Dr Karen Reinhold Wojdemann tells us about her days training doctors and midwives from Suntreso Hospital in Kumasi, Ghana, where the course also took place in September 2010:
The smell of Ghana is “black pepper”. It’s my first time in Africa – The expectations of differences are fulfilled. Tony and I went to Suntreso Hospital to supervise and teach trainees after the first day with a course for all the trainees.
“Births and Deaths” is on the sign sponsored by the local energy soft drink and shows the way to the maternity ward – where four trainees and 34 patients are waiting for us. The room where we scan is 2 x 4 meter – and we are 7-9 people in the room most of the time. The patients show up in the morning and wait for their turn.
Mixed gynaecology and obstetrics – nearly all abdominal scans – only the doctors are used to doing transvaginal scans, but not very often. The trainees – two midwifes and two doctors, scanned: Dating scans and growth scans, a case with a vanishing twin, a 5 week pregnancy in a uterus with necrotic myomas, a case with polycystic ovarian syndrome (she thought she was 5 month pregnant), a case with premature ovarian failure, IUGR, oligohydramnios, missed abortion, complete spontaneous abortion – only two transvaginal scans.
We had some problems with the machine – the zoom function doesn’t work and sometimes it freezes ( f ex when Doppler is used). Technical support from Siemens arrived – the picture improved – but the other problems remained. Dr, Hamilton arranged regular (every 3 month) visits with Siemens and the manager of the hospital – great.
While Siemens were there – we had the chance to visit other parts of the hospital, including the labour ward. 15 patients in one room seems to be standard. In this hospital they have 3-3500 deliveries every year.
The hospital driver took us back to the hotel – for Chinese food, beer and airconditioning.
Today is African Union Day, a national holiday, but still there are patients waiting. The trainees have really improve and today we challenge them – focus on more systematic scans, and then they get assigned an organ each – Emilia trains to be expert in abdominal cord insertion, Evelyn in cerebellum and Kwabena in kidneys. Dr. Hamilton had some clinical work and showed up a little later, so he didn’t get an organ – yet!
Cases were mixed like on Tuesday. We also had a serious anomaly: lobar holoprosencephalus, showed up in week 28 with head measurements like in week 36 and breech presentation. It was the patient’s first baby and she was referred to discuss delivery with the doctor. The sad thing was that a scan in a private clinic had been done in week 18 and they had seen some “dilated lateral ventricles” but done nothing. She even had a photo of the head in her file.
Today we went to the Theatre with Evelyn, who also is an anaesthetist. They performed a CS. Again very interesting to see the differences from our own hospital, but the cry of the baby was the same as at home.
We left hospital early and the driver took us to the palace museum – with a dedicated guide who told us which photos to take – so now I have these pictures with me and three different kings in wax.
The drives between hotel and hospital and today to the museum are fantastic. People, people, people – women carrying up to 70 kg on there heads and a baby on their back. Bananas, shoes, bread, TV, water, shirts, wheels, furnitures, goats, eggs – you can buy every thing along the road.