Experiences: Clinics

Kevin Narag, a medical student from USA volunteered for a month in Domiabra from July to August 2003. The following is his experience, expressed in his own words.

Eager, apprehensive, perhaps slightly naive...I came to Ghana with a woefully inadequate vision of West African life. After all, the American attitude towards Africa is steadfastly fixed on a mixture of CNN news stories, Conrad's "Heart of Darkness", and the occassional image from National Geographic magazine. But when I stepped off the plane in Accra and inhaled the moist Ghanian air, I knew there was something greater here than any photograph could capture.

My month as a medical volunteer was a blur of intriguing cases and unforgettable sights. Didi Vinambra, Junior, Sumitra, and Uma welcomed me with a warmth that I later realized to be a corner-stone of Ghanaian life. They even gave me some honorary titles -- "Doctor Kojo," as Didi Vinambra would call me (since I was born on a Monday), and "White Man," as the villagers knew me (a strange bestowal considering I am Asian). It seemed as if few Ghanians were familiar with the name "Kevin," so those in the clinic made do with my personal favorite, "Doctor Kelvin."

I have yet to happpen upon a more hospitable group of people than those with whom I worked in Domiabra. Upon my departure, they had become not only my colleagues, but my friends and a second family as well.

Didi Vinamra was kind enough to grant me considerable responsibility for patient care. And with the help of the staff, I was able to see more than sixty patients during the entirety of my one month stay. Of course, for a student like myself, it was an amazing opportunity to add a practical dimension to my mostly theoretical knowledge. We dealt with numerous complaints of malaria, GI tract infections, and prenatal issues. Nevertheless, we also had our share of demanding cases -- status epilepticus, angina, wounds requiring suturing, and post-natal complications. As I was not as comfortable with the more complex OB/GYN type cases, Didi Vinambra was always willing to assist, sharing her wisdom and experience.

The task of the health care worker in Ghana is fraught with difficulty. In the Domiabra clinic, there are no laboratory facilities; and thus we made do without the luxuries of CBCs, chem panels, cultures and sensitivities. Keen observation replaces expensive diagnostic tests. Heavy reliance on the history and physical guides treatment decisions. In this environment, you learn to hone your problem-solving instinct and embrace the "detective work" aspect of medical practice. Still, all that is asked of you is to do what you can, to give what you are capable of giving. I suppose the old truth remains valid: "Medicine consists of entertaining the patient while nautre cures the disease."

During those brief respites when patients were not gracing the entrance of the clinic, the staff and I would lounge in the shade and discuss anatomy and physiology. Our talks moved on to some pharmacology and even a bit of traditional Chinese medicine, a long time personal interest. Of course, it was not all about medicine. Sometimes, our conversations would stray to the marvels of Western living (ie hot showers and flushing toilets) or my fascination with fufu and akple (local foods). Somehow, we always managed to find our way back as soon as a patient wandered in our direction. Curiously, I think it will be these lazier, lighthearted moments that I remember most about my village experience. Stealing a quick nap under the branches of a neem tree, harassing the chickens that roam freely about the grounds (just ask the staff), looking at my watch only to realize I could not care less what time it is.... It is this unique union of simplicity and hardship that makes me reconnect to the purity of medicine: compassion and smiling; comfort and healing. Though I have left Ghana, I doubt if Ghana will ever leave me.