patients and how care differed between the UK and India it really reinforced the importance of dignity, patient/nurse relationships and the use of distraction and play therapy. This experience has confirmed my enthusiasm and passion for nursing and once qualified I hope to return to Sree Gokulam along with many other countries to continue my professional development.
By undertaking such a placement with Global Medical Projects I shared a home stay with other volunteers where our meals were provided. Babu Menon (in country director) was fantastic in meeting all of our needs/requests, insuring our safe travels to placement, being overall in charge of organising my placement and helping us to plan our weekends. Although you can organise your own placements direct with hospitals I would strongly recommend going through a company such as Global Medical Projects as this provides you with the security of a pre organised placement, food and accommodation. At weekends I was able to travel around Kerala with other volunteers. Weekend adventures included sightseeing, beach visits, elephant riding, exploring Trivandrum, temple visits, staying on a house boat and canoeing down the backwaters.
I am forever grateful for the great hospitality that all the staff and students both in the Nursing College and hospital showed me during my placement. I would also like to extend my thanks to the School of Health Sciences, Southampton, Global Medical Projects and all my family and friends for the support and encouragement they provided making such an experience possible.
In April I travelled to Cape Coast, Ghana where I spent one month working in Central Regional Hospital for my medical elective. I was based in the Global Medical Projects house with other volunteers, approximately a twenty minute journey away from the hospital. The large house was very clean and comfortable, and quickly became my home. The house is set away from the hustle and bustle of the local market and feels entirely safe with its walled courtyard, locked gate and security guard. In a building next to our house lived Eric Essuah and his wife Mary, the house “mum and dad”. Night and day, they were always around and really helped in every aspect of the trip. They helped show us around, ensured we had everything we needed, organised the placement at the hospital, advised us on prices so we were never overcharged, put us in touch with a very cheap and trustworthy taxi driver (who became our private chauffeur when we explored the area), arranged for a local seamstress to make Ghanaian outfits for us and even took us out for meals and to a local bar. Mary took us to her gospel church one Sunday morning and to an Easter celebration beach party, which are experiences I will definitely never forget! They were both always so cheerful and had huge smile on their faces; they made me feel completely at home and safe. Having a housekeeper six days a week, who prepared three meals a day, cleaned our rooms and arranged for our clothes to be washed really was a luxury. It really took away the pressure of having to cook and prepare meals in a foreign country with ingredients I had never even heard of. It was also a fantastic experience to try some of the delicious, local cuisine on a daily basis.
The Obstetrics department of Central Regional Hospital
Central Regional Hospital is a large and busy hospital. Not only does it receive patients from the Cape Coast area, people are referred here from all of the smaller district hospitals in the Central Region. It therefore has a number of experienced speciality doctors and the patients have unusual and complex medical conditions as well as the diseases that are typical of an African hospital, such as HIV and malaria. The hospital is also a teaching hospital so there are always a number of very friendly medical students on the wards receiving teaching from the consultants, which was great to join in with. The placement was well organised and I was assigned to a doctor on my first day who helped me find my feet and plan my time there. I spent my four weeks working in the obstetrics and gynaecology department, as this is what I had planned to do for my elective, but I could have worked anywhere I wanted in the hospital as staff were very accommodating and flexible. Before travelling to Ghana I had decided that I wished to undertake some research in the hospital, and with the help of Eric, this was approved before I arrived. This was easy to arrange with Global Medical Projects as having somebody in Cape Coast who was in regular direct contact with the hospital allowed my project to be arranged quickly and efficiently. I successfully completed my research by interviewing doctors and patients, and using healthcare records and registers.
During my placement I divided my time between the ward, delivery suite, theatres and outpatient clinic. All of the nurses, midwives and doctors were very approachable and helpful. I became good friends with a few of the house officers and they spent a lot of time sharing their knowledge with me and teaching me new skills. The delivery suite consists of one room containing twelve beds for all the women in the first stage of labour (if there are more than twelve women, they have to lie on the floor) and three special delivery rooms down a corridor where the babies are delivered. After completing four years at medical school, the doctors regularly allowed me to assist them in their work and encouraged me to get involved in caring for the patients, but they were very keen for all volunteers to have a hands on approach. I was able to monitor the women in the first stage of labour, perform vaginal examinations and keep a check of the fetal heart rates with a foetoscope (the only piece of equipment available to monitor the baby in the suite). I was able to assist the midwives in the deliveries, and I was taught how to suture any tears that had occurred. Following the deliveries, I monitored the women and babies, and helped to check the women over before they were discharged. Also on the suite I assisted the doctors in treating women who had suffered miscarriages and incomplete abortions. Abortion is illegal in Ghana, but there were many women who took herbal remedies to initiate the process. There were therefore a number of women on a daily basis who presented requiring the treatment.
