Nathan & Megan’s Blog

Back in Accra

It’s been fun getting to be a tourist for the last couple of days.  Accra is okay, but they REALLY hassle you here to try to sell things.  It gets a bit old, so Nathan and I started trying to play with them.  We told one guy, “No habla ingles” and just started talking to each other in Spanish.  He replied, “Parlez-vous francais?” to which we replied, “No, solamente espanol.”  It actually worked!  He walked off with his buddy saying, “Now when you’re in Spain, you really need to learn Spanish….”  Hilarious.  We also bartered with one guy over an Obama shirt while a man was bugging us to take his taxi.  We ended up blaming the taxi guy and saying he said we should get the shirt for some ridiculously low price.  I don’t think the taxi man liked it, but we thought it was kind of fun.

Jimmy Huey is our liason here at the Baptist Guest House in Accra and has been really helpful.  We’ve got reservations for a bus ride to Capecoast at 7:30 tomorrow morning.  We’re planning on visiting the slave castles and hopefully doing the Canopy Walk at the national park nearby.  Then we’re going to stay at the Coconut Grove Resort in Elmina (the town adjacent to Capecoast).  It’s supposed to be a very nice place to stay, so we’re really looking forward to just relaxing for a night.  We’ll catch a bus back to Accra on Wednesday by noon or so and hopefully will have time to get all our luggage situated and take a shower before catching our 11:30 pm flight to Frankfurt.  We’re hoping this leg of the journey will be a lot easier than when we flew in.

Anyway, things are good here.  We’re looking forward to coming home and talking to everyone soon!

Trip to Paga and Bolga

Megan here.

Nathan and I got to practice being tourists this weekend!  I was on call Friday but luckily didn’t get called in overnight.  We got up early on Saturday morning and rounded on all the medicine patients.  Then we piled into a pickup truck with Andy (a medical student from Guernsey, which is actually its own country), Carolyn (a Peace Corps volunteer), and Issahaku (our driver).  Luckily the hospital was nice enough to loan us a truck, and Issahaku was nice enough to agree to drive us up to Bolga and Paga in Northern Ghana.  Unfortunately this meant we had to endure the rough dirt road between Nalerigu and Tamale again.  (Dad, I know you think the Knoxville roads can be bad at night in the rain, but trust me, you ain’t seen nothin’.  At night in the rain here, the roads don’t exist.)

We dropped Carolyn off in Bolga to do a radio show on HIV education.  The rest of us continued on for another 30 kilometers or so to Paga, which is right on the border between Ghana and Burkina Faso.  **DON’T FREAK OUT, PARENTS** but our first stop in Paga was the Crocodile Pond.  For a few Ghana cedi (the local currency), you can buy a wimpy looking chicken and pay to have your picture taken with a crocodile.  They let you hold the crocodile’s tail and squat above it.  Nathan and I figured we should probably NOT tell our families we were making this trip until we came back safe from it, but everything went fine.  The crocodile made one or two kind of quick moves, but otherwise was fine.  We took our picture with the largest crocodile we could find, but there were about 4 others waiting around hoping for a photo-op (and so also a chicken).

Our next stop was Pikworo slave camp, which was actually very interesting.  They gave us a guided history around the camp.  We saw the rock formation where there were bowls carved in the rock for them to eat out of, the large stones they used as tribal drums for entertainment, the slave cemetery, and the punishment rock.  It was almost surreal to see the conditions the slaves endured.  It was also interesting to hear that the camp was originally run by Ghanaians who trapped there own countrymen and other Africans to become slaves.

After sightseeing in Paga, we drove back to Bolga for lunch.  We went to a semi-popular restaurant that is featured in one of the Ghana good books.  Because of this, there was a table of about 20 white people which seemed absolutely bizarre to us.  On a side note:  the Ghanaians (especially the kids) like to yell “saminga” (white person) or “samisi” (white people) when they see you passing by.  This is more of a greeting than any sort of racial thing.  It gets annoying after a while.  I have to confess, though, that when we saw two white people walking down the road in Paga, we all rolled down the windows of the truck and yelled, “Samisi!!”  Even though I know how annoying it is to be on the white person end of it, it was really fun.

