Ashley Shira’s Blog

Day Seventeen and Day Eighteen

Day Sixteen Part Two

After we left the internet cafe Saturday night, we got a pizza to go from the food court then got some groceries from Shop Rite before taking a taxi back to the mission house.  When we arrived at the mission house we had no power! We ate pizza by candlelight then called David because the power had never stayed off for that long.  Before he could arrive the power was back on.  He offered to come check on us, but we reassured him we were fine so he agreed not to come.  We read a little, wrote in our journals, then called it a night.

Day Seventeen

We arrived for church service around 7:45am and were amazed to see that there were only a few people there.  Usually praise and worship is in full swing when we arrive.  By 8am there were many more people there and the guest pastor, Larry Johnson, gave a great sermon.  There was a lot of upbeat music and a whole lot of dancing this Sunday….we hadn’t witnessed that the past two Sundays.  We also took communion this week.  Kim and I wore our swimsuits under our dresses so that we could head to the pool right after church service….we were excited about the idea of being at the pool around 9:30am.  Little did we know we were in for a 3 and 1/2 hour church service! At 11:30am Kim and I snuck out during the offering….we aren’t sure how long the service went on.  We got to La Palm Hotel around noon to spend the day by the pool.  It was very hot so we were glad to spend time in the water.  We met a young couple from Canada, Chad and Julie.  They are here working in an orphanage very near Manna.  We exchanged phone numbers and are going to try to get together with them before we leave.  I really want to go visit them at the orphanage and spend some time with the kids! We also offered for them to come over and use our shower and washing machine anytime because they don’t have running water where they are staying.  Kim and I decided to walk over to Labadie Hotel for dinner because the only option for dinner at La Palm was a buffet that cost 26 cedis.  We decided neither of us would eat enough to justify paying that much. We made a stop by the restroom and that is when we both realized how much sun we had gotten that afternoon.  We are both fried to a crisp! We wore a little sunscreen, but we haven’t been getting much sun the last two weeks so we didn’t really worry about it.  Apparently the rain we got on Friday settled the dust and took away our bit of protection from the hot African sun!! We both look like lobsters! After another wonderful dinner at Labadie we got a taxi and headed home. 

Day Eighteen

This morning we made pancakes for breakfast!! It made us both very happy.  Especially since we don’t get to eat lunch on clinic days. When we got to the clinic we were told Dr. Akosua wasn’t coming in because her son is still sick.  We thought we were going to spend the day working on our powerpoint presentations, but they had other plans.  Since Dr. Akosua wasn’t coming in and Dr. Asare was doing a c-section they were very short-handed.  They put Kim and I in an exam room together and we saw our own patients all day.  We were nervous b/c of the language barrier, but excited to be functioning more like medical students who are about to be doctors.  After a patient or two we really got the hang of it! We even admitted a 6 year old girl to the ward for malaria and bilateral conjuctivitis and periorbital cellulitis.  It was a bit scary that whatever we signed they did…labs, meds, etc.  But I guess in July we will be doing that all the time. After clinic we walked down to Gilbert’s wife’s shop to get measured for some dresses.  She told us how much fabric to buy and we will take it back to her in a few days so she can start on our dresses.  I’m very excited about having a one-of-a-kind dress from Africa! While we were walking I also got to make some great pictures.  I’ve been sad that I haven’t had the time to make the kind of photos I want because we are usually zooming by in a cab.  I am planning to do some more walking around next week with the sole purpose of making pictures.  Tomorrow Dr. Akosua is still planning to take us to Korle-Bu…I hope that works out.  The new students will also be here tomorrow!! I love everyone very muchh!

