This is what the Ghanaians say when they are done work for the day. They will always ask, “are you closed?” And now I am officially closed. Done. Only one week left in Ghana, which will be spent at our favorite beach. I am very much looking forward to this time, hoping for some rest and time to think about what’s next in life. I am also looking forward to hanging out with the amazing friends I’ve made. How blessed and protected we’ve all been. Thank you all for your emails, love and prayers. I can’t say how much I appreciate it all. Can’t wait to see you all at home!!
Thursday, April 15, 2010
Three Countries in Five Days
As the week in the village concluded…we began to realize that we were DONE! No more clinical, no more school! It’s pretty cool to finish it out in Africa! And if you Did not already know, there was some confusion about dates, so we ended up with 3 extra weeks of free time at the end of our trip. I debated what to do, to volunteer somewhere or to travel with some of the girls from our group. After looking at a few volunteer opportunities and experiencing some time at the Osu Children’s Home, I decided that this was not the trip to do that! Too many letters, too many hoops to jump through. Therefore…I am celebrating my degree with the girls as as we travel a bit of West Africa!!
A celebration breakfast in Kumasi - all together one last time
before we went our separate ways.
Sarah, Kate, Heather, Laurie, Erin, Stephanie and I started by making the 12 hour trek by bus and tro-tro to Mole National Park, which is in north western Ghana. Half the trip was in a tro-tro on the worst washboard EVER! It took us about 6 hours to cover 86 kms. When we reached Mole we went on a walking safari and got to see warthogs, various kinds of antelope, crocodiles, baboons, monkeys, soldier ants and best of all elephants. We got to walk around them – probably a couple hundred feet away!
After visiting Mole, we stayed at Larabanga, a strictly Muslim village of about 3000. We stayed at the Salia Brothers Guesthouse, where we slept on the roof under the stars (kinda like sardines on little mats). It was actually amazing…and also the beginning to ‘roughing’ it with using a hole for a toilet and bucket showers! We really appreciated Lasani, the owner as he looked out for us, and ensured we got fair prices and were comfortable.
Ghana`s oldest mosque in Larabanga.
After Larabanga, we lost Sarah and Kate as they had to catch their plane back to Canada. The five of us carried on with another 12 hour travel day to Burkina Faso. We noticed a change in country as soon as we crossed the border! All of us absolutely adored Burkina, with its interestingly French atmosphere, patisseries (with all kinds of croissants, pastries and French bread), coffee (that you could get ANYWHERE), and motorbikes! Of our two full days in Burkina, we spent one on the road, with a hired guide and driver to take us to a town of Banfora, where we spent the night.
The next morning we went to Lac Tengrela, where we had a canoe trip through water lily and hippopotamus infested waters! We got to see about 8 hippos or so (from a safe distance). I wanted to go closer but no one else seemed to think it was a good idea (and of course it wasn’t until after that I learned that hippos are one of the most dangerous mammals).
After hippo watching, we went an hour or two down the road to hike through the Sindou Peaks. From the road they looked like average to moderately interesting rock formations but as we hiked in with our guide we found they actually tipped the charts!! We had about an hours hike through the rock formations and were able to summit and have 360 views.
The next day we spend in the city of Bobo-Dioulasso, which is a fairly quiet (by Ghanaian standards) place. The goal for that day was to rent motorbikes and cruise the city (renting motorbikes being the major reason why I wanted to come to Burkina)! We waited until after lunch, so we could rent for a half day and our guide arranged for three scooters for us. Not quite the motorbike I had dreamed of, but it certainly did the trick! It was probably a lot safer considering my driving habits too! So after two minutes of instruction (in French) we were on our way, coasting down the streets of Bobo. It was a great day, and I’m sure the next time I rent a scooter I will definitely perfect my wheelie!
The next two days were spent travelling back to Accra where we took some time to recover, wash clothes and pack again. Then we were off to Togo, this time just four of us, as Stephanie had a flight to London. Monday was spent travelling to Togo and once there we enjoyed a beautiful drive towards the small city of Kpalime. The next morning we woke early and hired a taxi to take us into the mountains of Klouto. We arrived in the quiet mountain-top town of Kouma Konda and settled in at the Auberge Papillons. Around 0900 we started out with our guide, Selestin, to do a ‘nature hike.’ I don’t think I’ve every been so excited to see butterflies as I was that day (actually I don’t think I’ve ever been excited to see butterflies). But we went off with our butterfly nets and cameras in hand.