After lunch in Bolga we went to the craft market in Bolga and managed to pick up some souvenirs.  They had a lot of beautiful baskets, tribal masks, paintings, metal sculptures, leather purses…  I can’t list what we actually bought, though, because the recipients could be reading this blog. 

After we finished in Bolga we came back to the compound and just spent time enjoying our last days with the other volunteers here.  All in all it was a great weekend!

At 4 am Monday morning (yikes, that’s only 6 hours from now!) we drive to Tamale to catch our plane that leaves for Accra at 7.  We’ll spend tomorrow sightseeing in Accra and stay at the Baptist guest house.  Tuesday we’ll make our way to Capecoast to see the slave castles, the beach, and one of the national parks.  We’ll stay there Tuesday night then head back to Accra to catch our flight that leaves around 11 pm Wednesday night.  We’re excited to have a few more days to explore Ghana, but we’re also looking forward to coming home.  I miss talking to my family and friends live!  Hopefully the  next time we blog will be from American soil….

Howdy!

Hey everybody,

Its been a couple of days since I’ve written (Megan’s better about writing), so I thought I would update you all on things here.  I’ll start off a little different tonight.

 Case Examples (its kind of like House, MD)  Sorry I’ll try not to be too graphic

1) 2 year old boy presents to the clinic with headache, fever, “yellow urine”, and mucous (red) stools.  Questions you’d like to ask…..Yes the kid has been vomiting, yes the kid has diarrhea.  We’ll stop there because that is usually as much as will get translated (unless we’re really persistent).  So you want the physical exam (next part).  Kid is warm, sweaty, pale conjunctiva, Heart rate is fast, some what sleepy/lethargic.  What is your differential diagnosis??? 

        Answer…..Malaria. 

 This a pretty common thing we see here, especially in rainy season.  At times I don’t believe it is so rampant, but the peds ward is full of malaria.  Most of the time it is not so bad, but after looking at the blood under a microscope and seeing the parasites if they look bad enough you’ll check to see if their anemic.  We transfuse for hematocrits >18 (hopefully they have a family member).   Lots of times they’ll have seizures due to the illness.  We have had a few kids really sick and not due well.

2) 49 year old female with waist pain (everyone has it), mice under skin, neck pain, fever, head ache, legs swelling.  Not much more to be had from the translator either.  Exam is mostly normal  (the people are very stoic about pain here).  Differential diagnosis.  Waist pain usually means low back pain. 

           Diagnosis: arthritis of the neck….probably malaria too

    Its amazing that most of these women do so well here.  When you walk around you see tons and tons of women carrying 20-30 pounds on their heads.  Pretty much anything you can think of.  Loads of sticks, water, food, etc.   We can’t do too much for them other than motrin and tylenol.  I don’t know how to tell them not to carry stuff on their heads since they rely on it so much.

We get lots of stuff like that in clinic.  We still haven’t determined what mice under the skin means.  We do see a lot of common stuff here as pointed out earlier.  Kids are a little different in that a lot of admits are for malnutrition, malaria, and respiratory stuff.  Also lots of newborns/preterm kids with fevers.   Common diagnoses for adults are pregnancy, heartburn, diabetes (most people do not have refrigerators for insulin), hypertension, arthritis, colds, abscesses, hernias, etc.  So, a lot of our training helps us out with that.

Call is usually when you see interesting stuff.  Although usually at the end of the day we help with procedures and stuff.  Lots of crazy skin infections and wounds (from bike wrecks and stuff).  Its been a really good experience with suturing and working with our hands. 

 Before I quit, the volunteers, myself and Megan included, tried fufu (a local delicacy yesterday) that a peace corps volunteer brought.  fufu consists of smashed yams.  Kind of like 1/2 cooked mashed potatoes with play dough consistency.  They usually eat it with soup (kind of a curry).  It was ok I would say.  The soup was good, the guineyfoul (chicken like) was good, but fufu not so much.  Its kind of like a filler (pasta, rice), but weird tecture.  But it was definitely worth trying as normally we have western food.

 The next two days are mine and megan’s last calls.  We leave for the capital on monday and site see for 2 days and head back wednesday.   We’re still doing well and will keep you updated.

 Nathan

 p.s. Chris Wheeler: If you want more details write me and I can share them, otherwise I’ll fill you in next time I see you.