Day Sixteen

When we left the hospital on Friday Kim and I were excited about spending the evening just reading our books and resting.  Kim finished the second book in the twilight series and I finished reading Three Cups of Tea.  It was the most amazing book…..and of course I cried…something that is not unusual for those of you that know me well. I highly recommend it to everyone!!! It also stormed on Friday night and we got about 30 minutes of rain.  We were glad because it cooled things off and settled the dust a bit.  We were also glad the power didn’t go out during the storm.  This morning we were awakened by Junior banging on our window and the front door at 6:30am.  He wanted to know if we wanted to go jogging on CoCo Beach.  I had no plans to leave my bed since I was up til 12:30 finishing my book, but Kim got dressed and went with him.  I couldn’t go back to sleep so I showered, wrote in my journal, and enjoyed some alone time to reflect on my time in Africa so far.  This has been such an amazing experience.  I can’t seem to put it into words for anyone which is so unlike me.:)  We met Dr. Akosua at the hospital at 9am.  Our first patient of the day was a very sick six year old little girl.  Back in December she contracted Typhoid fever and ended up with a bowel perforation which required a laparotomy for repair.  Her mom brought her in today because she was complaining of severe abdominal pain and she had a fever.  She did not look well and on physical exam she had a distended abdomen with generalized tenderness and rebound tenderness…perotinits.  She most likely had a re-perforation and she needed another laparotomy.  We referred her to Korle-Bu (the teaching hospital in Accra).  Her mother had to take her there in a taxi….something unheard of in America! We will be able to check on her on Tuesday because Dr. Akosua is taking us to Korle-Bu to show us where she trained! We had several good cases today, but I will have to write about them later.  We are at an internet cafe in the mall and our time is almost up.  I love everyone very much!

Day Thirteen Part Two, Day Fourteen, Day Fifteen

Day Thirteen Part Two

After work on Wednesday Kim and I took a taxi back to Coco Beach to spend a little time by the pool since clinic finished early. The taxi only cost us 2 cedis and we paid 5 cedis to use the pool….not bad for an afternoon of relaxation.  We both took a little nap by the pool then decided to go for a walk on the beach.  After only a few minutes on the beach we were bombarded by young Ghanaian men wanting to meet the “white girls”. Three of them introduced themselves and walked down the beach with us to the fishing village of Teshie.  We wanted to get a closer look at the many huge canoes we had seen many times out fishing in the ocean. There was one guy named Eric (his American name I’m sure) and he had lots of questions for us.  After we walked to the boats and back to the hotel we were ready for dinner.  We said goodbye and promised Eric we would come back and visit his shop when the other students arrive.  We had another great dinner at the hotel then took a taxi back to the mission house. Kim tried to get in the shower, but there was no water. We suddenly realized that we never asked Emily to show us how to pump the water.  Once again we put our heads together and figured it out! We each had a shower and then collapsed into our beds.  David was supposed to pick us up the next morning at 9 to go to the National Museum….but we’ve already learned that David’s time and our time aren’t always the same.

Day Fourteen

We got up and got ready to head into Accra.  When David hadn’t arrived by 9:30am we decided to call him.  He told us to go to the hospital and speak to Selassie and Tina then he would come get us.  We weren’t sure what that was about, but we headed off to the hospital.  When we got there they told us that the car was for the hospital and only available for students for pick-up and drop-off at the airport and emergencies. We were surprised because we had been told that David was our assigned driver and that they didn’t like for us to use taxis.  We apologized for the misunderstanding and went to the front of the hospital to get a taxi to the museum.  We arrived to the museum around 10:30am.  It was very interesting and I enjoyed learning about Ghana’s history! We spent about an hour in the museum (it is fairly small) then ventured outside to the craft shop.  After looking around there and purchasing a few small art prints we decided to eat lunch at the outdoor restaurant on the museum grounds.  It was really good! We had a chicken stirfry that tasted very similar to chinese food. After lunch we decided to just walk around Accra and take in the scenery.  Not far down the road we stopped at a gas station that had an ATM because we were both running low on cash.  I got some money out without any problem, but when Kim attempted to take some out the ATM “detained” her card!! She called the bank that was listed on the ATM and long-story short, the man said someone would come around 3pm to get the card out and she could go to the bank and show identification and get it back.  While she was on the phone, I went to change my SIM card on my phone and found that my U.S. SIM card had slipped out of  the case and was missing….not a good day for cards! I called Mom and she called AT&T and had the SIM card shut off and they are sending a new one to the house.  At least no one will be able to use the old one if they find it!! With our problems handled as well as we possibly could from another continent, we set off for the Accra Mall.  The taxi driver got lost and we got stuck in traffic, but we finally made it.  The mall was very, very nice! It has been open for less than a year! We shopped a little (we were excited they had a bookstore….we are both on our last book and still have 2 weeks left), ate dinner, and had some awesome pistachio ice cream from Frankie’s for dessert.  Kim’s dad called to let her know that due to a bank error when they were putting a note in the computer about her travel to Africa, her card had actually been turned off before we ever left the states.  So we decided not to go to the bank to pick up a card that wasn’t going to work. After dinner we went upstairs to the cinema.  We went to see Australia and it was a fabulous movie!! When the movie was over we went out front and got a taxi back to Manna.  We went to bed as soon as we had showered and written in our journals….we were exhausted!!

