Ghana Blog: Kwashiorkor

July 7th, 2017 Contact: Alex Anderson  |  706-542-7614  | More about Alex

This week we volunteered at the children’s hospital in Accra. The name of the hospital was called Princess Marie Louise hospital or PMLH for short. This is the only children’s hospital in Ghana, so it is well known. The hospital was named after the granddaughter of Queen Victoria of Great Britain. One of the most amazing things about the hospital was that Dr. Cecily Williams did research there which aided in her discovery of protein deficiency in children. The name of this condition is called kwashiorkor.

The hospital looks like any other building in Ghana except that there are several connected buildings inside of a compound. After looking at the building several times, I noticed that the building somewhat resembles a big house. There is a large sign with the hospital name and services provided in the front of the compound that can be clearly seen from the main road. We entered through one of the side entrances. The first section I saw was mortuary. Walking by that disturbed me because this is where the children who died were sent. There was no one working around there, so luckily we did not have to go in. The next stop was the outpatient department. This was one of the most crowded areas I have seen. One of the ladies who was giving us a tour of the hospital, Nurse Victoria or Auntie Vic, told us that patients cannot schedule appointments ahead of time. This means that some of the families will be there all day waiting to see the doctor.

For my first day of observations, I shadowed the nurses and doctors in Ward 2. This ward is for admitted patients. The Ward had two big rooms and one small room. The rooms were on a very narrow hallway that was hard to walk through. Most of the patients were divided between the two big rooms. That was the first difference I noticed between Ghanaian hospitals and American hospitals. Usually in the American hospitals, there are either two patients to a room divided by a curtain or each patient has their own room. I think that was established because of privacy laws. In Ghana, all the children patients share the room. There are two possible reasons for this: the privacy laws in Ghana are more relaxed or because the patients are children, they do not request to have privacy and the parent do not find it necessary. From what I observed, the mothers did not mind being in the room all together and there were at least 10 people in the room. After the introduction of staff members of the ward, I was put to work. They assigned me to take vital signs of patients and to record them in the patient folders and the ward register. The vitals were temperature, pulse rate, respiratory rate, and SPO2. I was nervous because I could not understand Twi fluently and I was scared they would not understand me. I was also concerned that I would not do the vital signs accurately. After working with several patients, doing the vitals became easier.

My last two days at the children’s hospital were as equally eventful. I was stationed at the nutrition rehab center. Mothers can go there to cook enriched and fortified foods for their children for free. Usually these are outpatients who will cook breakfast and lunch and feed the children there. Then the mother will cook dinner to take home. On Fridays, the center will have a CMAM clinic. CMAM stands for Community-Based Management for Acute Malnutrition where parents will come in with their malnourished children and receive plumpy nut meals from UNICEF. The center was composed of an open room with a kitchen, a playroom, and two offices. In the open room, there were several cribs available for mothers to put their children down. One of my favorite things about the center was the attitude of the nurses towards the mothers and their patients. These mothers come in every day to cook for their children, so they get to know the staff. It feels like a family setting. Once again, the nurses allowed me to take vitals (weight, MUAC – mid upper arm circumference, temperature, etc) and record the data in patient folders. I would carry children while the mothers cooked and even distributed the plumpy nut meals based on age. I learned that malnutrition is a very big issue in Ghana. The mother or grandmother would come in and look very healthy (or sometimes be overweight), but the children would be moderately to severely malnourished. This occurs because sometimes the mother does not give the child nutritious foods or the mother would not know what to feed the child. On the second day at the rehab center, this young girl was the textbook definition of kwashiorkor. She had thin, light hair with a large distended belly. Her skin was cracked and peeling. She came in with her grandma who you could tell loved her very much. The girl was quiet, but she smiled often. We gave her many plumpy nut meals and sent her on her way. I was grateful to witness the slow, but steady improvement of some of these children. Most of these patients come every Friday to get those meals and you can see the progress being tracked in their files.

Next week, we will be going to Ridge hospital which is the regional hospital. We will be witnessing a lot of surgeries and well as deliveries. 

Chelsea Murphy

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