Megan’s Second Call

My second call definitely felt eventful!  Saturday (my call day) was a busy one.  First off, rounding took longer than normal because Dr. Hewitt was off this weekend and we were at half strength to round (we’ve been dividing up the weekend to get days off).  One of the first guys I saw in the male ward was diagnostically interesting.  He was admitted with the complaint of dark stools (melena), puffy face, and generalized weakness.  Melena can be a sign of gastrointestinal bleeding.  His story sounded kind of weird to me, but then I looked at his eyes and realized he had big hemorrhages in both eyes.  That concerned me because it suggests that he’s having a bleeding problem.  We’re limited in what laboratory studies we can order here, but I ordered a complete blood count, urinalysis, and a clotting time.   The nurses were very dubious about the clotting time, because normally that’s only ordered in snake bites.  I’m glad I ordered what I did, though, because the patient’s blood didn’t clot.  His blood count showed a white count of 127 (very high), platelets of 29 (very low), and 90% myelocytes.  All of those values told us that he had acute myeloid leukemia and so didn’t have enough platelets to clot his blood well.  Unfortunately, there’s not really anything we can do for AML here, so he ended up dying on Sunday from bleeding complications.  It was an interesting diagnosis but was hard to watch him deteriorate when we could have at least given him more time and possibly cured him if he’d just been back in the States where there are good blood banks and chemotherapy.

I also scrubbed in on an exploratory abdominal surgery on a 6 year old girl who had a hole in her small bowel secondary to typhoid fever, a disease we don’t see back home.  After that surgery I assisted Matt, a resident surgeon, with a skin graft on a woman who had had a left mastectomy due to invasive breast cancer.  She had a large hole in her chest that we were able to mostly close with skin we took from her left thigh.  The best part about her surgery was that we did it using ketamine for anesthesia.  Ketamine definitely works, but it makes people have strange dreams and often say really weird things.  The whole surgery she kept saying, “Hallelujah!  Jesus….  Baptist.  Amen!”  (not necessarily in that order)  She also managed to grab a hold of the back of Matt’s scrub top and was holding on for dear life.  We got a kick out of her. 

We had a ton of admissions that night, including a lot of run of the mill pediatric cases (eg malaria with convulsions, respiratory distress, malnutrition, etc.), a child with liver failure, a case of appendicitis, a woman with decreased mental status after a bike accident, and several snake bites.  One of the snake bite cases was a little out of the ordinary.  Her bite occurred 4 days prior to her visit to Nalerigu.  She’d received anti-venom at another hospital but was having these weird spells of gasping and shaking.  They didn’t look like normal seizures, so Mel (the med student) and I did a lumbar puncture.  Her LP came back grossly bloody, so we think that she must have bled somewhere in her brain after the snake bite.  (Some poisonous snake venom works in part by not allowing your blood to clot so you can bleed to death.)

I took an hour break for lunch, a half hour for dinner, and then we got back home around 11 or 11:30 that night.  Unfortunately, we got woken up around 2:30 a.m. because a woman came to the hospital in labor but had a cerclage.  A cerclage is sometimes used in women who have had several early miscarriages and involves putting a suture through the cervix to basically tie the cervix closed until the baby gets to term.  We went up to the hospital and managed to get about half the suture out but unfortunately had to call Dr. Dickens (the OB doctor here) to get the other half out.  Weird night!

The other thing that happened on call that was really not good was that I lost my wedding ring.  I knew I tied it to my scrubs before I went in to help with the surgery on the young child, and I remember when I untied my scrubs in the surgery office.  I searched the surgery office 3 or 4 times and even had Mel crawl on the floor with me with a flashlight but couldn’t find it anywhere.  Needless to say, Nathan was not happy.  The strange thing was that I didn’t really feel that upset about it.  Somehow I just had a peace that God would return my ring to me somehow, and that even if he didn’t it was just a physical object.  Not having a ring doesn’t in any way change how much I love my husband or how good my marriage is.

The next day I slept in while Nathan went to rounds.  He stayed at the hospital a little bit late helping with an appendectomy.  When he came home we were sitting at the table chatting when I suddenly saw a little silver band on his pinkie finger!  Immediately I knew that God had provided, just as I knew He would.  In the surgery office they have several pairs of clogs and stained shoes that can be worn into the operating room so you don’t ruin your own shoes.  Nathan had put on a pair of white clogs to go in the OR and spent the whole surgery annoyed that he had some rock or something in his shoe. Of course, when he got out of the OR and looked in his shoe, there was my ring!  God works in mysterious and wonderful ways.

