Tuesday, August 19, 2008
August 9th Saturday: Last Day at Daboase and Donation of Land
Today we got to sleep in a little (9am) since today is a travel day. We are planning on heading up near Kumasi to the Asokore Mission Hospital, the last of our three locations. Asakore Hospital is located in the Ashanti region which is in central Ghana. For clarification, Kumasi is the capital of the Ashanti region and Asokore Hospital is a small village 45 minutes away from Kumasi. The morning before our journey was spent enjoying yet another amazingly large breakfast by our more than gracious hosts. We then walked up to the hospital to begin packing up the supplies we don’t plan on letting them keep. The workers are extremely helpful as they have been throughout our whole time here. We take our time talking with them as we pack up.
A few of us continue to linger behind after the family leaves; we take pictures and continue to talk with some of the locals in the area. Jill and I pick up a conversation with Enusu, the young boy who I was talking to the other day about my African name. As we talk with him, we start asking questions about school, assuming he is getting close to college age and unbeknownst to us, we stumble right into one of the saddest stories we have ever encountered. Enusu explained that he was not even in secondary school yet because he cannot afford to go. He wants to go very badly and has been saving money so he can go. He works at the hospital, where the doctor has taken him in, to earn money and receive some schooling from the facility. He has been taken in by the doctor because at the age of 12, he was orphaned- both of his parents died of “disease”. While we are not positive which disease, we are pretty confident that it was AIDS. He is the youngest in the family, but his
older brothers and sisters cannot take him in because they have their own families and cannot afford to feed/ cloth/shelter him. At this point we both want to cry our eyes out. Here is this young, sweet boy who has almost nothing- and sadly he is just one in a sea of children here in Africa who have the same story. We ask how much it costs to go to school for a year? We find out it only costs $50. Yes, that is correct, 50USD. At this point we are at a loss for words and are having increased difficulty remaining composed.
The morning wanes on and we are greeted back at the house by the rest of the locals. We have some spare moments and notice that the men have machetes- they are using
them to cut the grass!! We were told of this when we got here, but I didn’t think we would actually get to see it! They try to give lessons and even let us try! I passed on the offer because I was afraid I would become our first trauma patient of the trip, but Sean, Victor, and Tarek all tried it- and it was hilarious- definitely not as good as the locals!
Fizan is beckoned to the back of the hospital by the main doctor there. We step outside to see a family who has walked a distance with their two young, beautiful children. Both children, who are about 3 and 5, have cleft lips. The parents are hoping that we can operate on both of their children like we did with our other young patient. Since we are not operating today, we tell them through the translator that they need to go to Kumasi and wait for us there- we will perform t
he surgeries there for their boy and girl. We are very hopeful that they can make it in time, but also worry that the long trip might be too much for the family. The walk is too long, 6 hours driving, and they are not sure during our conversation whether they can get a ride. We tell them that if they get there, we will put them on the schedule. I do hope that they are able to make the long journey to see us at Asokore- these are the children that move you and remind you of all the good we are doing and how we can positively affect so many lives. So often people speak of their need for a greater or higher purpose in life, to give back, or to make an impact in the time they are here on earth; to the lives we have touched so far, we have done just that. I only hope that we can continue our mission at this same pace, and year after year, to really achieve the level of outreach and service we aim for.
he surgeries there for their boy and girl. We are very hopeful that they can make it in time, but also worry that the long trip might be too much for the family. The walk is too long, 6 hours driving, and they are not sure during our conversation whether they can get a ride. We tell them that if they get there, we will put them on the schedule. I do hope that they are able to make the long journey to see us at Asokore- these are the children that move you and remind you of all the good we are doing and how we can positively affect so many lives. So often people speak of their need for a greater or higher purpose in life, to give back, or to make an impact in the time they are here on earth; to the lives we have touched so far, we have done just that. I only hope that we can continue our mission at this same pace, and year after year, to really achieve the level of outreach and service we aim for. A few of us continue to linger behind after the family leaves; we take pictures and continue to talk with some of the locals in the area. Jill and I pick up a conversation with Enusu, the young boy who I was talking to the other day about my African name. As we talk with him, we start asking questions about school, assuming he is getting close to college age and unbeknownst to us, we stumble right into one of the saddest stories we have ever encountered. Enusu explained that he was not even in secondary school yet because he cannot afford to go. He wants to go very badly and has been saving money so he can go. He works at the hospital, where the doctor has taken him in, to earn money and receive some schooling from the facility. He has been taken in by the doctor because at the age of 12, he was orphaned- both of his parents died of “disease”. While we are not positive which disease, we are pretty confident that it was AIDS. He is the youngest in the family, but his
older brothers and sisters cannot take him in because they have their own families and cannot afford to feed/ cloth/shelter him. At this point we both want to cry our eyes out. Here is this young, sweet boy who has almost nothing- and sadly he is just one in a sea of children here in Africa who have the same story. We ask how much it costs to go to school for a year? We find out it only costs $50. Yes, that is correct, 50USD. At this point we are at a loss for words and are having increased difficulty remaining composed. As we head back into the hospital to help the others finish packing up, I encounter Jill sobbing in the OR. The story is just too much and we talk about it together and what we could possibly do for him. Helping him pay for his education seems like something we can do and would forever change his life for the better.
The morning wanes on and we are greeted back at the house by the rest of the locals. We have some spare moments and notice that the men have machetes- they are using
them to cut the grass!! We were told of this when we got here, but I didn’t think we would actually get to see it! They try to give lessons and even let us try! I passed on the offer because I was afraid I would become our first trauma patient of the trip, but Sean, Victor, and Tarek all tried it- and it was hilarious- definitely not as good as the locals! As we leave, Jill and I try to offer money to Enusu for his education, but learn from team members who have done this before, as well as the doctor there, that we do not give it to them directly- it should go to the doctor who will make sure the funds go 100% towards education. That certainly makes sense- I doubt when I was 16, I made the best decisions! We both gave the doctor money which covered the first 2 years of Enusu’s education. We both feel good about making the contribution; I hope I get the chance to go back and talk with him and see how he has progressed through school. It’s amazing how much he wanted to go to school and how hard he was working- makes me crazy how so many people here in the US don’t want to go to school, or don’t take it seriously- and that all of us get to go to school. It is amazing how much we take for granted in the US.
Also, here's a picture of our clef lip boy the day after surgery- he's so cute!
Team Daboase!
Lastly, a group led by Dr. Khan and Dr. Abdullah meet with the local tribal Chief to discuss the donation of land and a building, possibly for the use of a teaching center or TPN clinic. The discussions go well, local politics aside, and we are enthused about the donation and what it will mean to the locals, and the ongoing effort of outreach and education. Right now the building is not finished, but that is just as well- the rest of the building might cost $40,000USD, but think of what we can do with the money that will not need to go towards purchasing land and starting the building! Additional supplies, more education, larger classes! How wonderful! I do not pretend to have any part in orchestrating the meeting or even being a key player during the talks; I was just honored to be able to go along to the meeting and see the mission of building a TPN clinic to help save many of the children here in Ghana.
