Melissa Halliday’s Blog

School children, rat poo, and Dinner the goat.

Well, I promised more stories, and here they are! There has been so much that happened in the last week that I’m sure I’ll forget some of it but that way I can just tell you in person!

1)      Trip to the local school: On Thursday, Donna, Ben, Alex, and I headed to a local school to meet the children and interact with them. I was really glad I got to go. Even though it wasn’t technically medically related, Dr. Young said I should go because this area is so focused on community and it would be a great experience. The kids were apparently on break but assembled especially just for us. When we arrived, they were all assembled outside the gate waiting for us and greeted us with “Welcome!” in unison. They presented Donna with flowers and then each took our bags and led us into their outdoor hut/classroom. There they sang songs for us, danced, and had a little presentation. These kids are amazing. Not only are they well behaved, but they are learning French, English and their native tribal languages and are fluent in all of them! Ivy, their teacher, has them all under good control, even the youngest. I took so many pictures and even got some videos! It was pretty funny though, because some of the youngest children here are scared of us because they have never seen a white person. One of the younger kids was sitting in his chair in the front, screaming crying with his hands over his eyes and refused to pull them down. Donna went to try to comfort him and he started screaming even more. Don’t worry…I got it on video.

2)      Cleaning out the storeroom: That same day, we headed back to the hospital. There were still a few surgeries going on, but Clint, Alex, Ben and myself decided to start organizing the storeroom of supplies off of the OR. I can’t describe how dirty and unorganized this room is. Because Dr.  Jean is so busy running both wards, doing surgeries and taking care of whatever needs to be taken care of, she has had no time to sort through the donations and so many of them sit there in boxes, unused.  Apparently, the first day the team started organizing that room, they found dead rats. It was unreal seeing what some people had sent to Saboba. Some of it is helpful, but many of the things sent were either A) so old they couldn’t be used anymore, B) broken,  or C) didn’t have all the necessary parts to use it. It’s like people think, hey this trash can be used in Africa…they’ll take anything! Unfortunately, all it does then is take up space in a relatively cramped environment already and not serve any good purpose. There are some really great donations in there, however, and I look forward to finishing organizing so that these things can be used!

3)      Dinner the goat: I don’t think I can express enough how giving and genuine these people are here. They live on so much less than I do on a regular basis and still want to give all they have to help the “strangers” (That’s what visitors are called here). The regent (remember him?? J ) Was so happy that the team from Buffalo had come, and that Clint and I were here that he donated a goat to the group for our dinner. Apparently tradition is that when you have a stranger come and visit you that you have them to your home and cook for them. However, because of all of the surgeries and other things going on, this wasn’t possible so he sent a goat so we could have it for dinner the last night the team from Buffalo was here.  I can honestly say, this was the first time in my life I’ve seen my food alive before I ate it. We went out back to see the goat and take pictures, and we were trying to decide what to name it. I suggested “dinner” and it stuck. So Dinner the goat, spent the night and early the next morning, making noise in the backyard. Then when I came back from the hospital later…no Dinner. We had a huge feast that night and a great time just hanging out and talking. Later, the Youngs presented us all with traditional African smock dresses for the ladies and shirts for the men. We tried them on and took pictures. It was such a fantastic night! I am so glad that all of these people were here. They were all such amazing and giving people and I am so blessed to have been able to work with them for a week. They will DEFINITELY be missed around here.

I have another great story to tell, but it’s kind of a long one, so I’ll share that in another post. I hope you all are doing well, are blessed, and I can’t wait to see you and hear how you are doing again!

Much love,

Melissa

Life in Saboba

Well, it’s almost the end of my first week here and I can’t believe all that’s happened! This week has felt like a year. There has been a lot of adjusting, a lot of meeting new people, and a lot of work! I feel like I’ve been so rushed for time that I haven’t given you all a good feel for what life in Saoba is like. I’ll do my best in this post and then tell a few other stories in another post later.

The drive into Saboba from Tamale is approximately 3 hours long and the last 35 miles are bumpy dirt roads. When I say bumpy dirt roads, I don’t mean a dirt driveway you’d find in central Indiana….I mean bone jarring rocks, pits, etc throughout the roads. The drivers obviously know these roads and are able to maneuver them quickly.  Each time I get in the car I wonder if we’ll end up at our destination. I learned later also that another danger on these roads are armed robbers. Apparently there have been more and more armed robberies on the roadways recently. Thankfully our group has been safe!

