Today is Thursday, and we did Medical Outreach as usual. I got back a bit early, so I’ve taken the opportunity to use the internet cafe!
After having spent two weeks on the surgical ward, I started work this week in the casualty ward – the emergency room. Already I have some significant stories to tell, but it looks like I’ll only have time for one today.
The casualty ward isn’t large: two rooms (male and female respectively) with about 8-10 beds in each. The majority of the patients are in and out and typically do not have to stay very long. There is only one doctor on duty at a time with a handful of nurses. However, every day I’ve been there so far, the doctor has left for no apparent reason, leaving NO doctors on duty and no way of knowing where they are or how to contact them in case of a real emergency. A fellow volunteer and I were left in this situation for quite some time yesterday.
A man with obvious head trauma was pulled into the hallway in a wheelchair. The orderly asked where the doctor was, and we answered that she should be back at some point. Meanwhile, we noticed that the man was spitting/bleeding onto the floor. He had a large laceration on his upper lip that clearly needed to be stitched up. Feeling a bit helpless and frustrated, my partner and I grabbed some gauze and attempted to stop the bleeding.
While cleaning and dressing his wounds, we noticed that his arm was twitching, and he would not answer any of the questions we asked him, though we were speaking in Twi. With the help of a nurse, we asked him to blink his eyes if he could understand what we were saying: he first widened his eyes and blinked twice, very clearly. The side of this head was swelling and painful, his eyes were twitching rapidly from side to side, and his blood pressure was unusually high. Based on what I already knew about emergency medicine from my days as an EMT and common sense, I knew he must have had some brain damage. Where was our doctor? She finally returned, stitched his upper lip, and gave orders to have him brought to a bed on the ward. When I asked what would be done about his injuries, she said that ultimately, he needs a skull X-ray and medication to help drain the swelling in his head. According to my partner, he received no scans or further treatment since yesterday early afternoon when he came in. Moreover, the patients on the ward don’t seem to be watched by the nurses or doctor: about an hour after his stitching, the man had rolled over almost off the bed, nearly ripped out his IV, removed the bandage on his upper lip, and was attempting to rip out the stitches as well. We went to stop him and try to calm him down, and he eventually laid peacefully until our shift was over.
I think my frustration with this ward is quite clear, and I’m still not exactly sure what to do about it. For now at the very least, when the doctor leaves, I won’t hesitate to do what I can.
I’m out of time once again, but I’ll write more later!