Sunday, May 2, 2010

Pics from the end of the trip

The internet is SOOO fast here!!! These images just popped right up!

Global Mama in Accra, Ghana

I gave this shirt to Chinny! He couldn't read it, but I told him what it said. He then kept repeating the phrase over and over each time getting a little more excited until he was stomping his foot and pumping his fist. It was great!!!

Cute child

At the "witches'" village

making necklaces

Friends from the Theatre. Zato, the guy on the right could probably do most of the surgeries himself.

My favorite nurses from the peds ward

my little Kwashiokor girl before she was discharged home. She did great on milk feeds (even though her feet are still a little puffy).

Last day in Nalerigu to Iowa

My last blog....

Wednesday was a very interesting day. We rounded again in the morning, did some procedures and then the women headed off to Gambaga to visit the witches' village. The witches' village consists of a group of mud huts containing around 90 so-called "witches." For one reason or another these women have been designated with that title and shipped off to this village due to their lack of safety. Some of the women were thought to have special "witch powers" and other women are there because when they cut off the head of a chicken, it fell in the opposite direction than is desirable.

A Peace Corps worker visited this community around a year ago and had some extra beads from which she taught the women to make necklaces. She then brought the completed necklaces back to the US to be sold. We were visiting the village to return the money she had received from the jewelry she had made. The women were so happy!! Wendy, one of the volunteers, then gave a short talk to the ladies telling them that although we may appear different from the outside, we are all the same on the inside. We are all women who desire to be loved and deserve to live without oppression. After the talk, we bought our fare share of necklaces and bracelets and then returned home.

Jessie and I headed back up to the hospital as Wednesday was another busy day in clinic. After clinic finished around 6pm, Wendy made us a wonderful dinner of potato soup and garlic bread. We then headed back to our house to complete packing. After all of our goodbyes were said we only had 2.5 hours before we needed to awaken.

The truck picked us up at 4am Thursday morning and it was officially time to leave Nalerigu. Yes, I did cry. The roads were in decent condition since it hadn't rained the day before, but the sleeping goats in the middle of the road made the trip like an obstacle course. Yisahaku was a great driver and we made it to Tamale around 2 hours later. From Tamale we flew back to Accra where one of the workers at the guest house picked us up. We had transported a sputum sample on one of the patients to be evaluated by the lab at the University of Ghana, so we dropped that off before heading back to the guest house.

At the guesthouse, I took a nice 30 minute nap after which Jessie and I headed to a store we had heard about called Global Mamas. The store was fantastic!! It is a small place that holds many fare-trade items made by the women in the villages of Ghana. They sell all sorts of things there like bags, clothing, jewelry, etc. Although, I prefer the items that were made by my friends in Nalerigu, this was also a great place and I did find a few more gifts to bring back. We returned to the guest house for dinner and then headed to bed as we were leaving for the airport at 5am.

The next morning went fairly smoothly and we were soon on our plane ready to fly back to the US. Unfortunately, our plane was delayed in leaving Accra which meant that our plan was late flying into JFK. This resulted in our inability to make our connecting flight to Detroit that night. Thankfully, Delta put us up in a hotel, payed for food and got us a connecting flight in the morning that would get us into Cedar Rapids at the same time. We got back to the hotel very late, I took a nice warm shower and then crawled into a VERY clean fluffy bed. I only was able to enjoy the bed for about 3 hours because we needed to leave the hotel at 4am to make our flight out of Laguardia. Yikes! Little sleep in the last few days. After just a few hours of flying and a connecting flight in Detroit, we have finally arrived back in Iowa. The air smells so clean here!

After arriving home, Joe was at the airport to greet me (he is doing so well with his hip since I left). We took Jessie home and then headed back to our house to unpack. As soon as all of the talking and unpacking were done, I was craving seafood so we headed to the only place that has seafood in Iowa City, Red Lobster. :) I had some delicious crab and then went back home, finished laundry and slept for 12 hours. I awoke at 10am this morning only to get ready for work which started at noon today. It's a bit crazy, I know, but I'm not complaining. My life is still about 100 million times easier than the people who I cared for in Nalerigu.

