Ridge Hospital Follow Up Visit

Yesterday, I had my first big shopping excursion since I've been in Ghana. I was walking along the street trying to find an ATM that would accept my debit card. Of course this street was covered in little souvenir stands, so every person was yelling at my "Abrunni Abrunni look for free, no charge for looking." I am in Accra right now so they say "Abrunni" for white person where in the Volta Region "Yahvo" means white person. I was so impatient with these people bugging me since I just wanted to get money from the ATM that I finally agreed to look at one guys paintings. I really like one of them so I figured I buy it from him. I had no idea what the going price would be so I thought I bargained down to a good price. I found out that I should have paid about $7 for it. I bought it for $20. Oops! I guess he had a good dinner last night.

After the street shopping, we went to Accra mall. It is a real shopping mall. When you are inside it you feel like you are in a US mall. It felt so comfortable, but you were also expected to pay Us prices. I did buy some pretty fabric for my mom who likes to quilt. It's not as cheap as I can get in the village, but I found the patterns very pretty and I knew it was good quality so I figured it was worth a little extra money. It still was inexpensive by US standards.

Today, Pastor Allan and Patsy's next door neighbor drove me to Ridge Hospital in Accra so I could do a follow up visit. I went to Ridge with Samuel about a month ago. Ridge is one of the main hospitals in Accra. It was good working along side the therapists there today. However, the therapist there have a little more of a true Ghanaian mindset so they were not as open to some of my suggestions. I don't want to be critical of what they do, but I have a hard time with the way patients are treating in Ghana. The patients are not suppose to ever question the doctors, nurses and therapists. If they do question they will be thrown out of the clinic or office. The "Patient First" mentality does not always exist in Ghana.

I spent most of my time working along side two of the PT interns. Since they haven't graduated yet, I find they are much more open to suggestions and they still want to learn. I tried telling them how US PT clinics are structured because they exercise treatment area is very chaotic at times. There are 4 staff members with 4-6 patients, but no patient is assigned to a staff member so often times the staff will just be sitting around talking as the patients are off on their own completing exercises without any guidance.  The interns seemed much more willing to try and embrace my suggestions for one on one therapy.

I was very excited though to see the patient I met a month ago with Lymphedema. I wrote about her in my blog. Last time at Ridge, I showed the intern named Samuel how to perform manual lymph drainage and apply compression wraps. He has been treating her for the past month. She has had a dramatic decrease in her swelling. The patient was so happy. I was really excited to see that the treatment had been working and that they had been continuing it as instructed. Ridge therapists now know how to correctly treat Lymphedema! Success!! :)

There was one patient to day that was really hard to see. She was a 19 year old girl presenting with major neurological symptoms. The doctor that referred to therapy wrote mild stroke on the referral sheet. I was flabbergasted and furious at that diagnosis. The girl was unable to move her extremities. The only active movements she could perform were shoulder shrugs and slight turning of the head. She had severe spasticity, increased muscle tone, and clonus. Her sensation was not intact. She was fairly oriented though. She was not able to assist at all with a stand pivot transfer from wheelchair to bed. I had to hold her in a sitting position on the bed and she was completely dependent for sit to supine. I found out after questioning the girl, her symptoms came on gradually. It started with mild weakness in her hands and progressively over a 3 month period of time got to the point that she could not walk. Since that time she has been bed bound. Her family did not take her to the doctor until today. An herbalist has been seeing her and that's it. An Auntie finally forced the family to take her to the doctor. The doctor she saw did not make a very good diagnosis though!!

I can only make an educated guess on what is going on with the girl, but I highly doubt she had a stroke. Usually, a stroke only affects one side of the body. She has bilateral involvement. A stroke is usually sudden onset, she has been getting progressively weaker. My hypothesis is that she has some sort of spinal cord or brain damage/disease. I sent her to the Korlebu teaching hospital immediately. Physiotherapy is not the most important thing. They need to know what is causing her paralysis. It could be anything from demylinating disease, spinal cord tumor, brain tumor, guillan-barre syndrome to name a few. The teaching hospital has an MRI and CT scan. They need to know what she has to get her on the right medications/treatments/surgeries so she does not end up dying. I do not think her prognosis is very good.

It just makes me so sad that families often just think some herbal medicine or tribal doctor can solve the problem and so they do not take them to a real doctor. The herbal doctors often are scams just to get money! The promise the world and do not deliver. That's life in a 3rd world country though. I couldn't do much for this girl, but at least hopefully she will finally get the medical care she needs!

I stayed at Ridge until 5 pm. The afternoon was so slow and mornings were so busy. It's like they don't want to actually work a full day so they have all the patients come in the morning at one time to allow them to just sit around and talk the last 3 hours of the day. I used the time to talk to the interns and help talk them through any patient questions they had. I did get a little bored though and was glad I had my Kindle.

Becky, Pastor Allan and Patsy's neighbor, drove me home from Accra to Tema. It was such a long drive! A 30 minute commute was an hour and half commute since traffic is always so bad! It's nice to be in a big city. I think I can only take village life for 1 month increments and then need a break; however, the traffic is horrible!! Patsy had chili waiting for me! Yummy!!! I also needed to come visit them for American food. Haha! :)

I feel so fortunate to have met Patsy and Allan. They are 2 of the nicest people I've ever met. They have done so much to help the people of Ghana. I hope I can make 1/100th of the impact that they made in this country. They have helped distribute thousands of wheelchairs/walkers/canes/crutches over the past 17 years. They also help perform many other humanitarian projects across Ghana. I don't care what religious beliefs you have, they are amazing!

Tomorrow, I will brave the hour and half one way commute to return to Ridge hospital. Until then....

Love, Kari