The wards

'Warning

Man on Fire

His word burns in my heart like a blazing furnace'

Not a particularly unusual caption to see written on a t shirt around here. What made us look twice was the fact that it was worn by the relative of the 2 kids in hospital with burns following a gas explosion! They arrived in Hohoe hospital on Friday with fairly significant burns - probably up to about 50% body surface area, and by Monday were still waiting to receive any treatment at all.

You may have spotted a problem by now but the staff on the ward did not think there was anything wrong with this. So I spent all day on Monday helping Kristina to clean and dress them (with much faffing as the family were sent out to buy the appropriate painkillers) because nobody else seemed to be available.

I am on the wards for my last 2 weeks in Ghana, supposedly in designated areas but it doesn't seem to matter where I go: people don't question who I am or what I am doing so I just float and find stuff to watch or do. Physiotherapy really is the nicest part of the hospital that I have visited: the wards are fairly primitive and the pace of work is if possible even slower than in physio. So slow on night shifts in fact, that the nurses on duty just sleep in the next room, and it's not extremely unusual for them to wake up to find that a few of their patients have died overnight.

Families pay per day for relatives to be held in the morgue and a lengthy stay with drawn out funeral arrangements is apparently an effective way of demonstrating wealth. A funeral incidentally is a big event - with procession, singing, dancing and celebration (of the deceased's life rather than their death, presumably).

I discussed the kids with the physio staff and Nancy duly came to see them with me. We are however having problems with getting either of them to move much since they are in so much pain. The nursing staff have just changed their dressings, ripping off much healthy skin along with them and making their burns much worse. The rationale for the lack of pain relief (being risk of addiction) is confusing in a country where you can buy valium over the counter!

Kristina has been jumping around trying to get them analgesia, appropriate dressings and transfer to the burns unit in Accra (where there are no beds). She eventually contacted Shriners, a burns charity who will apparently fly them to America for treatment. I found myself in a quandry: Appalled as I was by the lack of humanity shown, I remained (as I usually do) less shocked or emotionally involved than my American colleagues (though admittedly I didn't personally witness the brutal dressing changes) and mindful of the fact that change needs to come from within the service and cannot be forced.

This is true regardless of how I feel about working practices or the treatment of patients and has stopped me from intervening on many occasions. I wondered uncomfortably if this time, for the sake of the individual, I could have tried harder to change the situation but am wary of the cultural differences and relationship with the volunteers and I know that the same dilemma will arise again, and the approach will be no different because the staff themselves don't recognize any need to change anything.

I find myself adopting the phrase commonly used here (often by Ghanaians themselves) to express frustration (and often resignation) about the way things are:

Oh, Ghana!