Once you arrive in Saboba, the main street through the town is somewhat paved. The first thing I noticed were all of the goats just wandering around. I was at first fascinated by all of the goats just wandering in the fields, around the hospital, etc. Now it’s such a normal thing that I can practically step on a goat before I notice it. I’m used to hearing them make noises outside of the windows when I’m inside. It’s weird that I’m used to that already.

The houses of the people in the villages in and around Saboba are mostly mud huts with thatched roofs. There are some freestanding buildings but most are very old and in bad shape. The house that I am staying in with Dr. Young and her husband Bob is well-kept but still not what most are used to in America. Thankfully they got electricity a few years back which works most of the time. There was one night it died and it was about 90 degrees outside (warmer inside) with no fan. Difficult to sleep!

We mostly walk everywhere. The hospital is about a 5-10 minute walk from the house and the clinic and administration offices are about the same. There is a women’s ward with approximately 30 beds and then several maternity beds, a men’s and children’s ward with approximately the same number of beds, and then the theater (Operating room…they’re very british here). What Dr. Young has done with what she has is amazing, but in comparison to healthcare in the U.S., it is unreal the conditions that are practiced in here.

By the end of the day, you are guaranteed to be covered in dirt and who knows what else both from walking places and also from working in the hospital. The wards are just open rooms with old beds and people laying everywhere. Often families are from so far away that when they bring their relative to the hospital they will stay with their family member, sleeping on the floor next to the bed.

I’ve been surprised at the acuity of patients I’ve seen here. I literally have only had one patient who DIDN’T test positive for malaria and typhoid. They all have it! One of my patients is end-stage AIDS and has tuberculosis. He hasn’t been on anti-retroviral medication and so his condition is slowly worsening. He is one of the most joyful people I’ve met though. I think what touches me the most are the children I see. Often, parents won’t bring their children in until they have been sick for a long time and they are very dehydrated and lethargic. It broke my heart to see a little 2 year old boy the other day, literally flopped back in his mother’s arms, not moving, not even wanting to eat. He had malaria (of course) and had been sick for a while, but was just so dehydrated that he was pretty much non-responsive. Thankfully, his had a happy ending and with treatment and hydration he seems to be doing much better.

This last week we saw a lot of women in the clinic and in the theater. Dr. Emmy Nylander was here with the team from Buffalo and she is an OB/Gyn. She was doing several gyn surgeries while she was here. One of the things that happens here in this rural area of Ghana is that women usually give birth at home in their huts. It is considered a sign of weakness to have to go to the hospital. There is a natural plant out here that is essentially Pitocin (increases uterine contractions) that is given to the women to help “speed along” the delivery. Unfortunately, many of these women are given this drug far too early and in situations where they should not get this. This early and increased pushing leads to a lot of complications, one of which is VVFs. (Warning: this is medical so if it might gross you out you can stop reading now. :)  )

VVF stands for vesico-vaginal fistula. Essentially what this means is that there is a hole between the bladder and the vagina. This hole allows for leakage of the contents of the bladder constantly without control. When I first heard this I didn’t realize how big of a deal it was.  For these women with VVFs, their life is over. They are complete social outcasts. Many of them live alone, they are usually avoided by everyone because they smell so badly and their husbands often divorce them. They are poor, abused, and lead miserable lives! It was so sad to me because even when we were examining these women, they are told not to cry (yes, not even during labor….). Some of these examinations were pretty painful, but the women never made a sound, but tears were streaming down their faces. It breaks my heart even now just thinking about it. So many of these women live like their lives are over. Dr. Nylander was able to help several of these women this week with surgeries, but there are so many more out there and many of them are incredibly young as well! I saw a 26 year old who had had the problem for 8 years already and unfortunately was not operable. Her life is over and at such a young age….So sad.

It is amazing to see how medicine is practiced here with so few resources. Unless the medication is on the WHO drug list (world health organization) they often can’t get it here and even some of those medications aren’t easily available. The ASV (anti-snake venom) which is used in snake bites was actually developed against East African snakes and not West African snakes and also not against both kinds so it is often not as efficacious as it otherwise would be. There are no x-rays, CT scans, or other diagnostic tools…only basic labs like urinalysis, hemoglobin, malaria peripheral smear, and widal test for typhoid. Often even with the best physical exam, the diagnosis and treatment becomes a creative guessing game where you have to pair what is most likely going on with what treatment you have available. Like I said before, Dr. Young is amazing at how she does all she does with what she has here available.

