Kristi Goes to Ghana

Back to Life in Springfield

I made it home safely and am already half way through a week of school in Springfield!  It is hard to believe that only one week ago I was sitting in a small room in the village of Sobiba (not to be confused with Saboba) administering vaccinations and vitamin A in 100+ degrees!  I enjoyed my time in Ghana so much and I have loved telling people about my experiences there.  Even though I am home am unpacked (for the most part) a big part of me wishes that I had more time to spend in Ghana.  I definitely left a piece of my heart there, and I cannot wait to return.  I am hopeful that I can design an elective during residency and make it back to the Saboba area in 2012.  For now, I will have to be content with texts, emails and phone calls with the friends I made while I was there.

There is so much beauty and kindness in Ghana, and I hope that I can continue to experience, first hand, all that the country offers for a long time to come. 

I wanted to upload photos to this site, but it is easier said than done.  I have put all of my pictures online at Shutterfly, and invite everyone to view them.  I tried to title the photos to explain what the picture is of, but if you have any questions, just ask!  I would be more than happy to sit down and go through the photos one by one, explaining everything about the photograph. 

Shutterfly photos:  http://share.shutterfly.com/action/welcome?sid=0AaNWjlo3aN2TzA

It is nice to be back to familarity and the comforts of life in America, but I know I will be missing the Ghanian people and culture for a long time to come.

I’m Ghana be home soon!

Feb 25-28

Traveling!  I stayed in Tamale the 25th and caught an early flight to Accra on the 26th.  I am currently in Agape Guesthouse in Accra passing time until my international flight leaves tomorrow (27th) evening.  The guesthouse has wi-fi, so I am in heaven!  :)  I had a really wonderful time in Saboba and met so many kind and amazing people.   I saw more of Ghana than many Ghanians ever do, and I loved all of it!  It truly is a place of beauty and I hope I will be able to return.  In the meantime, I am hoping for safe and timely flights on my way home,and am excited to see family and friends! 

Feb 24

Today I went on an outreach!  I went with 2 nurses to the neighboring village of Sobiba. The purpose of this visit was to see how the 4 community volunteers are doing and observe them educating the people of the village and weighing the children, in addition to administering immunizations.  For the first portion, the community volunteers took turns teaching the people about diarrhea causes and treatment and proper nutrition/what to feed children of different ages.

After that, the weighing of children began.  A hanging scale was hung from the center of the small room we were in, and children were stripped naked and put in a cloth made to suspend them from the scale.  The cloth is basically a large pair of underpants with a long loop/strap attached to suspend the child.  Most women brought their own suspension cloths, in a variety of prints and colors!  After being weighed, the community volunteers record the weight in each child’s health record book and figure their weight percentile.  Then, the record books were passed along to the nurses and me and we looked to see if they were due for any immunizations or vitamin A.  Because vitamin A deficiency is a problem here, children receive supplements every 6 months starting at 6 months old and ending when they turn 5.

When the day began, there were only about 20-25 women present, but by 1230, we had seen around 100 children!  It was great for me to see all the children and get to play with and hold a few.  Most seem to like me, but a few are afraid of me because of my white skin.

After finishing up with the outreach, I headed over to the PHC to give my presentation.  All of the medical staff had been invited to my presentation, and many showed up!  I gave a brief presentation on the importance of patient education and then taught them how to sterilize water using plastic bottles and the sun!  Dr. Jean had mentioned this in a meeting my first week here, and I was so interested!  There is a website, SODIS, with information, instructions and research on how you can sterilize water without chemicals or boiling.  This is great for people in Ghana, especially those in small villages without access to wood or charcoal for fires.  Everyone seemed really receptive and had a lot of questions about the process.  My hope is that nurses on the wards can teach patients, especially those transmitted by dirty water, how to sterilize their water with this method.  I had also talked with Joshua about this, and he is going to incorporate it into the outreach trips to the villages!  This could make such a big impact on the lives and health of people in Ghana. There are some setbacks to the method, such as access to clear bottles, and the fact that bottles must be less than 3 liters, but hopefully they won’t deter people from utilizing this method.

My hope is to keep in touch with Joshua to follow up on how he feels the project is going.  Then, if I come back to Ghana, I can visit and see first hand how often it is utilized and how successful it is.  If all goes well, maybe the Italian-Ghanian Project can incorporate this into their outreaches as well!  I wish I had given the presentation at the beginning of my stay, so that I could have seen it put in action and be available to help answer questions and educate more staff how to teach the method. 

