Nalerigu Day 21, 22 and 23

Gaffula Pom Pom (Very Very Sorry)!!

I am so sorry for the lack of blogging I have done over the last few days!! It has been VERY busy! I'll try chronological order of the events today.

Thursday:

Morning rounds were great. The children were doing very well! We did several procedures (I even got to do a dilation and curettage) and then headed back to the house. Thursday was the last day for the West Virginia students so there were many events planned. We ran to the "gas station" for some soda to bring back to the house at which time we had invited some of our favorite translators Adam and Oluu for our favorite dessert, mango cobbler. We had great fellowship and enjoyed learning more about their schooling. The both hope to go to medical school at some point in time. Unfortunately, if you don't have money to pay your way in, you have to go through MANY years of school and jump through many hoops to show you have the capabilities. They are hopeful that they will one day go and then plan to return to the Northern Region of Ghana to provide their services which would be well needed. After mango cobbler, we all got washed up and ready for dinner. I guess you could say it was a progressive dinner. Since it was the WV group's last day, we had a special dinner of groundnut soup and fufu. Definitely a favorite Ghanian dish. The fufu is made from pounded yams and is fairly tasteless, but still delicious. The only problem is that it seems to expand quickly after you eat it as you can only eat a small amount before you are STUFFED. After dinner we had our weekly station meeting. Station meeting is really just a devotional time for the volunteers. This time our meeting was at the teacher's home. We sang songs, listened to guitar playing and just enjoyed each other's company. One of the favorite events of the evening is when Stephanie (one of the WV students) asked Dr. Hewitt if he would speak in his three different languages for us to keep on video. It was truly awesome! Unfortunately, the Internet is not fast enough here to download, but someday I will try to post the video. Dr. Hewitt started out in his Mississippi accent, then transition to his excellent African English accent and then he began speaking Mampule!!! Incredible. The people here tell us that Dr. Hewitt speaks perfect Mampule. After station meeting, we spent a little more time with our friends that would be leaving the next day. We exchanged photos and helped them pack. Soon it was past our bedtime.

Friday:

Friday morning, around 4:00am, I awoke to Stephanie jumping on my bed saying goodbye. Their van was about to leave. We really enjoyed having them all around. I went back to sleep for a short time and then was up a couple hours later to start rounds. Round went well again yesterday. As usual, when we came in the morning to ask "how are the children", the response was "the children are doing well". The difference was that over the previous two days, they really were doing well. We did a couple procedures after rounds including a repeat incision and drainage on my little girl with a neck abscess who I sent home later that day. Around 10am clinic started and we began seeing patients. Clinic was quite busy on Friday as, although there weren't the mass of crowds that you may see during the high malaria season, there were very sick children. I personally admitted 7 sick children that day, two of which I ran to the ward myself to get LPs (lumbar puncture) done, IVs placed and antibiotics started. I am very thankful as all of the children that had been admitted are now doing very well. We saw patients until around 6pm and then headed back to our house for dinner. Dinner was quiet without the other students there, but still nice. After dinner, Dr. Dickens family (one of the staff physicians) came to visit and invite us to their house for an outdoor game of hide-and-go-seek. Unfortunately, we had all already committed to a gathering at the Wichita resident's house, so headed over their for some treats and a couple episodes of "The Office". It's hard to turn down "The Office" in Ghana. The party didn't last long as we were all completely exhausted, so we headed back to our beds for some shuteye.