Although I am very thankful to be home with my husband and can't wait to see family and friends, I greatly miss the people who I met in Ghana. The feelings about leaving are definitely mixed. I feel like I was able to make a small difference there, but know that the people of the community provided so much more to me than I did to them during that month. I also feel that I left with unfinished work. I have the utmost respect for all of the people of Ghana. It is a wonderful country and I do look forward to a time when I can return to the city of Nalerigu, this time with Joe.

I wanted to thank those of you who have been reading my blog. I appreciate your patience in reading my poor grammar and punctuation. I also am so grateful for all of your positive comments and prayers during my journey. I have been so enriched by you all. I do pray that this blog may make some of you think about serving abroad or if nothing else help you to appreciate the life that you have been given. I am planning to empty my closet this next weekend as there are certainly people in this world that could use them more than me. You may consider doing the same. I also hope to not revert to American portions of food. It feels unfair to have a plateful of unneeded food when I watched children die from starvation in front of my eyes.

Today I am thankful for the calling that led me to Nalerigu, Ghana. I am thankful for each and every moment I had with the people there. I am thankful that they have opened my eyes to a new world. One where happiness does not come from the square footage of your home, the amount or brand of the jeans you are wearing or how full your refrigerator may be. I am so thankful for the life that has been given to me and for the wonderful people that have been put in it.

What are you thankful for today?


Tuesday, April 27, 2010

Nalerigu Day 26

Esabisia (how did you sleep)?

Allafia Bene!! I slept VERY well!!

Early this morning I awoke to a cool breeze coming through my window. What a special treat. It was so “chilly” that Jessie put on a sweatshirt and I used my second sheet to cover up. I think it was about 80 degrees.  Rounds were good again today as most of the children were doing well. Most of the ward is filled with children who have malaria, typhoid, malnutrition or burns. We are getting pretty good at treating these conditions as they are certainly the most common. After rounds, we headed over to the theatre again for more procedures. We had a few ultrasounds to do, an incision and drainage, lipoma removal and a twin c-section that several of the wives and other volunteers came to see.

After we were finished with most of the procedures, I went over to visit Moses (Dr. Hewitt’s interpreter that I talked about yesterday). Moses was still looking ill this morning and his hematocrit was low enough that he was in need of a blood transfusion. They did a lab to obtain his blood type which was A+. The problem here, as you may already know, is that we don’t have a “blood bank”. We just send a family member into the community to try to find someone with the same blood type. This can be quite difficult as you might imagine and can take a lengthy amount of time. Moses was in no condition to wait around for someone to go find a donor, so I decided to give a little of my own since I’m O positive. I figure that I won’t be able to donate for a long time after I return home because of the risk of diseases I may have acquired during my stay, so I might as well give now to someone I know that needs it. I certainly was an interesting experience. The lab tech brought in the bag with tubing and a need attached (don’t worry everyone, it was a brand new needle). He then put a glove around my arm as a tourniquet and had me hold a toilet paper roll to improve blood flow. He then put the bag on the floor and let the blood pour down. He told me I was a slow bleeder, but I was able to get a unit of blood out for Moses which made me happy. I’ll make anemia the disease of the day today.

By the time theatre was finished, we headed over to the guest house for lunch. After lunch, I came home, took a 20 minute cat nap and then headed with some of the other volunteers to market for the last time. I found a couple more small things that I wanted to bring as gifts and took some pictures. I then returned home to gather the whole group of temporary volunteers as Terry (one of the med students) arranged a meeting with the chief/king of Nalerigu. I will spend most of my time discussing this experience as it will certainly be one of the most memorable experiences outside of the hospital.