I think this is where I left off last time…

Feb 23

This morning I was in the records department and I spent the afternoon in the injection/dressing room.  After things wound up there, I went to see the River Oti.  This is the river that separates Ghana from Togo. Last week I had someone offer to take me to the river and cross into Togo. I decided to check with Dr. Jean and Bob on that, because it is a different country, and they advised against entering another country without permission!  So today, we just went and visited the river, without crossing!

It was so beautiful and it was interesting to see how high the river gets during rainy season.  Often, toward the end of dry season, people can wade across the whole river!  The river is unusually high for this late in dry season, and would have been impossible to wade across.  There were people on the Togo side washing their clothes and laying them out to dry on large rocks.  There were also a couple of canoes taking people from one side to the other for a small fee.  There used to be many crocodiles in the river, and allegedly there still are as some people come to the hospital with tetanus from crocodile bites, but we didn’t see any!

After returning from the river, I went over to meet David’s family and see his home.  It was a nice social visit and I was glad to meet 2 of his 3 children, even though his youngest was afraid of me!  Christopher is 14 months old and when I held him in my lap, he tried so hard to get down was not happy!  It is amazing to me that the small round clay homes that look so small and simple look so modern inside.  His home has electricity in all of the rooms and different round dwellings are different “rooms” of the house, with a common area outside connecting them all.

Feb 19-22

Extra long weekend!  The Buffalo team had to head back to Tamale to catch their flight to Accra early Saturday morning, so we all left early Friday morning.  When we arrived in Tamale, we went souvenir shopping!  We found lots of great stuff at Colwod, the place where Dr. Jean got me the dress.  We also went to the “Culture Center” which is basically a bunch of shops selling souvenirs!  I got lots of great stuff and had JK help me do some bargaining!

After getting back from our shopping (and sweating!) we hung out at the “Jungle Bar” at the guest house we were staying at and some of us enjoyed some Ghanian beer- Star, not too bad!  It was sad to say goodbye to the team, as I really bonded with them.  After they were on their way, the rest of the weekend was spent relaxing.

Dr. Jean was worn out from all of the surgeries and chaos of the week, so we spent the rest of the weekend at the guest house reading and catching up on sleep.  It was very hot though, and the power was off all day Saturday, which meant no fans either!  Yuck!  Sunday we went to a Catholic Mass at Mt. Caramel, which was a beautiful church!  I was glad Dr. Jean and Bob didn’t mind taking me to a Catholic mass; the familiarity was comforting!

Monday morning Dr. Jean and I attended a surgical meeting at Tamale Teaching Hospital.  It was similar to a Grand Rounds presentation, in that it was just a lecture on a previously chosen topic.  It was interesting to see the teaching hospital and meet some of the faculty/doctors that work there.  After running a few errands in Tamale, we made it back to Saboba. 

Once back, I had a wonderful chat with Joshua, the Primary Health Care Coordinator about general health in the area and the different interventions they have implemented to improve health in the region.  I also talked to him about solar sterilization of water, and he is willing to try to add it to the education they deliver on their outreach trips to smaller villages!  I am very excited about that and plan to work hard the next couple of days to organize the information and teach some people here in Saboba how to sterilize water with sunlight!  Something I can do to significantly impact lives and health of the people here!  Wednesday I am going on one of the outreach trips- I am so excited!  More on that to come…

Feb 18

“Africa to me is a place like no other, a place of friendliness, struggle, poverty, corruption and beauty.  The positives and negatives leave me strong impressions and an equally strong desire to return.”
-Lynn

That is a quote I read while learning about the Italian-Ghanian Project (IGP) that really stuck with me.  It really describes how I feel about Ghana!  The combination of that quote and learning about the IGP made me start planning my next trip!  The IGP is an outreach project that is based out of Saboba in which people from all over the world, not just Italy, come to Saboba and go on daily outreach trips to the different small villages in the area to educate people and perform nursing care.  They teach the people of these small villages the importance of nutrition, keeping their living area clean, how to clean wounds and even train a “birth attendant” on normal labor and signs that a woman needs to be seen by a medical professional. 

To me, this sounds amazing.  This kind of project, going out into the villages and caring for and teaching the members of the community, is something I am very interested in.  And, the best part is, you don’t have to be in medicine to be a part of this group/outreach.  Which means, that anyone could come… including business professionals who currently reside in Chicago ;)  It is definitely something I plan to look into and hope to be able to participate in.

