Observation Day #2

OBSERVATION DAY 2

Each student shadowed a mentor at Cape Coast University Teaching Hospital in their respective fields. 

Ann Marie, School of Medicine
Today, I joined UCC medical students in grand rounds in the pediatric ward. I learned about the management of a case of severe hydrocephalus concurrent with gastrointestinal issues. Additionally, the attending physician, medical students, and I discussed the etymology of anemia in malnutrition. While fascinating, the cases were also very sad. I was touched when I observed the medical students put together a couple of cedis for food for an HIV-positive neonate suffering from malnutrition. Interactions like these underscored the contribution of health care workers in combating social inequalities.

Anna, School of Social Work
As a social work student, attending medical grand rounds with medical students gave me a firsthand look into the importance of interprofessional teams.  Medical students for each patient mentioned different psychosocial stressors which often contributed to exacerbating their condition. Many of the patients we observed struggled with financial difficulties as well as stigma from their community. Furthermore, I observed that the role of a social worker at CCTH is often dispersed into the roles of the doctors, nurses and community health workers. These compassionate practitioners join together to provide the best services for their patients, even if they cannot afford treatment.

Maya, School of Pharmacy

Today, I had a chance to interview two pharmacists in the outpatient UCC TH Pharmacy Department. I learned in January of this year the government's primary storage facility for medication and supplies burned down. This impact was huge as it supplies all of Ghana. This may have an effect on supplies in the future, but now the Pharmacy seems to be running effectively.  I learned a lot about the structure, staff, and processes in that are in place at the Pharmacy. The Pharmacy usually dispenses 120 prescriptions a day which minimizes the opportunity for pharmacist to patient interaction due to limited staffing. Adherence counseling, focused on chronic conditions such as diabetes, hypertension, and asthma as well as TB and HIV/AIDS is conducted mostly by the nurses and medical with reinforcement from the pharmacist. A good example is the hospital's efforts to combat TB by increasing awareness of treatment that is 99% effective in curing TB and taking advantage of community workers to ensure compliance with treatment.

The second interview was with the lead pharmacist for the ARV clinic which is run every Thursday. I learned that UCC only started dispensing ARV in 2006 and drugs are given to HIV patients regardless of insurance coverage. A small token of 5 cedis is paid by the uninsured during monthly visits. HIV positive patients have a strong adherence counseling process (First 3 weeks upon start of ARV treatment, then monthly thereafter).  Pharmacist adherence assessments include a combination of pill counting, body weight (to determine any drastic decreases evident of noncompliance or lack of response to current treatment regimen), and a teach back method of determining how well the patient understands how to take their medications.

Natalie, School of Nursing
Along with four midwifery students, I observed consultations in the antenatal clinic.  According to the UCC TH protocol, every new client receives an HIV/AIDS rapid test .  That day, there was only one new client and she tested positive for HIV Type I.  The midwife conducting the test did not disclose the results while the UCC students were in the room for fear that the new client would be embarrassed by the result.  It was a powerful experience.