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….
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