Rachel in surgery during her elective in Ghana
The delivery suite has two theatres attached where caesarean sections are performed. Due to the lack of equipment in the suite, the doctors admitted to being overly cautious and would decide a woman required a caesarean with little definitive evidence of there being a problem. There were therefore a lot of procedures carried out, with 71 caesareans undertaken over the month, the majority emergency surgery. Nearly all were carried out by the house officers and I was able to assist in a number of cases, gaining experience in suturing during the procedure. A common occurrence was power cuts. With no backup power in the delivery theatre, you either had to wait and hope it came back on soon or carry on in the dark. During one caesarean that I assisted in, there were two power cuts: the first whilst the placenta was being removed from the womb and the second whilst the wound was being sutured. During the first we had to pack the uterus with swabs and “pray she does not bleed to death”. Luckily the power came back on after 5 minutes and the woman survived. During the second, after waiting for fifteen minutes, we had to stitch the woman up in pitch darkness using only the light from a mobile phone to guide us. It was definitely one of the most exciting, if not anxious, moments in theatre. In the main theatres, other procedures were carried out and I was able to assist in myomectomy and salpingectomy cases and observe cervical cerclages being performed.
The outpatient clinic consists of one small room, one examination couch and one desk with three doctors crowded around, each seeing a different patient at the same time. With no booking system or prioritising of patients, if a person wants to see a doctor they arrive at the hospital early in the morning (the majority at 4am) and queue for many hours. During the clinics I clerked the patients and then either examined wounds, performed vaginal examinations, helped collect vaginal specimens for the pathology lab, scanned pregnant women or scanned women with suspected fibroids and cysts. I also practiced cleaning and dressing wounds. I was taught how to give guidance to couples who are having difficulty conceiving (which included telling the couple to pray hard and sing loudly in church!) and I was encouraged to discuss a number of gynaecological conditions with patients.
The obstetric and gynaecology ward consisted of 40 beds and two examination rooms. Here I clerked patients, performed vaginal examinations, checked wounds and changed dressings, assisted in induction of labour and monitored pregnant women. Catheterising and cannulating a number of women helped improve my clinical skills and I was able to assist in treating one lady who required chest and abdominal drains inserting before resuscitation was needed due to metastatic ovarian cancer.
Rachel on the outreach project in Ghana
I think the most fulfilling and enjoyable experience of my trip was working on the outreach programme. We travelled out of Cape Coast to the rural villages where we went into the schools and treated children who required healthcare, but could not afford health insurance or the money to see a doctor. We taught the children how to treat cuts and bites, stressing that they must try to keep them clean and hygienic to avoid infection. We then cleaned any dirty wounds that the children had and put on sterile dressings. The children were so joyful to see us and receive treatment, they were pretending that they had more wounds that needed treating and clung to us as we tried to leave the village. This was very touching and made me really feel that I had helped children that are so greatly in need and hopefully made a difference to their lives.
Rachel drumming during her elective
During the weekends I thoroughly enjoyed travelling around the area and really experienced the Ghanaian lifestyle and culture. I made the most of my free time outside the hospital by visiting nearby towns and villages, browsing through the markets, eating from the road side stalls and cafes, taking guided tours through the rainforest, relaxing on the glorious beaches, learning how to play the Ghanaian drums and visiting the many historic sites and tourist attractions in the area. I never sat still during my time in Ghana, each day was filled with new and tremendously fun activities and the time seemed to fly much too quickly.
