Not just a woman’s job anymore! – Nursing in Ghana

With poorly equipped hospitals, high patient numbers and attractive pull factors leading nurses to move overseas [3] it would be easy to forgive a lack of enthusiasm and passion amongst nurses. However, this was far from the case when Charlotte, Communications Officer at THET, met with Obuobi Abdul-Rahman, a Nursing Officer at Korle Bu Teaching Hospital in May 2018.

 Through a partnership between the Royal Hospital for Sick Children in Edinburgh, World Child Cancer and Korle Bu Teaching Hospital, Obuobi is receiving training in laparoscopy to help improve the provision of care for the estimated 1300 new cases of child cancer in Ghana each year. Treatment is very expensive and footed by the families which currently leads to a high level of care abandonment. The hope is that by using laparoscopic techniques to perform biopsies and surgeries, the procedure will be less invasive and the quality of care for children will improve.

 The only public tertiary hospital in southern Ghana, Korle Bu Teaching Hospital is a sprawling complex of buildings attending to over 1,500 patients a day. From 200 beds in 1923 to 2,000 beds and 17 clinical and diagnostic Departments/Units today, it is leading the way in introducing specialised services in Africa[4]. Despite these impressive statistics, it is hard to ignore the difficulties and limitations the health workers face on a daily basis, from out dated surgical methods – the use of open surgery instead of laparoscopy for biopsies being just one example – to limited speciality knowledge and lack of resources.

And yet the dedication and determination embodied in the health workers at the hospital was truly inspirational. Here is Obuobi Abdul-Rahman’s story (we defy anyone not to be drawn to nursing after reading it):

“I went into medicine because I have always had the zeal to help people, especially the sick. I used to fall ill a lot when I was young and I was always in and out of hospital. Even if I was just visiting a relative in hospital, I often didn’t come back as I would fall sick and have to stay there. So initially I thought I wanted to be a doctor, but later on I realised that nurses are always with patients and that is what I wanted, so why not become a nurse?

When I first became a nurse patients and their families had difficulty in differentiating between male nurses and doctors and used to think that because I was male I must be a doctor. Still today people call me doctor and I try to explain to them that I am a nurse but often the more I explain the more they call me a doctor. It is changing though, here at Korle Bu, we have a very good mix of male and female nurses. Nursing is now a much more popular avenue into the medical environment for men and we are seeing more and more male nurses. I must say I don’t ever regret choosing to be a nurse and I would not change being a nurse for anything, I would always want to be a nurse.

So that is why I became a nurse. After my training, I realised that what fascinates me most is watching the surgeries being performed.  I kept thinking: “Wow, someone is sick and you get to open up the person and cure them”, and that is ultimately what motivated me to come into the surgical sector. I also love children so when you join the two together I am extremely happy to find myself in a paediatric surgical unit! That is where I have been now for four years.

In our surgery department, we have a team of 16 nurses who work in the theatres and some auxiliary nurses. Here surgery cuts across all ranks of nursing and we all do our parts. We don’t discriminate between our roles, we all do what we do passionately. We always try to keep a positive attitude because especially when you work with children it is easy for them to pick up on your stress and worries and that can end up scaring them more. So sometimes you have to add some comic relief because often when they see the theatre they start crying and so you play with them a little and soon their smile returns.

We do all of the paediatric surgeries except some specialities like plastics, Ear, Nose and Throat (ENT) and cardio, because we don’t have the training or the equipment. Every day is a different operating day: urology, colorectal, etc., so within one place we get to gain experience from different angles, which is quite interesting. Our work is entertaining and always different! Especially when we hear that in other departments and hospitals nurses are just specialising in one thing. We are privileged to be knowledgeable in a lot of areas. Some of us feel like we are living the dreams we always wanted to.

When I heard about this project I realised that laparoscopy in this part of the world is barely used and yet it is not a new technique. In countries like the UK it is even fading out as a new, more advanced technique, called Da Vinci, is becoming more and more established. But here laparoscopy is now gaining grounds at least. So when I heard about this training, I was like, “Yes it’s going to help us!”

It is very important that the nurses are involved in the laparoscopic training because at times there can be technicalities or difficulties in theatre and the doctors just turn to look at us for solutions. The surgeons and doctors are like visitors because they just come to theatre to perform their surgery and then they leave again on their rounds. But As nurses we are always there and watch all of the different surgeries and work with different surgeons and so we get to pick up experience from them. Being able to collaborate with the surgeons is particularly gratifying, as in my previous job the neat distinction between nurses and doctors was a line not to be crossed. You didn’t see doctors and nurses sitting together. Doctors have their offices and nurses have their rooms it is totally differentiated.

I think this training will go a long way to helping the patients too. At the moment we use open surgery to do these simple procedures and as a result there are high rates of infection and all the complications that go with it. Beyond that it also affects the patients and families psychologically because when parents see big plasters on their children they wonder what we have done to them! But with laparoscopy we can use tiny plasters and the patients and parents see that it’s minimally invasive and the rates of infection are low.

I cannot wait to see how this training will help us and our patients. I have such high hopes for the future of care here in Ghana and I am proud to be a nurse. At the end of the day, if you come to work and you are able to go about your duties you get home and you have some big relief, you have some fulfilment in your heart, you feel like “I have done something good with my life today”.

[1] http://www.ghanaiantimes.com.gh/ghana-improves-on-doctor-nurse-to-population-ratio/

[2] http://citifmonline.com/2017/06/19/ghanas-nurses-and-midwives-deficit-hits-38000/

[3] http://www.bbc.co.uk/news/world-africa-31637774

[4] https://pdf.usaid.gov/pdf_docs/PNABZ208.pdf