In Ghana, stroke remains one of the top three causes of mortality and is a major cause of adult hospital admission. The Wessex-Ghana Stroke Partnership, which began in 2009, has created four multi-disciplinary ‘stroke-leads’ at the Korle Bu Teaching Hospital supporting the development of stroke-specialist clinical skills through delivering a training programme for hospital staff. The partnership also created a dedicated Stroke Unit in 2014 which has to date treated over 700 patients.
“Since my employment, I’ve worked in various departments in the hospital but I love working in the neurology department the most. Whilst working in the department, I met Dr Akpalu, the head of the stroke unit. Dr Akpalu, is a very lively person, he loves teaching and engaging, so I quickly fell in love with the ward because he makes you feel very comfortable and he always wants your views on how his patients are faring, which is rare for doctors in Ghana. You can discuss anything about the patient with him and he always goes the extra mile because he loves his patients.
The training we received at the stroke unit has given me the confidence to discuss and ask for different opinions on specific therapies for patients. I wouldn’t stand up in a group and talk, but now I am able to stand in front of 50 to 100 people and deliver training to new physios, interns and students. Dr. Akpalu has inspired others and every nurse and doctor who passes through here goes back to their department with a changed outlook and approach to work.
As a physiotherapist, I have learnt that the simple basic things such as how we handle patients make a lot of difference. The functional independence of a patient is so important, so we start training them from the ward, that way they don’t have to wear diapers. We support the patients to use the bathroom or a commode, which we place by their bedside and we teach them other non-verbal means of communication if they can’t speak, so they can raise the alarm when they want to use the bathroom. Even just small things like working with the patient on their swallowing technique can make such a difference and bring independence back to their lives. What has also been a great outcome of the training is the way we now work with families to teach them how to move and support their relatives.
I have been working most recently with a patient from Liberia who was flown in because they had heard of our stroke unit. In three weeks he has gone from being paralysed and losing the ability to speak to now sitting up and saying hello. His wife is so happy and it has been lovely to work with her to teach her muscle techniques for when they return to Liberia in a week or two. I think he really will make a full recovery – what could be better than this!
A huge challenge in Ghana is that the system requires patients to pay for physiotherapy treatments, which can be difficult for our patients because insurance doesn’t cover physiotherapy in the acute ward. Some patients’ relatives even refuse to let them have physio because they can’t afford it, which is sad, but we are doing our best to explain the importance of physio to the relatives and little by little we are seeing more patients paying for the therapy.
I hope for sustainability in the future. I believe that here at the stroke ward, we will continue to do our bit and train, and hopefully we can inspire attitudinal change in other departments so we can all be on an equal level as health workers”.