Wednesday

Wednesday was a day of scanning. Again the group was split into 2 groups. The physicians and ultrasonographer worked together seeing a mix of GYN and OB while the NMWs concentrated on OB. About 20 patients were sccanned. An unexpected intrauterine fetal demise in the mid trimester, twins, oligohydramnios, healthy pregnancies, low lieing placentas and multiple uterine fibroids causing pain and infertility were diagnosed. Today the students also learned how to write up reports summarizing what they found and we started checking them off on the competency check list. This is a list of the basic items we expect the course participants to be able to do on a scan: the presentation, biparietal diameter, abdominal circumference, femur length, placental location, amniotic fluid level and presence or absence of a heart beat.
During lunch Abeena took Ann and Dario on a tour of the other government hospitals. There are 5 government hospitals in the city plus a teaching hospital. There are about 3,000 deliveries a year at Suntreso per Dr Opoku- Adusei, 30,000 per year if count all 5 government hospitals and the teaching hospital together. Prenatal care insurance is provided by the government for free so most women get prenatal care and deliver at the hospital and home deliveries are not the norm. But there are many health issues including sickle cell anemia, malaria, TB, HIV, hypertension, diabetes and preterm delivery. The majority of the deliveries are performed by the NMWs. A group of 15 work at Suntreso in shifts covering the hospital 24/7. There are 4 full time physicians at Suntreso Hospital and 2 part time hired physicians. Their days start at 6:30 AM and end late.
After the last patient had been scanned Ann introduced the participants to the ISUOG web site were they can access lectures and educational resources on women's health issues. Dr Annie Opoku gave Ann a hug and expressed her gratefulness for the tools this collaborative effort had provided her. These Ghanaians are now the newest members of the ISUOG family!
In the evening we all met at a lovely new Indian restaurant where we enjoyed a wonderful meal, comraderie and several speeches. We shared stories about ourselves and our families. It was memorable. I know we have made some good friends for life!