Friday, February 29, 2008

Babies

Dr. Faile and Christy Lee (4th year med student)
Dr. Faile delivering a baby
The triplets. To keep the track of which triplet is which, the first has nothing on her hand. The second one to be delivered as a string bracelet wrapped once around her wrist. The last to be born has the string bracelet wrapped three times. It's quite a blessing here that not only were they delivered safely, but they are surprisingly large and healthy.

Thursday, February 28, 2008

TRIPLETS!

Sorry, I've been busy this week. I'm having difficulty getting my pictures to load! :-(

I have seen a lot of death here. BUT this week, I thankfully have been enjoying the start of life! Dr. Faile delivered via C-section a set of triplets! In all of his time here, he said this was a first for him. All girls, and all looking quite pink, healthy, and cute! I will admit I've missed the actual C-section, but I've been to 2 other C-sections this week.

I think I'm getting more skittish about waifu (manpruli for snake). They tell me it's NOT snake season, yet we are treating so many snakebites. And just for my edification, one of the patients brought in the dead waifu to show me. People are bitten by carpet vipers and cobras around here. The venom causes the patient's blood to not clot.

I'm becoming a budding surgeon around here. Today I took out a large lipoma myself (a benign fatty tumor). And I know by the time I get back, I will be an expert at incision and drainage of abscesses of any sort and any kind. I really wish my pictures would load, because I have great pictures of all the above mentioned things.

Monday, February 25, 2008

Medical Differences

**I am going to discuss medical related material, so please self-select if you are not the type to enjoy reading about medical things.

This is a goiter.

Today was another crazy day in clinic! It was only Dr. Faile, Dr. Hewitt, Christy Lee (another 4th year medical student, who is staying the entire time I'm here), and myself. Throughout my short stay, I've been impressed by cultural differences in medicine between the US and here, but today they stuck out more than usual.

One of my first patients today complained of "piles." Maybe some of you know what that is, but I did not. So I ask her to show me in the exam room, which is behind where I talk with patients. By the time I get back there, she is completely naked, prostrate on the floor (we do have an exam table, but she chose the floor) with her bum in the air, as she points to her hemorrhoids. It was slightly different than how that would work in the US. :-)

Then there are the COUNTLESS number of translational issues. I often sit for 5 to 10 minutes at a time with my interpreter and patient chatting vigorously, to then have my interpreter say ONE word about what is wrong with the patient!

No one has back pain in Ghana, but EVERYONE has WAIST pain.

I have taken quite a few good medical photos, but I think many are too graphic to show on this forum. If I get a chance on a weekend, I will try to upload them to snapfish, and people can go look at them there.

Sunday, February 24, 2008

A few more pictures

A compound we visited on our trip.
A country school we stopped at along the way.
Making foofoo

Come and Go with me to my Father's house




Yesterday, I was on call. It was a rough day. I treated 4 snakebites, incised and drained pockets of pus on two patients, sewed a cut finger back together, put a chest tube in (after the patient ripped it out the first time), and helped out with countless other short procedures and admitted a few other patients. Overnight 3 of my patients died. It was heartbreaking, but there wasn't anything else that could be offered here, although in the US I think some of them would have made it. Two were children. It's a fact of life here, but it's hard nonetheless.

Today I got off the BMC compound, and went to church with Tommy Harris. It was a rather nice break from the hospital work. Tommy is somewhat of a legend around here. From what I can gather, he came here around 1984, originally working on the compound. He is still a full time missionary, working on his own. He travels to several villages and is a lay preacher. I really can't do his story justice, but he does amazing work. He has the best mastery of the local language and culture, he farms along side of them, and ministers to them. He is sort of like a circuit pastor, going on a schedule to different villages to preach. If you are wondering, they have traditional churches here in town too. But I thought it'd be more fun to go with Tommy.

Dr. Fuller and Dana joined us too, as well as various locals we picked up along the way. Getting to church was interesting. I had been on the dirt roads here, but Tommy goes way out, he basically drives over what would be considered maybe a path. In some cases, it was more like adventure off-roading, I have no idea how he exactly got his truck over some areas. Needless to say it was quite bumpy. You should have see the truck ford a river we drove over, it was quite impressive.

Service was held under a tree. It was rather refreshing. There's alot of dancing and singing, then the message. I read the children the story of Zacheus from a children's Bible I brought, the children loved it. Except for Tommy telling us occasionally what was going on, I have no idea what was said, but I can tell the people love Jesus.

