2nd Day of Work

SO I JUST WANT TO APOLOGIZE FOR ALL MY GRAMMATICAL AND SPELLING ERRORS! IT TOOK ME 10 MINUTES TO GET THE PAGE PULLED UP ON MY COMPUTER SO I DO NOT HAVE TIME TO PROOFREAD IF I EVER ACTUALLY WANT TO GET THEM POSTED!!!

So today was very slow. We only saw 4 patients. According to Celestine and Doris, the hospital is not getting reimbursed well enough from the Ghana health insurance and so they are charging a ward fee to stay in the hospital and for basic equipment such as exam gloves. Therefore, a lot of patients have not been coming because they cannot afford the extra cost. It is pretty crazy because health insurance costs a person in Ghana 14 cedis, which is probably the equivalent to 10 US dollars. You can tell have impoverished of a nation this is when many cannot even afford that. So the hospital adding on extra charges really makes it hard for people to come.

Yesterday, when I was questioning Celestine about how she treats the patients in the ward, I did not realize that she does not get them up out of bed for therapy. I guess she only does bed exercises with them. So today, we got our 1 ward patient out of bed. She stood and took a few steps into a chair with hand held assist of 2 people. It took 2 attempts to get her back into bed since the bed heights are so high and the beds do not raise and lower like in the US. It was not the pretty attempt from sitting to supine, but she did not fall on the floor. As long as she is in the bed we can do rolling and boosting to get her into the correct position. I’m very glad I brought my gait belt.

The other thing that I feel I can offer them here is the importance of positioning in bed and early intervention to avoid plantarflexion contractures at the feet (its when the foot is stuck in a pointed position). Some of the littlest things that I now consider common sense as a therapist really are not. Many times I wonder what I’ve learned as a therapist because there is still so much information out there that I do not know, that I forget how much I do know.

I am trying to put together a pseudo-manual for Celestine, so she knows how to treat certain parts of the body. I am trying very hard not to overwhelm her with information. Once medical terminology became part of my daily vernacular, it is hard to remember that the lay people do not understand what I am saying a lot of the times. Hopefully, I can help her understand if a patient is truly having leg or arm pain or if it is coming from the spine. Then, once she knows where the patient is having pain, hopefully, I can give her ideas of what exercises will be helpful to that body part.

So this is how day 2 went and more of what is going through my brain right now, in order for me to make this a successful adventure to Africa!!

Love, Kari