The rest of my day was spent in the Cashier’s office.  It turned out to be a great experience!  I was able to learn about Ghanian National Health Insurance and see how everything is billed.  To be insured in Ghana, it is about 10 cedis (7 dollars) for a year of coverage!  Not only that, but everything is covered!  Medications, labs, doctor visits, hospital stays, surgeries… EVERYTHING!  Coming from the United States with all of the health care insurance issues, it is amazing to me that a third world country is able to provide such comprehensive care for so little money!

And the heat goes on…

Feb 17

This morning I went with the MOCA team to visit one of the local schools.  When the MOCA team was here last April, they went to a school and donated money to help them build a new facility.  Today, as we pulled up, the children were all singing “MOCA Team, God bless you, MOCA Team, we love you, MOCA Team thank you” over and over.  It was so moving.  Then, all of the students lead the way from the old school building down a dirt path to the new school building. 

The new school was beautiful!  They had one of the members of the team, cut the ribbon to open the new school.  We got a tour of the classrooms, library and offices.  They didn’t have enough money to put aluminum roofs on the classrooms, so their roof is one thin layer of thatch, that definitely won’t hold up once rainy season comes!  After opening the new school, the children began singing again and dancing!  We joined in and had a great time.  The small children were so excited to be able to hold our hands and touch us. 

I had four girls around me, each holding a few fingers of each hand.  I don’t think I have ever had anyone be so happy to hold my hand!  They were quite a bit shorter than me, so I squatted down to be closer to their height and talk with them.  The sweet little girls, all squatted too, mimicking me!  It was adorable!  The children here are so unbelievably beautiful- all of them.  It was such a moving morning to see how much they all appreciated the team’s donations and us physically being there.  A couple members of the team stayed at the school the rest of the day, but the rest of us left, most to get to the surgeries.  I headed to the Pharmacy.

The Pharmacy, or Dispensary as it is called here, is a busy place!  Almost all patients seen at the OPD (outpatient center) are given multiple drugs (most often, something for malaria and acetaminophen!)  I was able to see how they dispense drugs and what the most commonly prescribed drugs are.  I even got to be a pharmacist!  I needed help giving the drugs to the patients and explaining how many and how often to take each of them (as most of the patients don’t speak English) but otherwise, I was pretty independent there! 

Overall, it was a great day, and I even got to watch “Up” again! I am definitely sweating a lot though- it was 122 today!  …Almost makes me miss all the snow in Illinois… almost

Feb 16

Today I stumbled upon a training session for community health workers(CHW)!  CHW’s are people from villages who have volunteered to be trained in certain aspects of health care so they can care for members of their community in the absence of medically trained professionals.  I had heard about CHW’s several times before I left for my trip and so I was very excited to find a training session.  I was able to sit in the session and learn the information as the volunteers were learning.  I even had one of the members answer all of my questions about the program!  The training session lasts 5 days, and they have about 5-6 training sessions per year.  The district is divided into sub-districts, and villages in the sub-district Saboba is in, come to Saboba for their training.  Once the training is complete, the trainees will be responsible for training other members of their community. 

There were about 20 people there, and only 3 of the workbook/textbooks available for learning.  Two men lead the lecture, emphasizing points on an easel and had to stop to translate to a tribal language (I think Konkumba or Twi- not sure which) for those who didn’t understand English.

The topic they focused on today was “Community Based Growth Promotion.”  The leaders discussed the importance of growth monitoring and growth promotion and went over everything several times so everyone would understand their responsibilities.  Everyone was broken into 3 groups to read sections from the textbook and answer questions, with one member of the group reading out loud, and then translating to whatever tribal language needed for those who didn’t know English.  Then the large group would resume and the leader would again go over everything, to make sure everything was understood by all. 

After a lunch break, they went over how to draw a community map.  When the training session is over, the volunteers will be responsible for drawing a map of their village, noting every house, school, church, bore hole, tree, latrine, road, etc!  Sounds like a lot of work, although, many of the villages are quite small.  After drawing the map, they are then going to be required to gather information about all of the members of the community so they can annotate their map with information about how many children under 2 are in each house, where newborns live, houses that have lost a child under 2 and houses where children are not growing well and at risk of malnutrition! 

Feb 15

As there were several new expatriates in Saboba, we began the morning by making rounds to the local chiefs, District Chief Executive and other important people for introductions.  As Dr. Jean went through introductions with the first Chief, whom I had met 2 weeks ago, he remarked that I am no longer a stranger but their daughter!  It was so great to hear that!  It made me feel even more welcome and at home in Saboba!  Definitely a great way to start my day!