Lastly, a group led by Dr. Khan and Dr. Abdullah meet with the local tribal Chief to discuss the donation of land and a building, possibly for the use of a teaching center or TPN clinic. The discussions go well, local politics aside, and we are enthused about the donation and what it will mean to the locals, and the ongoing effort of outreach and education. Right now the building is not finished, but that is just as well- the rest of the building might cost $40,000USD, but think of what we can do with the money that will not need to go towards purchasing land and starting the building! Additional supplies, more education, larger classes! How wonderful! I do not pretend to have any part in orchestrating the meeting or even being a key player during the talks; I was just honored to be able to go along to the meeting and see the mission of building a TPN clinic to help save many of the children here in Ghana.
Saturday, August 16, 2008
August 8 Friday- Varied cases and my African name
Another late start to the day (8:30am) and we start right off the bat with more bugs in the operating room. Luckily we have brought the Raid from our sleeping quarters with us so we proceed to “clean” the OR of any remaining bugs. I guess at this point, true sterile technique is not really going to happen- especially since the room itself is not that clean and the patients often are not freshly showered (you can tell by the overwhelming body odor in the waiting area). Good thing we have brought our own supplies and a TON of Betadine and other microbicides to clean and sterilize the op site on the patient.
I did get my first stomach gurgle today so I started popping Cipro- bleck. Luckily my stomach was well enough by lunch to enjoy more fantastic mango- seriously the BEST I have ever had. While the typical fare is chicken, fish, and rice the fruit here is amazing- the plantains, mango, papaya, and pineapple are all the best I have ever had- sweet and juicy and actually picked RIPE (unlike here in the US). If I could, that is all I’d eat here! Unfortunately, the culture dictates that you have to take what is offered to you… and seeing that they cook sooo many dishes for us (typically 3 meat dishes a meal in addition to the rice, bread, etc…) I’m going to come home weighing more!
Today we operated on a 7 year old girl who had a giant lipoma (a benign tumor composed of fatty tissue) on her side. It was HUGE; about the size of a tennis ball. This is remarkable as most lipomas seen in t
he US are smaller (usually under 1cm and seen in adults) but as we have seen with the majority of patients, the progression of disease is so much greater here as they are unable to afford or even get to a location where they can be treated. It is so sad to see some of these patients- many of whom may not make it, where in the US; they would have a 90%+ chance of recovery.
he US are smaller (usually under 1cm and seen in adults) but as we have seen with the majority of patients, the progression of disease is so much greater here as they are unable to afford or even get to a location where they can be treated. It is so sad to see some of these patients- many of whom may not make it, where in the US; they would have a 90%+ chance of recovery. 
One such example is of a little girl whom we evaluated and sent on to Korle Bu. Her entire right left was swollen and she had lesions popping to the surface which typically indicates metastatic status. We suspected bone cancer and IF it is not metastatic, and they amputate her entire leg, she might have a chance of 
survival. We did not do this case as it was too advanced for the facilities at Daboase. We also operated on the child who had the cleft lip- which we were relieved to see that it was indeed only the lip so we were able to proceed with the surgery. We actually were so efficient that we ran out of sheets- like Korle Bu they air dry them and the ones they washed for us were still wet!! Well, at least that gave us a little break so we could grab a quick lunch (feast really) made by our wonderful hosts.
I was talking with Enusu, a 16 year old boy who worked at the hospital as well as some other locals and found out that my African name is Efiah (pronounced ih-FEE-ah) which means I was born on a Friday. The male version of the word is Kofi- which is why Kofi Annan was given that name- he too was born on a Friday- pretty cool. I like my African name, it is really pretty and the fact that they want to call me that is a sign of endearment and makes me smile.
survival. We did not do this case as it was too advanced for the facilities at Daboase. We also operated on the child who had the cleft lip- which we were relieved to see that it was indeed only the lip so we were able to proceed with the surgery. We actually were so efficient that we ran out of sheets- like Korle Bu they air dry them and the ones they washed for us were still wet!! Well, at least that gave us a little break so we could grab a quick lunch (feast really) made by our wonderful hosts.I was talking with Enusu, a 16 year old boy who worked at the hospital as well as some other locals and found out that my African name is Efiah (pronounced ih-FEE-ah) which means I was born on a Friday. The male version of the word is Kofi- which is why Kofi Annan was given that name- he too was born on a Friday- pretty cool. I like my African name, it is really pretty and the fact that they want to call me that is a sign of endearment and makes me smile.
Today was an exciting day all around- scrubbing in on so many interesting cases and making a real connection with some of the locals.
August 7 Thursday- More power issues and operating all day
Well, there was still no power in the morning (they had to turn it off again to reconnect things) so we were able to sleep in until 9am! WOW!! I took my second cold shower of the trip- it still felt good to be clean even if the water temperature was a shade above arctic. One would think that because it is so dang hot in Africa (and we are here during the cold season) that the water from the taps would be warm, but NOOOO, that is a very ill conceived notion indeed!
We were able to begin operating again around 11:30am and we were once again treated to the afternoon rains around 2:30pm. We were also treated to a mouse in the recovery room! I did not see it (thank goodness) but I was assured by the other ladies that they were able to get it outside. I did have a run in with a spider in the OR though. I was designated the stomping person and attempted to squish it before it made its way towards the patient we were operating on. I missed it, but someone did chronicle the excitement on their camera. He looks tiny in this picture (upper right corner), but trust me, he was about the size of 2 silver dollars- yuck.
A funny story for today. Fizan was examining a patient who had an inguinal hernia and he asked the patient to cough (in an attempt to get the hernia to pop out). Well, the patient did EXACTLY what was asked of him- he coughed right into Fizan’s face!! After we all stopped snickering (except Fizan of course) he modified his request to “TURN and cough”- that did the trick.
Here's a picture of one of our little patients waiting to be operated on; they were all so cute- scared and compliant- and so very trusting of us.
Today we stopped at 11pm as the other cases were larger and we didn’t want to run too far into the next day. We proceeded to have a large dinner served to us around 11:30pm. Looks like my proposed "Ghana weight loss plan" is not going to work after all….
Today we stopped at 11pm as the other cases were larger and we didn’t want to run too far into the next day. We proceeded to have a large dinner served to us around 11:30pm. Looks like my proposed "Ghana weight loss plan" is not going to work after all….August 6 Wednesday- Heading for Daboase and Elmina Fort
The day starts early with roosters that crow at all hours of the day- We leave at 7am and today we head for the most remote location, Daboase (pronounced Dah-bwah-zee) which is about 4 hours away from Accra and is more north in the Asante region of Ghana. I’ve been told that Sami, our driver, is a bit of a nut driving, but since he is the head driver at the Ministry of Health (and overseas all of the other drivers) I guess he is our best and safest bet. The group has been using him as our driver for the past 6 years and I’ve been told I’m in for a real “treat”…. Uh-oh. We are to pass through some jungle and I should expect a lot of bumpy dirt roads and cold showers.
<3+hours>
So yes, the roads we traveld are rather bumpy and I think I left an organ or two behind a few miles back- the roads are AWFUL!!! The ones that are paved (only a few) have pot holes that are more like sinkholes! Some of the holes take up an entire lane, leaving drivers to swerve into the other lane (and oncoming traffic) to avoid wrecking the car. Nothing like a forced game of chicken to get the old ticker pumping. After about 30 minutes I stopped looking out of the front window.
As we approach Daboase hospital I get beeped by my boss over the walkie talkie. I am asked whether or not I see the barren tree tops on the side of the road and in the jungle that is just past the road. “Why yes, I do”…. I quickly learn, and to my dismay that it is from BATS! They strip the trees. GOOD GRIEF. Bugs and bats…. Lovely. Apparently we are truly in the jungle and the bugs and bats are rather prevalent here. Oh how I love the fact that I packed 4 cans of OFF – which I have a feeling will be my new best friend during this trip! We did see a Megabug later in the evening which we called a Rhinobug. Not sure what it really was though...