First off, the chief’s palace is right outside the market area. In order to get into the palace you must have an elder of the community escort you inside. We had connections as one of the medical assistants at the hospital is second chief. Unfortunately, he was at a conference today, so he had planned for another elder to meet us outside the front of the palace. Unfortunately, due to Ghanian time or lack of communication, there was no one to meet us at the front when we arrived. We stood outside for quite a long time while a group of children and others surrounded us. Terry spent some time calling our connection and trying to figure out why we didn’t have anyone to meet us at the front. After some work, an older gentleman finally showed up brought us into the palace.

The palace is not really a palace at all. In our world it would just be a glorified union of mud huts. We walked through the entry until we came to a square building. We were told to remove our shoes and then enter the building. Upon entering, there were three men on an elevated cement slab at the front of a large room. The center man was obviously the chief as he was sitting high on pillows and had a hat with a gold marking on it. Two other men sat to the side of the chief, one being an elder who could translate and another whose job we could not understand, other than he held the staff of the chief. There were large leather chairs and sofas lined up along the other walls of the room which we were told to sit in. The elder then asked us what our mission was for this visit. We couldn’t really tell them that we just wanted to see the palace a take a picture :), so Terry our group spokesperson told him that we would like to learn more about Nalerigu. The chief told us that we should know about Nalerigu by having read books about it prior to our arrival. Not a good start. Things got better, when the chief thanked us for the cocoa seeds (caffeine) that we had brought him. He initially told us that it is custom to all share in eating the seed which we were all worried about since we had heard that some people have hallucinations from eating it, but he soon asked Terry if we had ever had the treat and Terry smartly said “no” so we were able to leave it that way.

The chief then talked more about the town of Nalerigu, but mainly talked about the hospital. It was actually quite amazing. He had only wonderful things to say about what the hospital has done for not only the community, but the entire Northern region of Ghana. The people here believe that people come to the hospital and are healed. Those that die at the hospital were either taken too late to be cared for appropriately or it was their right time to die. He feels that the hospital has a 100% cure rate for those that are able to be cured. Definitely an interesting way to look at things! The chief also talked much about going back to our homes and appealing to the people to come and help in any way they can. He made the point that one physician cannot see 100 people in one day and possibly care for them appropriately, so we need more volunteers to come. He took special interest in saying that we also need further training for the people who work in the hospital. He compared this to teaching someone to farm. You would not go to farm on someone else’s land only to leave a short while later and go back to farming on your own. You much go to their land and teach them how to farm. So that when you return home they are able to sustain themselves. This is the epitome of what is needed in developing areas and I certainly could not have said it better myself.

Overall, it was a very interesting and excellent experience, but it was definitely NOT without a plethora of awkward moments!! First, we really had no idea the proper way to act around the chief. One of the funniest parts for me was after the chief first started talking, the other men at the front starting clapping at one put. We silly sulamingas had no idea what to do, so we just started clapping too! I thought this was terribly funny and felt as though I was at some place where something is funny has just happened, but it would be completely inappropriate to laugh which just makes the situation that much funnier and you can’t contain yourself. I had tears rolling down my face. Another interesting moment was when the chief was done talking and we asked if we could take pictures. He said that it was no problem. Well, there was one problem in that we weren’t exactly sure how to take a picture. We didn’t know if we could go up to the king, give him a high-five and put our arm around him or if we should stand in front of the cement pad with him in the background. Eventually, we figured out that we could go onto the slab and sit near him for the photos. Everyone teased me as I sat about two body lengths away, afraid I would get to close. Now, for the most awkward moment of probably the entire trip….

Just as we finished photos and were about to leave, Terry asked the elder how to properly say goodbye (whether you clap and say na). The elder then told us all, “you must sit down in the chair and stay a while”. Darn! We thought we had successfully made it through the even without difficulty and now we have to sit again. We all looked at each other in utter horror. But, soon after we sat down, we realized why he wanted us to wait. The chief had sent one of his men to gather a treat for us. The chief told us that unfortunately, he did not have dinner prepared so instead he would have to offer us two life guinea fowl that we can eat at a later time. Yes folks! Just at that moment, a man walked back into the room with two live fowl in his hands!!!!!!!! We really wanted to just die of laughter at that point, but this time I was able to control myself. As none of us really wished to hold the live fowl, we made a deal with one of the other men in the palace named “John the Baptist” to come with us, sit in the back of our truck and bring the fowl himself to our home. He agreed to help us with the birds for only a small fee and a ride back to his home. On the way back to the house, several of us stopped at Joyce’s shop to get our final orders in (I got a baby wrap), while the rest returned home with John the Baptist and the two birds.