By the time introductions were finished, it was after 11, and the team hadn’t begun any of the 3 surgeries we had scheduled for the day.  As Dr. Brar, Dr. Jean and Debbie headed into the theatre to begin the first surgery, Ellen, Gaggan, Cate and I began going through the 5 totes they had brought full of supplies!  They had brought all kinds of donations for the hospital, mostly medical, that needed to be sorted and counted.  We started sorting right away, but shortly after noon, we decided we wanted to go to Market Day and get some lunch!  The market was as busy as it had been my first time, but this time I had fellow Americans with me, and JK to help us bargain!  We all found some beautiful fabric to have dresses made and took some photos.  After we were covered in sweat and had our cloth in hand, we headed back to sorting. 

We finally finished all of the sorting/counting around 5:30.  Half of the team was still in the theatre, working on the second case of the day.  They finally finished and made it back to Dr. Jean and Bob’s place just before 8 for dinner!  They only preformed 2 surgeries, but for getting such a late start, and screening several more patients between surgeries, I think they did a great job!

Safari love it!

(So far I love it!)
Feb 13-14

Another great weekend in Ghana!  This weekend I met the MOCA (Mission Outreach and Community Assistance) team that arrived from Buffalo, NY and went to Mole National Park for a safari!  The trip there was LONG!  First, I travelled 2 hours with Bob to get from Saboba to meet the team in Tamale.  From Tamale, the trip was 4 hours and the roads were awful!  Our driver, JK, drove slowly and tried to avoid all of the bumps and corrugations on the dirt roads, but the van we were in was very old, with no shocks and no air conditioning!  We were VERY lucky that it rained the night before, so the roads were wet and not dusty.  Otherwise, by the time we arrived at Mole, we would have been hot, sweaty and covered in red dust!

The team from NY is great!  There is one ob/gyn doctor, Dr. Brar, and her daughter, Gaggan as well as two nurses, Ellen and Debbie and a nurses aid, Cate.  They are all so nice and welcomed me into their group!  It was so nice to be around people closer to me in age, similar to me in personality and from
America!  It definitely made the long, bumpy ride much better!

Mole was fantastic!  We took the two hour afternoon walking tour and had our own guide, complete with a gun to warn any animals that got too close or put us in danger.  We saw lots of antelope, birds, warthogs, monkeys, one crocodile and ONE elephant!  There are over 800 elephants in the park, but the park is so large and spread out, that the rest must have been deeper into the park.  Plus, because of the rain the night before, they didn’t need to travel to the watering hole for water.  At least we saw one!  The scenery was beautiful, but it was hot!  We were all covered in sweat when we finished the tour.  Luckily, Mole has a pool!  A few of us put our suits on and enjoyed the pool before dinner, and it was amazing!!  Dinner was very good too- we all had omo twu with groundnut soup, which was very good!

Sunday was a whirlwind!  We got up early to eat breakfast outside by the pool, looking at out the gorgeous scenery, and the watering hole with no elephants!  Then, it was back on the road.  The trip back to Saboba was quicker than the journey there, but despite leaving before 9am, it was 3:30 when we got back.  As soon as we walked in the door, Bob told us to rush over to the PHC, where there was a possible ruptured ectopic pregnancy to be seen!  We grabbed water and rushed back to the van.  When we arrived at the PHC, the situation had been resolved, and there was no ruptured ectopic, or acute abdomen.  However, there were 20-30 women who had been waiting to be seen by the team for possible surgeries!

I should explain; the main purpose of the team coming was to perform hysterectomies for women with vaginal prolapse, fibroids and uterine tumors.  Dr. Jean and I had seen/screened several of these patients to be evaluated by the team for possible surgical repair of their condition.  Because of all the snow on the East Coast, the team was a day late arriving, and thus a day behind schedule for evaluating patients/scheduling surgeries.  Women had been waiting all day to be seen by the American doctor.  We began screening patients right away, but were only able to see about 12 before it was past 7pm and we were all exhausted and starving.

To help expedite everything, I made a list of all the patients we did not have time to see, and organized them into groups to be seen in the next few days.  I went out with a translator to help explain to the women that not everyone could be seen, and when to come back.  As we were going through the list, you could see the disappointment on the women’s faces when they learned they had waited, and fasted (for possible surgery) all day for nothing.  It was heartbreaking, but most of the women just nodded and left to return again. 