Well, I have SO many more stories to share, but I will try to write more later. I hope you are all doing well and I can’t wait to tell you some of these stories in person!

Midnight traumas, marriage proposals, and that one time I got locked in a bathroom in Ghana…

Day #3 in Ghana (4/14/09)

I am sorry it’s been so long since I’ve posted. The internet is not exactly reliable here and I haven’t been able to connect nearly as often as I would like. I’ll try to update you on what’s happened in the last few days.

Sunday: I left the Baptist Guest House in Accra at 5am to try to catch my flight to Tamale. We weren’t sure if it was going to fly or not since it was Easter Sunday and Antrak (the in-country airline) can be unreliable at times. Thankfully they were flying that day. I was only allowed approximately 20kg (about 44lbs) on my flight to Tamale, but they allowed me to bring the extra weight due to all the supplies I was bringing for the hospital. For 24 extra kilos they only charged me 10 Ghana Cedi which is the equivalent of $7 USD. Not too bad for almost 50 extra pounds of weight!

Once in Tamale, I was picked up by a driver who then drove me to a gas station in Tamale and a driver from SMC picked me up from there. It was approximately a 3 hour drive on VERY bumpy roads back to Saboba. The last 35 miles of the drive were not paved and were rocky dirt roads.

Sunday night was spent at Dr. Young’s house. There is a team of approximately 7-8 people here from Buffalo, NY that is helping the hospital and Clint Olsen, a family practice resident from Oklahoma is here as well. It’s been really good having so many Americans here at least initially because it’s helped me to have that social interaction and made my homesickeness a little less.

Monday started our first official day of work. It wasa long day of moving supplies to the hospital, seeing many women with Dr. Nylander (she’s an OB/Gyn from Buffalo who is here until Friday and is doing several surgeries while she’s here). Dr. Nylander (Emmy) is incredibly nice and caring and a fantastic teacher so it’s been great working with her for the past few days. Today was more of the same…rounding in the morning, surgeries and other patients in the afternoon.

I think what makes the days feel so long here is the heat. I am usually up by 5am or so and go to bed at approximately 9pm. It sounds early, but after  a day of being in over 100 degrees heat and incredible humidity, you’re tired! The first night I was here the electricity went out due to a storm somewhere else in Ghana and at 3am I woke up to a REALLY hot room and couldn’t fall back asleep because it was so hot!

Since my brain’s not functioning to well right now, here’s a few highlights of the last few days:

1) Marriage proposal: So apparently a girl has to go all the way to Ghana to get a date. Yesterday (Monday) morning we went to meet the regent. Apparently here, in the tribal system there is a “head chief” (Not the actual name but I can’t remember his title). Well, he recently died, but until they perform his funeral (which could take several years due to traditions) they can’t appoint a new chief. So, in the meantime his son is acting as the regent and I guess does whatever the head chief would have done. Well, it’s very important in Ghana to meet the important figures in the local villages. We went to meet the regent and as we were talking with him (through a translator) the regent said that he had talked to Dr. Young and asked her to bring a girl from America so that he could have a child with her that would bring together both cultures. He said “maybe the Doctor Melissa can stay and be my wife.” I’m really hoping he was kidding. I’m sure it was all good-natured, but if they show up at the door with goats and chickens I think it’s time to get worried.

2) Midnight trauma in Ghana: Last night as I was drifting off to sleep, I was in that perfect place in between being asleep and being awake when suddenly I heard my name called. I thought I was still in the U.S. at that time. I quickly figured out that I was in Ghana and it was Dr. Young at my dor and she’s telling me that there was a tractor accident and she wasn’t sure how many casualties there were. I threw on my scrubs and stethoscope and headed out the door. Apparently the tractor had tipped over and two women had fallen off, one crushed below the trailer behind it. She had a lot of hip pain and leg pain and a large laceration to her right great toe. I stitched up the toe, but without x-rays it’s difficult to tell if she had a pelvic fracture or not. We’ll watch her over the next few days to determine if we think she does have a fracture or not. It’s been interesting seeing the difference in how the medical care takes place here without all of the ancillary studies we have at home….they still get great care, but sometimes it’s frustrating because you never know what’s really going on.