I am sort of sad that I didn’t get to see what happened when they returned home, but I can tell the story that was told to me. Apparently, when then made it to our house, Chinny (the mentally delayed, but not in soul man that is also known as “strange horse” and “hallelujah” and “man without TB who still lives in the TB village” and “keeper of the monkey”) was sitting outside the guest house. Chinny was so excited when he saw the fowl and jumped up to help. He clapped at the birds and then quickly cut off their heads. The cooks in the kitchen then finished cleaning the bird and creating the meat and now we have guinea fowl in the deep freeze waiting for us at tomorrow’s dinner. Now that was a crazy day!

We had a great dinner (with chicken, not fowl) and then headed over to the Wichita house where nearly all the volunteers gathered to sing praise songs. We even had Caleb (one of the cooks and the keeper of the house for Jessie and myself) come over with his guitar to sing. Eventually, we gave him one of the African drums that had been bought which became a concert in itself. You’ve heard the term white men can’t jump? I will transition this statement to white men can’t play the drums like this!!!! It was absolutely amazing. What rhythm and pure talent!! I’m now blogging, planning to pack a little and then want to head to bed. Tomorrow, we have clinic all day except for a side excursion with Dr. Hewitt’s wife Mona to the witches’ village. Should be another interesting day!! I will apologize now as I may not have the time tomorrow to blog depending on the business of the clinic, how much packing I get done tonight and how many events we have planned for tomorrow evening.

Today, I am thankful for the cultural experience I have had here which has only reiterated the fact that although we all appear so different from the outside, we are so very much the same. I am reminded of a verse in a song that says:

“We teach the young our differences, yet look how we’re the same. We love to laugh, to dream our dreams. We know the sting of pain.”

What are you thankful for today?


Nalerigu Day 26 Pics

Me carrying Jude on my back with my new baby wrap

My friend Joyce with her daughter Susan and Jude outside her shop

John the Baptist with Jude

The chief's children and grandchildren (he has 19 wives - what a tough job!)

Outside the palace

Part of the palace

Outside "the room"
Me with the chief

All of us

The chairs at the palace

Funeral procession

Little girl showing me her beads

Cameleon that the Nyhaus family

Chinny in his glasses. Yes, these are surgical glasses. He thinks they are great. Chinny does not do surgery.
The guinea fowl

It's the end of life for the the guinea fowl

At the market

Cocoa beans

At the palace

Monday, April 26, 2010

Nalerigu Day 25 - Pics

Must stop getting fabrics!! This is me bargaining with one of the women at market. I've bought most of my fabrics from a very sweet, quiet women with good quality fabrics and none "Sulaminga (white person)" prices.
This is me blogging. Thought you might like to see it in action.

Lisa and I

One of my patients who took 3 days to find the funds to go home. We became friends.

Child with osteosarcoma of the leg. The disease is metastatic already, but the family wishes to do an amputation for symptomatic relief.

Me with a family of (by my diagnosis) Marfan syndrome patients. I do see a slight resemblence to me here! (A friend at the hospital took the picture and since they aren't used to cameras got it a little crooked. I love it because of that!)

Child with a facial tumor of unknown type seen in clinic today of our favorite patients. She had severe skin infections with osteomyelities requiring bilateral leg amputation. She has such a great attitude and is loved by all. She also has an adorable little brother! The exciting thing about Mary is that she was discharged home today. Her mom will help carry her around and help her roll from side to side to not get bed sores. We hope for the best and will miss her!

Nalerigu Day 25

Hello friends and family!