One woman had a condition that could only be repaired with a hysterectomy but she wanted to have more children.  We explained to her husband that there was nothing we could do for her until she was finished having children.  The husband got VERY upset.  He was upset because they had been told to come and be seen by the team, only to wait all day to be told there was nothing that could be done.  I don’t blame him for being upset, as I am sure I would be too.  As he became more argumentative, I took a step back and let a couple of the health workers talk to him and reprimand him for behaving irrationally.  Then, Dr. Jean stepped in.  She must have heard the commotion, and came out control the man.  She got right up in this man’s face- more like his neck as Dr. Jean is not a tall woman, and began speaking in a calm, but very firm voice.  It was quite amusing to see her inches away from this man, looking up at him, putting him in his place!  He finally backed down and took his wife and left.  By the time we all made it back to the house, we were ready for food, showers and bed!

You’re Ghana Want to Read This…

Feb 9-12

This week has flown by!  Tuesday I spent at the hospital going on rounds and in the theatre with Dr. Jean.  Wednesday I checked up on some patients for Dr. Jean and then spent the day at the PHC (Primary Health Center) for antenatal day, where pregnant women from all over come to get their prenatal care.  Thursday I spent the morning on the wards and the afternoon in the laboratory and Friday I spent all day in the lab.  Here are a few interesting stories from the week:

Tuesday I went to the OR with Dr. Jean.  Our first surgery was for a woman with bilateral inguinal hernias.  When the patient was on the table, we noticed that she had un-healed horizontal incisions, symmetrically placed on either side of her abdomen medial to her iliac crests.  Wondering when and what these were from, we looked at her records and realized she had been operated on in October 2009, while Dr. Jean was back in the states, for bilateral inguinal hernias!  Dr. Jean was immediately upset; these incisions were in the wrong place and were not big enough to repair inguinal hernias, and the hernias were still present.  As we began the operation, it was unclear what the previous surgeon had done and obvious that he had no even visualized the hernias.  Dr. Jean was very upset that a Ghanian doctor operated on her patient, and didn’t seem to know what he was doing at all. 

After we finished with the first of the woman’s hernias, we moved to the second.  Halfway through the second hernia repair, I felt so hot!  I felt like my scrubs were soaked in sweat, I had sweat dripping down my face and it was difficult for me to breathe.  I was not too sure what was going on, because the OR has air-conditioning.  I tried to take some deep breaths and keep going, but I was a little worried I might faint!  I told doctor I wasn’t feeling well, and she had me sit and had one of the nurses give me some water.  I felt a little better sitting down, but still, something wasn’t right.  I remained sitting the rest of the surgery, and then doctor told me to just go back to the house, and even had Bob come pick me up, despite the hospital being a 5 minute walk back.  I guess I was just dehydrated, as I felt better later in the evening.  I am so glad that doctor was so kind about everything, and even told me how her first day working at another hospital in Ghana, she had to get IV fluids because she was so dehydrated!  …At least I was able to be rehydrated orally!

Most days on my walk to the hospital, there is a group of children walking to school.  They always stop and wave and we exchange hello’s.  I usually begin with “N doo pwaa” which means “Good morning.”  They respond by saying “Good morning,” in English and the girls usually give a little curtsy and the boys generally give a small bow.  They are so cute!  I think they are just starting to learn English, because they do not know much more than that.  I always offer to take their picture, which they all love!  When I show them the picture I have taken, I hear many giggles and see many smiles. :) It is a fun interaction.  After our exchanges yesterday morning, the group of about 10 children went along, skipping and running.  I tried to take a picture of them skipping away, but they saw me and all grouped together for another posed photo!  It was adorable!

The past day and a half I have spent most of my time in the laboratory.  I have learned how to do a Widal test for typhoid, blood grouping, Gimsea stains for malaria, testing for hemoglobins and clotting time, in addition to HIV screening, HCG (pregnancy), Hepatitis B and C.  All of these labs are preformed in a small room with 2 microscopes, a centrifuge and chemicals for tests.  They wash and re-use almost everything (not needles) and have very little waste.  In a room attached, they have 3 machines for other testing:  chemistries, blood counts (CBC) and CD4 counts. 