Although each day seems to get better and better, this hike was the definitely the best day ever! As we slowly walked along, I was constantly amazed at God’s creation. Selestin took us on a walk through the mountains, stopping to show us anything and everything. While his English was limited, we were able to understand for the majority of time and learned a lot from him. There were so many amazing things, unbelievable things.
We saw tattoo ferns, ferns that would fold up in a wave with the touch of your finger, leaves that would turn into red ‘paint’ when rubbed together, leaves that turned into green ‘paint’, bark that pulled off a tree with orange ‘paint’ underneath, leaves that stuck to our shirts like velcro, leaves that were as rough as sand paper, waterfalls, scenic views, trees of every kind and the list goes on and on. We saw millipedes, masked grasshoppers, a preying mantis and butterflies of every size, shape and color. We also got to see (particularly to Laurie’s and my interest) the local farms of cassava, pineapple, yams, and peppers, as well as coco and coffee plantations. Walking through a tropical jungle…how can I even describe it? Then to top of the day, when we got back Selestin showed us his pet Walking Stick bug, which is a girl and is named Fuosa. Haha, we couldn’t believe it!
Our guide, Selestin, with Fuosa!
Overall though the entire day was amazing and screamed of God’s creative and loving character. As silly as it may sound, I had been really disappointed that I hadn’t been able to visit any farms in Ghana, and here out of the blue and unplanned we had an amazing tour of several farms. I feel so blessed and humbled, so overwhelmed with God’s love, kindness and mercy.
The next day we took enjoyed a breakfast by Pedro (the chef) and then hurried out to meet our motormen (as called by Appo, one of our guides). We rode motorbikes down the scenic, twisty mountain roads (praying the entire way for a safe trip). They motormen took us to the border where we caught a taxi to take us to the nearest town to catch our tro-tro. Just as we finished the worst of the winding twists of mountain roads, the taxi went out of control. Our driver tried to correct it, but couldn’t and we went flying into the ditch. Thankfully we just hit the bank and stopped, but poor Heather ended up with a goose-egg on her head from the roof. We were otherwise ok and were then able to find a tro to the next town.
Again I was amazed at God’s provision. That morning I had read about how in 1 Kings, God gave Ahab king of Israel victory over Ben-Hadad king of Aram (a few times). God kept telling Ahab, I will do this for you and “then you will know that I am the Lord” (1 Kings 20). After the events of the last few days I was impacted again at how God continues to show that he is the Lord. He truly is always present, all-knowing and all-powerful.
The Village: Apenamin
For our final week of clinical, our group and instructor packed up and headed out to a small village north west of Kumasi (which is the second largest city in Ghana). We had been invited by the village chief Nana (means chief in Twi), to come and do a community assessment and assist with plans for a health clinic.
The village has a population of about 300 people, with over half of the population below the age of 16. They do not have a clinic or any kind of health center and a Community Health Nurse visits only twice a month or so (arriving on a motorbike). The nearest clinic (staffed by a community health nurse) was several kilometers away and the nearest health center (more of an outpatients department but having midwives and a medical assistant) was 7 km away. So if you were a pregnant women in Apemanim, you would have to walk, or attempt to hire a taxi, if you wanted to have your baby at a health center. It’s crazy. While 7 kms may not seem far, it is when both you and your neighbors don’t own vehicles. If you decided to stay and have your baby in the village, it would often be done alone or with the help of a traditional birth attendant.
So we started the week (on Sunday) by going to a palm Sunday Methodist church service! This was pretty fun as it was my first palm Sunday with real palms! The service was done almost entirely in Twi, but they did translate the sermon in English after – which I think was lost a bit in the translation. For the rest of the week, we worked on a community assessment, breaking off into teams (maternal child, families with school-aged children and geriatrics) and doing interviews with the village residents.