We get word early on that there are several patients already waiting for us in Daboase. We know that there are a lot of hernias and a small boy who has a cleft lip. We are a little cautious as we hope it is only the lip that is cleft as we do not have the resources (machines etc…) to do a full palate- fingers crossed that the child is only cleft in the lip. I really hope that we can help him- we think kids are mean in the US- think how mean a culture can be when they think that you have a birth defect because of something you did or because you are cursed.
Before we head all the way to Daboase, we are told that a side trip is warranted and we must see Elmina Fort- one of the locations that housed
slaves before they came to America. The village we pass through is amazing- a fishing town it is, boats everywhere, men hand pulling in the nets they cast out the evening before, and as before, small, dirty homes stacked one on top of another.
Before we head all the way to Daboase, we are told that a side trip is warranted and we must see Elmina Fort- one of the locations that housed
slaves before they came to America. The village we pass through is amazing- a fishing town it is, boats everywhere, men hand pulling in the nets they cast out the evening before, and as before, small, dirty homes stacked one on top of another. 
I will spare you all the details of the tour of Elmina fort with the exception that it truly is sad and remarkable what the Portuguese, Dutch, British, and even other Africans did to the people of Africa; the abuses are beyond your worst nightmare. The women’s holding cell STILL had an odor that was overpowering and gagging- I cannot imagine the stench of this room centuries ago. T
he cell typically held over 300 women who were not able to shower for over 3 months at a time- leaving them to sit in their vomit, feces, menstrual blood, and decay. I did get a really interesting book that chronicles the history of Elmina, the Fort, and the slave trade in the region. Elmina was originally named for the gold in the area (El mina), but later the highest selling commodity were slaves.
he cell typically held over 300 women who were not able to shower for over 3 months at a time- leaving them to sit in their vomit, feces, menstrual blood, and decay. I did get a really interesting book that chronicles the history of Elmina, the Fort, and the slave trade in the region. Elmina was originally named for the gold in the area (El mina), but later the highest selling commodity were slaves. <3+hours>
So yes, the roads we traveld are rather bumpy and I think I left an organ or two behind a few miles back- the roads are AWFUL!!! The ones that are paved (only a few) have pot holes that are more like sinkholes! Some of the holes take up an entire lane, leaving drivers to swerve into the other lane (and oncoming traffic) to avoid wrecking the car. Nothing like a forced game of chicken to get the old ticker pumping. After about 30 minutes I stopped looking out of the front window.
As we approach Daboase hospital I get beeped by my boss over the walkie talkie. I am asked whether or not I see the barren tree tops on the side of the road and in the jungle that is just past the road. “Why yes, I do”…. I quickly learn, and to my dismay that it is from BATS! They strip the trees. GOOD GRIEF. Bugs and bats…. Lovely. Apparently we are truly in the jungle and the bugs and bats are rather prevalent here. Oh how I love the fact that I packed 4 cans of OFF – which I have a feeling will be my new best friend during this trip! We did see a Megabug later in the evening which we called a Rhinobug. Not sure what it really was though...
We get into Daboase and get settled and begin seeing patients. We see children with advanced lymphoma (we sent him to Korle Bu for a biopsy and chemo), undescended testes, cardiac arrhythmias, and lipoma- just to name a few. I think there are about 60 people waiting to see us. I'm not quite sure as everytime I go to check there seems to be more and more people waiting. I learn that some people learned ahead of time that we were coming and started walking days ago to come see us. Moving and heartbreaking at the same time.
As we proceed with the examinations and setting up our storage room for the supplies we will need for the surgeries, the power goes off. We are told that it happens often as the power supply is not consistent out in this region. GREAT. This might become a real issue as we begin to operate as we need light- obviously – and a power outage can have catastrophic consequences for a patient who is being operated on when the power goes off. So we decide this is a good time to have lunch (it’s 2:30pm at this point) and we meet Dr. Ahmed’s wife Amtul who is beautiful and sweet- and their 2 children are adorable. We learn that they have dedicated 5 years of their lives to serving this region/hospital- both Dr. Ahmed and Amtul are doctors and run the hospital by themselves with only a handful of extremely dedicated “nurses” and help (most are uneducated except for what they have been taught by the doctors).
As we finish up lunch- which was amazing- we learn that the reason the power is out is because a bamboo tree, somwhere in the jungle, has fallen across the power line and broken it. Luckily they were able to find the break quickly (which sometimes can take days) and they had already begun working on fixing the power line. It is interesting to note that the entire village of Daboase is served by this line so no one had any power. AND BOY DOES IT GET DARK OUT THERE! We did get to experience our first African rain around 3pm- the sound of the rain coming through the leaves and hitting the foliage of the jungle was really soothing. The rain cooled and cleaned everything- it was wonderful.
The power comes on around dinner time (6pm-ish) and we are able to perform some surgeries this evening. We are working 2 beds in the tiny OR which is about the size of 1 OR room in the US. As we are operating we also learn that we have no water!! How crazy is that! First the power, then the water. I have a feeling that we are in for some major challenges this trip. Well, the reason we have no water is because the water and power supply are fed by 1 line and so what they decide to do was to divert the ENTIRE area’s power for the water supply to us so we could have electricity so we could begin operating. This is one of the amazing sacrifices and examples of generosity that we will see on this trip by the people of Ghana.
Still, their generosity is not immune to the powers that be as we still lost power later on in the evening- and while we were operating. After an initial “Oh Crap” comment by just about everyone in the OR, we regroup
ed and worked in the dark for a while before the generator could kick in. Luckily Victor, our 4th year Resident, had a spelunking light with him and we were able to proceed. It is important to note that we were still without any other equipment that needed electricity so it was a little scary at times, hoping that the case would stay routine and therefore not need the extra equipment. We were more than overjoyed when the operation ended and all was well as our first and most important motto of the trip is ""First, do no harm" or "Primum non nocere". Hoping not to have to repeat that episode EVER, we finished up for the day around 12:40am (Thursday morning) and I think I was asleep before my head hit the pillow – and the fact that we were 3 to a bed in the ladies room- didn’t matter. This was to be the only time we were able to get to bed without a HUGE, late meal served by our gracious hosts.
ed and worked in the dark for a while before the generator could kick in. Luckily Victor, our 4th year Resident, had a spelunking light with him and we were able to proceed. It is important to note that we were still without any other equipment that needed electricity so it was a little scary at times, hoping that the case would stay routine and therefore not need the extra equipment. We were more than overjoyed when the operation ended and all was well as our first and most important motto of the trip is ""First, do no harm" or "Primum non nocere". Hoping not to have to repeat that episode EVER, we finished up for the day around 12:40am (Thursday morning) and I think I was asleep before my head hit the pillow – and the fact that we were 3 to a bed in the ladies room- didn’t matter. This was to be the only time we were able to get to bed without a HUGE, late meal served by our gracious hosts.Tuesday, August 5, 2008
August 5th Tuesday- Another senseless loss
I have not finished writing the blog for this day, but wanted you all to know that the TE fistula baby died this morning (the 5th) around 2am. She had not been fed since birth and basically starved to death.It saddens and angers me because this death is 100% preventable- it is the lack of emergent care from the initial hospital coupled with the lack of resources and TPN program that led to this child's senseless death; unfortunately she will not be the last to perish before this program is fully instituted. I have a heavy heart today but am emboldened in my effort to get the TPN program up and running. To see an example of the very thing we are trying to prevent has given me even more resolve than before.