There is currently a 12 year old boy on the ward who tested positive for HIV.  For the past 2 days, the workers in the lab have been cleaning and trying to run labs to get his CD4 counts, but the CD4 machine is not working!  It is very frustrating for the workers, and me, as we are following manual instructions exactly and keep getting error messages.  We then look up the error codes in the manual and check everything it suggests, but it still isn’t working.  I am hopeful that the problem can be fixed.  It seems that the next nearest machine, in Tamale, is not working either.  The further away you send a sample, the more trouble it is because you have to drive it there on dirt roads full of pot-holes, goats, chickens, pedestrians and bicyclists! 

One final note, on the weather!  Saboba is very far north in Ghana, and is much warmer than the coastal town of Accra. Currently, daytime temperatures are over 100 daily, and most days over 110.  It is very dry here, so the heat isn’t usually too horrible, and it had been cooling down to the high 60’s/70’s at night.  With a temperature difference of over 40 degrees, the nights/early mornings had been seeming very cool- I even had goose bumps a few mornings!  Well, as it is getting later in February, the temperatures have not dropped as much in the evenings.  When I woke up this morning and checked the thermometer at 6:45am, it was already 84 degrees!  I can definitely tell that it is not cooling down as much, as I am no longer covering up at all to sleep and wake up warm/hot!

Weekend in Kumasi!

Feb 6-8

Weekend trip to Kumasi!  We left Saturday morning at 5:30 and didn’t arrive in Kumasi until 6pm!  We did make several stops on the way in Tamale, Kintampo and Sunyani for visiting with Dr. Jean and Bob’s friends and running errands.  We still drove for at least 8 hours though!  The roads are really poor, with lots of pot holes, broken down vehicles, bikers, pedestrians and speed bumps; plus, some of the roads are dirt. 

Our stop in Sunyani was to visit a friend of theirs who works for the Forestry Commission/Wildlife Division, Mr. Haizel.  Dr. Jean wanted to talk to him about possibly working with an American bicycle manufacturing company to form bike trails between Saboba and several of the surrounding smaller, rural communities.  Not only would this make biking safer for the people of these towns and visitors, but it could be a tourist attraction, bringing in tourists with money to help support the members of these communities.  Dr. Jean really does so much for the people here, not just in Saboba.  Mr. Haizel seemed very receptive to the idea, so hopefully it is something that will materialize! 

Kumasi is a town of about 2 million people, mostly of the Ashanti tribe, and is very different than Saboba.  It is much more urban, with more brick buildings and tin roofs than Saboba.  In Saboba most of the dwellings are small circular buildings made of clay with thatch roofs.

When we arrived in Kumasi, we ended up staying at Big Man’s for the night.  Sunday morning, we woke up and went to church with Big Man at the school where they are teaching girls skills such as sewing.  The church experience was very different from what I am used to, but I enjoyed it!  There was a lot of singing and dancing and Dr. Jean gave the sermon, with Big Man translating.  There was one particularly cute little boy, probably around 18 months old who was clapping along with everyone and dancing to the music, bending his little knees to the beat of the song.  In the middle of the service, he started scooting out into the center of the floor and he peed!  I thought it was pretty funny, and one of the pastors just wiped it up with a cloth and kept on preaching!  The building where the service was held was a small room that had a roof, cement floors and walls open to outside. 

After church, we went to Ghana National Culture Center and got lunch.  Dr. Jean and I took a tour of the museum which had a lot of artifacts from previous Kings and things taken from the British when they were in Ghana in the late 1800’s.  We then browsed all of the shops and I found a few souvenirs and a really neat acrylic painting for myself!  I had a really great time.

When we were finished there, we headed over to meet a couple of missionary friends of Dr. Jean and Bob at a Guesthouse.  The guesthouse was so beautiful!  It had tiled floors and great water pressure….these things are not common in Saboba!!  We had a lovely dinner there and chatted with LeAnn and Parker (the two missionary friends). 

Sunday night/Monday morning Bob got up around 1 to follow the Superbowl on his computer because the TV in the guesthouse didn’t have satellite.  He was really tired Monday morning!  It was nice to be informed of who won and how the game went

The end of my first week…

Feb 5

Today was the day of gifts!  This morning Dr. Jean took me to meet another Chief, and to welcome me to Saboba, he had someone catch me a guinea fowl.  Tradition here is that the native people like to feed/dine with visitors.  If it is inconvenient, then they give a gift of food so that you can dine later.  Not too sure how I feel about watching a couple men chase around the birds until they finally caught one.  Kind of made me sad, but, I’m sure I will eat it when it is prepared.  We will wait until next week to prepare it because tomorrow morning we are headed to Kumasi for the weekend. 