Day Fifteen

Today we did clinic at the hospital.  It was actually quite slow! We were all also very tired (even Dr. Akosua).  Tonight we are just going to chill at the mission house and read!  We are working tomorrow so we need to get some rest.  We are planning to go back to the mall after work tomorrow.  We might see another movie and there is a large grocery store too and we need to get some things.  The internet isn’t working great today so I will have to fill in the gaps in this blog and put up some more pictures on Monday! I love and miss everyone!

Day Thirteen

Day Twelve Part Two 

After our shift yesterday we decided to go over to the Labadie Hotel and have dinner.  While we were at the house waiting for David to arrive, Selassi called us to tell us there was a doctors’ meeting going on and they wanted us to join them. So we quickly put our scrubs back on and walked over to the hospital.  It was interesting to hear them discuss the frequent problems they see in the hospital and possible ways to go about education the population and possibly working on prevention.  Sitting in on the meeting also made Kim and I quite confused about the medical education process here in Ghana…we will have to investigate that more! After the meeting, David picked us up at the house and took us to Labadie Hotel.  We were disappointed to find the gift shop was completely over-priced, but we did buy a few postcards and small items.  Then we headed to the outside restaurant for dinner overlooking the pool.  I had an amazing Ghanaian spiced chicken kabob and fried rice….it is the one in the picture above…very impressive. It was very good and once again Kim and I were quite hungry after skipping lunch again. We even shared a brownie with ice cream and toffee sauce for dessert. YUM!! We tried to walk down to the beach after dinner, but stopped by security guards and told the beach was for residents only. So we called David to come pick us up and waited for him in the lobby.  On the way home we bought MTN credits for our cell phones while we were waiting in traffic.  The people walking amongst the traffic selling their goods makes it very easy to accomplish “errands” while you are sitting in traffic!

Day Thirteen

I didn’t sleep well last night for some reason….lots of tossing and turning! So it was very hard to wake up this morning.  I started my morning at the hospital with about an hour of research for my malaria presentation because Dr. Akosua was running late.  We found out when she arrived that her 2 year old son is sick. Clinic this morning was good.  We saw two newborn exams, a woman with a probable CVA that left her with a very frustrating expressive aphasia, and we even had Junior as a patient in clinic today.  He has malaria. After seeing all our clinic patients we walked over to the male ward to check on a patient that was admitted yesterday in sickle cell crisis and our patient from Monday with the head laceration. We looked at an x-ray of the trauma patients head and today it appears that he has a small epidural bleed so he will need to be transferred so that he can get a CT scan. We finished our day a little early so that Dr. Akosua could check on her little boy.  She is off tomorrow so we are going to take the day off as well then work with her on Saturday.  Right now we are planning to visit the National Museum in downtown Accra tomorrow! Love and miss everyone!! P.S. I added some pictures to the first blog or two b/c the computer is working very well today!

Day Twelve

Last night Junior ended up dropping us off at Coco Beach Hotel (a Ramada Inn) for dinner.  It is very near the hospital….we didn’t even realize we were that close to the water! Kim and I had quite the romantic dinner!! The tables were on a small balcony area overlooking the water.  We ate a wonderful meal with the sound of the waves crashing on the beach in the background.  I never imagined our dinners in Africa would be like this…especially after our adventure with the oven on our first night! After dinner we just sat and enjoyed the view for a while then took a taxi back to the mission house.  The taxi driver (Solomon) told us he lived right by Manna and even gave us his cell phone number and told us to call him day or night and he would drive us.  That may come in quite handy!! When we got to the house, the light in our room wasn’t working so we had to do everything in there by flashlight.  Because it was dark, Kim fell asleep around 8:15.  I showered and read a book by flashlight.  Then my cell phone rang and I was so excited because I thought my mom had gotten the phone card to work, but it turns out she was calling to tell me she couldn’t make it work.  For some reason she can’t get it to go through…so sorry for the hope that maybe you guys could call me…..if someone figures it out please let everyone else know!

Day Twelve

Today so far has been the same as all our other days at the hospital….devotion then clinic.  We actually didn’t see any malaria today! Just hypertension, diabetes, Staph infections…..pretty similar to clinic at home.  I’m not sure what Kim and I are going to do this afternoon, but I’m sure we’ll find something to entertain us.  We will be excited when the other students arrive on the 3rd. Again I love and miss everyone very much!!