Afterwards since Dr. Fuller was with us, we extracted any teeth bothering the congregation. Then we headed back for a foofoo, a traditional food here. It's similar to the teazet I ate the other day, but it was made from yams. It has the consistency of play-doh, and you pick it up with your hands, then dip it into a soup. I think it is an acquired taste. :-)

Dana and I were quite exhausted (and still a bit hungry) when we got back, so now we are checking our e-mail while enjoying a tall glass of coke! It tastes so yummy!!!

Friday, February 22, 2008

Happy Birthday Dad!

Pictures from the our trip to the bush yesterday! It was a good day for us to leave the hospital because there were alot of medical volunteers at the time.

Here's our sheep we were given for our work, we named him Fuller after Dr. Fuller. Goats and sheep look very similar here, and I still don't really know how to tell them apart. Apparently this is a sheep though, not a goat.

Dr. Fuller's ingenious set up to clean teeth.
And Dr. Fuller training his newest dental associate--ME!

Thursday, February 21, 2008

Dentistry in the Bush

Last night we met Dr. Fuller Robinson, who has been visiting BMC yearly since I was born (someone told me that he's turning 80 years old this year). He is a dentist in Virginia. He is here with his granddaughter, Dana, who is just 15. When he comes, he spends most of his days going out to the bush villages and extracting teeth. He has taught some folks here how to extract teeth as well. Two of the other volunteers and myself had the opportunity to with him today. We headed out to a village 5 miles from the Togo border, it was somewhere between an hour and an hour and a half drive.

One of the medical assistants with us was from the village we went to, and it turned out that his mother made us lunch that day, which was quite yummy, but we'll get to that. Dr. Fuller had fully briefed us on all the customs that go along with these visits, he had prepared us for dealing with the chief, which is the first stop at the village. You usually go into the chief's hut, and you have have to bow on the ground and go through all this ceremonial stuff before the chief sends you out to do the work you came to do. This was Dr. Fuller's first time to this particular village, so he wasn't sure what to expect. So we get there, and we walk down to meet the chief. They sit us outside this hut, and honestly I thought we were out there waiting to be invited into the hut. Come to find out though, this was actually the chief and his elders out there! I guess this chief was really relaxed compared to some. Mainly he was interested in having us white girls take pictures with him, which we certainly obliged him with.

Then we headed down and set up shop. I won't be able to share enough pictures to really give you the picture. BUT the back of the truck is set up so that we can extract teeth. The front of the truck, we attach inverters to the motor, so that they can do cleanings in the front. Dr. Fuller went to the school to sort over the children into who needed what. I was left behind with Isiac, one of the assistants, to start numbing people and extracting. Yes I'm in medical school, not dental school. Yet within a few minutes I was extracting my first teeth. In fact, by the end of the day we all got pretty good at it. Anyone need a tooth out?

At some point the chief came down to preside over us. But mainly we just had at it. Afterwards they invited us to lunch. Now often it's one of the chief's wives who cooks for us, and Dr. Fuller has many stories about the weird things he has been forced to eat. However, since Thompson, ones of the assistants with us is from this village, and he is an assembly man here, his mother cooked Teazat for us. This is a very traditional food here. It's essentially a cooked maize, that you pick up with you fingers, and dip into a soup. The soup had guinea fowl in it. It was actually really good. We were glad to not be eating a chicken with ALL of it's parts in a soup.

After lunch, the village presented us with a gift for our work. We became the proud owners of sheep and a chicken! Faith, one of the volunteers, and a third year resident in CA, accepted the gifts, which we had to load in the truck to bring home with us. We thankfully were able to give the sheep and the chicken away to one of the other workers, and we are sad to say likely they are no longer living.

The ride to and from the village was a trip. It was a mix of dirt and paved roads. However, with everyone with us, there wasn't room for all of us inside the truck. I volunteered to sit in the back of the truck. We actually sat on a wooden bench we were bringing to the village. The locals do it all the time, but they thought as a white girl, I was crazy. They absolutely insisted I wear a surgical towel on my head to protect my hair, and surgical mask on my face so I didn't breath all the dust, when you added my sunglasses, it was QUITE the ensemble! And with the dust from the road, by the time we got back, I had the Ghana equivalent of a spray on tan. I was COVERED head to toe in red dust.

