Julie Myhren’s Blog

Two more weeks have gone by already???

Another long overdue hello!!  Thank you for the emails and the posts–I am just now online for the first time in about a week and it has been so special to hear from home!

I don’t think I can possibly write a play-by-play post of the last 14 days (I am very sorry it’s been THAT long already!) so here are some highlights:

A DRUG HUNTING EXPEDITION: This past Tuesday, Jane, Yissah, and I set out in monsoon-type rain at 6:30 am to drive to Tamale.  The rain was so powerful that it woke me up at 4am and, for those of you who have experienced the roads of the developing world, you can just imagine how that affected our trip.  The drive took about an hour longer than we expected, in four wheel drive, and we almost got stuck a few times.  Jane drove like a champ, though! 

Jane and the other missionaries who live here full time were scheduled to leave for their annual conference in Cote d’Ivoire this Thursday, and Jane realized on Monday that we would run out of a few things while they were away.  So, unlike in the US where you call up the drug wholesaler or submit an electronic order, we spent twelve hours on Tuesday scouring Tamale for antacid tablets, antibiotics, and malaria medications.  (That’s not an entirely fair summary, because there was a plan and, as Jane explained, it is a much more straight forward process now than it used to be.  However, compared to drug ordering at home, that should give you some idea of how the process felt…)

We arrived in Tamale (still raining) around 10am and dropped Yissah off at the grocery store.  Then, Jane and I began the rounds to the government-run medical stores and Ghanaian pharmaceutical manufacturing offices.  Jane explained to me that the hospital used to purchase all medications that could not be made on site from wholesalers in Europe.  Drugs were ordered and shipped for about six months at a time and if something didn’t come in the shipment, well, they would just have to find a substitute or do without it for six more months.  Over the past several years, a few Ghanaian pharmacists have opened manufacturing plants in southern Ghana.  In order to make the hospital more sustainable and less dependent on supplies from abroad, Jane and the pharmacy team try to use medications made in Ghana whenever possible. At first, they thought the supply would be more reliable, but unfortunately, that is not always the case.  However, it is now possible to order drugs for shorter periods of time and to replace unavailable products with similar products within weeks instead of months.

So, back to Tamale (still raining…) Our first stop was at Medical Stores.  I didn’t realize that was actually the name of the place at first…  All drug purchases require filing with the Ghana Ministry of Health, so many of the wholesale offices are combined in one little compound called Medical Stores where you can walk between offices and get several items in one place… kind of like a drug store strip mall arranged in a horseshoe with warehouses at the far end.  Each purchase is entered in a government-issued ledger with 3 carbon copies–one for the buyer, one for the seller, and one that is submitted to the Ministry of Health.  While it is nice to have several sellers in one location, we still had to walk back and forth between offices (still raining) for the appropriate signatures: signature of the seller that he has our quantity of antacid tablets in stock at a specified price, signature of the accountant (on the other side of the courtyard) that we had paid by check, signature of the pharmacist on duty that we had received our boxes (back across the courtyard), signature from the warehouse (in the rain again), and signature of the watchman at the gate that we were leaving with the appropriate number of boxes.  Stop #1 complete!

From Medical Stores, we crossed Tamale to Ernest Chemicals, a company based out of Accra.   The process at Ernest was quite different: we handed the pharmacist on duty a list of what we needed, he checked off what was available, and then the packed it in big boxes while we sat in the office and chatted.  We left Ernest around 12 noon and Jane was impressed that we’d gotten so much accomplished already!  By noon, it was STILL pouring! 

We arranged to pick Yissah up for lunch and but had to move the boxes of drugs into the back of Jane’s truck, under a tarp, in order to fit Yissah in the truck with us… We had hoped the rain would let up, but no such luck.  We stopped at a diesel station to fill up and Jane asked the pump attendants if they’d be willing to help us–Ghanaian people, as I’ve shared before, are absolutely wonderful and they were happy to spread out the tarp and pack the drugs in the back under their overhang, although two of the men informed Jane that after they helped us, they would also be happy to marry her daughter (yeah, me).  Welcome to Ghana.

Finally, we collected Yissah, waded through four inches of water in the restaurant parking lot, and settled in for lunch.  (Jane and I just trudged through in our flipflops… poor Yissah took his shoes off, waded to the door, and put them back on…still pouring!)  By the time we finished lunch, the rain had slowed a bit.  We made the rest of our stops by about 3:30 and headed home, loaded down with drugs and groceries.  We had found everything we needed except for some blood-giving sets and the dextrose IV fluids Jane wanted to supplement the fluids we make ourselves.  In all, it was a productive day, but wow, what an experience!  I will never complain about calling Cardinal (one of the wholesalers we use at Walgreens) again!  It finally stopped raining around 3pm, but the road home was worse than the road going.  We got home just before 7pm and were all asleep by 9pm.  Mission accomplished!

EXPLORING PUBLIC HEALTH:  This past Friday, I ventured over to BMC’s Public Health complex for the morning to check things out and get a grand tour.  Mrs. Baba, the director, was employed as a midwife at BMC for several years and then studied public health in the US.  She is a talented, wonderful lady!  The public health branch of BMC handles immunizations, antenatal care, baby check ups, family planning, and most of the health education programs.  The facility is set up like a housing complex with round cement huts arranged around a courtyard, but painted white and blue with little gardens throughout.  After my orientation with Mrs. Baba, Agnes, one of the nurses, showed me around and explained how everything works.  Overall, I was extremely impressed with their system and with the programs that are available.

(Sorry to run, but if I don’t leave right now, I’ll be late for church! Stay tuned and I’ll finish this post later today!!!!)