Teaching in Ghana

Hi, this is Nancy speaking here. Today I taught an endocrine unit to around 120 sophomore and junior nursing students. They were very engaged and attentive despite the heat. In fact I gave them a chance to talk among themselves to answer some questions on some case studies on acromegaly and hypothyroidism and I had trouble getting their attention back. They asked some great questions and guess what? they even argued with me about some of the answers to the practice multiple choice questions that I gave them.
I'm learning about nursing education here. There is a council that decides on the nursing curriculum. As prerequisites, they take anatomy and physiology, chemistry, biology, math, English, microbiology, physics, and African Studies. Then they start their 200 level nursing courses in the sophomore year. This consists of two semesters of fundamentals of nursing while they are taking pathophysiology. The 300 level consists of three med surg courses, one is called Crisis Intervention. They also take statistics and nursing research. The 400 level has psych nursing, OB, and pediatrics in it. Community nursing is all throughout the curriculum.
I learned some about patient care in the hospital. Some conditions they see here in the hospital are malaria, inguinal hernia, and TB. People don't seek health care or dental care unless they have a severe problem. There is health care if you sign up for it with the government and pay regularly. Obviously not everyone can afford it. Length of stay in the hospital is longer in rural areas because people can't get to the hospital easily and are sicker when they do get there. As far as community nursing, there are some community nurses who live in the community they serve which sounds like a good idea to me.
In 2006, the Ministry of Health changed their focus from curative to preventative. So this is a step in the right direction. But if you can't pay for your hospital stay, they keep you in the hospital until you do. How does that work?
After the nursing students graduate, they wait around 10 months to take an exam to be registered. They take a practical exam in the hospital on any random skill that is chosen for them to test out on. Can you imagine? Then they have a written essay exam. Some committee hires nurses who are practicing to grade these exams. Sometimes the nurses who were the students' preceptors are the ones who serve as examiners. That would mean I could be grading your exam for registration even though I was one of your teachers! Anyway, every university student has to do one year of national service. The nursing graduates work in a modified student nurse role for that one year after graduation. I guess that means they don't have to look for a job right away after graduation, but it also means that they don't have any choice where they work at first, too. We are going on hospital visits tomorrow and there will be many graduate nurses doing their clinical skills testout while we are there.
I'm learning that nurses are not highly valued or trusted here like they are in the United States. Apparently, nurses don't treat their patients very well and patients don't always realize how unsafe their treatment is. It sounds like we can all work on our nurse/patient relationships!
We were talking about mental health nursing which some of you are in right now. There are three psychiatric hospitals in the whole country (geographical size of Ghana is about the size of the state of Illinois). There are about 15 psychiatrists in the whole country and a limited number of mental health nurses. I hope these statistics change since this is pretty bad.
I learned that the average yearly income is $1400 and a policeman makes about $125 per month. There is free tuition for college students but lots of fees to pay. These can amount to around $1000 for a student at the University of Cape Coast where I'm at. Most people are not educated past 6th grade. Nine years is the average amount of years spent in school. College is just for the very exceptional students. People do value education and try to get their children to get as much as possible although getting a loan is difficult and students may spend on the average of 9 years to finish college.
Moving away from nursing education, I went to church on Sunday morning. The women were dressed in very colorful dresses and their music was very upbeat and people were moving around a lot. It was all I could do to clap at the right time. The people were very friendly and welcoming and I would definitely go again. It's very interesting the role Christianity plays in the culture. You will see names of stores and businesses such as God is Great Trucking Company or Grace of God Beauty Shop or He is Coming Again Water Company. In fact there is a prayer meeting with singing going on above the Internet cafe I'm in right now!
Well, I hope you are enjoying or did enjoy your springbreak. I'm thinking of GVSU and feel fortunate I can work there. There's a lot I've taken for granted that I will come back to and really appreciate.