It was a really fun day! Dr. Fuller bought us all coca-cola and cookies on the way home! (kind of funny for a dentist to buy us soda and cookies)

Tonight we had a station meeting, where we sing hymns, a little devotional, pray together, and then had a birthday celebration for Mona Hewitt (Dr. Hewitt's wife). It has been a pretty exciting day!

PS I have great pictures from today, but they aren't loading, so maybe I'll get them on another night.

Wednesday, February 20, 2008

Pictures from the Road Trip



See if you can find the goat on the truck. This is common. Fesheni tells me, sometimes truckers will put a hammock underneath the truck, and someone will ride down there.


PS It's nice to know that when I head to Ghana, the president follows! A surprising number of the locals have reminded us that our president is visiting Ghana today.

PPS Two pictures at a time is the maximum the internet here can handle.

Market Day


Yesterday when I signed off I was heading to market. Three of us were supposed to be going with one of the attending physicians, but that didn't end up working out, so we headed out ourselves. We had some vague directions on how to get there and off we went. It was our first time out of the gates surrounding the BMC compound.

It was a pretty fun adventure. We had alot of kids following us around, some would just run up and hug you. Then this big group of children came running and chanting through the street, and our gaggle joined them. It's not that unusual, from what I could tell from my drive up here, for groups of kids to go out singing and running at the same time. Maybe if more of the kids in the US did that, we wouldn't have an obesity problem.

The market was slightly farther away than we thought, but that was alright, we just had to ask some people for directions. We did have a group of men tell us they were in love with us. This is actual common in Ghana, it's part of their humor. You are supposed to laugh. Then if they persist, you tell them that my dad will request 30 horses for my hand in marriage. In Ghana, it is common for the man to give a present (usually cows, but since Americans are supposed to be rich, the Ghanians think we should ask for horses). And 30 horses would be EXTREMELY EXTREMELY expensive for someone from here. Then everyone laughs and moves on. I guess it's supposed to be a compliment.

The market is like this mass of people, stalls, and items to buy. For my first true African market, I enjoyed the culture of it. Because we are far away from big cities, people push a little for you to buy things, but for the most part they aren't very pushy. We more got stares at our white skin.

We didn't buy anything, but I have 8 weeks, I'm sure I'll do plenty of shopping.

Tonight is my first night on call, so I better go check back at the hospital.

Tuesday, February 19, 2008

Nalerigu Baptist Medical Center

Yesterday was my first day at the hospital, and first time seeing Nalerigu in the daylight. The facilities are well thought out, very basic, but try to meet the needs of the patients. Every Monday, Wednesday, and Friday is clinic. So in the morning we see all the patients in the hospital, then start seeing anyone who has arrived for clinic. Clinic is a bit overwhelming. Yesterday we had 600 patients show up. Thankfully, there is an unusually high number of volunteer residents, an extra doctor, and two med students (me being one of them) this week. There are only 2 full time permanent doctors here. All 600 patients were seen, we didn't finish until around 7:30pm.

Tuesdays and Thursdays are procedure day, including surgeries and all minor procedures, it's alot quieter. Besides the hospital, there is a nutrition center, where mothers and children can stay to learn how to properly feed their babies, and try to get the children back on track with their weight. And then there is also a TB village, where patients can stay with family and finish the required 6 month treatment program for TB.

The medicine side of things is a bit overwhelming. I've only seen one or two cases of malaria in the US, and practically every other patient has it here. I've never seen typhoid fever in the US, and it's very common here as well. I'm learning snake bite protocols, which are also new. Yesterday I just shadowed Dr. Hewitt, a full time doctor here, and at times I felt more like a 1st year medical student, than one just about to graduate. But Dr. Hewitt is very patient and kind, and I think I will be learning a great deal from him in my time here.

Things we so commonly treat in the US, we do nothing here for. For example, diabetes--in the US it is bread and butter medicine to be managing a diabetic patient. Here, the patients don't have refrigerators, and the pharmacy stocks little insulin. If a patient has diabetes, we can give them some oral drugs, but that is it. There is no such thing as having a patient test their blood sugar at home.

I think it's time to head to market, so I'm off!

Road Trip

I had been told that Ghana had many uniquely named businesses, so during my road trip, I kept track, and I'll share some:

- Thank you Jesus Fashion House
-God's Time Enterprise
-Blessed O' Motors
- Psalm 100 Instruments
-God First Refrigeration
-Heaven's Gate-No Loans
-Have Faith in God Motors (my personal favorite)

The trip from Accra to Nalerigu was quite fun, just a bit long (about 14 hours). The scenery changes pretty dramatically over the drive, from lush rainforest to the very arid northern region that I'm in. My driver was an office assistant named Fesheni. He grew up in the town where the hospital is, and now works for the mission in Accra. We stopped at least 3 times for cows to cross the road, once for a donkey, and too numerous to count for goats....and once for "overspeeding." The speeding could be a whole story in itself, it's quite different than being pulled over in the US will have to suffice for now.