The time spent in the village was great! It was so nice to enjoy the peace and quiet of country life again. And by peace and quiet I am choosing to forget about the dozen (or more) roosters which began the wake up calls around 0430 every morning! All I can say is thank goodness for ear plugs (though others were not so fortunate). The time spent in the village was also eye-opening. It offered us a taste of the realities of life in rural Ghana, as the people welcomed us into their homes and willingly shared with us (with the much needed help of translators). With assessments we considered their access to water and sanitation, nutrition, working conditions, access to health care and education. Many times I felt as if I were walking through a scene off a World Vision commercial; with the red dirt roads, mud and brick homes, and half-clothed, bare-footed children who became our constant shadows wherever we went.
Our initial focus was to gain as much information as possible and then develop plans and interventions which could be carried out by the next nursing group coming from U of A (in May). As the week progressed, plans for a clinic began to form and by Thursday we went on a shopping trip into Kumasi to purchase rudimentary supplies to outfit the clinic (weigh scale, Veronica bucket, stethoscope…). Nana volunteered a room which we cleaned and then organized with a bed, desk and wardrobe for the clinic. Jael, the Community Healht Nurse already assigned to the village, will now hold a clinic at least twice a week out of the new ‘facility.”
It was amazing to be involved with setting up this village clinic on my very last day as a student nurse. So special to play a small part in making a difference in the health of the individuals of a community. In May, our group is going to work with the next group of nursing students (who are going in May) to hold a fundraiser for the Apemanim Clinic. As we fundraise and as the next group goes, I that this clinic will be sustainable and beneficial as the health needs of the community are great.
Jael, Apemanim`s Community Health Nurse, in her new clinic.
Mamprobi Polyclinic
After finishing at 37 Military Hospital, we spent two weeks at the Mamprobi Polyclinic, which is similar to a community health center. Different clinics within included, nutrition, community health, mental health, STI, family planning, antenatal, maternity and labor and delivery, postpartum, and outpatients (and probably a few more I’m forgetting). It is located in an area called Mamprobi and it took anywhere from 45 minutes to two hours to reach.
We spent the first week at the polyclinic rotating through the various clinics inside. I spent two days at in labor and delivery (and failed to see any deliveries!), one in nutrition, and one between mental health and family planning.
The polyclinic does not have an inpatients, but it does have a labor and delivery ward, where midwives assist with deliveries. After delivering, women and babes are sent to a post-partum unit until they are well enough to go, which is quite often only a few hours. While I didn’t see any deliveries, there were a few emergencies that happened including meconium staining, postpartum hemorrhage, obstructed labor, and a babe in respiratory distress. I found it a little unnerving have such things happening at this clinic, as the woman would have to get a taxi to be transferred over to a major hospital about 10-15 minutes away (and that depending on how the traffic is).
The nutrition clinic has many focuses including weight gain or loss, cardiac and diabetic diets, etc. They also focus on rehabilitation for malnourished children. This program starts with the Community Health Nurse who assesses for malnutrition at child welfare clinics. Malnourished clients will be referred and encouraged to attend the nutrition clinic every day, where they will receive nutrition counseling and learn how to cook different foods in nutritious ways. Food supplies for breakfast and lunch are provided.
The mental health clinic was interesting as I sat in with a psychiatric nurse (who also happens to be the pastor of a Pentecostal church) doing patient counseling. Patient confidentiality flew right out the window (or perhaps it was never there to begin with), as the nurse assessed the patient, with me and about 5 other nursing students and a few nurses present. At times there would even be another patient in the same room. It seems absurd to me, but the patients didn’t seem to mind or be worried about others hearing about their illness/situation.
We spent the second week in community health, where we would be paired up with a community health nursing team to go out and do either child welfare or school clinics. I spent three days doing child welfare clinics, which consists of weighing babies and giving immunizations. The last day I spent at a school clinic where we went to a school for kids 3-5 years of age. There were (according to one teacher) about 500 kids at this school. The nurses and three of my peers and I sat in a semi-circle, while the kids lined up on benches and then came to us one by one to be assessed. We did a quick head-to-toe assessment on each child, assessing their skins, eyes, nose, ears, heads, looking for rashes or boils, anemia, lice, etc. It was a pretty intense process…much like an assembly line. Most of the kids were so excited to see us, but a few sobbed when they had to come near us. We seem to have that effect on kids! Haha.