I thoroughly enjoyed working in Central Regional Hospital, I learnt a number of new skills that will help me in my work in the UK, saw interesting medical conditions that I have never seen before UK hospitals and observed and assisted in surgery that was also completely new to me. It was exceptionally eye opening to work in an African hospital and I learnt a great deal about the way healthcare is given in Ghana, and how medical conditions and treatments differ to those found in British hospitals. At times I found it very difficult, especially working in such difficult conditions with the unhygienic and unsanitary wards and the lack of medical and surgical equipment. I will certainly always appreciate the healthcare and facilities available to us here in the UK. However, I found the challenge extremely rewarding and a very exciting experience. It is definitely one I will never forget. The main image that will stay with me is the friendliness, happiness and optimism of the staff and patients who were always extremely pleasant, had a smile on their faces and made my elective such an enjoyable and fulfilling experience. I am confident that I will return Ghana in the futures and will hopefully be able to work at Central Regional Hospital again.
I could not have wished for a more exciting and successful trip to Ghana. Everything, from what I experienced in the hospital, to meeting some truly inspirational people, exploring the country and making some great friends along the way, it was second to none. I would recommend Global Medical Projects to anyone planning their medical elective. They organised and planned my placement quickly and extremely well, eliminated any stress that I had about spending a month in a foreign country on my own and took care of all the other things that I hadn’t really thought about, for example, providing my meals, taking me to and from the airport and ensuring that I was safe and well every day and night. I would like to thank Global Medical Projects, and everybody who helped me during my trip, for making my adventure in this fascinating country possible and enabling me to get the most out of my elective.
I stand crammed between people on a creaky bus, grasping onto a pole for dear life, my knuckles white. The driver accelerates with gusto and I look down to see bitumen racing by through a hole in the floor. More than once I have to apologise as I bump into people as the bus sways. A man tries to sell me chocolates in a language I barely comprehend, all eyes are on me; a white, blond Australian in a foreign land.
Welcome to Mexico!
This, my “life-threatening” daily commute (I say it with a hint of sarcasm but one person actually dies daily on the buses here), is to ‘Crusa Verde de Norte’ or the ‘Green Cross of the North’. This is a hospital and ambulance station in Zapopan, Guadalajara. Out of my element, but feeling more at home each day, I have travelled to Mexico to volunteer in the hospital and ambulance service for two weeks, through the Global Medical Projects organization.
The Green Cross Ambulance Service is one of the primary ambulance services here in Mexico. It boasts 5 ambulance stations in the Zapopan region. The Northern station, where I volunteer, is one of the busiest. The Paramedics have a one-year study program, followed by a four hundred hour placement commitment (usually taking approximately 6 months) to become fully qualified. The Ambulances are kitted out with a range of drugs and equipment, some which are similar or identical to SA Ambulance, others which are vastly different:
Similarities – many similar drugs, similar airway kit and trauma kit, oxygen, able to intubate, radio communication, paramedics return to a home station, two paramedics work in partnership Differences – some differing drugs such as frusemide and paracetamol solution, AED instead of ECG monitor, minimal paramedic specialization, able to suture (albeit uncommon), no pagers (solely rely on radios), less manual handling and safety precautions (gloves are infrequently worn and sharps are re-sheathed)
The biggest difference, however, is the type of work. My experience in Mexico in both the ambulance and in the hospital was that trauma equates to approximately 50% of the workload. When an ambulance is called it’s usually because the family literally can’t take the patient themselves due to the injury or complaint.
In the ambulance service I was always welcomed by the crew with a cultural kiss on the cheek and hug and often generously fed tacos or other delicious Mexican food. Although there was a communication barrier, I worked hard on my Spanish to understand as much as I could but will be forever grateful for universal sign language!
When I worked on the ambulance our shifts were particularly quiet for the region. However, we still attended multiple dislocations and broken bones, strokes, assaults and falls to name a few cases. To give you more of an idea of the work, one of the patients we picked up had fallen down two flights of stairs, resulting in a crushed vertebrae and two broken legs. The roads are so bad over here that three of us had to help hold her still in the back of the ambulance on the commute because she was bumping up and down so drastically. I’m not sure who was grimacing more – her, or me feeling so sorry for her! We also got called to a shooting, however on arrival we quickly established that a man was threatened with a pistol and punched in the face but fortunately not shot. Multiple paramedics informed me that shootings and stabbings are regular jobs, occurring weekly… it’s another world over here!
