Ghana

Writing this sitting on the balcony of the doctor's house on the grounds of the Mampong District Hospital. We just had a refreshing mid-afternoon rain, and now I'm looking out across the dripping trees and listening to all sorts of birdcalls.

Last week was spent at a series of lovely beach resorts along the coast. Beautiful beaches, almost no one around, and surprisingly fantastic food. And nothing beats falling asleep to the sound of surf.

Heading north to the hospital involved a fairly typical 12-hour trek involving multiple taxis, long-distance buses, roads in various states of repair, and that workhorse of intercity travel around the world, the mini-bus (called a "tro-tro" here). Had an interesting changeover in Kumasi, Ghana's second city, where we waited after dark in a what was basically a smoky, excavated pit for a tro-tro that turned out not to be coming. But the daylight segments on the roads were very scenic -- lush greenery and all sorts of interesting roadside activity.

Mampong is a town of about 20,000 with a district hospital. I've been hanging out in Casualty (basically the emergency room) and following along on rounds. Have already seen some interesting cases, including a relatively rare tropical worm infection.

Today was market day. On the way back to the hospital we passed what was obviously a recent and serious two-car collision and hustled back to Casualty, figuring that the victims had probably been taken there and to see if we could help. As we pulled up we saw two men wheeling a person-sized metal cart from the mortuary to the hospital, and inside we found one of the patients dead in the room used for resuscitations. Another patient from the accident was also being treated and was fine, and a third person had already been seen and released. We tried to figure out what had happened to the dead man, but realized that it would have been unlikely that we could have done anything for him, given the limited resources available.

Tomorrow is a big training day and I've offered to help out; we'll see if my vacation-dulled mind can recall any emergency medicine.