Well my call was again much better than my first. PM rounds went quickly and I didn’t get contacted again until 6am this morning. Unfortunately, I am too neurotic and awoke every half to one hour thinking I heard the nurses knocking at my door. I wasn’t correct until 6pm when a nurse from the OB ward handed me a chart. The chart had no writing inside other than a note that said there was a female woman who was pregnant with twins. She delivered the first twin at home, but then developed severe bleeding and became unconscious so was brought the med center for further evaluation. The note at the bottom of the page said, “Please doctor, kindly please come to assess this patient. She is bleeding and unconscious. There is malpresentation with a retained second fetus.” The bells went off in my head saying “this is not something a pediatrician can handle”. So, I went over to the Wichita house as they are excellent at obstetrics patients, but unfortunately could not wake them up, so I headed (quickly) to Dr. Dickens’ house as he is the staff OB and his house is also on the way to the hospital. I knocked as loudly as possible, but everyone must have been tired from the evening before since there was again no answer. By this time, I had spend a few minutes trying to wake people, so quickly drove our “on call” truck to the hospital and figured I would stabilize the situation and in the meantime have someone go to try harder to get the help I would need. As a side note…I am very thankful to my father for insisting/forcing I learn how to drive a manual transmission or I wouldn’t be using the “on call” truck. When I arrived in the OB ward, the patient was alert and there was a large mass of tissue on the bed. I went over, realized that the bleeding had stopped and the patient was awake and then looked down at this blob. What was it you ask? The second twin (twin B) had been inside its own sack and the sack was attached to the placenta. The baby delivered still inside the sack with the placenta. Unfortunately, due to the placental bleeding the baby was already gone at the time of delivery. We still removed the baby from the sack, started chest compressions and bag mask ventilation, but there was no response. It was a sad story, but I was thankful that the mother was able to live through the problem and the first baby (twin A) was also doing well. You have to look at the bright side here.

I then returned home where I showered, ate breakfast, took my anti-malaria medication and then headed back to the hospital for am rounds. Rounds were good this morning. I discharged most of my children today. One child who had severe respiratory distress was singing for me this morning!! It was wonderful! After rounds we headed over to the theatre to do some procedures before clinic started. Well, I only did one procedure that took an exceptionally long time. There was a dilation and curettage to be done on a patient who had a failed pregnancy. For those of you who don’t know, a D&C is where you go in to remove the remainder of the fetal tissue as this can be a source of infection or bleeding if left in. I’ll be quite honest, this is not a procedure I enjoy doing and I enjoy it even less today. John (one of the Wichita residents) and I decided that we would team up and he would be my mentor to complete the D&C. The problem was that this particular D&C was exceptionally complicated. I won’t go into all the details, but the procedure took us about 4 times as long as normal and was very sad. Thankfully, the patient did very well and didn’t have any problems. Getting the tissue out was the difficult part.

After we finished the D&C we all headed off to our prospective spots in clinic. As usual there was a vast array of people to be seen in clinic. Jessie was in the pediatric area today so I saw mainly adults which the exception of some scattered kids in between. Patients had the usual complaints of generalized body pain, waist pain, dizziness, scanty urine, fever (but not really fever), etc. The most interesting patients of the day were the following:

1) Child with a slow growing facial tumor of which a biopsy was done and sent to the US. We’re still waiting on the results.
2) Family with obvious Marfan syndrome
3) My baby with Down syndrome returned with her mother and is doing very well. She is now tolerating nursing which is very exciting!
4) Child with severe hepatitis due to a prior blood transfusion for whom transplant or treatment are not options here. We gave her extra stickers today. She melted my heart.
5) The most interesting patient of the day….untreated osteosarcoma. See the pic for more information.