Overall my time at Mamprobi was refreshing and a lot of fun. I appreciated seeing a different side of Ghanaian health care and felt like I had actually contributed and was able to help. At the end of the week I finished up my final assignment, a photo journal on water and sanitation. No more journals, papers, powerpoints or presentations!
A New Beginning
It has been over a month since I last posted a blog…and a lot has happened since!! I have started the countdown to coming back to Canada…ten days…and so I thought I would try and post a quick overview of the last month.
And to begin I want to share something which is by far the most exciting and important thing that has happened on this trip – about a month ago one of the girls in our group, Sarah, accepted Jesus as her personal Lord and Savior!! What an amazing and joyful occasion that was! It has been a wonderful and humbling experience to see Sarah’s personal growth and hunger for God and His Word (as well as a challenge to be just as hungry)! Please pray for Sarah as she is now back at home in Canada and beginning her journey with God.
Wednesday, March 10, 2010
Bible Study
On Tuesday nights (of most weeks) we have been going to a Bible study run by international students (mostly Americans). This has been a neat experience to get to know students from other countries and to fellowship. A few Ghanaian students have started coming and it has been amazing to see their passion. One guy named Edward was sharing with me last night about how privileged he feels to share the gospel of Christ with others. It seems that the mindset of some is so different and unique here in Ghana. Passionate is the only word that I can use to describe it. Some mornings, we will wake up to a ‘preacher’ in our front yard. There is one guy who will stand out in the parking lot literally shouting his message, if only he would share it in English! I still haven’t learned enough Twi.
Laurie and I have also started a Bible study for our group. We have met twice now and are going through a study guide on the book of John, which is focusing on getting to know Jesus. It has been wonderful to get together with others in our group and learn more about each other and where each is at in their spiritual life. Everyone comes from such different backgrounds. Please pray for us as we continue to meet.
I can definitely say that in being out of my comfort zone and seeing and experiencing so many difficult things, I am being challenged and tested in my faith. God has been showing me things that I need to change or work towards. He has also been showing me more of Himself and His character. There is so much to learn, but it is definitely a continual process. Praise the Lord for the good work He is doing!
"Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen." Ephesians 3:20-21
For the Love of Food!
Escargot anyone? We were offered snails when visiting the market in Akosombo.
However, this is about as close as one got to my mouth!
Food has been an interesting topic here in Ghana. While the new flavors and smells did not sit well for the first couples weeks, it has not taken long to adjust and I have been enjoying Ghanaian food ever since! Common dishes found in Ghana are fufu (mashed cassava and plantain) and kenkey or banku (fermented maize) which are served in a soup with meat. Other dishes include rice (plain, jollof, or watchi), plantains, and red red (bean stew). You can also find a meat pie and other pastries anywhere you go!
Erin and I have been trying to cook on our shared hot plate in our room as much as possible. We also go to the market often, where we can get a meal of rice, sauce and plantains or meat for about 1 Cede (less than a $1). Fruit has definitely been the food group of choice while in Accra. Fresh pineapple, mango, bananas, papaya, watermelon and oranges are in abundance. There is also a lady, Louisa, who sits on the sidewalk selling desserts. Banana pie, mango pie, pineapple pie, banana chocolate chip muffins, etc. Her treats are not at all the versions you would find at home, but nevertheless hit the spot!
One thing we always look forward to is Friday Seminar, where we gather at our instructor Bev's apartment and prepare a scrumptous breakfast together. Favorites have been banana pancakes and french toast. Fruit is always in abundance.
Saturday morning breakfast with the team. French toast made with fresh baguettes, cinnamon, vanilla and icing sugar. And more fruit!
Last week, Erin and I were invited to go her friend, Angela’s place for fufu. Angela, is a grad nurse working at Military 37, and lives with her sister Patricia in the army barracks behind the hospital, a small but cozy place. We arrived around 2 in the afternoon and found out that we had missed much of the work, as preparing fufu takes most of the day. It begins with peeling and then boiling cassava and plantains until soft. After this the plantains and cassava are mashed with a giant mortar and pestle. As I cut up the plantains and cassava, Erin attempted to help with the mashing, but was quickly dismissed, as she could not do it fast enough. Haha, I didn’t even try as I can’t keep a beat let alone pound with the pestle without smashing Patricia’s fingers.