This incident highlights once again the amazing potential that the TPN program can have- thank you all for supporting me with this effort.
August 4, 2008 Monday– Ride thru town, visit to Korle Bu Hospital, and visiting the Market
Today we had an earlier start (7:30am) with the same breakfast as before. We went to the Mission house to get more supplies to send ahead to Daboase and Kumasi as the van will be packed and we do not have enough room to bring the supplies with us on Wednesday when we go to the remote locations which are 3 hours and 6 hours away, respectively.
We get to Korle Bu around 10:30a and visit with some of the Dr’s in pediatric surgery. We get there just as clinic is to start (which works out nicely). The odd thing is, the clinic is only 2 hours every day- one hour in the morning and one in the afternoon. As you can imagine, not everyone can be seen in 1
clinic and many people must come from far away to be seen at Korle Bu. Families will come early in the morning and if they are not seen that am, they will wait there all day for the afternoon clinic. They must bring their own food as there is no “cafeteria” at the hospital. Should there be too many people there for the evening clinic, they will stay overnight and stay as many days as they need to be seen, sometimes waiting for a week or more. This astonished me- one of many things that baffled and amazed me this day at the “largest and best” hospital in Ghana.
As we toured the hospital we noticed that outside in the courtyard below was the laundry hanging out to dry.
The best part of the day was meeting with the Chief of Surgery Dr. Hesse who was recently promoted from the head of the pediatric surgery department. SHE, yes, it was a woman (another pleasant surprise) to discuss the TPN program, QA/QC, mixing the TPN, establishing where the center will be, etc… She was extremely excited and as enthusiastic as we are about the potential to save many many children from a death that is 100% preventable. Since her focus before promotion was pediatrics, she obviously has a predisposition to spend more resources (time, $, man hours) on programs that benefit the smallest of patients at Korle Bu. The meeting was very important on many levels and she wants us to come more frequently than 1x a year so we can get moving quickly (well, quickly for Ghana who do everything s-l-o-w-l-y except for driving) on the TPN program and a program to bring Laparoscopy to the pediatric surgery department.
We leave around 2pm to grab some lunch. After finally exchanging our USD to GHC, we find this authentic Indian restaurant and sit down for a “family style” meal. Everything was fantastic, spicy, and was a nice change (already) from the rice and chicken that we have been eating. The entire meal was 15GHC which comes to about 9 or 10USD.
With our converted money, we decide that since we are still waiting for the anesthesiologist to arrive (he was delayed) that today would be a good opportunity to go to the local market and haggle and by gifts to bring home. This way, once he gets to Ghana, we can go to the outlying areas (where they DO NOT have an anesthesiologist) and perform more surgeries instead of coming back early to shop and therefore reduce the number of patients seen and operated on.
The dusky, narrow streets of the market are lined with tiny shacks selling everything from food to fabrics, paintings, masks, statues, and everything in between. I thought it would be fun because I LOVE a bargain, but they are sooooooooooo aggressive and you seriously have to haggle in order to avoid getting ripped off, that it because exhausting rather than exhilarating. I paired up with some of the guys on the mission and they helped me as I KNEW the locals saw us coming a mile away and couldn’t WAIT to try to rip us off. As a female I felt particularly vulnerable (I was not scared or in danger at all, I just didn’t want to overpay). After a draining 2+ hours I have come away with some pretty amazing crafts and local items that I cannot wait to share with you all.
The last stop in our long day as we made our way back to the hotel was to help Dr. Khan find one more piece of equipment that was still MIA. While we did not find the equipment, we did get word that the airport found Dr. Khan’s luggage! 1 for 2 today. The group let off some steam and decompressed back at the hotel with some 40oz beers that cost 1.50GHC (about 0.90USD). We have found that while the exchange rate of USD and GHC is pretty close (0.60USD= 1GHC) things are very cheap here (like internet for an hour is 1GHC or 0.60cents).
Overall today was a real eye opener. I often found myself heavy of heart as many of the deaths and disease states/ conditions seen at Korle Bu are totally avoidable and some procedures and lack of aftercare would actually be criminal back in the States. Wednesday morning we leave EARLY for Daboase. This means that I probably will not be able to connect and upload the daily blogs until around Wednesday August 13th – I’ll keep writing and taking lots of pictures though!
We get to Korle Bu around 10:30a and visit with some of the Dr’s in pediatric surgery. We get there just as clinic is to start (which works out nicely). The odd thing is, the clinic is only 2 hours every day- one hour in the morning and one in the afternoon. As you can imagine, not everyone can be seen in 1
clinic and many people must come from far away to be seen at Korle Bu. Families will come early in the morning and if they are not seen that am, they will wait there all day for the afternoon clinic. They must bring their own food as there is no “cafeteria” at the hospital. Should there be too many people there for the evening clinic, they will stay overnight and stay as many days as they need to be seen, sometimes waiting for a week or more. This astonished me- one of many things that baffled and amazed me this day at the “largest and best” hospital in Ghana.After meeting at the clinic we get a tour of the hospital. We see the children’s ward, the operating theatre, the neurosurgery unit, E.D., the NICU, and of course the pharmacy. The pharmacy is roughly 8’x10’ and is barely stocked. They do a lot of HIV drug management for the children (high HIV ra
te as you can imagine) and do not have a lot of items to give patients while there; they often have trouble getting supplies. The outpatient pharmacy is larger and I was intrigued by the system they have for dispensing and paying for medications. There is no national plan for medications and they cannot turn people away so they either take cash or if the patient cannot pay they must give the drug to them on “credit” which they tally and track. This amazes me that in a country with millions of people, poor people, that they still track “credits” like the small towns in the US used to do decades ago.
te as you can imagine) and do not have a lot of items to give patients while there; they often have trouble getting supplies. The outpatient pharmacy is larger and I was intrigued by the system they have for dispensing and paying for medications. There is no national plan for medications and they cannot turn people away so they either take cash or if the patient cannot pay they must give the drug to them on “credit” which they tally and track. This amazes me that in a country with millions of people, poor people, that they still track “credits” like the small towns in the US used to do decades ago. In the NICU we see many babies that are malnourished (starving actually) as there is no way to feed them because they do not take feeds by mouth yet. One baby in particular was in their sole incubator in the hospital (amazing no?) and she was about 14 days old, and just recently had a T.E. fistula repaired. She could almost fit in the palm of your hand she was so tiny from not being fed. Part of the problem stemmed from the remote hospital where she was born and who did not transfer her to Korle Bu until about a week after her birth. When she arrived in Korle Bu she had to wait 3-4 days to get the fistula repaired, which tallied the days without food/nutrition to 10+ days. When we saw her she was about 14 days old and was still not receiving any nutrition as they do not have a TPN program and are therefore unable to feed her until she heals and can suck. As you can imagine, healing capabilities are greatly diminished and infection rate greatly increases when you are not eating and are malnourished. Her sad, hungry little crys tugged and my heart and looking around the “ward” brought tears to my eyes as these children ha
ve quite a battle for survival ahead of them- all because of where they were born and the lack of resources in Ghana.