Today:
Today was another good day. We've remained without any pediatric deaths for three days now, which is a true blessing. Jessie and I decided to round a bit earlier than usual this morning since I had decided to admit the whole city the day prior. :) The good news was that many of the children had significantly improved and we were able to send some home. It's a relief for two reasons to send a child home. The first, of course, is that their medical status has improved. The second, it that the shorter the hospitalization, the less money the family needs to gather to pay. It's a balancing act here. After rounds, we headed over to the theatre where we completed a couple procedures and then went back to the house. Just prior to lunch, Lisa, Jessie and Lisa's Nalerigu Friend Rukaya and I went to the Market. Lisa and I bought a couple bracelets, sandals for our husbands and waist beads as a wedding gift for one of the volunteers here. We then went over to Rukaya's home to meet her family including her daughter. I had not yet been inside one of the homes here and certainly am glad I had the opportunity. See pictures for a better idea of what a rural Northern Ghanian home looks like. After some visiting, we headed back for lunch. After lunch, Jessie and I determined what gifts we wanted to get for our fellow residents at home, so headed back to the market to complete the gift list. I'm going to keep that information a secret for now. It's now time for some blogging after which I'll head to the guest house for dinner and then possibly over to one of the volunteer's homes for some movie watching. I'm on call tomorrow, so hope to get a little sleep tonight.

Again, I apologize for the lack of blogging the last few days and for the inevitable loss of detail in the blog today. I truly hope you are all well and thank you as always for your thoughts and prayers. Today, I am thankful that I have something other than a mat and cement floor to sleep on at night.

What are you thankful for?

Jill

Two side notes:

This is a song that we sing often at church at home. I found out on Thursday that it is actually a Ghanian Folk song written by a missionary who lived not far from Nalerigu. I think the words are quite fitting.


Jesu, Jesu, fill us with your love,
show us how to serve
the neighbors we have from you.

Kneels at the feet of his friends,
silently washes their feet,
master who acts as a slave to them. Refrain

Neighbors are rich and poor,
varied in color and race,
neighbors are near and far away. Refrain

These are the ones we should serve,
these are the ones we should love;
all these are neighbors to us and you. Refrain

Loving puts us on our knees,
serving as though we are slaves;
this is the way we should live with you. Refrain

Kneel at the feet of our friends,
silently washing their feet;
this is the way we should live with you. Refrain

The second message today is a big Congratulations to my fellow resident Erica LeClair on the birth of their new baby girl Nadia Rose!!! We can't wait to snuggle her when we get back!

Nalerigu Day 20

Good Evening!

For some reason I'm exceptionally tired today, so have just created a picture blog today. Overall, the day was wonderful as usual. We had rounds in the morning and clinic all day. Below you'll find pictures of some of the interesting patients I saw in clinic today. After clinic, I went on a run with Lisa which was very nice (and much cooler at 530pm than high noon). Regardless, exercise here really feels like 4 times as much work than at home. We felt like we were trying to run in the high mountains. :) I didn't have time for much else today since I spent most of the evening working on our presentation that we have to complete for INMED before we leave. I'm talking to the volunteers tomorrow about Neonatal Resuscitation including resuscitation in developing areas. I was able to do a small amount of research tonight which was VERY interesting. I'll tell more at a later time! I hope that you are all well as usual. Today I am thankful for the slowness of the day here. It gives me time to reflect on the truly awesome experience I have been blessed with. I won't discuss any of my thoughts for the day since this would be too long. Instead, I'll leave you with a passage for you to reflect with on your own from Philippians 2: 3-4

Do nothing from selfish ambition or conceit, but in humility regard others as better than yourselves. Let each of you look not to your own interests, but to the interests of others.

Have a wonderful day and please keep the people of Nalerigu in your thoughts!

The mom told me that this child would not wake up. I grabbed the child, held it upright and it immediately awoke and started smiling playfully with me. This was not a sick child. PS I can do a near complete pediatric history all in Mampule! It's so funny. The mothers all laugh when they hear me because they think it's strange for a sulaminga to know their language. In fact, if I ask if the child has vomiting by saying uteera, sometimes the mother looks at the interpreter for help until she realizes that it wasn't an English word I was saying. They just expect that it will be. Funny!

Neck abscess that I did an incision and drainage on.

These are all of the baskets that we bought during our trips to Bolga. Only 5 of these are mine. Mom's is hiding.

Drew and Rachel's little girl Emma holding an African drum. Emma always finds a way to entertain all of us. She is a great dancer!