Meanwhile, a soup is made, which has peppers, garden eggs, tomato paste, spices, etc. Meat is often included, and Ben has shared stories of ordering fufu with beef and receiving not only the meat, but the hide and intestines as well! It’s common to have it with fish as well (the whole fish, eyes and all). We had goat, which was amazingly tasty. Erin and I generously saved Angela’s favorite parts for her – the hide!
When the fufu is ready, it was put in a bowl with the soup and meat. I can’t say that fufu is my favorite, or that I will ever have it again, but the experience was more than worth it. The best part, was hanging out with Angela, her sister and their friends. However different our cultures may be, girls are still girls!
Angela preparing the soup.
Smashed plantains.
More smashing!
Erin's giving it her best shot!
FUFU!!
True to Ghanaian style, we ate with our right hands, Erin and I sharing a bowl - as a married couple would do in Ghana. Haha
Red Red with Plantains
The Night Market. Always a busy and popular spot for a quick bite to eat.
Heather and Sarah enjoying one of our favorite indulgences: Iced Coffee at Frankie's.
While the food has been overall delicious (or “tantalizing” as Louisa describes), I am definitely looking forward to being able to cook and bake in a full kitchen when I get home!
Osu Children's Home
For the past two weeks, our group has been going in pairs to the Osu Children’s Home, a government run orphanage. Caitlin and I spent Monday and Tuesday there. Throughout our time there the manager was very busy so we weren’t able to find out very much about the Home. As far as I know, it is a home for children who were abandoned, whose parents died or are keeping them there until they are able to fully care for them. Apparently they take in about 2 children per month, and are able to facilitate about 2-3 adopters per month. The orphanage is not staffed well and often depends on volunteers for help (which can be sporadic at best).
We spent the first day at the nursery, which was home to about 40 infants and toddlers, 0-3 years. Their daily schedule was something like, wake up, eat, toilet, bath, play outside (if old enough) until lunch, then eat, toilet, bath, nap…and so on. The toilet time consists of lining up all of the toddlers on their own little pot or bowl until they have gone. Very efficient!
I found it absolutely heartbreaking, while all of the physical needs of the children were met (adequate food, clothing and shelter), they were only lacking love and affection…and a family. The toddlers were not at their appropriate developmental stage and many were not well with respiratory illnesses. Probably the most difficult part was seeing the children who were around the same age as my niece and nephews. While Tyller is crawling around, a girl about the same age hasn’t even rolled over yet. I expected these toddlers to be running around but many of the children would sit there aimlessly playing with a toy or lying on the cement. It seemed they just wanted to be held. They wouldn’t even respond to tickling, but were just content to sit on my lap and be held close.
Volta Region
Wli Falls
Last weekend we took a trip out to the eastern region of Ghana. I left on Saturday with Ben and Sarah to meet up with a group who had left the afternoon before. We left the U of Ghana around 5:30 am to catch a tro in Madina. We found one and went straight to HoHae, where we caught another one to go to the tiny village of Wli (pronounced Vlee). On this last tro I think we broke another record, counting 26 inside, plus two foul (haha – a couple chickens one guys bought and held on his lap)! We met up with the rest of our group in Wli and went on a hike to the Upper Wli Falls.
The Upper Falls were amazing and well worth the hike. We were the only ones there – making it a relaxing getaway. Again, I am amazed at God’s creation and the diversity of plants, vines, trees, etc. Gorgeous!
Taking a break...one of many!
We made it!
A view along the hike.
A picture of the treacherous hike.
This little girl from the village of Wli came up and asked us to take her picture!
The next day we met up with our instructor and a few others from the University of Ghana and Military 37 in Akosombo. This town is located on the south end of Volta Lake, the world’s largest artificial lake (3283 square miles). It was made for the Akosombo Dam, under the leadership of Kwame Nkrumah, which has the potential to provide power for all of Ghana. We went on the Dodi Princess a boat which gives a 5 hour ride on the lake, taking passengers to the Dodi Island and back. This was a nice and relaxing way to spend the day, with a live band, barbeque, and some reading and sun-tanning (which is seemingly a recurrent weekend theme).
What would be a cruise on the Volta Lake without a game of Dutch Blitz??
Sarah and I catching some rays!
