I spent three weeks last summer working with a team of five other physicians at the Baptist Medical Center in Nalerigu, Northern Ghana. Our trip allowed the permanent physician staff to take their only vacation of the year and gave me clinical exposure to tropical medicine and infectious diseases that one could only see in a developing country.
I rounded on the pediatric, adult medicine, and obstetrical wards, seeing up to 60 children daily on quinine drips for cerebral malaria. I saw unresponsive babies who were carried on foot to the hospital after multiple seizures at home, but who, after a few hours of quinine treatment, were smiling and breastfeeding. Other children were brought in with rigid bellies and bodies stiff with pain, only to be rushed into surgery due to typhoid perforation.
We treated wound infections, malaria, typhoid, pneumonia, meningitis, and dysentery. We operated on perforated bowels and ulcers, removed a ruptured uterus after an obstructed labor, and saved an eclamptic mother and her child with a timely cesarean section.
In the outpatient clinic, I saw up to 60 patients a day, triaging those who needed to stay from those that could go home with simple medication. I learned how to do dilation and curettage for miscarriage management, remove lipomas, debride large wounds, perform skin grafts, and tap distended bellies to give end-stage liver disease patients much-needed palliation.
Most importantly, I was not alone. I had the great fortune of working with Dr. Vince Waite, an attending from my residency program who has worked in Nalerigu for 15 years. Because of his wonderful guidance and support, I was able to learn how to practice medicine in a rural, third-world hospital, avoiding unnecessary lab tests and acting quickly when a patient had a life-threatening illness.
My experience in Ghana was an invaluable part of my clinical training. I hope to someday return to sub-Saharan Africa to improve the public-health infrastructure of countries like Ghana.
It’s a wonderful feeling to save a child’s life. However, it would be even better to prevent diseases such as malaria because so many children die unnecessarily before they reach the hospital. My experience in Ghana will most certainly help me be a better physician and public health practitioner in the future. v
Dr. Andrea Mendelsohn is the 2009 International Health Studies grant recipient and a family-medicine resident who practices in Lawrence, Mass. and Charleston, S.C. This article is reprinted from Vital Signs, the journal of the Mass. Medical Society.