3)That one time I got locked in a bathroom in Ghana: So the other night I headed to the bathroom and shut the door behind me as usual. Anyway, the doors here are a little difficult to shut and have a tendency to swing open, I pushed on the door until I heard it latch. I had done this several times before and no problem. This time when I went to open the door, the handle turned, but nothing happened. I turned the door handle, pulled on the door…nothing. I ended up having to knock on the door until someone heard me at the back of the house and about a half an hour later was rescued. I had fun hanging out with the lizards in the bathroom…. Not a huge story, but I look forward to being able to say….”Hey, you remember that time I got locked in a bathroom in Ghana???”

Well, I’m sure I have more to write, but my connection is dying and I’m tired and my brain isn’t thinking well. I miss you all and hope you’re doing great! With the internet speeds here I don’t think I’ll be posting pictures until after I’m back in the states in May.

Blessings!,

Melissa

Updates!

Note: I wrote this post on my first day in Ghana but am just now getting to post it. I’ll try to post as much as I can but the internet connection here in Saboba is a little spotty.

Ghana Day #1: (In Accra, Ghana)
A few things before I start the post: First of all, if you have known me for longer than a day,  you know that I am a very talkative person. That being said, most of these are going to be pretty conversational. I’m not a writer or anything but what I can promise is that each of these posts will be written exactly how I experience things. Some might have some significance, and others will just be a retelling of what happened. Either way I appreciate you following how I’m doing! Secondly, I will try to write something most days of the week, but not knowing when I have an internet connection, several may be posted in one day or as one huge post.

It’s my first day in Ghana. After nearly 24 hours in airports and on planes, I arrived in Accra, Ghana around 6pm local time. My body clock is so off-schedule right now. While I didn’t sleep well on any of the flights and I am tired, it’s almost midnight local time and I can’t fall asleep. Tomorrow should be interesting! I’m scheduled to go to the airport to catch a flight from Accra to Tamale at 5am tomorrow. From Tamale, I will be picked up and driven to Saboba where I’ll be staying for the next four weeks. I am praying that the flight ends up flying tomorrow since this airline has been known to cancel at the last minute and it’s Easter Sunday.

On the flights, I mostly kept myself busy by trying to read, trying to sleep (trying being the operative word), and watching some in-flight movies. I did finally get to watch Marley and Me on the flight from Frankfurt to Accra….and yes, I did cry like a baby during the movie. I think my neighbor thought something was wrong with me.

Not much else to report. I am anxious to get to Saboba for many reasons. I am more homesick than I thought I would be. I’m sure this is all natural and a part of the adaptation to the new culture, but I am acutely aware that I am no longer on my home country’s territory. Being a social person, it’s been difficult for me to spend the last 24 hours of my travel essentially without conversation and uncertain of what the next four weeks hold. Don’t get me wrong…I know this is an amazing opportunity and holds so much potential and I am excited for it. I am just feeling the pull right now between my life at home and my life here for the next 4 weeks.. I’m reminding myself that growth isn’t possible without growing pains. I have been reading Mark Batterson’s “In a Pit with a Lion on A Snowy Day” book on the way here. Great book and so appropriate right now. It’s all about facing your fears and living up to the potential that God has for you. Below I’ve listed two great quotes I read in that book over the last day.

“Ho much happer you would be, how much more of you there would be, if the hammer of a higher God could smash your small cosmos.” G.K. Chesterton

“The greatest breakthroughs in your life will happen when you push through the fear. The defining moments will double as the scariest decisions.” Mark Batterson

Oh and one other small blessing that brought  small piece of home to Ghana..in my room in the guest house where I’m staying, the sheets are the same as Rachel and Brandon’s where I stayed for one of my rotations. It reminds me that this truly is a small world and makes me smile a little.

Until next time,

Melissa

I’m leavin’ on a jet plane…

I can hardly believe that in less than 24 hours I’ll be at the airport getting ready for the first leg of many flights to Ghana! I am excited, nervous, and praying like crazy! I will miss my family and those of you at home and around the US but I know this will be a life-changing experience for me. I am trying to get all of the little last minute things done before I leave but I thought I’d give you all a general idea of my travel plans. I’ll try to update this as soon as I can in Ghana but I’m not sure what my internet connectivity will be there yet.