John and Lisa's adorable little boy Jude. He's a fan favorite! He was placed in a Boga basket for pictures tonight.

Young girl with fabric on that was similar to my new skirt made by Joyce. This young lady had been in the procedure room just a minute before getting an incision and drainage of a buttocks abscess by Jessie. Jessie expressed nearly 2-3 cups of pus from the abscess. She was in significant pain during the procedure, but in normal Ghanian fashion stands beside me smiling immediately afterward. Love it! If only I could be 1/4 as tough.

Child sent to me for a check of his umbilicus. Notice the hyperpigmentation in a whorl shaped pattern on the abdomen. When the internet is a little faster, I need to do some research since I believe there are some genetic syndromes associated with hyperpigmented whorls. You just never know what you're going to see here. Another possibility is that this was ink from some home remedy although the mother insists the child had this pattern from birth. Incidentally, the child was only two weeks old and had a fever, so was admitted for possible sepsis.

Child who was dropped into a fire and suffered third degree burns. I was seeing this child on follow-up.

As you can tell, his new skin has almost no pigmentation and he has severe contractures of his lower extremities (legs) which will need to be reduced as he gets older. His skin has healed very nicely and didn't have any evidence of infection. The fact that a young infant could survive such terrible burns here is an absolute miracle.

African child with Albinism (disease of the day). We didn't believe them at first since all of the books we see of albinism show very white African children. The people here assured us that the children can have very dark skin. Aside from the orange hair and eyebrows, he did have some areas of skin hypopigmentation (loss of color).

Just a really cute baby I saw in clinic today. I'm getting compliments on my language skills and I think it is also helping with how scared the children are of me. :) Of course this child doesn't know if I'm speaking Mampule or English. He's just happy!
I am trying to figure out if he would fit in my suitcase (or one of the baskets).

Child with extremely bulging fontanelle (soft spot) in the isolation ward. This child has presumed meningitis, although we don't do CSF cultures here.

PS Sarah and David: Thanks for all of the wonderful comments. I can't believe you have also have Bolga baskets! I will continue to send my warmest greetings to the wonderful Ghanian people! Best wishes!

Nalerigu Day 19 with pics

Baskets, Baskets and more baskets….

Today was a wonderful day. I would classify today as hot, not hotter thanks to the rains yesterday. Call was MUCH better than my last with many admissions, but no deaths. I am very thankful. We finished pm rounds around 1130 and headed to bed only to be awoken twice through the night. The first awakening was around 530am when a motorbike parked directly outside our window started honking. I jumped (literally jumped) out of bed, went to the door to find one of our wonderful nurses in the men’s ward smiling at me. He was looking for some anti-venom to give a patient with a snake bite. The anti-venom is stored in the refrigerator of the house next to us as refrigeration at the hospital isn’t really an option. I sent them down to the next house to obtain their needed supplies. Around 630 am, I heard “doctor, doctor” outside my window. It was the exact same story, except this time it was one of my favorite sister nurses from the peds ward. I again sent them to the house next door. That was then end of my call.
After our usual morning routine we headed to the hospital for am rounds. The peds ward had a few more children in it after the admissions from the clinic day prior, but wasn’t too overwhelming. I was able to discharge several children and all were still alive from the day before. The baby with Down Syndrome is doing very well. He still has trouble breast feeding, but will take expressed breast milk without difficulty. Immediately after rounds were finished we had a 7 month old patient who chewed on a small amount of the family’s very acidic soap. The child developed sores in the mouth and had a moderate amount of pain. Unfortunately, there is not much we can do for this here. Thankfully, it was only a small amount. We are maintaining pain control and hoping for the best. Since this was a VERY short day of medical work, I’ll make toxic ingestion my disease of the day. Children are children and can get into anything, even here in Northern Ghana.

