Strange days....

Yesterday was a funny day. I received a payslip from the Accra office that bears absolutely no resemblance to the pay that I am supposed to receive according to my contract or what is paid into my bank account. I also received a big envelope which contained a zip-lock bag with 2 squeezy jars of marmite and a post-it note that had my name, title and address in Ahafo on it but no information on who it was from. Still, never look a gift horse in the mouth or question some free marmite!

I got home, immediately changed and headed to the gym; mid-workout the skies blackened, the power went out and all hell broke loose from the sky. By the time I had finished my 40 minutes of aerobic exercise, sheets of water were cascading downwards and sideways and I walked through it, arriving home rain-drenched, wind-battered and cold! There was no power or water so I briskly toweled off in the dark and sat in my pyjamas waiting for the power to come on so I could make dinner. As I waited I noticed that my phone wasn't working due to penetrating water injury from the walk home and changing to my other phone I managed to cancel the morning alarm function.

So, the marmite rose to the occasion on a couple of water crackers as a make-shift breakfast in my consulting box this morning as I had woken at 6.25 am wondering why it was already light and "oh S***" as I realised the time, dove into my clothes and bolted out the door to be at work at 7am!

My morning was pretty quiet and I achieved a complete overhaul of the Pharmacy Standard Operating Procedures before lunch.

Arriving back from lunch I was met by "Lawn Mower Man" for his wound and fracture review. Wounds looked good, patient is well and the temporary cast was successfully replaced with a full below knee cast which resulted in my trousers attaining the speckled hue of someone who sits under a flock of seagulls, from all the plaster splots. As I was finishing up I was informed that there had been a car accident and the casualties were on their way in to us. As we put Lawn Mower Man under a hair dryer to set his cast and wiped the plaster from the emergency table the 2 casualties arrived. The passenger had 3 facial lacerations including 2 around his eye which required me to utilise all my cross-stitching and crafting finesse in order to place sutures in the eyelid crease and above his eye. The driver had minor lacerations; patching him up took less time than it did to fill in all the incident reports and documentation. By this stage the Health Safety and Los Prevention people were informing me that one of the pedestrians that had been hit by the Newmont vehicle was admitted to the local hospital and they wanted one of our national doctors to review her condition.

I sent off Dr Darko to see the patient and he reported back that she was 28 weeks pregnant, her abdomen was distended and they had aspirated blood from the abdomen; she was stable but obviously seriously injured. We decided to transfer her to a neighbouring hospital for better care however by the time that the paramedic and ambulance arrived to the local hospital her condition had significantly deteriorated and she was not fit to be moved. Despite Hwidiem hospital being a tiny, under-resourced facility the doctors there elected to take her directly to theatre (which apparently hosts at least one over-size cockroach) and the ISOS team went into theatre to assist. Thank God! On opening the abdomen they found the uterus distended with no source of bleeding outside the uterus; they opened the uterus and found haemorrhage compromising the baby and delivered it immediately. The baby came out flat, not breathing and blue; fortunately the paramedic and ISOS doctor were there and resuscitated it. Then followed another 2 hours of phone calls back and forth to decide on the best course of action. Kudos to Newmont, they agreed to do everything possible for the woman and baby, so at 8pm the ambulance, paramedic, ISOS doctor, Hwidiem nurse, family member and a security officer set off for the 2 hour trip to Kumasi to get the baby into the neonatal care unit there. Hopefully mother can join them tomorrow.

In the middle of all the phone calls I also managed to do my weekly shop and see a patient with a burn to his hand who just happened to drop by the house to see if I could see him there rather than going all the way back into the clinic. Thank goodness for the emergency cupboard of medical supplies at the house - I put on a burnshield dressing and a bandage, prescribed paracetemol for pain all with my phone tucked into my shoulder coordinating medical care/food for the team/accommodation in Kumasi and updating the Newmont Rapid Response team.

Now I've rested, eaten, made sure my alarm clock is set for tomorrow and will see what the rest of the week brings!