This child in particular can be saved with the TPN program we are beginning to establish at Korle Bu and eventually in outlying areas. Working on the grant back home I knew this was important and has the potential to save many lives but now that I have actually seen a child that can be saved, it makes the work even more poignant and urgent.
ve quite a battle for survival ahead of them- all because of where they were born and the lack of resources in Ghana.This child in particular can be saved with the TPN program we are beginning to establish at Korle Bu and eventually in outlying areas. Working on the grant back home I knew this was important and has the potential to save many lives but now that I have actually seen a child that can be saved, it makes the work even more poignant and urgent.
Another small child was born with an omphalocele and was abandoned by her mother. The hospital had to feed her until she is well enough to be sent to an orphanage and as you can imagine, they are not feeding her that much (lack of resources) so she too is very weak and tiny.
In the children’s ward there was this little girl whose entire belly was a neuroblastoma. The edema and advanced stage of her disease makes her prognosis bleak- all because of a lack of money and mobility as well as the ability to get diagnosed at an earlier stage.
In the children’s ward there was this little girl whose entire belly was a neuroblastoma. The edema and advanced stage of her disease makes her prognosis bleak- all because of a lack of money and mobility as well as the ability to get diagnosed at an earlier stage.
Another little boy was there for a minor surgery but contracted a typhoid infection while recovering – very sad indeed.
Next we visited the E.D. where the few medications they have are sitting on a shelf in old peanut butter jars (w
hich they call ground nut). At first we did not realize that we were in the triage room as people were sharing beds, there were beds without sheets, as well as the general level of chaos and people.
Next we visited the E.D. where the few medications they have are sitting on a shelf in old peanut butter jars (w
hich they call ground nut). At first we did not realize that we were in the triage room as people were sharing beds, there were beds without sheets, as well as the general level of chaos and people. As we toured the hospital we noticed that outside in the courtyard below was the laundry hanging out to dry.
The best part of the day was meeting with the Chief of Surgery Dr. Hesse who was recently promoted from the head of the pediatric surgery department. SHE, yes, it was a woman (another pleasant surprise) to discuss the TPN program, QA/QC, mixing the TPN, establishing where the center will be, etc… She was extremely excited and as enthusiastic as we are about the potential to save many many children from a death that is 100% preventable. Since her focus before promotion was pediatrics, she obviously has a predisposition to spend more resources (time, $, man hours) on programs that benefit the smallest of patients at Korle Bu. The meeting was very important on many levels and she wants us to come more frequently than 1x a year so we can get moving quickly (well, quickly for Ghana who do everything s-l-o-w-l-y except for driving) on the TPN program and a program to bring Laparoscopy to the pediatric surgery department.
We leave around 2pm to grab some lunch. After finally exchanging our USD to GHC, we find this authentic Indian restaurant and sit down for a “family style” meal. Everything was fantastic, spicy, and was a nice change (already) from the rice and chicken that we have been eating. The entire meal was 15GHC which comes to about 9 or 10USD.
With our converted money, we decide that since we are still waiting for the anesthesiologist to arrive (he was delayed) that today would be a good opportunity to go to the local market and haggle and by gifts to bring home. This way, once he gets to Ghana, we can go to the outlying areas (where they DO NOT have an anesthesiologist) and perform more surgeries instead of coming back early to shop and therefore reduce the number of patients seen and operated on.
The dusky, narrow streets of the market are lined with tiny shacks selling everything from food to fabrics, paintings, masks, statues, and everything in between. I thought it would be fun because I LOVE a bargain, but they are sooooooooooo aggressive and you seriously have to haggle in order to avoid getting ripped off, that it because exhausting rather than exhilarating. I paired up with some of the guys on the mission and they helped me as I KNEW the locals saw us coming a mile away and couldn’t WAIT to try to rip us off. As a female I felt particularly vulnerable (I was not scared or in danger at all, I just didn’t want to overpay). After a draining 2+ hours I have come away with some pretty amazing crafts and local items that I cannot wait to share with you all.
The last stop in our long day as we made our way back to the hotel was to help Dr. Khan find one more piece of equipment that was still MIA. While we did not find the equipment, we did get word that the airport found Dr. Khan’s luggage! 1 for 2 today. The group let off some steam and decompressed back at the hotel with some 40oz beers that cost 1.50GHC (about 0.90USD). We have found that while the exchange rate of USD and GHC is pretty close (0.60USD= 1GHC) things are very cheap here (like internet for an hour is 1GHC or 0.60cents).
Overall today was a real eye opener. I often found myself heavy of heart as many of the deaths and disease states/ conditions seen at Korle Bu are totally avoidable and some procedures and lack of aftercare would actually be criminal back in the States. Wednesday morning we leave EARLY for Daboase. This means that I probably will not be able to connect and upload the daily blogs until around Wednesday August 13th – I’ll keep writing and taking lots of pictures though!
August 3 Sunday– First day at the mission, sorting supplies and seeing patients
We started our day off early with a wonderful breakfast of fried eggs, toast, mango and papaya (which are AMAZING), beans and a “breakfast sausage”. The only thing that made it a “breakfast sausage” was that it was a type of sausage and we were eating it at breakfast- it was more like a hotdog. We all thought that it was pretty funny (and cute) that they wanted to have an “American” breakfast for us but obviously missed the concept of the breakfast sausage! Everyone here is very nice and so eager to please us. We also had pineapple juice at the end of the meal which was a pleasant surprise. I was hesitant to have the entire glass they gave me as I think pineapple juice is too sweet, but I accepted as it is a custom here to accept everything that is given to you (hence the goat meat last night). The juice here is more like nectar and the pineapple juice was refreshing and not sweet and syrupy at all- it was wonderful! Definitely looking forward to this juice every morning we are here in Accra.
It’s Sunday so while we were waiting for breakfast on the upstairs deck, we were treated to a chorus of church bells and choirs rejoicing all around us. Our hotel is set up higher than almost everything around us so we have this amazing panoramic view of Accra and the variety and sheer number of church music we hear was truly inspiring. They are so happy and they have so very little and work so very hard- lessons we can all learn from and ones I hope to never forget.
After our “American” breakfast, we headed to the mission where all of the supplies have been stored. It takes about an hour to get anywhere around here (a geographical oddity this place is) and on our various drives we see some of the worst conditions, dirt and filth everywhere, and almost all the women are carrying things on their heads.
During our breaks we were getting to know the children who live at the mission, two are Maria, pronounced “Mah-ee-ahh” who is 4 years old and was practicing balancing things on her head and her older sister Nyla pronounced “Ni-lah” who was so shy but wanted to just hang out with us.
It’s Sunday so while we were waiting for breakfast on the upstairs deck, we were treated to a chorus of church bells and choirs rejoicing all around us. Our hotel is set up higher than almost everything around us so we have this amazing panoramic view of Accra and the variety and sheer number of church music we hear was truly inspiring. They are so happy and they have so very little and work so very hard- lessons we can all learn from and ones I hope to never forget.