After rounds, most of the volunteer women got ready and headed off with Esahaku (our driver) to Bolgatonga again for a little shopping. We had gone to Bolga last week but spent the majority of our day at the crocodile pond and slave camp, so didn’t get much of a chance to see the city. The major attraction of the day was the baskets. This city has a warehouse area (mainly just little buildings side by side) where all of the baskets made by the women of the villages nearby are taken to be sold to stores in Europe or the US. There are tens of thousands of baskets in this small area. It was incredible. I must say, that I wasn’t very excited about the idea of basket shopping initially as baskets and bows have never really been my “thing”. This all changed today. The baskets here are phenomenal. Not only is it wonderful to know that they were handmade in the villages we pass by during our trip, but they are unbelievably beautiful with not one basket being exactly like another. The colors and the weave patterns were amazing. My task for the day was to find a basket for mom. It wasn’t difficult. I saw a basket right off the bat that I thought would be perfect for her, but I was concerned that it might be a little big to fit in my suitcase. I continued on through all of the stores, but there wasn’t a single basket that was as perfect as this one which is navy blue and tan with a little lid on the top. It is just perfect for carrying some quilting supplies. Regardless of the size, I bought it and will figure out a way to get it home. Incidentally, I also found two very colorful baskets for myself and two baskets for friends back home. I bought a total of five baskets which was pretty good considering some of my friends here have over 30 baskets themselves between our two trips to Bolga. They are that wonderful!

Some of you may be curious about how much a basket like these would cost. My baskets ranged from 4 Cedis (around 2 US dollars) to 18 Cedis (around 12 US dollars). My largest basket would have cost $60-100 at home. The baskets are beautiful and will certainly be enjoyed, but will never compensate for the joy that I feel in the work that we are doing here and the people we have met.

After returning home, I was pleased to find that Joyce had finished making my two skirts. I love them! She really did a great job and I am so excited to have some dress that is more Ghana appropriate (colorful and less bland). I then put on one of my new skirts, headed over to the other guest house for dinner and after dinner over to Dr. Dickens home for some dessert. The women here really know how to make delicious desserts! It was wonderful! I’m now back at home, finishing my blog before I head to bed. I need a little better sleep tonight before a hard day of clinic tomorrow.

Just a quick note before I sign out. I was doing some reading last night before bed and came across this most appropriate Bible verse I’d like to share from James 2: 14-17.

What good is it, my brothers and sisters, if you say you have faith but do not have works? Can faith save you? If a brother or sister is naked and lacks daily food, and one of you says to them, “Go in peace; keep warm and eat your fill,” and yet you do not supply their bodily needs, what is the good of that? So faith by itself, if it has no works, it is dead.

There are people here EVERY day, most commonly children, who are naked and lack daily food. There are children who die because they are not fed. The pictures on National Geographic are not just pictures. The stories on the Discovery Channel are not just stories. They are real people. They are friends, parents, brothers, sisters and children. They are individuals that have more spirit, more strength, more hope than I have ever seen before though they have nothing of the material world. In some way, we all can help. We just need to take a little time out of our busy day to care.

Today, I’m thankful for the hope that the Ghanian people have given me. Hope that overcomes adversity, poverty and death.

What are you thankful for today?

Jill

Nalerigu Day 18

Nisa Nuri!

“ I touched the rain down in Africa” again! I could also say “I touched the hail”. Oh how glorious it was! As I mentioned previously, there are really only three weather reports for each day; hot, hotter or raining. Today it was hotter, but then rained. The hail was most amazing. The Ghanians call the hail ice balls and actually pick it up to eat. Ice cubes are difficult to create in a mud hut. The rain made for a joyous day.

The morning also was well. Jessie and I were able to discharge home four children from the peds ward leaving very few left. I actually was able to discharge our heart failure child (of course with close follow-up) which made me especially excited since funds were becoming quite a problem for the family. Funds here are frequently a problem. In fact, this morning on rounds a child who I discharged yesterday was still sitting on his hospital bed with his mother. Funds were the problem in this case as well. It took over 36 hours for the family to find the means to gather 40 Cedis ($29 US dollars) to pay for their 4 day hospitalization.