I really enjoyed working in the hospital as I got to see multiple orthopaedic, paediatric and general surgeries; I got taught to suture; I was able to regularly cannulate and aid the doctors in a plethora of tasks. Again, we had many broken bones, we had deep lacerations to mend, brain lesions, large chemical and thermal burns, over doses, hypoglycaemic patients, asthmatics, anaphylactic patients, a newborn and even a lacerated eyeball as some examples. The work was very interesting and the trauma treatment very efficient given the ample practice. The most memorable job that I aided with was an elderly gentleman who fell over on concrete, breaking both wrists and receiving a nasty 15cm gash to his head. He had nicked an artery in his scalp causing a spurting flow of blood and an increase in sympathetic response. Having already lost approximately 500ml of blood and losing more by the minute (approximately 1L on completion), a doctor and I worked in unison to control the bleeding. We used countless gauzes and multiple clamps until we finally found the end of the artery and stopped its red stream. After a neat suture and IV saline the patient appeared a different person and was very grateful. It’s practical jobs like these that act as a kind reminder of the difference we can make, and what a priviledge it is to do so.
I will miss the people I worked with and their friendly and generous nature, I will miss the Mexican food which far outweighs the Australian take on it and I will miss being able to assist Mexicans, young and old. If you are interested in doing this project or for more information please visit Paramedic and Emergency Medicine placements in Mexico or feel free to contact me.
Whether you’re a pre-university student looking for work experience, a medical student looking for a worthwhile elective, a medical professional taking a career break or simply just want to volunteer your time and skills, a medical project overseas can be a daunting prospect. When leaving the comforts of home behind to embark on a new adventure, you’ll want to be sure that you know what to expect when taking on a medical volunteering project.
We’ve put together a brief introduction to medical volunteering, from the personal and career benefits to daily life and the working conditions you’ll experience.
Personal Benefits
They say that travel broadens the mind, and by volunteering with us on a medical project overseas you will be able to travel to an amazing country you probably wouldn’t have considered journeying to before.
Volunteering is an extremely rewarding thing to do and you’ll have the opportunity to create some amazing memories and make new friends in an entirely different environment.
It’s important to remember, that whilst rewarding, it will be a demanding experience and one that you should prepare yourself for. Working away from home, surrounded by people you don’t know and in an environment which may be emotionally draining can be challenging, but you’ll be supported by our friendly overseas staff and the comradeship of your fellow volunteers who will all be based in the same area.
Career Benefits
Everyone has different motivations for joining our medical volunteering placement. Whether you’re a pre-university student looking to boost their application to medical school, an elective student or qualified professional, volunteering will look great on your CV / Resume.
Aside from what you learn about medicine overseas on the placement, volunteering abroad will allow you to learn a new language and experience a new culture, both of which are great qualities that universities and employers will be keen to make use of. Helping a local community will show your charitable spirit and can also help to aid your career choice or your next step in life.
Daily Life
At Global Medical Projects we have a variety of volunteering options available for those interested in medical, nursing, physiotherapy, dentistry, paramedic or radiography projects. You could be assisting on maternity wards, providing dental care or shadowing doctors and nurses. No two days are the same and you will have the opportunity to experience a variety of hospital departments and clinics but rest assured that you will be fully integrated into the team.
Typically you will work office hours, Monday to Friday, leaving weekends free to travel with the other volunteers but be prepared to work occasional evenings and weekends too.
Working Conditions
Volunteering certainly isn’t a luxury holiday and working conditions during your hospital experience will be vastly different to home. You’ll be working in a variety of communities, most of which are under privileged, and see the challenges these communities face on a daily basis.
Volunteering abroad will give you real hands on experience and you’re likely to see different tropical infections and diseases that you may not have encountered previously. You may see a lack of funding during your placement and experience times when patients can’t afford to pay for treatments.
What’s included on a Trip?
Your trip with Global Medical Projects will include;
Accommodation
UK support
Airport pick-up
Local induction and orientation
Medical placement and donation
Local overseas support
Food provided by your host family or organisation
You’ll need to take care of the following;
Flights
Insurance
Spending money
Visas
Inoculations
Food at weekends
Volunteering is a life changing experience and one that we hope will stay with you for a long time. We look forward to welcoming you on one of our placements soon!
