The Operating Theater

(Pictured: myself and another intern, Thomas, modeling the latest in scrubby fashion)

Although Princess Marie Louise(PML) is the only pediatric hospital in the entire country they must out-source lab work, scans, and other tests since they do not have the funding to do so on-site. Similarly, surgeons are only available once a week, Wednesdays, and even then are sometimes cancelled. Surgeons come in from other hospitals to conduct the surgeries. PML does not conduct emergent surgeries, those are referred to a larger hospital in the area. Therefore they only had about six patients when I came to observe surgeries. I was able to observe umbilical and inguinal hernia repairs and a hydrocele repair. The two surgeons were able to finish surgeries in about four hours. There was a very laid back feel to the surgeries, a little girl started to wake up from anesthesia while the doctor was still suturing and no one really reacted. They injected some local anesthesea and finished up.

Afterwards we had a conversation with the surgeons. They talked about how surgeons made little money doing surgeries at PML, since it is a public hospital. There is a lot of talk about how in the US, our doctors make so much more money because of privatization. Money is a conversation topic a lot, and US vs. Ghana resource availability. These conversations are uncomfortable but it allows for both myself and the doctors here to understand different healthcare systems.Here, there are simply not enough resources and doctors. At PML there are only four attending doctors. Each of the four wards has only one attending, if they are even at the hospital that day. If doctors in the US complain about too many patients they have not seen the pandemonium of a low-resource setting. Residents are given free-reign just so there are more doctors. Nurses at this hospital are also not given the task of placing IV lines which puts more work onto doctors. Gloves are only used if there will be contact with patient fluids to conserve them. Most furniture at the hospital are marked with a "Donated by...". Betadine is not even used in surgery, possibly because of costs, so an alternative disinfectant is used. With so few resources in this functioning hospital it makes me ask the question, "Does the US have excess?" I need to take a hint about resource allocation here.