Lisa’s Blog

1 October 2011, Saturday

Sigh.  This is my last day in Ghana.  In Africa.  I got to do some fun sightseeing.  We took another tro-tro to Usher Town today.  Our first stop was the Movenpick Hotel.  It was 6 months new, and one of the nicest hotels I have seen for sure, even by American standards.  We sat and enjoyed some light breakfast then headed to where the Makola market was.  It was a sight I’ll never forget!  The streets were lined with vendors even up to the third story.  Some people were calling out, trying to get your attention.  Others were telling you what they sold and how much.  Then we got to the food section and they were even more cramped, their stalls spilling into the next.  From peppers to yams, fish, to pieces of meat, spices and oil, anything and everything you could think about using to make your next meal.  The aisles were so narrow, you could walk single file comfortable, and then practice balancing if someone was coming in the other direction.  We got to a point where we were so deep in the maze of Makola market that we could imagine trying to get out of there by ourselves.  Luckily for us, when we asked how to get to the National Theater, she said, “follow me.”  Gladly!  But she was stealthy.  It was obvious she knew her way around and how to get around.  I was forced to dodge and duck and slither my way through the crowd, if only not to lose her! Finally we got to a busy street corner and she asks us whether we were going to get a taxi.  No, we will walk.  We walked a little while longer and started to call a cab.  I said, it’s ok.  She really wanted to call us a cab to take us there.  I puffed up my chest.  I’m from Colorado, I can walk.  Haha, just kidding.  I didn’t do any such thing.  But I did insist that we would walk.  She kindly pointed us in the right direction and left us.  I was amazed at how friendly and willing to help these Ghanaians were.  She completely went out of her way and took us way farther than she needed to.

We were hoping to have lunch at the National Theater, but since they weren’t serving food, we moved on.  After a little more souvenir shopping, we headed to get some food on our way back to the Guest House.

I’m writing this just before I get ready to pack, shower and go to the airport.  My flight leaves at 11pm tonight.  Ghana has been such an amazing experience, both medically and culturally.  I really wish I had more time to explore the country.

Days until I’m home:  1

30 September 2011, Friday

The driver didn’t show up until 4:30am.  The drive to Tamale is long and bumpy: 2 hours on a road only halfway paved.  Then the flight to Accra was short and noisy: 1.5 hours and the plane’s propellers were so loud that I could barely hear myself think.  I had the sort of headache you have when someone holds a vibrating object on your skull for 1.5 hours.

Once we got settled in Accra, Cody, Brittain and I head out to do some sightseeing.  First stop, Global Mamma to check out souvenirs and get some postcards.  We had an “incident” with one of the local street vendors: he had attached himself to Cody to try to sell him some artwork after Brittain and I politely but firmly said no thanks.  Cody is sometimes too nice and couldn’t say no effectively enough, so I decided to come rescue him.  I tried to say that we had to go.  I tried to re-iterate that he was not interested.  I tried to pull him away physically, but the guy had a death grip on Cody’s hands.  Finally, I got Cody loose, and we start to go, but the guy follows us!  We ducked into a souvenir shop where we hid for a while.  When we got out, he happened to be around the corner and called out to Cody.  When he saw that I turned around also, he said some not very nice things about me.  We quickly decided to get a cab and go to the beach.  On the way there, I know I was pretty shaken up and was discouraged from being able to do much more sightseeing without getting into awkward situations that had the potential to get ugly.  Luckily, we met three American girls doing a study abroad at the University of Ghana who had been here for almost 2 months.  They shared their experiences and gave us suggestions on different things to see and do.  They also gave us the courage to keep exploring.

We decided to get a tro-tro back to the guesthouse.  Tro-tros are probably the most commonly used mode of transport.  Basically, they are vans with seats from window to window and usually pretty packed with people going somewhere.  We got stuck in a bit of traffic, but decided that we were close enough to just walk the rest of the way.  Technically speaking, we were close enough to walk home.  Practically speaking, however, no map or pedestrian could tell us where we were, what the street intersections were, or exactly how far it would be to get where we were going.  There were no street signs to correlate on the maps.  There were no sidewalks.  There were lots of cars driving in the wrong lane.  There were even ambulances and police cars that tried, mostly without much success, to get ahead of the traffic.  An hour and a half later, we managed to get ourselves safely home.  But boy was I exhausted.  Between the early start to the day, the walking and the heat, I just could not muster up the energy to do much more than check email for a while.  Early to bed and early to rise will make tomorrow a much better day.

Days until I’m home:  2

29 September 2011, Thursday

Ah, the last day.  It was hard, but it was easy.  Everyone knew I was leaving.  I didn’t really try to say goodbye to everyone.  I said goodbye to the people I would really miss.  I think that it was better that way.  It’s always so hard to say goodbye.  Last day of rounds finished.  We passed out crayons and coloring books.

Station meeting tonight was fun.  I got to say goodbye to the rest of the team there.  I had planned on getting to bed early because we had to leave at 4:30am!

