Tema Hospital Day 2

I went back to the Tema General Hospital today with Kenneth and Samuel of Step FaR Organization. We each split up again with the various therapists and observed treatment sessions. We gave our input when appropriate and often ended up taking over the treatment sessions, even though that was not our goal. The therapist seem to have the knowledge, they just do not have the training or mentoring to treat effectively. Next week, we will be running a continuing education program at another General Hospital, so hopefully we can help them put their book knowledge to use better!

I saw some very interesting cases! A little girl around 4 or 5 years old came into the clinic. She had foot drop, meaning her anterior tibialis muscle is paralyzed at the moment and so she could not bring her foot up into dorsiflexion (towards your head). Her foot just flops down into the pointed position. The little girl had malaria a month ago. She was treated by an injection in her buttocks. Either the malaria medication damaged her nerve or they hit the nerve when they injected her. The therapists were trying to use electrical stimulation to help get the anterior tibialis muscle firing again. That is a very appropriate treatment. I made sure to let them know that. The problem was their electrical stimulation machines are very old with huge electrode pads inside wet sponges that you strap to the arm or leg. Since the little girl was so tiny the electrodes were too large to stimulate just the anterior tibialis muscle; thus, we ended up also stimulating the calf muscle that causes plantar flexion. Plantarflexion is the motion we were trying to avoid. I think for a while we had some dorsiflexion and so I let the therapist know that it was an appropriate treatment to continue for another month. After a month if they do not notice any active dorsiflexion, they need to consider bracing the girl with an ankle foot orthosis (AFO) to allow her to have a more normal walking pattern.

Shortly after treating the little girl, we went to the maternity ward. We saw 2 patients who gave birth a few days ago. Both were complaining of severe pelvic pain and had severe leg weakness. The doctors labeled it as paralysis. The doctors feared their nerves were damaged from giving birth. Kenneth and I after our examination felt they were just in severe pain and may have had damage to their pubic ligaments and tearing in that area from childbirth. Hopefully, with good pain management and gentle strengthening exercises they will return to normal walking. They did not have any sensation issues, bowel or bladder incontinence, or weakness from neurological damage to indicate nerve injury, luckily.

In the afternoon, Kenneth, Samuel, and myself gave a short in-service on safety and patient positioning. It was very basic information, but stuff that will allow the therapist to conduct safer and more efficient treatment sessions. I think they were pretty responsive and some had great questions! While we only have 3 days with the staff at this hospital, I think if they took away just 1 or 2 things, they will hopefully be better therapist.

The Ghana physical therapy program has a long long way to go!!! There are so many barriers that make it hard to treat patients; however, hopefully future volunteers and us will allow some of the roadblocks to come down.

Patsy and Pastor Allen, the missionary couple I’m staying with this week, just made a wonderful pot roast for dinner! It was so nice to have an American meal. I’m really getting spoiled this week!!! I get to take showers with hot running water. My room had air conditioning last night! I shouldn’t get too use to it since I will have over 2 months in Kpando before I have conditions like this again! It’s amazing how much the littlest things make you happy after you’ve gone without them. I feel so blessed that I’m getting the opportunity to go on a trip like this. I get to help people who truly need it, but I’m also learning what is truly important in life.  Please, if you learn anything from my experience, we have such a good life in the US! Do not take it for granted. Tell your family and friends you love them. Do not fret about the small things. Lastly, realize that it’s the people who you love and love you that matter, not your things!!!

I’m staying with a missionary couple, it’s only right that I get a little preachy! Haha!!!

My internet connection is better right now. However, it is still taking too long to upload on blogger. Friend me on facebook and you will be able to see a few photos!

Love, Kari