Alumna Shawna Riley: My eye-opening nursing placement in Africa

Shawna Riley graduated in May 2021 with a bachelor's degree in Nursing from the University of Akron. She completed a four-week internship this summer in Takoradi in the African country of Ghana to see the differences between health care in the U.S. and the developing world.

This is Shawna's story.

I was originally scheduled to go overseas on my nursing internship before my last year of study, but then COVID struck so I delayed it until this summer.

It was not a requirement for me to go overseas on a nursing placement, but I love to travel and experience different cultures and it was something I knew I wanted to do before I started a full-time nursing job, so I sought out this opportunity on my own.

I was originally booked to go to Nepal but I then had the option of going to Ghana this summer, and I was so pleased as I loved the sound of Ghana from what I had researched.

I’ve travelled a lot, but I had never been to a country in Africa before.

I was traveling on my own and after nearly 30 hours I finally landed in Accra Airport in Ghana. I was met at the airport by the Work the World team. It was so hot and I was exhausted, but other people were arriving at the same time as me from various other countries and we immediately clicked. We arrived in Takoradi very late and went straight to bed.

The next day we had a tour of the World house and the city of Takoradi. We had a hospital orientation too so I knew exactly where I would be starting my placement the next day.

My first impressions of the hospital was, "this is a stark contrast to what I am used to." The wards were so busy - full of patients with not a lot of privacy. At a glance it appeared grubby, but after spending a month there I soon realized that they were doing the very best they could with what they had. I would see people cleaning the whole time, cleaning equipment every day.

I was going to be in Ghana for one month and I had decided to spend two weeks each in Pediatrics and the newborn intensive care units (NICU).

For my last two weeks I spent time in the Accident & Emergency department. I was so pleased with my choices and it was a great learning experience.

Shawna, pictured at left, with two of her co-workers.

It was so interesting to see cases I would never have seen at home, like Sickle Cell and Malaria. I was amazed at the level of really advanced cases I would see as more often than not patients would delay going to hospital. So, when they did finally arrive for treatment their cases were often very severe, which made all the doctors’ and nurses’ jobs that much harder. Early interventions and treatments weren’t really an option.

The doctors and nurses were incredibly knowledgeable but were often let down by the lack of resources. An example of this was one day a patient went into cardiac arrest, and it became apparent quickly that this team did not have access to a defibrillator. They had tried adrenalin and nothing was working. It was eye-opening to see this is how parts of the world are and this is a reality.

The teams were resilient and they did the very best with the little they had.

As I didn’t rotate through a different department every week I had time to build up a rapport with the staff in the hospital. They began to understand what I could do and were much more open to giving me more opportunities. They answered all my questions and by the end of my placement I felt I had made some really good friends with them all.

Back home, at times, I’ve had hospital staff say, “I’ll do that, it will be faster for me to do it” therefore removing the opportunity for me to possibly fit an IV cannula for example. But the supervisors in Ghana had patience and are used to teaching local students, so they were fantastic and made me feel very welcome, comfortable and involved.

Language was not an issue as we were given language lessons at the house, which I loved. They were so much fun. No one in the hospital expects you to know the language, but being able to greet the hospital staff and patients, you could see they really appreciated the effort. It helped me build good relationships and allowed me to interact with the patients.

During my time in NICU I saw a case I had never even heard of before. There was a baby who had Harlequin Ichthyosis which is a very rare and severe genetic disorder that affects the skin. The baby had very thick leathery skin which cracks and continues to peel off. It can be really painful and this baby's eyelids were flipped. The family did not know until the baby was born that it had this condition and they were still very much adjusting. Along with other team members we spent a lot of time rubbing oil all over this baby, it had to be done every 30 minutes as the skin would continue to crack and split apart. The doctor said hydration was going to be key to the outcome of this patient and there was a chance the skin could eventually grow back. It was so sad to see but I was humbled to have had the opportunity.

The overseas team was lovely, I’m already missing them! They were so welcoming and straight away I felt at home. It was also great sharing the house with other health care students.

At the dinner table we’d be sharing stories of what we had experienced that day in hospital. It was a super fun environment to be around people with the same passion. We were also able to discuss our own health care systems at home and compare it to the Ghanaian one. In the US we do pay for health care, as they do in Ghana, but being confronted with a cash environment within the hospital where patients could simply not afford some options for their treatments was incredibly eye-opening.

Although I’ve travelled extensively in the past, this was my first time traveling since the start of the global pandemic. I was so excited to step onto a plane - although after 30 hours of traveling I soon realized I didn’t miss it quite as much!

When I was not on placement I spent my weekends with my housemates exploring Ghana.

One weekend we were fortunate enough to be invited to a Ghanian wedding (it was a Work the World staff member) - a money can’t buy experience. It was clearly an opportunity not everyone is going to have and we had no idea what to expect, nor could we believe we were invited. Everyone was singing and dancing, it was so much fun. 

Another weekend we went to Mole National Park. This is not close to Takoradi - about a 15 hour drive away so initially I was hesitant. But it was the best weekend of my life (including the long drive!). The experience was thoroughly enjoyable and it flew by. We stayed at a luxury safari lodge right in the middle of the park. The lodge looks out over the savannah and two busy waterholes which the animals frequent. You would walk out and see monkeys running around, you’d see elephants at the watering hole and it had a beautiful infinity pool. It was unreal, I enjoyed every second of it and loved traveling with my housemates.

My advice to anyone considering going overseas is to go in with an open mind and a positive attitude. Living in Africa is very different to living ‘at home’. Immerse yourself into a different way of living and a very different health care system and you’ll come away having had the time of your life.

Ghana was incredible and it met all my expectations. The people are so nice - I would recommend this to anyone!

Work the World specializes in customizing overseas nursing placements in Asia, Africa and Latin America. Their destinations provide eye-opening insight into the challenges associated with delivering health care in the developing world.

Media contact: Cristine Boyd, 330-972-6476 or cboyd@uakron.edu