In July 2022, I had the amazing opportunity to do a four-week internship in Accra, Ghana. I lived in a student house with other Germans who were working in Ghana, as well as locals who were helping us with everything. My internship took place in Ridge Hospital.
Ridge Hospital, also called Greater Accra Regional Hospital, is a major hospital located in Osu Accra, Ghana. It has a capacity of 420 beds and a staff of 654. The hospital comprises eight departments: gynaecology, labour ward, emergency room, surgery, paediatrics, psychology, intensive care unit and neonatal intensive care unit.
The location is quite far from the student house I lived in. My colleagues and I either took a Trotro or a Bolt. The latter is a cheap taxi company which is unlikely to fleece you. Trotros, in comparison, are privately owned minibuses that travel fixed routes. They are the most popular means of public transportation in Ghana. While there are Trotro stations indicated by a group of people standing next to the road, these vehicles can be boarded anywhere along the route. My first time taking a Trotro was very confusing due to the fact that the conductor isn’t shouting out the destination clearly. Therefore, it took some time to get used to the system and know which one to take.
During my time at the hospital, I saw and learned a lot. I was assigned to different departments and spent one week each in paediatrics, gynaecology, emergency as well as the neonatal intensive care unit. This way I got an insight into in numerous different departments and gained a considerable amount of medical experience.
I began my internship in the paediatric ward where my trainee doctor took his time and explained every patiently to me. I was allowed to accompany the doctors from the respective ward on their daily medical round where they visit every patient and discuss their case. Here, I learned a lot about illnesses such as stroke and malaria and also learned how to identify trisomy 18 by the looks of a new-born child. In addition, I found out about malnutrition and the symptoms coming with it.
In my second week, I had the chance to visit the gynaecological ward. The first day started off great as I got the chance to witness two c-sections. It was my first time in the operating room. Therefore, seeing all the procedures was really interesting. However, the most special and at the same time scariest moment was the time between a child being born and their first cry. This is due to the fact that this first cry shows whether or not the child’s lungs are healthy.
On my second day I was allowed to be present at a natural childbirth. When we first started our shift in the morning, we were determined to watch a natural childbirth. Unfortunately, we had to wait for several hours, which was worth while. The experience was so emotional for me that I had tears in my eyes by the time the child was born.
I spent my third week in the emergency room. The first half of the week, I was at the ward where patients stay for up to 72 hours. I was able accompany the nurse handing out the medication. She showed me how to change infusions, calculate the number of pills to give and measure blood sugar levels. Another task of mine was checking vital signs like blood pressure, temperature, oxygen saturation and pulse. For the other half of the week, I was at the triage where patients are only staying for up to 24 hours. Here, I wasn’t allowed to do as much as in the ward, but I got to see some highly interesting cases. I learned a lot about illnesses such as diabetes and withdrawal syndrome.
In my final week, I visited the neonatal intensive care unit. This unit provides extra care for premature babies or sick new-borns. The illness the majority of the children suffered from was new-born jaundice. This illness can be identified by a yellow discoloration of their skin or eyes. It can be left untreated in most cases, however if the discoloration isn’t disappearing, the child should be treated with phototherapy. This therapy took place in the neonatal intensive care unit where I had the chance to observe it. Additionally, I followed the doctors for their rounds and saw nurses feed the children or lay a feeding tube.
During my internship, I came in contact with the many problems the Ghanaian health system still has to cope with, one being that there is no general health insurance. Therefore, patients need to pay for almost everything themselves, for example drugs, food, water and surgery. This results in doctors paying more attention to the costs of the treatment. For instance, doctors are sending patients home when there is a sign of improvement in their health. They are paying particular notice to their diet and try to avoid unnecessary testing. Another problem I perceived was the lag of sterility. Even though the Ghanaian doctors and nurses did as much as they can, I still had the feeling that generally, awareness for sterility was missing. Therefore, the Ghanaian standards in that regard were not the same as German standards.
This is just one difference of many between Germany and Ghana. Another one that really stood out to me was that people in Ghana in most cases were very welcoming, friendly and always willing to help. One time I was lost at a bus station and didn’t know which bus was the right one to take. Immediately people came up to me and helped me to find the right bus. I also felt very save in Ghana and never found myself in a situation where I was concerned about my safety. To be fair, I didn’t risk anything and was never out alone at night. For me, this proved the people wrong who told me that Africa was scary and dangerous.
In contrast to these warnings, my internship showed me the beauty of Ghana. After work we were able to explore the city Accra. We visited markets or the beach. At the weekends we went on trips to see more of the country. I visited the Wli waterfalls and did a hike with a local guide who explained everything about the jungle, the animals and the nature there. During this hike I ate the best pineapple of my life, straight from the bush and even walked on the ground of the neighbouring country Togo. I spent my last weekend in Ada Foah, a small village located at the beach. We did boat tours, went swimming in the sea and slept with the sound of the waves. Ada truly felt like paradise. Overall, I had a wonderful time in Ghana. I am unbelievable grateful for the time I was able to spend there and the things I learned, not only about medicine but also about the Ghanaian culture. This internship definitely changed me and put my views and values into perspective.
Eva Gundlach