Of course, I hope I don’t have to lose my wedding ring again for God to remind me of how He provides. 

Speaking of God’s provision, morning rounds in the Peds ward started off with a bang for me today.  The first baby I went to see was a 1 month old baby who weighs about 4 and a half pounds.  He was one of a set of triplets and was born at 7 months.  He was admitted to the hospital for pneumonia.  When his mom pulled back his covers today, he wasn’t breathing.  I couldn’t feel a heartbeat but could hear a slow one with my stethoscope.  The charge nurse came over and we did chest compressions.  They also got the Ambu bag to help give him oxygen.  Normally the children we have to resuscitate don’t make it.  We got him to start breathing again and got his heart rate up, but I have to admit, I didn’t think the baby would make it through rounds.  I left to see some other children, fully expecting that baby to be dead by the time I came back to check on him.  (Unfortunately there is no respirator here, so we don’t have much to offer a child that really crashes.)  When I had finished seeing the other children in beds, though, he was there making normal baby faces, stretching, and breathing just fine.  It was a crazy way to start the day, but we managed to save a little life.

So that’s some of the medical craziness we’ve been seeing over the past few days.  It’s not quite an ER, Gray’s Anatomy, or House episode, but it was still interesting. 

Just an ordinary day

I felt like Nathan and I should post something, but I’m not sure that we’ve got a ton to report! 

 We’ve settled into an easy routine here.  At first I thought it was sort of strange that no one here seemed to care that their feet were so dirty, but now I’ve stopped caring, too.  The majority of the roads in Northeastern Ghana and all the roads around the hospital compound are red dirt roads.  You get used to having red powder on your shoes and between your toes.  Everyone leaves their shoes at the front door, because otherwise you’d have to sweep the houses constantly.   I’m also getting used to having gnats in my drink.  I still pick most of them out, but I’m starting to care less and less every day.

I made another attempt at befriending the monkey in the back of House 6 the other day.  (She has a reputation for hating women.)  She was tolerating me pretty well, so I got brave enough to actual walk within range of her rope to get her empty water dish to refill.  Everything went fine until I carried her water dish back into range.  As soon as I bent over to put her water dish down she ran up behind me and jumped on my butt.  I don’t know if she meant any harm by it–she didn’t bite or scratch me.  More than anything it seemed like something our cat Jackson would do and made me laugh.

 I’ve learned a few phrases in Mampruli, the local dialect.  I can say good morning, yes, no, good afternoon, is she having diarrhea, do you have abdominal pain, and go to the pharmacy.  Obviously that’s not quite enough for a really good, deep conversation, but it’s a start.  For the most part the people seem so surprised I’m trying to speak Mampruli they just giggle.  When in doubt here, it seems like if you just say, “Naah,” in a sweet tone of voice, that seems to get you through.   One woman said something to me in Mampruli that was absolutely foreign to me today.  I shrugged my shoulders, grinned really wide, and said, “Naah…. That’s all I got.”  She laughed at me and we both went on our way.

 It’s funny to see how language doesn’t always matter here, though.  I feel like at least some of the patients here see that I really do care about them, even though I can’t say the words myself.  Also, kids are great to interact with.  A lot of the African children are terrified of us because our coloring and speech is so different.  In fact, we went to visit a village and a little boy was staring at me.  Without really thinking about it, I patted him on the head.  He screamed bloody murder!!!  About five women, all laughing because they’d seen what happened and knew I was as embarassed as the kid was scared, came rushing up to comfort him.  Never doing that again…  On the other hand, some of the kids more familiar with the hospital kind of like having us weird white people around.  Nathan and I were walking home from the hospital today when this little boy, probably 5 or 6 years old, came running up between us.  He didn’t really say anything, he just grinned at us.  We said some things in English to him, and he smiled and nodded at us.  He was just content to walk with us.  Then Nathan and I started doing silly duck walks, moonwalks, etc.  That got him giggling.  Language was completely unneccessary in that interaction.