After am rounds, I was on call so spent the day either in the Theatre doing procedures or admitted patients to the ward. We saw so many interesting things today, so I’ve decided to make a list:

1) Patient who was talking with a resident in the morning and suddenly become unconscious with cool extremities. The resident started drugs for cerebral malaria and gave a bolus, but the patient continued to have neurologic abnormalities. This was brought to our addition (Stephanie and I were on call together today) and after further examining the patient decided on a lumbar puncture. I helped Stephanie successfully complete her third LP! Way to go Stephanie! The spinal fluid was cloudy, so we started antibiotics and sent the patient to the isolation ward for presumed meningitis.
2) We did many ultrasounds on pregnant and non-pregnant women today. The most notable patient was a 28 year old female who was having significant vaginal bleeding with dizziness. Her systolic blood pressure was 50 on initial exam, but had improved to 75 after a normal saline bolus. Pelvic exam revealed significant clots and ultrasound showed a 14 week old (estimated) fetus with a heartbeat. Her hematocrit was also low so was given a blood transfusion from a matched family member. She was admitted to the hospital and continues to be observed overnight. We hope the bleeding will stop and she will continue to carry the baby to term. We hope.
3) We also had an 18 year old patient today who refused to walk or stand. He had no history of trauma or any other abnormalities on exam other than significant pain with motion around the hip. He was also febrile. We decided that he most likely had a septic hip, but since we don’t have anyone trained well in joint ultrasound are treated him presumptively for now with antibiotics.
4) In the theatre, I did a couple incision and drainage of abscesses which are always fun. I also did a bladder straight catheter on an older gentleman with bladder cancer who is unable to pass urine due to the tumor mass.
5) One of the other medical students saw a patient with a funny toe. The baby toe looked very similar to the big toe since there was a large tumor within the area making it look large and making it protrude to the side. (see pic)

Now I come to my favorite diagnoses of the day (the kids):

1) John saw a meningomyelocoele today in clinic. See pic. This was INCREDIBLE!! Interestingly, they have what we believe to be a neurosurgeon that just started working in Tamale (approximately 2 hours from here). It’s a little sketchy whether this will be appropriately cared for, but is the best we can do. The child is moving his legs appropriately and doesn’t currently have any problems stooling or urinating.
2) A couple of the volunteers told me about a child they had seen in clinic. The story was that the mother was being seen for an incision site infection from her c-section that was done around 1 week prior. However, when the mom handed the baby to the translator, the translator felt the baby appeared ill. He then showed it to the volunteers who agreed with the translator. Apparently, the child had not been sucking well and the mom didn’t produce significant formula until day 4 following delivery. The child appeared jaundiced and hypotonic. The team then decided to admit the child for IV antibiotics and a consult from the nutrition center. They then let me know about the child. So, as you have already learned, there are no emergencies here. So, the triage people sent the baby to the nutrition center to be evaluated by them, before admitting them to the hospital. Thankfully, the baby made it through and I was able to see it this evening. Ok, now for the interesting part. I went to look at the baby and the first thing I noticed was that the baby appeared to have Down Syndrome!!!!!!!!!!!! This is NOT commonly seen here and since I am a lover of genetics (OK you can make fun of me for being very nerdy), I was very excited. Here are the findings that make this a consistent diagnosis. The child had the features of Downs including a flat facial profile, upslanting palpebral fissures, small ears, single palmar crease, large tongue, wide fontanelles, epicanthal folds, hypotonia. The patient also had…get ready budding pediatric cardiologists…a VSD (ventricular septal defect) murmur which was a loud, harsh holosystolic murmur heard best in the left lower sterna border. The child also had an umbilical hernia. I am planning on sending the photos that I have taken to my favorite geneticists at Iowa to confirm, but am pretty convinced at this point. The problem with this diagnosis here, however, is that our resources are nil. We can help the child try to feed (which will also improve the jaundice), but there is not a lot more that we can do. Please keep this child in your thoughts and prayers. We don’t see many people with special needs around here, so I’m not sure how well they are tolerated in the community and certainly will have a more difficult time if coexisting illnesses are encountered.