I completed a medical placement with Global Medical Projects in Ghana from June-Aug 2015. As a final year medical student from the UK, the placement was my medical elective. I spent 7 weeks on the medical placement and then 2 extra weeks in Ghana for my own travelling. I thoroughly enjoyed my time and would highly recommend it – the experience was eye-opening and challenging, but also fun, exciting, inspiring and memorable.
Preparing
I chose to travel with an organisation as I found it can sometimes be difficult to make direct contacts in developing countries and to get as many opportunities organising things yourself. I was also travelling alone, and going with an organisation meant I felt I’d have more support and security, and be able to meet other volunteers when I was out there. Global Medical Projects was a great choice of organisation to go with and I’m very pleased that I chose them! They gave me lots of information and support before I went, which was great. I spoke to Kevin on the phone before booking and he was very helpful in answering all my questions and giving me more details. As soon as I booked with Global Medical Projects I got my own webpage with all the info I needed before I left – this was really useful for things such as advice about currency. I didn’t have a great deal of time to organise my trip overall, so it was brilliant that it was so straightforward and quick as soon as I got in touch with the organisation.
The Medical Placement
I spent my time working in the Cape Coast Regional Teaching Hospital, Ghana. Although this is the largest hospital in the region and receives referrals from other medical facilities, it was actually smaller than I expected (in comparison with UK hospitals!) However, there were many departments and it was busy – there was plenty to do!
On my first day I met the Medical Director, who asked me about my interests and allowed me to decide what my timetable would be whilst I was there. There were opportunities to work in various areas such as A+E, Male/Female medicine, Male/Female surgery, Obs and Gynae, Dialysis, Paediatrics and NICU, Outpatients, Radiology, and Pathology Labs. The flexibility was great – I was able to choose which areas I wanted to work in, so could tailor the experience around my own interests and skills. As an elective student (so with lots of clinical experience) I was able to get very involved and have hands-on access to all the things that local Ghanaian medical students do, including theatre. Volunteers without medical training were slightly more restricted but still had a huge amount of hands-on experience, for example many of them learnt how to perform malaria tests, take bloods and got involved in resuscitation in A+E. Really it depends how much you are willing to put in – if you are enthusiastic and willing to join in with the medical team then you will find that they give you more opportunities!
I personally spent most of my time in Paediatrics and NICU, with some time in Obs and Gynae, outpatients and A+E. The staff were welcoming, especially the junior doctors, and I was made to feel a part of the team. I did many of the things that I would in the UK, such as attending ward rounds, assisting in outpatient clinics, clerking patients and performing examinations and investigations. However, I was also allowed to participate in some things that I haven’t had the opportunity to in England, such as independently putting in neonatal lines and assisting with lumbar punctures in NICU. Sadly with the higher rate of childhood mortality there were many paediatric and neonatal resuscitations every week which I was often involved in – this was a very useful experience however and an important part of medical training. I also found on-call and night shifts really interesting, as although they are long and tiring they can present you with a variety of different cases and challenges and there are generally fewer staff meaning that I could be even more involved.
Overall, the hospital experience was very different to the UK and a good opportunity to get a different perspective on medicine and healthcare. There is a significant lack of resources compared to developed countries and often equipment and investigations that we take for granted were simply not available. Patients also have to pay for medical care and many cannot afford all of the things that they need. However, seeing how the staff and patients coped in these situations was inspiring and taught me new approaches to medicine that I will remember in the future.
Accommodation, food and basic living
In addition to the medical placement, Global Medical Projects also organised accommodation and some meals and transport.
On the first day in Cape Coast, Eric showed me around the main areas in town, got me a local sim card for my phone and helped me to get local currency. This was really helpful, as these things can be stressful to organise by yourself, but are much easier done by a local who knows where to go! It was very easy to get to town from the accommodation and to get around to places. Everyone travels by taxi for short distances, which are exceptionally cheap and pretty convenient!