This afternoon was the first time I’ve felt brave enough to actually venture out to run.  I think I was starting to get a little restless, so when it started thundering this afternoon, I decided within about 3 seconds that I was going running.  (The last few days it’s thundered and gotten very dark but not actually rained.  It really cools things down and makes for a beautiful lightning show.)  I changed into the longest pair of shorts I brought with me (knee level) and went for a run.  There’s something wonderful about running down red dirt roads in Africa with waving grass all around you and distant hills on the horizon, especially with the fantastic cloud formations rolling in and heat lightning.  It was also kind of funny having all the people on their bicycles and motos looking at me like I was crazy for actually running.  (Why would anyone waste their energy like that?  Where was I trying to go so quickly?)

Nathan and I have had the pleasure of working with a 79 year old retired pediatrician named Chuck for the last 2 weeks.  He had a wonderful story about being called to the mission field by the Lord during one of the darker hours of his life (after his wife passed away 10 years ago).  He’s been serving in a variety of different mission locations for the past decade.  He was a real delight to work with, always patient, humble, and kind.  Plus he had a sense of humor, which should never be underestimated.  Unfortunately, yesterday was Chuck’s last day.  He left for Accra early this morning and will be flying home to Delaware tomorrow.  Last night the Hewitts (the main missionary family here) hosted a litte going away party for Chuck at their house.  Some of the other volunteers had printed him up a certificate of appreciation, which we all signed.  It was a neat way to honor him for his service and to thank him for all the teaching he’s done for us over the past 2 weeks.  We were very sad to see him go but thankful we had the chance to meet him.  He was truly an inspiration.

 I have plenty of medical stories I could share:  lacerations repaired, a great number of end stage cancers newly diagnosed, the man with the strangest heart condition I’ve ever seen that died yesterday, the malnourished kids we’ve treated, the ultrasounds we’ve done, spleens bigger than livers, and the list goes on.  I won’t go into detail, because that might end up boring even me with the great number of stories.  :)  Suffice it to say that we’re seeing a lot of pathology, doing a lot of procedures, and hopefully helping a lot of people.

We miss everyone back home and appreciate all your prayers!

First Call

Hi,          (this is nathan)

 So, I had my first call at the hospital yesterday (megan has hers today).  At the hospital call consists of see emergencies (or what the workers think are emergencies) and seeing the people that the medical assistants admit.   MA’s are ghanans who triage/treat and are the first line of attack.

The day started with making rounds on hospitalized patients.  I had a first on pediatric rounds yesterday.  As I was sitting on the bed trying to examine a little boy, he started peeing (not too unusual), however this time he actually found his own mouth.  I was a little shocked my this, yet the mom just wiped his face off and went on with the exam.  During the morning I helped Matt, the general surgery resident, with a skin graft and then got to remove an infected finger.  Kind of cool I guess.  I wouldn’t have guessed it before I got here, but skin grafting is a very valuable thing to be able to do.  Lots of people with infections/accidents who need grafting.  After that I got to see a pregnant patient who was bleeding at 16 weeks.  Luckily she still had a viable pregnancy.  We do have an ultrasound machine here to look which helps.  After breaking for lunch, we came back (a 4th year medical student and I took call together) to make afternoon rounds.  This basically consists of seeing new patients and changing orders that MA’s make.  We had two incarcerated hernias come in during the evening which we had to go see.  We spent about 2 hours on one guy trying to reduce (put the intestines back in the abdomen).  After 4 people trying we were unsuccessful.  However the other guy’s just popped in for me after about 10 seconds which was pretty cool.  About this point (9pm) the one guy was being taken back for surgery on his hernia when a guy got in a motorbike wreck and sliced open his heel pretty badly.  The 4th year student and I fixed that while Matt fixed the hernia.  We tried to talk the guy out of riding motorbikes but apparently he left the hospital today on a motorbike. 