Other fun things that happened today…I visited the pharmacy to see what the “Uncle Kim” of Ghana is like (my Uncle Kim is a pharmacist). :) it was fascinating! One gentleman walked me through how the IV fluids are made which was awesome! Take a look at the photo for more information. I have a whole series of how fluids are make, but the internet is too slow to include them all.

We continued to admit several more patients including a patient who was an alcoholic who became unconscious and was found to have a glucose of 16. Yes, a glucose of 16 (that’s REALLY low). The patient developed seizures and is currently not responsive. It doesn’t look good for this 26 year old.

I hope that the rest of the call night goes well, but am happy to have had even a chance to tell you about my day so far. I pray that all is well with you. As usual, please keep the people of Nalerigu in your thoughts. Today I am thankful that I can have ice to keep me and my water cool at almost any time, not just when it falls from the sky onto the dirty ground.

What are you thankful for today?

Jill

Nalerigu Day 18 pics

Downs baby/flat facies

Single palmar crease

Down Syndrome baby

Grandma from the nutrition center who ran with me the other day

myelomeningocoele or meningomyelocoele (pota- long a- toes/pota - aw- toes)

One of of 8 walls filled with medical records

Bottles of IV fluids

picture of part of the line to the pharmacy on a clinic day

She touched the rain down in Africa

Ice Balls

Pet Monkey outside the med student house eating a mango

Guy with a stocking cap on in 100 degree weather. That is a fan in his hand.

Toe growth

Child with the burns who went home today after doing a little dance to music (only Tylenol for pain)

Nalerigu Day 17 pics

cute children

another cute child

this is an example of a table of goods for sale in the village. There are raw groundnuts, roasted groundnuts, rice and the balls in the bottom left corner are soap.

Child with an old man's cane

Child after the old man took his cane back

A child with an Obama shirt. You can find more Obama shirts here than you can find soap.

"Let us rise up and build" written with foam animals on the front of the church. The back of the church had a sign that said "You are now going to going to communicate with God. Please turn off all electronic devices"

Nalerigu Day 16

Hello Samisi (another word for white person)! We had another rodent free day! Whoever invented duct tape is a blessed person!

Interesting topics about the culture around Nalerigu. The primary "tribe" here are the Mampusi. This is where the language Mampule comes from. Although they are the most prevalent people here, there are actually around 30-40 tribal languages that we see at the hospital. Another common tribe are named the Fulani. The Fulanis and the Mampusi, however, do not live in perfect harmony with one another. Although there is very little violence (Ghana is actually a very peaceful country), there is a sort of cast system here. If a Mampusi person were to marry a Fulani, it is said that the Mampusi would need to cross 7 rivers to cleanse themselves. Very interesting and not just folklore! For the right guy, it might be worth it. :)

Other interesting facts about the culture here. There used to be arranged marriages within the Mampusi people. Now, the people are free to chose who they wish for a husband or wife (except a Fulani). Mum said it best last night the people now "remain free to roam and choose who they wish with only God overseeing the decision".

The cultural lesson continues...we have all noticed beads around both the children and the adult women's waists. My friend Lisa asked one of her Nalerigu friends about these beads after which her friend became quiet and appeared very embarassed. Last night we found the answer to the bead question. The older women wear the beads around the waist as a type of sexual ornament. The younger women who do not yet have a man wear more beads and let them be shown. Married women tend to hide their beads for only their spouse to see. One of our male friends told us that women who don't wear the beads are called "snake women" since they are too smooth. We're still a little confused about what exactly that means. We were also still confused why the female children would wear the beads. They told us that the beads on the girls are not for sexual purposes at all, but instead are used to increase their "booty" size in order to give them more beautiful figures. Later today, I had the opportunity to babysit John and Lisa's little boy Jude for a short time while they went to market. They returned with a gift for me. You guessed it...waist beads! Let's just say they are not at all discrete with 4 rows of beads in bright pink and lime green colors. Thanks Lisa! haha