We leave tomorrow at 5:30am because it is a long drive (more than 6 hours) on dirt roads.  We will be there for the weekend, and head back Monday morning.  We have to leave early in the morning because you can’t drive in the dark because the dirt roads are filled with potholes and man-made speed bumps and there are no street lights!  I plan to take lots of Dramamine! 

The other gift I received was from Dr. Jean and Bob.  They had a traditional African dress made for me!  It is beautiful and I am excited to wear it to church on Sunday!  It was made at a place called Colwod in Tamale.  This place brings in women from prostitution and teaches them skills and gives them an opportunity to learn a trade and have a place to sell items to make money for their families.

The rest of the day I hung out on the Children/Men’s Ward helping admit new patients and perform injections/nursing duties.  I rounded with Dr. Jean this afternoon and saw a few surgical patients in follow-up or who may need surgery.  Then I went back to the ward to hang out with the nurses and help them with their duties.

On a sad note, a 52 year old man was brought in unconscious this morning and was thought to be unconscious from alcohol poisoning.  He was completely unresponsive to pain and Dr. Jean was concerned for possible meningitis.  We performed a LP and it turns out he had meningiococcal meningitis, and he passed away this afternoon.  It was sad to witness and his family is not wealthy, from far away, and they now have to figure out how to get the body back to his home town, or have him buried here in Saboba. 

Feb 4

Today was a great day in Saboba!  I am starting to feel more comfortable here with the culture and even the language!  This morning I rounded with Dr. Jean, then she had a morning meeting so I went to the Outpatient Area.  I spent the rest of the morning and early afternoon working with Frances, a medical professional (similar to a PA in the
US).  In just four hours or less we saw at least 25-30 patients! 

After leaving the outpatient center around 2pm, I went over to the Children’s Ward to help the nursing staff.  Again I helped give medications/injections and socialized.  I really like one of men working this afternoon- David.  He was very nice and chatted with me about Saboba, the US and his upcoming trip to Italy!

Now, for the two best parts of my day-

As I was walking home from the hospital to the house for dinner, there was a group of 3 girls, ages around 3, 5, and 7. I smiled, waved to them and said “Good evening” in Konkumba (yes, I am learning some Konkumba! …Very little) And they responded and kept talking to me, which I didn’t understand, and the youngest one of the group came up and hugged my leg! It was such a great moment for me! I of course hugged her back and then she held my hand for a few moments while we smiled at each other and tried to communicate further, without success. That moment made me feel more welcome and liked here; a feeling that I hadn’t been receiving from most of the children. Dr. Jean says they are scared of me because I am white and give injections!

The second best part of the day was this evening.  Dr. Jean and I went out after dinner so she could introduce me to some more people.  While we were at a Pastor’s home, sitting outside chatting, his dog came up and I got to pet him!  It was so nice to be able to pet a dog again, as I have been missing Cohle a lot!  I wasn’t sure if it was a stray, or had diseases at first, but after Dr. Jean began to pet him, I knew it would be okay if I did too.  When I stopped petting him for a few moments, he even pushed my hand with his snout to get me to keep petting him, just like Cohle does!  :)  It was great!

My first two days in Saboba…

February 3

This morning I met a few more important people of the community I had yet to meet:  the Reagent and the Chief of Saboba.  After that, I headed to the hospital and started rounds with some of the other medical professionals while Dr. Jean ran some documents over to someone.  Rounding without Dr. Jean is not very educational for me because there are so many tribal languages that no one speaks English, so I had no idea what was going on.  When Dr. Jean is there, she has people translating to English, so then I know at least partially what is going on.  Dr. Jean arrived and we continued to round for a bit, but then she had to attend the Annual Performance Review for the District.

I went along with her for the first portion of the meeting which was very interesting.  I learned a lot about the different bodies that play a role in the health care system/public health in Ghana.  Saboba Medical Centre is the only hospital in the entire district which serves over 60,000 people, many of whom obviously have transportation issues in trying to reach the hospital.

Bob picked me up early from the meeting to go to “Market Days” with Augie (one of his housekeepers).  Market Days was so packed!  Every six days, people come in from all around to sell items that you either cannot normally get in Saboba or are very expensive.  There were people selling used clothes, cloth, all kinds of food, spices, shoes, garbage cans, cooking pots, toiletries… basically everything you need!  I got a few pictures of the crowds and all of the stands.