After this we didn’t get any more “calls”.  A call consists of someone going to your house and knocking on your door.  This is probably a little more annoying than a pager I think.  Today I have had the day off while Megan is taking her first call.  Hopefully she won’t have any “calls” tonight either because I need a good nights sleep

Nathan

Monday was an extremely busy day.  I helped with Peds again.  We rounded on all the kids in the Peds wards then went to clinic.  For about 1-1.5 hours it was Dr. Chuck (the almost 80 yr old pediatrician volunteer), a med student from the UK, and me seeing patients.  The med student (who’s been here a while and is pretty good) got called away after the tea break, so for the rest of the day it was me and the pediatrician.  At the end of the day, we counted up and realized we had seen 192 pediatric patients just in clinic.  And of course that doesn’t count any of the 40 or so that we saw in the wards on a.m. and p.m. rounds.  It was crazy!  On evening rounds in the peds ward we watched one child die.  He was just too malnourished.  Tuesday was a lot better, though.  We had 3 of us seeing Peds clinic patients, and we only saw 88 patients.  It felt really slow.  Monday was so busy because it was when the clinics had been closed over the weekend AND it was market day. 

We finished early Tuesday, so Nathan and I went down to the Operating Theatre to see if we could help with things.  I removed a sebaceous cyst, and Nathan removed 2 cysts/tumors.  Then we offered to help Matt, the surgery resident, do a skin graft. We’ve never even seen a skin graft before, so it was pretty crazy.  The guy was sick and had been drinking and fell into a fire.  He had extensive burns over his upper chest, left cheek and nose, and left eyebrow.  He’s actually pretty lucky to still have an eye on his left.  We ended up taking maybe 1/4 of the skin off his thigh and grafting that over his face and chest.  It was kind of wild!  We helped do everything, including sewing down the grafts on the face.  I didn’t really start the day expecting to do that!  All we can do is pray that the skin grafts will actually take, but if they do, then we gave that man a new face. 

Sunday we got to go to one of the only local tourist attractions–the Escarpment.  It’s kind of a sheer cliff face that drops off into this huge plain that stretches below you.  It’s something like 20 or 30 miles from both Burkina Fasao and Togo there.  We didn’t exactly realize what we were getting into when we agreed to go, but I’m very glad we went.  Eight volunteers piled into a pickup truck driven by Dr. Hewitt, a missionary who’s been here for something like 20 years.  4 volunteers rode in the cab and 4 in the back.  Nathan and I volunteered to ride in the back (it was nice out).  Eli and Andy sat on a bench against the cab of the truck while Nathan and I settled into fold out lawn chairs braced against the back corners of the bed of the pick-up.  Yes, fold out chairs in the back of a pick up.  We thought we’d probably feel reasonably secure, but we didn’t exactly take into account all the potholes in the dirt road.  At one point Nathan’s chair bounced up into the air, at least a few inches off the bed of the truck. At that point we both decided to hold ourselves down with at least one hand at all times.  <grin>  It made for tired arms by the end of the ride!

The trip itself was lovely, though.  The weather that afternoon was actually quite nice. I remembered to put on sunscreen so didn’t get burned, and the scenery was great.  We drove through small village after small village of clay huts.  At least half the people yelled and waved at us.  (I’m sure they don’t see a truck full of 9 white people drive by every day out here.)  We got some good pictures on the way and thoroughly enjoyed the trip.  The view from the escarpment itself was great.  We climbed our way to the top of a large rock formation, scrambling our way through “Fat Man’s Squeeze”, one of the first obstacles of the little climb.  The view was worth it, though.  I think the worst part about the whole day was that Monday I realized I had a horrible, itchy red rash on the backs of my arms.  Everyone else had it afterwards, too, so I think it’s from all the tall grass we walked through (something like chiggers).

I’ve had a little bit of difficulty posting pictures on the blog site, so I’ve decided to just post all the photos on Facebook.   If anyone wants to look at pictures from our first week, please feel free to look up my page on Facebook and look under Ghana.

We miss you all!

Love,
Megan

The Escarpment

Sunday Dr. Hewitt took a group of volunteers to the Escarpment, a fairly sheer cliff face overlooking a huge plain below.  8 volunteers piled into his pickup truck for the 1.5 hour trip over pot-holed dirt roads.  On the way there, Nathan and I rode in the back of the pick-up in fold out lawn chairs.  That was certainly an experience!

First Day of Rounds

From Megan:

One thing Nathan forgot to mention was that we also talked with a Nigerian man while we were stuck for 5 hours in Casablanca’s airport.  At one point, he spoke up and told me that I looked African.  I was a little confused as I’m very white and have blonde hair and grey eyes.  After some explaining, we realized he meant that I had wide hips and a bit of a booty.  :)  I decided to take it as a compliment but have never before been told I looked African.