After our “American” breakfast, we headed to the mission where all of the supplies have been stored. It takes about an hour to get anywhere around here (a geographical oddity this place is) and on our various drives we see some of the worst conditions, dirt and filth everywhere, and almost all the women are carrying things on their heads. We need to start sorting all of the supplies into general surgery, anesthesia, vascular, orthopedic, drugs, etc… and then sorting out those groups into what goes to which location- Kumasi or Daboase (we don’t bring supp
lies to Korle Bu as that is the main hospital in Ghana and they have the most equipment and drugs- which is still not that much). Here is a picture or two of us sorting stuff out (trust me, the photos on this blog are just samples, I’ve been “picture happy” so far). Many hands make for light work is certainly true as we had all of the items sorted in about 2 hours- which is apparently in record time compared to previous years. Once they were sorted out we had a late lunch (which I will return to in a moment) to have a clinic.
The clinic was simply a large room on the second floor of another building in the area with 2 adjacent smaller rooms for the exams. It is interesting to note that even though it is a surgical clinic, people come from far away just to get aches and minor issues checked out. For people here, routine doctor visits just don’t happen so they were all very excited to see us and the waiting room was always full! We thought that we would see about 30 people, and by the end of clinic we saw 81 patients! We do have some surgeries lined up from that clinic, but as I mentioned before, many people came for ailments that are easily treated back home. Some of the cases we saw included IBS, cataracts, cervical stenosis (surgical case), “female issues”, Umbilical hernias (surgical cases), arthritis, high BP, diabetes (we actually diagnosed the gentleman who was complaining of the classic signs of the disease), lactose and nut intolerances/allergies, eye problems (a LOT of people need glasses), Malaria, and Typhoid (yup, typhoid- sure glad I took those pills now).
A funny story from clinic (WARNING-CONTAINS ADULT CONTENT):
A gentleman comes in and complains of weakness “all over” motioning up and down his body. We are immediately suspect and let him continue describing his symptoms. We ask his age, (71 years old) and other Dx questions and he states “I’m weak all over, but some places are a little weaker than others at times” and makes it REALLY obvious as to what he is talking about (E.D.)!! We are trying not to snicker b/c he keeps trying to tell us discreetly what he is talking about and we just have to tell him that we understand what he is trying to tell us b/c it is very uncomfortable for him to admit to us that he is having issues related to his “manliness” as that is a very big pride thing here (like how many children you have etc…). Then, and this is the kicker, he says meekly: “Yes you see, I have 2 wives and I can’t keep them both happy”. AHHHHHHH!! Talk about needing to bit your lip!
Another gentleman, we found out later by sharing stories, double dipped and went into both rooms! I guess since he traveled so far he wanted 2 opinions! He just had arthritis in his knees!
Yet another young man came in just for a routine check up and as we started the exam, as soon as he pulled up his shirt we saw he was a surgical case- an umbilical hernia, popping out right in front of us! What a find! We showed him what it was and let him put his finger on it and push it back in (therefore reducible and operable). Not a HUGE deal, but since their work is typically manual labor, a hernia can be a very big deal and the likelihood of it getting incarcerated?? strangulation which can lead to a lot of problems, one of which includes necrosis and massive infection (leading to sepsis and death).
Last funny story: One guy came in and said that his eyes water whenever he eats something spicy! Too funny! It is amazing how we, with so much education we take for granted common sense things and forget that simple things mystify people here.
lies to Korle Bu as that is the main hospital in Ghana and they have the most equipment and drugs- which is still not that much). Here is a picture or two of us sorting stuff out (trust me, the photos on this blog are just samples, I’ve been “picture happy” so far). Many hands make for light work is certainly true as we had all of the items sorted in about 2 hours- which is apparently in record time compared to previous years. Once they were sorted out we had a late lunch (which I will return to in a moment) to have a clinic.The clinic was simply a large room on the second floor of another building in the area with 2 adjacent smaller rooms for the exams. It is interesting to note that even though it is a surgical clinic, people come from far away just to get aches and minor issues checked out. For people here, routine doctor visits just don’t happen so they were all very excited to see us and the waiting room was always full! We thought that we would see about 30 people, and by the end of clinic we saw 81 patients! We do have some surgeries lined up from that clinic, but as I mentioned before, many people came for ailments that are easily treated back home. Some of the cases we saw included IBS, cataracts, cervical stenosis (surgical case), “female issues”, Umbilical hernias (surgical cases), arthritis, high BP, diabetes (we actually diagnosed the gentleman who was complaining of the classic signs of the disease), lactose and nut intolerances/allergies, eye problems (a LOT of people need glasses), Malaria, and Typhoid (yup, typhoid- sure glad I took those pills now).
A funny story from clinic (WARNING-CONTAINS ADULT CONTENT):
A gentleman comes in and complains of weakness “all over” motioning up and down his body. We are immediately suspect and let him continue describing his symptoms. We ask his age, (71 years old) and other Dx questions and he states “I’m weak all over, but some places are a little weaker than others at times” and makes it REALLY obvious as to what he is talking about (E.D.)!! We are trying not to snicker b/c he keeps trying to tell us discreetly what he is talking about and we just have to tell him that we understand what he is trying to tell us b/c it is very uncomfortable for him to admit to us that he is having issues related to his “manliness” as that is a very big pride thing here (like how many children you have etc…). Then, and this is the kicker, he says meekly: “Yes you see, I have 2 wives and I can’t keep them both happy”. AHHHHHHH!! Talk about needing to bit your lip!
Another gentleman, we found out later by sharing stories, double dipped and went into both rooms! I guess since he traveled so far he wanted 2 opinions! He just had arthritis in his knees!
Yet another young man came in just for a routine check up and as we started the exam, as soon as he pulled up his shirt we saw he was a surgical case- an umbilical hernia, popping out right in front of us! What a find! We showed him what it was and let him put his finger on it and push it back in (therefore reducible and operable). Not a HUGE deal, but since their work is typically manual labor, a hernia can be a very big deal and the likelihood of it getting incarcerated?? strangulation which can lead to a lot of problems, one of which includes necrosis and massive infection (leading to sepsis and death).
Last funny story: One guy came in and said that his eyes water whenever he eats something spicy! Too funny! It is amazing how we, with so much education we take for granted common sense things and forget that simple things mystify people here.
During our breaks we were getting to know the children who live at the mission, two are Maria, pronounced “Mah-ee-ahh” who is 4 years old and was practicing balancing things on her head and her older sister Nyla pronounced “Ni-lah” who was so shy but wanted to just hang out with us. It does get a little weird at times because they look up to us so much it is indeed an awesome responsibility placed on us with this mission. You want to do so much more for the people who came to clinic today, but the technology they have here is minimal and what they can afford to have done is even less. It did get frustrating for so many of us because we are so severely limited by the available resources- it does get discouraging at times and it is very sad to see some of the cases - but every little bit we can do helps so much. They all look to us to be able to fix it all and make them 100% better; it truly is humbling how much blind faith they have in us.
In the evening we went to Dr. Adrisu’s (pronounced Ahh-dree-su) house for dinner. He is the Chief of Neurosurgery at Korle Bu hospital and we were his honored guests for the evening. We had more fufu, a salad (which I ate despite my better judgment- you have to take a little of everything so you don’t offend your host), more fried rice, lasagna (which was awful), more fried chicken, fried plantains again (they were amazing- much better than at lunch), and most interestingly, “guinea fowl”. Guinea fowl is this little “free range” type of chicken (supposedly) – it was a little hairy (I peeled that off) and it was pretty tough too. That was one of my interesting food items for the day.