Days until I’m home:  3

28 September 2011, Wednesday

Ahh, last clinic day.  I had a good start today.  I woke up at 6am, had pancakes for breakfast, and then headed in for rounds about 7am.  I just wanted to be done by the time clinic started so we wouldn’t have to be there forever again today.  I ended up seeing patients in Hakeem’s room, which is nicely airconditioned.  Overall, clinic was actually fun for a change.  Hakeem and I were sharing cool physical findings with each other.  We consulted each other on unfamiliar medical issues.  We were colleagues and friends.  It was nice.  If I had known that clinic would be so much more fun with him, I’d have shared rooms with him much sooner!

Days until I’m home:  4

27 September 2011, Tuesday

Days until I’m home:  5

26 September 2011, Monday

I went out with Dr. Fuller (Robinson) who is a dentist.  He arrived yesterday and carries the reputation of being an energizer bunny.  We went to Sakogu, a small village nearby, and started pulling teeth.  I watched the first few, and then did some myself.  I probably pulled out about 7 or 8 teeth.  I never thought that pulling teeth would be such hard work!  I know my arm was sore by the end of the afternoon.  Now I know exactly what they mean when they say, “It’s like pulling teeth!” So if you ever need a tooth pulled, I’m your girl.  You’ll just owe me dinner.

Days until I’m home:  6

25 September 2011, Sunday

I was called to the maternity ward because a primip was not pushing effectively.  She had been pushing an hour and a half and got the baby down to +2 station.  The nurse wanted me to put a vacuum on.  I have only ever personally used a vacuum once in my life and that was under direct supervision of an attending.  And with everyone at church, I didn’t feel comfortable using a vacuum in case something went wrong.  So I did what I knew how to do: I evaluated her pushes and agreed that they were completely ineffective.  I coached her, as  best as I could through an interpreter who probably thought I was crazy and incompetent, how to push effectively.  An hour later, she was pushing only minimally better than before.  We turned her to her side.  Another 40 minutes goes by.  Let’s try squatting.  Only about 20 minutes pass before she complains that her legs were getting tired.  And I felt that squatting was the least effective position for her.  Back onto her back, we finally are making progress.  In just 20 minutes she delivered a healthy baby boy, who looked great!  I was so pleased with myself.

After I got her squatting, I was thinking, gosh, I’ve seen it used a couple of times.  I’ve done it once myself.  I know where to put it.  I am pretty sure I can put it on and can pull.  You could tell she was getting so tired, it was almost 4 hours that she had been pushing.  I came so close to just using the vacuum.  But everything about the whole situation made me feel that something terrible was bound to happen if I did what I knew I shouldn’t do.  And so I didn’t.  But boy, when she got on her back, it all seemed to click for her.  She was bringing the baby down beautifully.  And with just a few contractions, she delivered her baby all by herself.  Whew!

I did sense some skepticism with all of the coaching that I’d been doing for the patient.  The nurses had obviously not been telling the patient to do this.  I’ve heard that sometimes, when women cry out, the nurses will slap the woman and tell her to shut up and push.  I have yet to see that for myself, but I fully believe that it’s something they would do.  What a concept.

And in case you were wondering or haven’t yet figured out, epidurals are not an option here.  Not unless you were going for a cesarean.

So now, the countdown begins.  Days until I’m home:  7

24 September 2011, Saturday

During rounds this morning, I could almost take a full history in Mampruli.  The interpreter even remarked at how good I was :-)  I like patting my own shoulder, but really only in regards to language skills.  I like to think that I have a knack for picking up languages.   The learning really is because everyone has such similar complaints and you have to ask a select few questions so many times a day (particularly when I’m seeing 40-50 patients a day!) that you can’t help but catch on.

And, for those who know my baking, I’ve created the perfect brownies tonight: chocolate AND peanut butter!  I know you can’t wait until I get home

23 September 2011, Friday

Today was a pretty satisfying day.  I went to clinic, not surprised anymore to see crowds of people lined up all the way to the gate.  I started clinic, but left early (around noon).  Today, I went to see one of the Adolescent groups in Nagbo (the next town over, about 3 miles from Nalerigu) that was initiated with Public Health.  These adolescent groups were comprised of school children in the 12-16 age group.  They met weekly in groups of 20-25.  The group meetings were avenues whereby they learn about HIV/AIDS, STIs, teen pregnancy, drug abuse, smoking, hygiene, and dental hygiene.  Today, there were two “Peer educators” who had each gone to a workshop on HIV/AIDS and drug abuse and were going to share with their peers what lessons they had learned.  The workshops were in larger cities and one student was invited to go on about a quarterly basis.  Their attendance was paid for by the school/public health funds.  It was interesting to see the peers participate in discussion.  Lots of good questions were asked.  But most importantly, the information was coming from the peer, and not generally from the facilitator.  I must have been quite engaged because I could now kick myself for not remembering to take any pictures.

The person whose leg is below, presented to clinic with “leg pain” for 1 month.  I have talked about him before: he denied any injury and was seen in Tamale.  Yes, that is his bone.  His leg, amazingly, was not gangrenous. Yes, I am wearing two different colored gloves. (sorry about the picture quality)

22 September 2011, Thursday