Day Eight Part Two, Day Nine, Day Ten, Day Eleven….this might be really long!!

Day Eight Part Two (Friday)

So Friday night was very relaxed.  The four of us hung out at the mission house and played UNO and Phase Ten Dice.  It was a nice change from all the venturing out we have been doing and we really enjoyed each other’s company! Emily told us that students aren’t usually expected to work on Saturdays and Kaitlyn had decided not to go see any surgeries so she had made plans for all of us to go to Aburi to the botanical gardens on Satruday.

Day Nine (Saturday)

So Saturday morning Kim and I got up and got ready then walked over to the hospital to tell Dr. Akosua that we wouldn’t be working.  We weren’t able to find her and waited outside her consultation room for about 30 mins before we finally gave up and walked back to the house.  David arrived around 9:30am to take us to Aburi.  We had to run some errands in town first though. We had to go back to the leather store, Vadek, and pick up something for Emily’s mom.  It was a little crazy b/c the store owner wasn’t there and we had to call her and wait for her to arrive.  In the meantime we went to the Forex Bureau and exchanged some money.  We finally picked up the items for Emily’s mother then we were on our way! While we were driving, David told us his family lives in the city of Akusombo which is just beyond Aburi so we decided to go there first and meet his family.  It took us several hours to get there, but there was lots to see along the way.  We saw monkeys (like the one in The Lion King with the blue and red on him!!) just chillin on the side of the road!! We weren’t able to get any pictures because we were driving too fast. (Speed limits here are just a suggestion apparently!) We also stopped and bought some mangos from a lady on the side of the road….they have so much amazing fresh fruit here! We also bought some plantain chips from a lady on the side of the road…..they were sooooo good.  I am going to have to buy a few bags of those to bring home! When we arrived in Akusombo at David’s home we met his father, Charles, and his youngest brother.  His dad had minerals (that is what they call soda) for each of us and we relaxed in his living room while we drank them and got to know each other.  When we were done we piled in the car (literally….six of us in a tiny car) and he showed us the Volta Lake and dam.  He also showed us the shipyard where he works.  They use the lake to run cargo from north Ghana to south Ghana.  It was very interesting and Charles was a great tour guide! After we dropped Charles off at his home we headed to Aburi.  We arrived at the botanical gardens around 5pm and by then we were starving because we skipped lunch! We walked around the gardens for a while.  They were absolutely beautiful! I found it odd that there was an old, rusted helicopter right in the middle of the botanical gardens, but we had a great time climbing around in it and making pictures.  We concluded our tour of the gardens with a trip to the restaurant.  I had grilled chicken and french fries….I’ve never been so happy to have good food!! We made a quick stop at the gift shop on our way out and Emily did a great job negotiating a good price on an African drum. (We are getting better at bargaining every day!) On our way home we stopped at Koala to get a few groceries and for Kaitlyn and Emily to get some Ghanaian chocolate to take home.  When we got home, Kim went to bed and I spent a few hours hanging out with Kaitlyn and Emily while they packed.  It took all of us to figure out how Emily was going to pack her drum in a way that it would make it home intact. The girls also modeled the dresses Gilbert’s wife made them for me.  They are very cute and Kim and I are going to see if we can have her make some for us before we leave.  That would definitely be a one-of-a-kind souveneir!

Day Ten (Sunday)

Sunday was Kaitlyn and Emily’s last day. We went to the first church service again and Kaitlyn and Emily sang during the offering.  The have beautiful voices!! They were asked to sing again at the beginning of second service so we went back to the house during sunday school then went back for them to sing at second service.  Afterwards, we headed to the Labodie Beach Hotel to spend the afternoon by the pool. Daniel, a guy Emily knows from when she lived here, came by the house to say hello right as we were leaving so he helped us get a taxi and negotiate a good price for our ride to the hotel.  We had to take a taxi because everyone was still in church.  It only cost us 4 cedis for the trip which wasn’t bad at all. When we got to the hotel we paid our 10 cedis  to swim (the non-hotel gues fee).  It was a very nice pool!! We spent the afternoon reading, relaxing, and swimming.  We all actually got some sun today, because we finally got to lay out before 2pm. I am excited about the chance to go home with a tan in February!! I didn’t think lounging by the beach and pool would be a part of our trip to Africa….but I’m very glad it is!! I also acquired my third mosquito bite while we were at the pool.  They must really like me…I have three bites and Kim, Emily, and Kaitlyn have none. (It must be because I’m so sweet!) When we got home, Kim and I played Phase Ten and ate some soup for dinner while Kaitlyn and Emily went to say goodbye to Junior and Linda.  When they got home we played a few last hands of UNO before David arrived to take them to the airport. We were very sad to see them leave….the house will be so quiet and empty without them, but I am so glad we met them and were able to spend the week with them.  Our time here wouldn’t have been nearly as fun if they hadn’t been here!! After they left Kim and I decided to move our stuff downstairs into their old room.  It will be easier for us to only have to use one level of the house, plus the shower in the downstairs bathroom is better! So after we got settled into our new room we cut up some mango and pineapple for breakfast on Monday then hit the sack!