One the way home to Accra. Sarah and Sarah (aka - Sally Mensah - Leftenant Colonel and our contact at Military 37 - a very amazing and compassionate woman. It has been a privilege to get to know her).
Hello Trauma
The staff on Yebuah - maternity and labor and delivery.
A wonderful and fun bunch to work with.
The Sister of Yebuah ward - Leftenet Colonel Kanadu, working hard!
A few weeks ago I said goodbye to Yebuah ward and the pregnant women and babies and went to Trauma Emergency. This has been an interesting switch and I have definitely felt more at ease with my nursing skills in Emergency. As I mentioned in an earlier post, the single most common cause of trauma in Ghana is road traffic accidents (RTAs). I have seen this to be very true as a great majority of patients who come into Trauma Emerg are there because of an RTA.
After working a few shifts in Truama I suddenly became very aware of the risks associated with crossing the street. While normally I love an adrenaline rush…after seeing first-hand the injuries associated with an RTA, it’s not so enticing to run across three lanes of traffic. A lot of the accidents involve pedestrians, as it is a very dangerous business to be a pedestrian in Accra. While there are some cross-walks if you choose to use them you still take a big risk as the cars do not slow down, only honk their horn!
One case was particularly interesting, as a man and woman came in after an RTA. The man had been driving his motorbike and somehow hit the woman who was walking on the sidewalk (see even the sidewalks are not safe!). The man suffered minor injuries to his face and was quickly cleaned up and released. The woman had some abrasions and lacerations but nothing too serious. After the doctor had finishing suturing a deeper laceration, they were ready to discharge the woman, but as she got off the table, we noticed a fair amount of blood left on the table.
Lifting up her skirt to expose her thigh, we were horrified to see a massive hole in the woman’s thigh, with a severed tendon hanging out. I think a golf ball could have fit flush inside this hole. All over her thigh and skirt were little chunks of flesh and tissue. For those of you who are health care personnel and are wondering why this woman wasn’t “exposed” in the ABC’s of trauma…the woman absolutely had refused to have her clothing removed, and as there happened to be a shortage of sheets the nurse did not make her.
The craziest thing about the whole situation was that the woman gave no indication that she might have any such injury. She had moved herself from the wheelchair to the bed and back. She did not complain of any pain. This is probably due to shock, but may also have cultural implications. The doctor explained that this woman was from northern Ghana, where it is expected that an individual does not show response to pain. As we have been adjusting to working in the Ghanaian culture, I am constantly amazed at the differences.
Another observation we’ve made is that if a fracture is queried, you can count on there actually being a fracture, and a complex one at that. It seems in Canada, that we take a lot of x-rays to rule out fractures and generally find that there is no such injury. In Accra, it seems that due to the mechanism of injury, complex and ugly fractures are common. The cases involving children have been the hardest for me to work with, as it is terrible to see such trauma and injury to such young children.
Overall Trauma Emerg has been very interesting. I have two days left and next we move on to the Mamprobi Polyclinic (and I will share details on that when we find them out!). You can check out Erin’s blog for more Trauma Emergency stories.
I have had the opportunity to work with my friend Ginger on the ward, which has been such a blessing. It is so wonderful to have someone who can understand and relate to what I am going through.
Tuesday, March 9, 2010
Rasta
In an attempt to become more Ghanaian, Laurie and I went to get our hair done in twists (aka rasta) last week! As if the color of our skin did not make us stand out enough, I think we get even more attention with our hair in twists now! We went to Madina, a district in Accra about a half-hours tro ride north of where we are staying, which has a very busy and interesting market. We found the Anointed Ladies Salon, where it took 4 to 5 (anointed) ladies about three hours to twists in my hair. It took about the same for Laurie’s head with about 6 women.
They kept asking ayewah (is it painful?)…and thankfully we didn't find it too bad. Overall, it was a neat experience…and amazing as Laurie had the opportunity to share Jesus with a Muslim girl, who was working on her hair. We are looking forward to returning to the same shop to have it taken out (which for me will be sooner than later!).
About to begin the long process...see the plastic add-in hair they're holding? Yes I get to pack that around on my head! It was a somewhat traumatic experience to have five ladies pulling my hair in every direction, speaking a language I can't understand, and laughing saying obruni, obruni! Haha!
The finished product!! Laurie and I are now both about five pounds heavier!
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