After that, I went back to the hospital to hang around and see how everything works.  Dr. Jean was still in the meeting (it lasted all day) and so I followed around a couple of the sisters (nurses) and asked questions, helped give medications/injections and tried to talk with some of the patients.  I really enjoyed it and feel like I am starting to understand how the system here works.  It is definitely different than the computerized HER that I am used to, but it is sufficient.  Unfortunately, none of the kids understand English, so I can’t communicate with them well.  Some of the kids are scared of me, I think because my skin is so much lighter; I actually made one child cry yesterday just by being in the room with him!  

February 2

Today was my first official day in Saboba.  Saboba is a town of about 8,000 people.  There are mostly dirt roads and people everywhere walking and on bikes, motorbikes and a few “lories’- SUV/truck type vehicles. 

I spent the early part of the morning meeting some of the important people of the community and hospital system.  I then met up with Dr. Jean in the hospital for rounds.

The hospital is divided into two main sections:  children/men and women/birthing.  In addition there is a “Theatre”(OR)  portion in between the two main wards.  The hospital has cement floors and many beds in a large room for the children and the men are in smaller areas with 2-3 beds per section.  The women/birthing ward is similar to the children’s ward with many beds in one large room.

After we finished rounding, we went to the OR for surgeries.  Before starting surgeries, Dr. Jean saw patients in what seemed to me like a Surgical Clinic.  Doing post-op follow ups on patients and screening new patients for possible surgeries. 

In the OR this afternoon, we took a very large mass (12cm x 5cm) off the dorsum of a 16 year old boy’s right hand.  Since there is no pathology or way to determine what the mass was, we are unsure of his prognosis.  Dr. Jean tried to cut into it, and it was very firm and cartilage/bone like- suggesting a more malignant diagnosis.  However, we will just have to wait and see if he develops any further problems.  The next two surgeries were hernia repairs, which went smoothly.  After that we went back to the men’s ward to check on a particularly agitated patient who may have meningitis.  He had improved slightly from the morning, but still has a long way to come.

By the time we made it back to the house for dinner, I was famished!  I guess I wasn’t thinking when I left this morning, because I didn’t take any food/snacks, and we didn’t have time for a lunch break!  Don’t worry- I already have snacks in my bag for tomorrow!

Saboba Bound…

I have made it through all of the flights safely!  I did have a tiny snag in London going through security.  They saw something suspicious in my carry on and had to go through everything.  Turns out, a reflex hammer looks dangerous through X-ray!  They asked me for proof that I was a medical student, which I didn’t have.  I told them they could keep it/throw it away as they aren’t very expensive, but they ended up letting me take it.  I may just leave that here when I come home so as to avoid the hassle!

I arrived in Accra last night around 11:30pm (local time), which was over an hour later than scheduled due to a late departure.  Tom, who owns the Agape Guesthouse where I spent the night, and a friend of his.  They took me to the guesthouse, where I was able to take a “shower” and sleep for a few hours.  I definitely had some troule falling asleep as my time was all off and I had slept on/off through my flights.  I think I probably got around 3 hours of sleep there, but had to be up to leave for my in-country flight at 4:15!  I made that flight fine and it was a short ride- only 1.25hrs.  The plane was small and hot/humid without air, but I managed to snooze a bit.  I am sure glad I can fall asleep so easily!

When I arrived in Tamale, Dr. Jean had sent a friend of hers, JK, to pick me up and he brought me into town to meet Dr. Jean and her husband Bob.  We got some breakfast and then met the Regional Director of Medicine and the Head of Nursing.  We are currently at an internet cafe in Tamale.  Dr. Jean is trying to set up the net book I brought her for one of the local medical students.  After this, I think we are going to stop to get some medical supplies and exchange some money, then will head to Saboba.  I think the drive to Saboba is about 2 hours, and the roads are pretty rough.  I am excited to get there and see what the town is like!

Tamale is very interesting.  The look and feel of the town is very poor, but then, we are inside an Internet cafe with lots of computers, air conditioning and hardwood floors- something that looks like it could be found in the United States.  There are people on bikes everywhere, women carrying heavy bowls and items on their heads, goats wandering around and little huts and women cooking in huge pots on the side of the road.  So far, all of the roads I have been on have been paved, but I think that is unusal for most of the country.

I am hoping to keep everyone as up to date as possible.  I am definitely missing family and Peter quite a bit, but know that once I am in Saboba, I will have plenty to do to keep myself busy.