Departure Itinerary:

4/10/09
St. Louis–>Washington D.C
Washington D.C–>Frankfurt, Germany (overnight flight)
4/11/09
Frankfurt, Germany–>Accra, Ghana
Stay overnight in Accra
4/12/09 (Easter Sunday!)
Wake up REALLY early and head back to airport for in-country flight from Accra–>Tamale, Ghana
Picked up at Tamale airport and drive approx 2 hours to Saboba

Return Itinerary:
05/07/09
Tamale, Ghana–>Accra, Ghana (leaving a day early so that I will not miss my flight home…important!)
5/08/09
Accra, Ghana–>Frankfurt, Germany (overnight flight)
5/09/09
Frankfurt, Germany–>Chicago
Chicago–>St. Louis (HOME!!)

Thanks for all of the prayers and support! They mean the world to me and I wouldn’t have this opportunity if it wasn’t for the support of all of you!

Much love,

Melissa

Welcome!

Hi everyone! I hope you were able to find this link easily. This is my first post on the blog I will be using to update all of you on my trip with INMED to Saboba, Ghana! It seems like time has flown since I first found out I was accepted to travel to Ghana with INMED for 4 weeks! It’s hard to believe that in a week I will be leaving for Ghana for four weeks. While this is an exciting time, there are so many things left to do before I leave! Below is an update on the progress of my preparation and a few prayer requests.

1. Funding–First of all, thank you so much to all of you who have been able to support me financially. Your help and support means so much to me and this trip would not be possible without you! I have been blessed with raising a significant portion of the funds required, but have not yet met my goal. I know that God will provide the rest though and am so thankful for what he has already provided!

2. For all of you who are praying for me and my trip THANK YOU! This means more than any help that you can give me. So many prayers have been already answered and I look forward to seeing so many others answered. Several huge blessings have happened already. Some of them are below
–St. Vincent Mercy Medical Center, the hospital I worked at my 3rd year of medical school, was able to donate several surgical supplies and tools which will be donated to Saboba Medical Center
–I have been blessed with financial donations from several family and friends and am so grateful for all of your support!
–I found a pharmaceutical representative who is donating her leftover pens and notepads to me for use at the hospital! It was somewhat difficult to find these as the US government changed the regulations on what pharm reps can give out to doctors’ offices anymore. This is so great because it will be used at the hospital in Saboba!
–I have received so much moral and prayer support from friends that I can’t even begin to thank everyone for all they’re doing! This trip would not be possible without you!

3. Travel: My official travel dates are April 10th through May 9th. I will be leaving St. Louis, MO on April 10th and flying Accra, Ghana via Washington, D.C. and Frankfurt, Germany. Once in Accra I will take a plane the next day from Accra to Tamale. In Tamale, representatives from the hospital will pick me up and we will drive the remaining distance to Saboba. The return will be fairly similar. All in all, I will be traveling about 2 days worth both ways.

4. I have my malaria prophylaxis in hand, I have gotten all of my immunizations (ouch!), and I have many of the various supplies I will need. I have  a few last minute errands to run but these will all be done this weekend.

Prayer Requests:
1. Safe travel–This is the first time I will be traveling internationally. I have many layovers and connecting flights to make. Please pray for safety as I travel, and quick adaptation to the new culture and time zone!
2. Please pray that I will be able to be a blessing to the people that I will work with and serve.
3. Finances–please pray that the remaining funds will be raised!
4. Last minute things–please pray that I do not forget anything that needs to be done in the remaining week before I leave and for the time and strength to do it all!
5. Health–pray that I will remain healthy throughout the trip! There are so many diseases in Ghana that are foreign to us in the US and to my immune system as well! Please pray that the vaccinations I got and my malaria prophylaxis will work as they are supposed to and that I will not pick up any other things along the way!

On a personal note–I recently found out that I matched to Indiana University’s emergency medicine residency and will be starting there on July 1st! This was my first choice for residency so I am very excited and feel very blessed! In all the chaos of preparing to leave the country I am also trying to find a place to live in Indianapolis and wrap up my med school paperwork and finances. If you could pray for all of this to get done as well I’d appreciate it!

Much love and blessings,
Melissa