Day Eleven (Monday)

It is always hard to get out of the bed on Mondays and it is no different here in Africa! It was nice waking up in our new room though.  My bed downstairs is much more comfortable than the one I was sleeping on upstairs.  We started our morning in clinic with Dr. Akosua.  After seeing a few patients we were told there was an emergency that just came in so we went to check it out.  It was a young man who was struck by a car and had a laceration on the back of his head. Kim and I watched as they assessed him, cleaned the wound, then sutured it closed.  I always find it interesting to see how things are done here….I am learning so much!!! When the man was taken care of we went pack to clinic.  We saw a lot of kids today…..and you guys know that made me happy!! We made some pictures in clinic today, but I won’t be able to post them.  My large memory card is an SD high capacity card and the computer won’t recognize it.  I tried putting it into the camera that I have here that has a cord to the computer, but it is an old camera and won’t recognize the high capacity card either. I will have to share those with everyone when I get home.  Junior just came in and offered to take Kim and I to dinner!! Yay!! We enjoy spending time with him and Linda.  He also gave me some other exciting news…..we can receive calls for free on our Ghana cell phone numbers.  So for those of you who have been wanting to call here is how you can do that.  Just buy a calling card at wal-mart or somewhere and follow the directions on it. (you won’t get as many minutes as it says on the card b/c those are US calls not international…but it should be a decent rate) When you get to the part on the instructions about making an international call you will dial:

011-233-240578624

011 is the access code, 233 is the country code for Ghana, then the rest is my cell number

I hope everyone is doing well and I miss you all very much!!!

Day Eight

Today was another really good day! We started working with Dr. Akosua today.  We shadowed her in clinic and she explained a lot of things to us.  We did clinic until about 1:45pm then we went to the doctor’s “lounge” and reviewed the things we studied yesterday about DKA.  The shift ended at 2pm and we are done for the day. I don’t know what the plans are for this afternoon, but knowing Emily, I am sure there are plans to do something. The clinic here runs 6 days a week so we will be back in the morning to work with Dr. Akosua in the clinic again.  All surgeries here, except c-sections, are done on Saturdays so Kaitlyn and Emily will be here in the morning too because they want to see some surgeries before they leave.  We are really going to miss those two when they are gone!!

Day Seven…a day late!

Well to pick up where I left off from day six…..we left the hospital and all went to the La Palm Royal Beach Hotel for lunch and swimming.  We paid 10 cedis to use the pool, but it was absolutely beautiful.  (there were big lizards all over the place, but they didn’t bother anyone) We enjoyed just relaxing, swimming, eating by the pool, and reading.  We bought some gifts in the gift shop and I was excited to see an ATM.  We needed to change money for several days, but hadn’t been able to get to an exchange bureau before they closed.  We called David to pick us up around 5:30 and headed back to the mission house.  When we got back Junior was there playing basketball so Kaitlyn, Kim, Emily, Andrew, Junior, and myself played a game of HORSE until it got dark.  Then we went inside and prepared dinner.  We all ate leftovers….Izzy and Andrew were glad we had leftover pasta for them, becasue they hadn’t had time to go to the store plus they were leaving the next day to work on a ship for 10 days so they wouldn’t need the food. After dinner we all played a couple hands of UNO and some Phase Ten Dice.  We had a ton of fun!! We had forgotten how much fun card games are.  So now on to day seven.  The water truck came at 4:30a.m.  It woke us up, but we were glad to have water again! When we got to the hospital, the ladies in the office (Selassi and Ernestina) had an assignment for us from Dr. Akosua.  We were excited to have something to do that was similar to what we do as medical students back home.  We researched DKA so we would be ready to present it to her on Friday.  We went to the male ward and followed up on the patient we admitted yesterday in DKA. After that I went back to the pharmacy to continue the project we started on Monday.  We took a short break for lunch in the hospital canteen.  We have been wanting to try some local food so we had Jolof rice (a spicy rice) for lunch.  It was pretty good! I went back to the pharmacy until the end of the shift at 2pm.  We went back to the house and changed into our swimsuits and headed to Labodie beach.  It is very close by and inexpensive to get in….it cost us 3 cedis.  Once we got settled into our chairs we were bombarded by vendors selling all kinds of things.  It was actually a little fun to have the shopping come to us…..like QVC but better. We stayed at the beach until about 5 then headed home.  Kaitlyn and Emily made pancakes for the four of us for dinner and we played some more UNO and Phase Ten Dice.  We are all really having a lot of fun spending time together!!