On with today's business. Rounds were very quick this morning as most of the children have been discharged from the hospital. It felt great. The first child I saw today is a little boy who we have been following since Jessie and I arrived. He was initially hospitalized for typhoid perforation, but returned to the hospital after discharge with malaria. Unfortunately throughout this process, despite treatment with Malaria he has had persistent respiratory difficulties. I saw him yesterday and noticed that he seemed somewhat fluid overloaded, had a large liver (which you can see with malaria as well), but also had a gallop heart rhythm. This child is currently in heart failure and made solely on the physical examination. There are no echocardiograms or lab tests here! I started the patient on Lasix (yes, we do have this medication) and today he is doing much better. Since we have very few patients today, I'll make congestive heart failure my diagnosis of the day. I hope and pray that he continues to improve. Several more patients were discharged today including the baby that wasn't pooping. We've had a few good days in a row which we both appreciate, especially since Dr. Hewitt and Dr. Dickens are trusting Jessie and I to run the pediatrics ward.

After rounds we all got ready and headed to church. Today we went to the Presbyterian church here in town. This was a smaller church than 2nd Baptist, but the primary language spoken was English which made things much easier for those of us that know only "small small" Mampule. The service was great including the music. They even said the Apostle's Creed in English. :) The sermon was interesting. The pastor spoke about listening to God and trying to hear what he is calling us to do. This couldn't have been any more appropriate for me since I am in Africa doing what I felt was my calling. As a second layer of that, I felt that just being here wasn't enough which made me reflect even more on what exactly I can do here and how I may help. One of my favorite parts of the sermon was when the pastor said that we need to be like the salt that improves the soups that we eat. We need to enrich the lives of those around us. Couldn't have said it better myself. Of note, they did mention how much they received in offering from the entire congregation the previous week which added up to 50 Ghana Cedis. This is total around $35 in the US. I will say that having 9 Sulamingas (non-Africans) visiting the church provided more funds than they normally receive in over 1 month. Not exactly your metropolitan mega-church.

After church we enjoyed some lunch and then several of us headed to the market for more exploring. Did I mention the market occurs every three days and frequently falls on clinic days when we cannot go? Market is always an enjoyable experience. I think they are getting used to us visiting since the fabric prices are starting to go down. It does help a little when you can speak some of their language. I, of course, could not resist some yards of fabric. I still remain torn on this matter as I enjoy the gorgeous fabrics and like to give back to the community that we are living in, but also try hard to not let the innate materialism win me over. I only lasted 1 hour at the market as it was blistery hot. After returning home, I got to play with baby Jude for a little while and then enjoyed watching a baseball game that was put together to include many of the volunteers here. I may have joined in if it were soccer, but no one really wants to see me try to swing a bat. Dinner came/went and I headed to the schoolhouse where I now reside to type my blog. My pictures will be limited today as my camera broke during church and would not let me take photos. After much deliberaton and help from my fantastic, amazing husband, I finally just broke off the switch that wasn't working and rigged up a fixed system. It's not perfect, but I can take photos again. No photos for the rest of my trip would have certainly been a sad occurence (although not the worst).

As always I hope and pray that you are all well. Please continue to keep the people of the Northern region of Ghana in your hearts. Today I am thankful for the overwhelming calling that has brought me to Africa to experience pain and heartache, death and dying that I never knew existed. I am thankful as it is through the most difficult of circumstances that we become stronger and more able to recognize and serve the needs of those around us.

What are you thankful for today?

Jill

Happy Birthday to my wonderful sister (in-law) Heather!! I hope you have a wonderful day!! I'm thinking about you!

Congratulations to Cara on her new baby girl!! I can't wait to meet her!! Jessie and I are fist fighting about who gets to hold her first!