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Thursday, 4 July, 2002, 11:03 GMT 12:03 UK
'Third world' medicine at first hand
A nurse attends an Aids patient in Zambia
Medics' dedication is the same the world over

The new head of the British Medical Association says parts of the NHS are verging on "third world medicine". But what is health care in a developing country really like?

My encounter with so-called "third world" medicine took place over two nights in Dunkorkrum - a town of about 5,000 people on Ghana's isolated Afram Plains.


We had a series of visitors, one a Spanish missionary suffering from typhoid. We were pleased when he left

I was working for a British charity and was accompanying one of our members who had contracted malaria.

The first problem was getting the patient to the hospital where there is no real ambulance service, the roads are little more than dirt tracks and the population is scattered in hundreds of small villages and hamlets.

In the end she had to rely on a lift in a Land Rover from an aid agency. Most people in need of treatment would not be so fortunate.

Ghanaian villager
Rural dwellers cannot rely on an ambulance service
Our first meeting with the hospital's only duty doctor - Steve - was on the two-hour ferry journey which took us across Lake Volta to the plains themselves.

He was returning from Accra and he agreed it was lucky there was no urgent need for him to get to work faster.

When we all reached the hospital, Dr Steve disappeared and began a round of the wards that was to last almost 24 hours.

Our patient was given a trolley to lie down on in a tiny room used by the hospital's eye nurse for consultations.

The charity's medic had to help install the correct intravenous drip - and then periodically remind the nurses that it needed to be changed.

Scrubbing up

She and I were allowed to put up our mosquito nets in an adjoining room - I slept on the floor with the cockroaches, while she had the luxury of a gynaecologist's couch.

UK Prime Minister Tony Blair and Ghana's president John Kufour
Resources gap: Ghana does not have the UK's wealth
The hospital's staff let us take showers in the room next to the operating theatre where the surgeon - Dr Steve again - scrubbed up before operations.

It would be hard to imagine patients or visitors being allowed anywhere near a similar facility in the UK.

The toilet was an airless room without a light - or one outside, open to the elements. I only just managed to avoid serious injury on a series of nails protruding from the toilet wall.

As it got late and we got hungry, there was no celebrity chef-designed menu for the patients at Dunkorkrum. In fact, we had to walk into the town to buy food for ourselves, before turning in for the night.

Hospital sounds

We were woken at about 4am not by a nurse doing an overnight check on the patient, but by the sounds of a woman giving birth in the next room.


Our patient was looking better, but the doctor looked shattered

Not long afterwards, although unrelated, we heard a man retching in considerable distress. Twenty minutes later a rooster began crowing outside our window.

Throughout the next two hours we had a succession of visitors - none of them medical staff - who had come to see the "Obrunis" (white people). Among these was a Spanish missionary suffering from typhoid. We were pleased when he left.

Dr Steve eventually returned to check on our patient's progress. She was getting better, but the doctor looked shattered. We asked him if this was a regular day. It was - and he was staying on for a few more hours to help out.

In respect of that sort of determination and commitment, there was no difference between Dunkorkrum's duty doctor and the vast majority of doctors in the world over.

But as the queue of people turning up for treatment on the hospital's doorstep grew longer and longer, the shortfall in resources looked greater than ever.

See also:

04 Jul 02 | BMA Conference
03 Jul 02 | Country profiles
Links to more Africa stories are at the foot of the page.


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