This is the fifth blog post of our FemInEM Forward series, featuring blog submissions from the The FIX19 International Attendee Scholarship. The post below is written by Dr. Nana Afia Nsua Boateng. Dr Nana Afia Nsua Boateng an Emergency Medicine Physician Specialist and the Head of Department of the Emergency Department of the Greater Accra Regional Hospital, Ridge, Accra (GARH EMD). She is a product of Kwame Nkrumah University of Science and Technology-School of Medical Science (KNUST-SMS). She did her residency training in Emergency Medicine at the Komfo Anokye Teaching Hospital, Kumasi and interned at the University of Michigan and Hurley in the USA during her final year of residency. She is an adept medical practitioner with thirteen (13) solid years of practical experience. She is dedicated to exemplary patient outcomes and follow necessary medical procedures to ensure the best with evidence. She is an outstanding leader and has made GARH EMD one of the most talked about departments in Ghana currently.

My desire to pursue Emergency Medicine was driven by two passions. The passion to see a fully functional system, where the patient is attended to based on the critical nature of the presentation as opposed to obtaining prompt care based on timelines, age, sex, political position and race to name a few influencing factors. The second passion that fueled my desire to pursue Emergency Medicine was my desire to apply my skills to care for every patient irrespective of age, gender, religion or race, particularly in an environment where ‘who you know’ typically precedes patients visiting medical facilities. I have witnessed patients presenting with chest pain wait in queues whilst other patients with headaches jump queues  simply because they were introduced by an individual with more ‘influence’.

A career in Emergency Medicine over the past 9 years (first as a resident and now as an attending) has not only been gratifying but has also been very fulfilling. Being in a position to save lives as well as making major decisions that have helped to shape the face of health care in Ghana has always been the drive to push me to do more as Emergency Medicine is still in the formative phase in most regions in Ghana.

In 2015, I was transferred to the Greater Accra Regional Hospital in the heart of Accra, the capital city of Ghana. I was transferred to the hospital as the first emergency physician in the hospital and likely the region as a whole. My assigned position was the head of a nonexistent department with the expectation to establish all operations. Upon visiting their medical and surgical emergency units, I immediately realized that they did not have a system in place to register and triage patients. Most things were done out of experience rather than stated procedures. Therein was my first challenge: to establish the much needed structure that the department lacked, and to facilitate a training program for the staff.

I organized a 6-week intensive training program that involved both theoretical and practical sessions on Emergency Medicine Department structures and descriptions, Triaging, BLS, ACLS, Trauma and ECG. Being in a space with male predominance did not make things any easier. I was faced with antagonism from my male colleagues and some female colleagues, but I did not let those sway my singular focus. Some said I wasn’t qualified enough, others said I was too young and hence lacked the experience and expertise. Some went as far as to insinuate that I wouldn’t even be present at the hospital on account of me being a nursing mother with a new baby at home.

Work started in earnest in the Emergency department in June of 2017 and I’m proud to say it is now one of the most talked about departments in Ghana, for all of the right reasons. We implemented a triage system which helps to identify critical presentations and a dedicated resuscitation area where countless lives are saved in a timely manner. In 2018, we celebrated Emergency Week; the first ever in Ghana which helped raise awareness as to what emergency services are. Deserving and notable staff were recognized and awarded for their dedication and efforts and practical BLS sessions were offered to the general public.

Currently, my focus is encouraging other medical facilities to replicate our effective triaging system across all of the Greater Accra region, and eventually throughout Ghana. This is one of the ways we can improve the health care services in the emergency units across the country. Even though we are still trying to develop our pre-hospital system, we will have enough trained personnel at the peripheral facilities to help carry out minor interventions.

It is my hope that the success of my team at the Greater Accra Regional Hospital in establishing and operating an efficient and effective emergency system will encourage more medical professionals in Ghana to pursue and specialize in Emergency Medicine.