Lunch- consisted of plantains (so amazing), rice again (regular and fried), fried whole fish (which I DID pass on), chicken, goat again, spicy tomato paste, and this spicy red soup that had cut up fish in it (they were just halved) which they call “light soup” (and they just change the meat in it depending on what they have). The guy tried to serve me the soup with a head and I (almost) freaked out and politely asked for a tail instead (which btw was still bizarre). The soup was actually REALLY good and I even went back for seconds (but only the broth this time).
Lunch- consisted of plantains (so amazing), rice again (regular and fried), fried whole fish (which I DID pass on), chicken, goat again, spicy tomato paste, and this spicy red soup that had cut up fish in it (they were just halved) which they call “light soup” (and they just change the meat in it depending on what they have). The guy tried to serve me the soup with a head and I (almost) freaked out and politely asked for a tail instead (which btw was still bizarre). The soup was actually REALLY good and I even went back for seconds (but only the broth this time).
August 2nd con't - first adventurous meal
Well, I didn’t have to wait long to get my wish of authentic cuisine here in Ghana. For dinner we had goat with this brownish sauce served with fried rice, chicken (also fried) and a paste/dough thing called “fufu”. It is about the color and look of polenta, but the consistency more like raw dough. One is to pick gobs of it up with their hands, roll it into a ball, and then dip it into the bowl of the goat and sauce. Very interesting. The goat had a definite “gamey” taste, but I really liked the fufu- it was interesting and didn’t taste all that bad! We also had a red tomato salsa/puree type dish that was REALLY hot called pepe (pronounced like the soccer player Pele, but with 2 p’s). That was great- until I realized that they use fresh tomatoes in the salsa puree…. Hopefully my stomach agrees with that dish and I don’t need to use my meds since they wash the veggies in the same water we are supposed to avoid due to high bacteria counts… The piece de resistance though was the ice cream; not only was it cold, but it tasted like cake batter- YUM.
After dinner we proceeded to head to the rooftop deck to see the lights of the city. Accra is HUGE population wise, but I was still surprised to see all the lights (as many areas shut down at dark b/c there is no electricity). It was beautiful many different colored lights, and the breeze off of the ocean was amazing- it was so peaceful up there looking out at the lights of the city below. We headed in to bed around 12am as we have a long day the next day at the mission- sorting all of the supplies into general surgery, anesthesia, vascular,orthopedic, drugs, etc.. and then sorting out those groups into what goes to which location- Kumasi or Daboase.
After dinner we proceeded to head to the rooftop deck to see the lights of the city. Accra is HUGE population wise, but I was still surprised to see all the lights (as many areas shut down at dark b/c there is no electricity). It was beautiful many different colored lights, and the breeze off of the ocean was amazing- it was so peaceful up there looking out at the lights of the city below. We headed in to bed around 12am as we have a long day the next day at the mission- sorting all of the supplies into general surgery, anesthesia, vascular,orthopedic, drugs, etc.. and then sorting out those groups into what goes to which location- Kumasi or Daboase.
Saturday, August 2, 2008
August 2nd- Touch down in Ghana
I left the confort of the States yesterday and landed today in Accra, Ghana. I’m safe and sound in Accra Ghana and my adventures have already begun! Attached is a picture of me (left) at the gate with Shelly, one of our 3rd year medical students.
Luckily the missing bag only had gifts for the people here in Ghana, not his clothes or medical supplies. It still stinks that it is missing, and given the items in the bag, he’s pretty confident that we’ll never recover it. Phrase of the day “Welcome to Ghana, this will prepare you for how well planned the rest of the trip will be!” Dr. Khan is a very funny man.
We took vans from the Ministry of Health to the hotel and boy did I see some sights. I didn’t take a lot of pictures, some images I wanted to soak in, others made me very sad and hurt my heart- I have a feeling that that is going to happen quite often while I’m here in Ghana. On some of our other trips out I’ll try to capture some of what I’m about to describe below. These first images were too much to attempt to capture then.
I saw a little boy, about Caden’s age (@2.5) in a dirt alley, all alone and squatting down to a small stream that is cutting the alley in half. As I look closer, the stream I see is a filthy mess of sewage from their open sewer system. Yes folks, that is correct- they have an open sewer system which lines both sides of the street and often cuts down streets or in the middle of intersections. You can also smell it too; it permeates your nose no matter how much you try to keep it out. The abject poverty is staggering – I already know how lucky I am to be who I am and in the car looking out at these sights instead of living them. The homes we pass are make-shift at best and some even seem to be made out of old, small cargo containers. Each house is like the next, as small as a shed, dirty, on top of one another, and many people crammed either in or around the home. These homes and images remind me of those Sally Struthers commercials “feed the children” where they are dirty and poor and in horrid conditions. I saw that today from my car window and it made me want to cry.
The area is not dangerous or totally gross, we also pass pleasant sights like children playing futbol and lush greenery due to the HUMIDITY here (Baltimore doesn’t hold a candle to this place!) I saw a man carrying a large luggage bag on his head and many many women doing the same with everything from peanuts to bananas to well, almost everything on their heads! They had the perfect posture too!
It took about an hour to get to our hotel, which we thought was more of a B&B, which it is not. Think more like the Econolodge….. There was apparently some miscommunication between Dr. Khan’s team and the hotel people (not sure, I was not involved) and they place was a tad misrepresented. It is clean though, has hot water (from what I hear a rarity in some places), air conditioning, and we do get fed. My first shower here was a cold one, despite the place having hot water- there was an issue with the hot water heater for the room, which was later fixed. The beds? Well, I thought my bed in college was hard- this bed is like a board!! Ken, tell Danno that that bedding at Balboa is still the best.
Lunch consisted of some chicken dish with mushrooms (which I picked out), 2 different types of rice, and some type of fish that was really good, but had a TON of bones in it. There was a salad too, but I have been advised by many people as well as the travel clinic to steer clear of salads as they wash the lettuce etc… with local water (which will lead to GI issues). It was all very good and we could tell that they are excited to have us here and want us to be comfortable. We had pineapple and I LOVED it, it was soft, white, sweet, and not bitter at all- smoother than the pineapple we have back home. Dr. Khan said it was just ok though- we’ll have some amazing pineapple in a few days when we go remote as well as some fresh coconut milk- I can’t wait!! The gentlemen here were eating some type of wet bread with a bowl of soup or something with their hands- that’s what I want to try, not this “Americanized” food!! It’s very nice of them to make us feel sooo welcomed, but I really want to try some authentic cuisine (remind me later that I said that)!
Today we are hanging out and resting while the rest of the crew comes in from other areas of the country/world. There are 15 of us total this year which is about 1/3 larger than previous years. I took a brief walk with Michelle Felix (nurse) and Shelly Choo (new 3rd year resident) around the block and saw some more of the housing that I noted above. The weather today though is amazing; the sun feels great (yes I have sunblock on) and there is this amazing breeze that keeps you pretty cool. I have heard that it gets yucky when we go more remote as the breeze I feel is coming from the coast. 2 more people come in tonight and I’m going with Dr. Khan and a few other people to pick them up (they won’t recognize him, just me so I have to go). I’ll try to get more pictures then to upload for this day’s entry.
Love you all and I’m staying safe and relatively cool.
My first views of Accra depict a crowded area with mostly deep red dirt roads. As we get closer to landing, we can see not only the nice houses, but the smallest of homes in the ghetto- everything has a bit of a film over it. We arrived only about an hour behind schedule at 9:30am Ghana time (5:30am your time). We made it through customs without any issue but when it came time to claim our bags, that is when the real adventure began!! The 1 turn style was 3 people deep so I stood back and “guarded” the bags that were already collected. When the madness calmed, we noticed that there was still one bag missing- Dr. Khan’s large bag….