Day Six…sorry these titles aren’t more exciting! :)

Well I’ll start by catching everyone up on the events of last night.  We experienced power outages for the first time last night.  They say it happens fairly regularly but it was only out for about 10 minutes both times last night.  It happened again this morning a few times too.  The new students arrived last night.  I got up about 11pm to get some water and found them downstairs checking the place out.  It is a guy and a girl.  They are 4th year med students from Virginia. I introduced myself and chatted for a little while before going back to bed. When we woke up this morning the water wasn’t working.  We found out that water is delivered to large tanks at each house and the water has to be pumped into a smaller tank for heating.  Apparently the pump has to be turned on occassionally to move water into the tank and it hadn’t been done at the mission house since we arrived. So it had to be turned on this morning so we could have running water again.  Thankfully, I showered last night before going to bed!! We got a bit of a late start because Emily had to help with the water situation and Kim needed to shower, but we got to the hospital around 8:30. All four of us (the new students aren’t working today) went to the wards to see what was going on.  They were finishing up a c-section and had one other lady in labor.  We all got to spend time holding the new baby while they doctors were sewing up the mother after her c-section.  They don’t have to twist my arm very hard for me to stand around and hold babies. The second lady wasn’t dilating so they started her on oxytocin.  It could be a while before she delivers so we went in search of something else to do.  Kim and Kaitlyn went to the lab and reviewed smears and stuff with the lab techs.  Emily and I went to see what was going on with a patient we heard vomiting in the treatment room.  I was so glad we went looking…..it turned out he was a Type I diabetic and was possibly in DKA (diabetic ketoacidosis).  The doctor there explained to me how they treat DKA here.  At home they would go to the ICU for an insulin drip and rehydration, but here they don’t have IV pumps to titrate things. So this particular patient would be admitted, get aggressive rehydration, and sliding scale insulin. He had been compliant with his insulin at home so we knew he probably had some illness that exaccerbated his diabetes so we sent blood to the lab to check for malaria, typhoid, and a few other things.  We also sent urine to check for ketones. It is amazing how new and exciting it can be to treat something I’ve seen a million times at home.  I enjoy learning how they go about things here without all the high tech stuff we use in the states.  It is almost 1pm and we are leaving early today to go with Kaitlyn and Emily to a nearby beach hotel for lunch and maybe a dip in the pool.  We will be sad when they are gone.  We also have to take the new students into town to pick up some items.  We found out today that they will be leaving tomorrow to spend 10 days on a boat doing some rural medicine.  They aren’t here through INMED and really won’t be working much here at the hospital.  I was wondering what they were going to do with so many medical students.  There are 4 more students coming in two weeks, but they are from UVA as well and will be doing the same thing as the other students. Well we are off to change before leaving for La Palm Hotel.  I miss and love everyone very much!!

Day Five

Our second day in the hospital began just like the first, with devotion.  Then Dr. Ablorh told us he wanted to take us over to the wards and introduce us to one of the doctors there.  He assigned us each a patient and asked to review their chart and be prepared to present them later today.  Kim and I were excited because that is a little more what we were expecting to do than working in the lab or pharmacy. When we finished reviewing our charts we went to present to Dr. Ablorh, but he was in a meeting so we went back to the wards to see what was going on.   We got to see our first delivery!! It is quite different than in the U.S. as we expected.  Surprisingly it was much quieter despite no option for an epidural.  It seemed much more natural and less painful (even without the epidural) than what I’ve seen at home. The baby girl was beautiful and if I can make it work I will post a picture of Kim holding her. Now we are waiting for Dr. Ablorh to be available, checking our email, and watching the Obama inauguration frenzy on the television (the first tv we’ve seen since we got here!). We don’t have any big plans for tonight, but we are curious about the new students that are supposed to be arriving tonight!