Clinic was exceptionally busy today. We got our usual 1 hour break in the middle for lunch, but stayed much later than usual since there were so many patients. After clinic finished, we all headed back to the theatre to help out with any further procedures that needed to be completed. Here’s where things got interesting again and where I realized what an absolute wimp I can be. Drew saw a patient earlier in the day with puss draining from his scrotum. I knew this information, because you could smell the patient down the hall. Well, lucky for all of us, he was left to the end of the day to have his abscess drained. The minute he was brought into the theatre area I began to gag. Not kidding, this is the absolute WORST thing I have ever smelled. Dr. Dickens, who has been working here for 2 years, says this one was in his top 20 which is definitely saying something because many things smell here. Thankfully, John and Drew VERY kindly said they would help out with this one. He apparently had the diagnosis of the day, which is necrotizing fasciitis of the scrotum (google this for more info). I couldn’t even be around the room without honestly gagging. Lucky for me, a nurse from the hospital came to ask for help in a different ward for which I raised my voice quickly to volunteer my services. What I didn’t realize is that the patient I was going to see was someone I knew and he wasn’t doing well. I grabbed the chart from the nurse, read the information and then asked him to show me to the patient. I was very confused when he walked me into the OB ward when I knew the patient was male. That’s when I realized I was headed to the “VIP” area. It was dear, sweet Moses, Dr. Hewitt’s translator in clinic who was lying on the bed. Unfortunately, Moses has a chronic disease for which he has intermittent times of worsening symptoms. Today, he was admitted by Dr. Hewitt because of similar concerns. I was called to his bedside as his blood pressure was dropping. I have a particular fondness for Moses as he is one of the people in the clinic who encouraged me on my first day when I had absolutely no clue what was going on, but was left to see patients on my own. He is truly a kind and gentle soul. I am wishing the best for him. We all are. After a bit of talking, I wrote some orders and then headed back to the theatre for more smelly-good.

Again, I was rescued from the deadly odor when I heard a woman screaming from the pediatrics ward. Here is the story:

A child was admitted by one of the medical assistants for respiratory distress. The pediatric nurses (who are excellent) received the orders and started getting ready to initiate them when the father of the child who was intoxicated grabbed the child and took him out of the hospital. Sadly, when the mother returned with the child, he had already died. The floor was a disaster. The mom was hysterical as any mother would be and the nurses were irate at the father as they felt they weren’t given a chance to help the baby. I tried to help the mother first and then proceeded over to the nurses’ station. They were discussing their frustrations and wished for the child to be sent to the morgue as they didn’t want the child to return home with his father. I told them that we should do what is in the best interest of the child, which would most likely be to return home with his mother for a proper burial. There motive was mainly to teach the father a lesson, but I reminded them that the father was really in no state of mind at that point to be taught. They finally agreed and the situation settled. It was very crazy for a while and of course sad that another child had to die.

I then returned back to the theatre at which point the smelly-good procedure was complete!! Good timing on my part. We then all walked back to the house for some dinner which was one of our favorites, chicken enchiladas (not exactly a Ghanian feast). Now, I’m doing some blogging, hoping to skype with my hubby and then headed to bed for a good night’s rest. Tomorrow we have am rounds, several procedures to do and then we are hoping to all visit the chief (also known as the king) of Nalerigu. Should be fun!

Two more things that happened today that haven’t yet fit into my story. Today, we greeted another new volunteer to the group who is actually a fourth year medical student from Midwestern in Arizona!!! We even know some of the same people. Amazing.

Today, I am thankful that my husband allowed me to leave him for the month to travel over the ocean, to an unknown land, in order to pursue my dream of serving in Africa. I had compassion for people in poverty before I left, but now I have understanding and hope that change is not an unreal expectation. Thank you Joe for being such a loving husband! I’ll see you soon!

What are you thankful for?


Sunday, April 25, 2010

Nalerigu Day 24 pics

The Dickens family
Baseball in the complex

Inside the nutrition center

Nutrition Center

Child with snake bite to face

Children outside church

Children climbing the mango tree

Outside the Fulani church

Children inside the church

Children at the front of the church (they know how to sing!)

Guy wearing a cycling jersey as a shirt! A nice cycling jersey!

The front