Ghana 2026

Part 6: Week 4

We went to the male ward this week. This ward seemed to have much sicker patients than we’d seen previously. Example diagnoses were hernias due/post operation, heart failure, chronic liver failure, tuberculosis, meningitis and sepsis.

We saw more how patient care was limited due to finances and limited resources. One patient needed a CT scan for their head but unfortunately relatives couldn’t afford the 750 Ghanaian cedis it would cost (£51.50 at todays rate), so treatment commenced without it.

We also saw many patients with low GCS scores – GCS around 3-4 – who were still on nasal oxygen and the priority seemed to be putting in an NG tube. (For the non-medical: patients were very unwell with low conscious levels and the priority of management seemed to be their nutrition rather than their breathing). This seemed to be partly related to costs but we were told oxygen face masks (the next step up from oxygen through the nose) were, at the moment, only available outside the hospital. In the UK patients with a GCS score below 8 are meant to be intubated and ventilated (their breathing done for them as they can’t control their airway) and the hospital does have an ICU here but I think the cost again is too high for relatives.

There also seemed to be some slow recognition of deterioration especially with regards to sepsis that we didn’t see in the female ward.

We also had many powercuts this week – every night we stayed in Nsawam. This was because of the storms. Sometimes when it rains it doesn’t cut the power but in a storm it always does. Sometimes this means our power (including most importantly our air conditioning!) is off until 6am even if it is a 5 minute storm.

We also had some coconut this week. I had some in Costa Rica and it was nicer over there. The coconut water tasted the same, but the inside was more bland than I remember (not that it had much flavour anyway).

Friday:

We woke up early to start travelling as we knew it was going to be a long day. The day before our administrator told us he wanted our house keys while we were away and this added another hour to the journey. (He wasn’t even at the hospital to recieve them despite saying he would be)

Our journey:

• Walk to hospital to drop keys 7:20am
• Left Nsawam 8am
• Nsawam to Accra circle
• Accra circle to Accra
• Accra to HoHoe (7 hours) arrived 18:00

We were exhausted by the time we got to Waterfall Lodge and covered in so much dust from the roads coming in through the trotro windows. Luckily we had ordered our dinner before we arrived so it was ready when we got there. The food was nice but more expensive here.

Our room had 2 fans and all of us together. It was nice. The bedroom was circular and had a double bed plus 2 singles. The bathroom was the cleanest we’d seen so far.

Saturday:

We had breakfast at 7am and I had some “oats with milk” as the other options contained egg. I had been having porridge last week for breakfast and was fairly sure this would be fine, but it was definitely more milk with oats.

We had ordered sandwiches to take with us. They didn’t have many options and I didn’t enjoy eating the sandwich I had on the hike.

We went to do the Wli waterfall hike. There are 3 different hikes that were available; the lower falls (easiest), loop to see upper and lower falls (steapest) and the Togo loop through Togo to see the upper and lower falls (longest). We did the latter.

In total the hike took us 7hours (8am until 3pm). It was long and tiresome and difficult. Most parts were steep and going up had little shade. I don’t think I have ever been as sweaty as I was then (and I do get incredibly sweaty day to day here).

The views however were stunning, the waterfalls were lovely and it is fun to say I have technically been to Togo as well. That said they only just make up for exhaustion.

For dinner we went to Miranda’s restaurant instead and that was lovely. We all really enjoyed the food and decided to come back for breakfast tomorrow.

Sunday:

We had met an external tour guide through recommendations of previous students. He hadn’t led us up the hike yesterday because of some disagreement with the people from Togo (better to let the official guides lead us) but had offered to take us to some places before we went back.

We had already wanted to go to the monkey sanctuary and this guide (Fred) was a trustworthy guy so we went with him.

He also suggested we went on another shorter hike to the highest mountain in West Africa and for some reason we agreed.

For this I had foolishly forgotten my inhaler with the thought of it only being 45mins-1hr each way and the thought that yesterday was fine for the 1st hour (I had obviously forgotten I had used my inhaler within that hour!). So obviously this hike was much more challenging for me and my lungs did not like it at all. It was steep, like yesterday, and I was very wheezy at the top. Thankfully I was mostly back to normal after a rest and the climb down was not asthma-inducing at all.

We tried the orange fruit on the right. We were told it was sour but it was more sweet for me so I was quite disappointed. Inside it has lots of white seeds and white flesh surrounding each.

After this we headed to get some bananas and then went to the monkey sanctuary. This was a fun experience and definitely one of the top 5 (possibly even the best) so far.

We were told to hold the bananas outstreatched and then the monkeys jumped from all directions to get them. We were told many times “with the banana the monkey is your friend. When there’s no banana the monkeys are not your friends” and that was true.

We started our journey back to Nsawam at 2pm. We had been told that it would be quicker on the way back and we would arrive perhaps just after sunset, but that was not true.

Our journey:

• Trotro to Koforidua
• Trotro to ?somewhere (we were too late to get a direct trotro to Nsawam)
• Trotro to Nsawam
• Taxi to the house

We ended up arriving back at 10pm and were starving so had some late night noodles and got to bed. At stations and stops there are lots of people selling plantain chips (crisps actually), bofrots, popcorn sometimes, drinks etc as well as other snacks and sometimes meals but when you’re crammed into a trotro in the heat appetite is often diminished.

• Just a note to say that almost all photos added here have been cropped/condensed to make the file size smaller so the real photos are better (and I do have lots and lots more + videos too that haven’t been added)