We got to help with morning rounds in the hospital this morning.  I spent my morning in the under 5 years old Peds ward with the pediatrician, Dr. Miller, who is currently volunteering.  There were so many children that several patients were sleeping on the floor.  The beds have no rails and consist of a thin mattress that they cover with a blue plastic sheet.  Any other cloth bedding is brought in by the parents.   The majority of the children hospitalized currently had malaria, so I’ve gotten pretty good with writing for quinine (10 mg/kg q 8 hours just so you know).  Many of the kids with malaria required blood transfusions, which come from the parents.  There’s no blood bank here.  We also had a case of suspected typhoid fever and several malnourished children, one with severe dermatitis.  We lost 3 children overnight, but I have to remind myself that we hopefully saved a lot more.

Later in the morning Nathan did a lumbar puncture on a sick teenage boy, and we helped Matt, a surgical resident who is doing his residency in Knoxville (we came across the world to meet somebody from home), do some wound debridements.  The surgical facilities are present here but definitely more primitive than home.  They mostly use ketamine for sedation, which means the people don’t remember anything but can still talk and move around.  People are very bizarre under ketamine, so it took a little bit of getting used to to hear them mumbling in Mrampuli (the local dialect) and making strange noises.  You’re never quite sure if they’re hurting or just deranged from the ketamine.

As for our living quarters, they’re much nicer than expected.  For right now, Nathan and I have a whole little house to ourselves.  We have a king size bed and an attached bathroom complete with functional toilet and a shower with hot water.  We have a small kitchen with filtered water right there, so we don’t have to walk across campus to get water.  There’s a guest house where we take all our meals.  They have a mysogenistic (is that how you spell it?) monkey tied up out back who hates women.  She got her rope wrapped around a tree and couldn’t reach her water today, so I distracted her while Nathan moved her water dish closer.  Every time I got remotely close to her, she ran and took a flying leap at me with her mouth wide open.  Yep, she definitely didn’t like me very much. 

There are also 2 African boys who like to hang out on the front porch.  I think they’re just inquisitive, but it’s a bit unnerving to have two children staring at you through the front window while you’re trying to read your Bible.  I guess when you’re tall and white you make for an interesting spectacle to the locals.

Well, that’s all for now.  There’s talk of venturing out to visit one of the local places to sightsee this afternoon.  More later!

Megan

We’re Here!

Hi everyone,

As this is our first post (and probably the first time I’ve ever blogged), I think it’s appropriate that it’s from Africa.

Megan and I had quite a time getting to our final destination.  I’m guessing that anybody who’s travelled to Africa can attest to some of the difficulties and delays.  Our flight out of DFW was 3 hours later which caused us to miss our connection to Accra, Ghana.  We did make it to Frankfurt without any trouble otherwise though.  After thinking about our options, I thought we’d end up staying a day in Frankfurt and flying out the next day (which would have been cool), but fortunately there was one way of making it to Ghana without staying overnight.  We caught a flight to Casablanca, Morocco from Germany and from there we flew to Accra.  Through our journey, we met a Ghanian doctor in Germany who practices in Dallas who was stuck in the same predicament as us.  He was a very talkative and friendly guy, and it was nice to have someone to travel with.  None of our other flights were delayed, which was nice, but we ended up traveling about 40 hours straight to our final destination in Nalerigu, Ghana.  We actually ended up getting on the flight we were supposed to get on from Accra to Tamale in Ghana, only that instead of sleeping the night before in Accra, we arrived at 2 am and left at 6 am.  We were allowed into the domestic terminal and shared benches with several sleeping guards.    One of the cooler parts of the trip was seeing H1N1 signs in English, Arabic, and French.

The hospital compound is pretty nice.   When we arrived they were in the middle of clinic, and it was a little daunting seeing several hundred people waiting to be seen.  The hospital and guest houses are pretty nice.  We actually have hot water, a fan in our bedroom and plenty of purified water which is nice.

Tomorrow we start rounding on hospitalized patients in the morning and after a few days of getting aclimated to the hospital I think we’ll be given more independence.  Sounds like a lot of malaria is being treated here.  Everybody so far has been really nice, and we think we’ll have a great month here.

We’ll post some pics and more comments as we go along!

Nathan and Megan