Luckily the missing bag only had gifts for the people here in Ghana, not his clothes or medical supplies. It still stinks that it is missing, and given the items in the bag, he’s pretty confident that we’ll never recover it. Phrase of the day “Welcome to Ghana, this will prepare you for how well planned the rest of the trip will be!” Dr. Khan is a very funny man.
We took vans from the Ministry of Health to the hotel and boy did I see some sights. I didn’t take a lot of pictures, some images I wanted to soak in, others made me very sad and hurt my heart- I have a feeling that that is going to happen quite often while I’m here in Ghana. On some of our other trips out I’ll try to capture some of what I’m about to describe below. These first images were too much to attempt to capture then.
I saw a little boy, about Caden’s age (@2.5) in a dirt alley, all alone and squatting down to a small stream that is cutting the alley in half. As I look closer, the stream I see is a filthy mess of sewage from their open sewer system. Yes folks, that is correct- they have an open sewer system which lines both sides of the street and often cuts down streets or in the middle of intersections. You can also smell it too; it permeates your nose no matter how much you try to keep it out. The abject poverty is staggering – I already know how lucky I am to be who I am and in the car looking out at these sights instead of living them. The homes we pass are make-shift at best and some even seem to be made out of old, small cargo containers. Each house is like the next, as small as a shed, dirty, on top of one another, and many people crammed either in or around the home. These homes and images remind me of those Sally Struthers commercials “feed the children” where they are dirty and poor and in horrid conditions. I saw that today from my car window and it made me want to cry.
The area is not dangerous or totally gross, we also pass pleasant sights like children playing futbol and lush greenery due to the HUMIDITY here (Baltimore doesn’t hold a candle to this place!) I saw a man carrying a large luggage bag on his head and many many women doing the same with everything from peanuts to bananas to well, almost everything on their heads! They had the perfect posture too!
It took about an hour to get to our hotel, which we thought was more of a B&B, which it is not. Think more like the Econolodge….. There was apparently some miscommunication between Dr. Khan’s team and the hotel people (not sure, I was not involved) and they place was a tad misrepresented. It is clean though, has hot water (from what I hear a rarity in some places), air conditioning, and we do get fed. My first shower here was a cold one, despite the place having hot water- there was an issue with the hot water heater for the room, which was later fixed. The beds? Well, I thought my bed in college was hard- this bed is like a board!! Ken, tell Danno that that bedding at Balboa is still the best.
Lunch consisted of some chicken dish with mushrooms (which I picked out), 2 different types of rice, and some type of fish that was really good, but had a TON of bones in it. There was a salad too, but I have been advised by many people as well as the travel clinic to steer clear of salads as they wash the lettuce etc… with local water (which will lead to GI issues). It was all very good and we could tell that they are excited to have us here and want us to be comfortable. We had pineapple and I LOVED it, it was soft, white, sweet, and not bitter at all- smoother than the pineapple we have back home. Dr. Khan said it was just ok though- we’ll have some amazing pineapple in a few days when we go remote as well as some fresh coconut milk- I can’t wait!! The gentlemen here were eating some type of wet bread with a bowl of soup or something with their hands- that’s what I want to try, not this “Americanized” food!! It’s very nice of them to make us feel sooo welcomed, but I really want to try some authentic cuisine (remind me later that I said that)!
Today we are hanging out and resting while the rest of the crew comes in from other areas of the country/world. There are 15 of us total this year which is about 1/3 larger than previous years. I took a brief walk with Michelle Felix (nurse) and Shelly Choo (new 3rd year resident) around the block and saw some more of the housing that I noted above. The weather today though is amazing; the sun feels great (yes I have sunblock on) and there is this amazing breeze that keeps you pretty cool. I have heard that it gets yucky when we go more remote as the breeze I feel is coming from the coast. 2 more people come in tonight and I’m going with Dr. Khan and a few other people to pick them up (they won’t recognize him, just me so I have to go). I’ll try to get more pictures then to upload for this day’s entry.
Love you all and I’m staying safe and relatively cool.
August 1 – Gulliver’s travels…
Today is the day I leave for Ghana! I’m excited and nervous and can’t believe this is actually happening! When we got to the airport, we found out that my bag was 10lbs over and with all of the other bags right at 50lbs; we had to pay a whopping $80 for those extra 10lbs!! I’m sure we’ll get reimbursed for that from the organization, but WOW, the airlines have it all figured out!! Lesson(s) learned? 1. Get a scale for home and 2. Don’t offer to take extra stuff for people (as that was what made my bag too heavy).
The BWI-JFK leg was uneventful except that we were on a 50 person plan- I will affectionately call it a “puddle jumper” plane. When Sean (the surgical tech) heard this term he was none too happy as he is about as comfortable flying as Ken is!! A little extra liquid courage later all was well. We all thought it was all very humorous and a great way to start our little mission in the bush, but he was not on board with our humor! We were a little delayed and arrived at JFK with only a little extra time to hit the lavatory and call Ken before we had to board the second segment to Accra. We then proceeded to sit on the tarmac for 2+ hours waiting our turn. Our 5:05pm flight from JFK ended up taking off at 7:45pm!
The second plane was much better than the first; it was a B767-300ER which has about 215 seats. The monitors on the plane showed our progress over the 9.5hr flight. Around 7:45am Ghana time we were passing over Monrovia, Liberia and then the Ivory Coast, and lastly Sierra-Leone. The plane was tight, but with my short little legs, I had more legroom that the average traveler (yessssssss!). I got an eye mask as well as earplugs and they worked wonders- except for one thing. There was this ADORABLE little boy in the last row who, I’m assuming is about 1.5ys. He was crying, but then proceeded to start SHRIEKING almost the entire flight. My earplugs were no match for the pitch or the decibels this kid was putting out. I can only assume that the pressure in his ears was not releasing and mom either didn’t care or more likely couldn’t help him release the pressure.
The BWI-JFK leg was uneventful except that we were on a 50 person plan- I will affectionately call it a “puddle jumper” plane. When Sean (the surgical tech) heard this term he was none too happy as he is about as comfortable flying as Ken is!! A little extra liquid courage later all was well. We all thought it was all very humorous and a great way to start our little mission in the bush, but he was not on board with our humor! We were a little delayed and arrived at JFK with only a little extra time to hit the lavatory and call Ken before we had to board the second segment to Accra. We then proceeded to sit on the tarmac for 2+ hours waiting our turn. Our 5:05pm flight from JFK ended up taking off at 7:45pm!
The second plane was much better than the first; it was a B767-300ER which has about 215 seats. The monitors on the plane showed our progress over the 9.5hr flight. Around 7:45am Ghana time we were passing over Monrovia, Liberia and then the Ivory Coast, and lastly Sierra-Leone. The plane was tight, but with my short little legs, I had more legroom that the average traveler (yessssssss!). I got an eye mask as well as earplugs and they worked wonders- except for one thing. There was this ADORABLE little boy in the last row who, I’m assuming is about 1.5ys. He was crying, but then proceeded to start SHRIEKING almost the entire flight. My earplugs were no match for the pitch or the decibels this kid was putting out. I can only assume that the pressure in his ears was not releasing and mom either didn’t care or more likely couldn’t help him release the pressure.
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