The accommodation was amazing! All the volunteers in Cape Coast from Global Medical Projects stayed in a volunteer house together, with Eric and Mary (the Ghanaian ‘host’ parents!) on the upper floor of the building. There were simple dormitories for boys and girls, with en-suite bathrooms (with Western toilets and running showers!) as well as shared areas – a living room with sofas and a TV, a dining room and a kitchen. Wifi was set up whilst I was there which was a great bonus, and fans and mosquito nets were provided. Although it may not meet with all Western standards (for example, there is no hot running water and power cuts are frequent!) the house was clean and comfortable, and a great place to hang out with volunteers in the evening.
Three meals were provided per day Mon-Sat, prepared by Favour, our local housemaid. Favour was brilliant – incredibly friendly and approachable and was happy to adapt meals if needed. She also taught me many local traditions and showed my where to buy certain things and get my hair braided. I had great fun spending time with her and learning more about the Ghanaian cultures. The kitchen was also available to use at any time by volunteers, so we could prepare our own food. The nearby markets sold plenty of food and there were some Western brands available to buy from shops in town, although these are expensive!
Support
Since I was travelling alone, having support whilst I was out in Ghana was important to me. I found that it was very easy to meet other volunteers whilst I was there, both within the house that I was staying in and also working at the hospital (with other organisations). We often went for meals or travelled together in the evenings and weekends. I never felt lonely and really enjoyed meeting new people, both from Ghana and other volunteers from around the world.
Having a local Ghanaian contact (Eric) who you could contact at any time was also exceptionally useful and gave great peace of mind. Eric and his wife Mary were very approachable and were always willing to give help and advice. They kept an eye on all the volunteers and made sure that we were safe and well, telling us to call if we had any problems, even when we were travelling out of Cape Coast! Certainly I enjoyed being very independent but it was good to know that they were there for support if needed. They even took all the volunteers out for a meal, invited us to go to church with them and helped to book taxis at good rates for us when we travelled to local areas at the weekends.
Travel and things to do
Cape Coast itself is a great place to be located and has loads on offer beyond the medical placement that I went for. In the local town there are historic sites to visit, such as the Castle which was used during the Slave Trade and busy Ghanaian markets. There are local music nights at restaurants (look at those next to petrol stations!) and bars such as Oasis, which seemed like a gathering ground for foreign tourists and volunteers! The beaches in the area are beautiful and in nearby sites you can go swimming, learn to surf or take trips on traditional fishing boats.
Myself and other volunteers had plenty of free time in evenings and weekends and often went travelling together. We went on jungle treks, canoed down rivers and visited the stilted village in the far West, Nzulezo. During my extra 2 weeks I also planned a big trip on my own travelling North through Ghana, including Mole National Park and Larabanga Mosque. If you’d like to travel then I recommend taking a travel guide with you but not planning too much in advance – it is easy (perhaps easier!) to plan things spontaneously in Ghana and fun to organise things as you go, along with others who you meet out there.
Great report Charlotte! Thank you for coming with us. To follow in Charlotte’s footsteps on the medical elective programme in Ghana click on the link below:
Similarities – many similar drugs, similar airway kit and trauma kit, oxygen, able to intubate, radio communication, paramedics return to a home station, two paramedics work in partnership
I really enjoyed working in the hospital as I got to see multiple orthopaedic, paediatric and general surgeries; I got taught to suture; I was able to regularly cannulate and aid the doctors in a plethora of tasks. Again, we had many broken bones, we had deep lacerations to mend, brain lesions, large chemical and thermal burns, over doses, hypoglycaemic patients, asthmatics, anaphylactic patients, a newborn and even a lacerated eyeball as some examples. The work was very interesting and the trauma treatment very efficient given the ample practice. The most memorable job that I aided with was an elderly gentleman who fell over on concrete, breaking both wrists and receiving a nasty 15cm gash to his head. He had nicked an artery in his scalp causing a spurting flow of blood and an increase in sympathetic response. Having already lost approximately 500ml of blood and losing more by the minute (approximately 1L on completion), a doctor and I worked in unison to control the bleeding. We used countless gauzes and multiple clamps until we finally found the end of the artery and stopped its red stream. After a neat suture and IV saline the patient appeared a different person and was very grateful. It’s practical jobs like these that act as a kind reminder of the difference we can make, and what a priviledge it is to do so.