You don't have to go to market here, because all along the road people are selling just about anything imaginable. My personal favorite was the bush rats, they are much larger than those in the US (about the size of a rabbit) and people eat them here. Once or twice I had a man come up the window and insist I buy one, but I think they were more enjoying trying to shock me than anything else.

Most of the day we were on paved roads, but the last 56 km to the hospital is all dirt road. And when I say dirt road, it's very bumpy, sometimes the road would be out. I learned quickly Fesheni had different levels of concern for bumps. There were small bumps, he would tell me it'll be bumpy ahead. Then it progressed up to seatbelt bumps, that it was imperative we had out seatbelts on well before the bump. Finally there were the we need to go real slow or we will be in a ditch kind of a bump, if the road was there at all. And for added fun, due to construction and other various issues, we didn't make it to the dirt road, till well after dark.

Nalerigu

I'm sorry I haven't posted. The internet has been down, and when it's been up there is a group from a church in the US here for the week, and they have been at the computer.

I have arrived safely! Lord-willing, I'll get to blog tomorrow night.

Sorry this is so short, but my time is limited.

Saturday, February 16, 2008

Arrived Safely

I just wanted you to all know I have safely arrived in the capital, Accra, with very few complications. My first flight was supposedly overbooked, yet I ended up with the only empty seat next to me, which was super nice. It turns out across the aisle from me, a couple I was chatting with were both doctors. The wife is an internist and the husband is in ID (infectious disease, if Heather is reading this she is probably peeing her pants). AND they have a daughter, who works at a small university in Maine--University of New England!

Half way to Amsterdam, I hear a message over the intercom, that if anyone has medical skills, please report to the front. I was pretty glad at that point that my aisle-mates were doctors, because I'm not sure I really wanted to jump in quite yet. It turned out a guy had fainted, he was fine, the doctor did nothing.

I leave at 5am for Tamale, and possibly Nalerigu--the BIG road trip! I met the Fusheni, the office assistant taking me, and I think we are going to have alot of fun. The pharmacist from the hosptial is at the mission house right now, and she was reminding him where all the toilets are along the way for me! I thought that was so nice of her.

Friday, February 15, 2008

On the way

I'm in the Newark Airport! It's been amazingly easy so far, everyone has been kind and helpful! I've had some very bad airport experiences, so it's been a blessing for it to go easy. The only issue has been that my parents plotted to get me here so darn early! I was already checked in at the gate, 3 hours before my flight!

Compared to South Africa, where I managed to cry from Newark to Cape Town or to El Salvador where I broke out in a full body rash cried to my roommate how I'm a leper this is MUCH better! You'll have to wait for my graduation party to get the full leper story as best told through my roommate Erica.

The weather in Amsterdam is supposed to be sunny and 41 degrees. And for Mr. C, the 10 day forecast for Accra is 90 degrees and sunny...all 10 days. In comparison, Portland, ME is supposed to be averaging about 25 degrees for the next 10 days! I love Ghana already!

Thank you to M/M Clune for a fantastic send off lunch and to my mom for driving me here!

Thursday, February 14, 2008

All packed!


Thank the Lord, I don't know how everything fit into 4 bags! Do you remember Harry Potter how Hermione could cast spells and fit everything in a carpet bag? Well God didn't have to cast a spell, but essentially the same thing happened.

In less than 24 hours, I will be on a plane to Amsterdam then to Accra, the capital of Ghana! I would greatly appreciate prayers for the following:
1) I'll easily get my bags checked without too much hassle.
2) That I will have a spirit of calmness, and use the time on the plane to relax and prepare.
3) When I make it Accra, that I will easily get through customs (that was NOT the case when I went to South Africa, but I am armed with a nice notarized letter stating I'm carrying donated supplies to a missionary hospital)
4) That they remember to pick me up from the airport (I know it's a silly fear, but it's a fear none the less)
5) That my cross country road trip will go smoothly, and that I'll have the stamina to enjoy the journey.

Sunday, February 10, 2008

Road Trip

I got an e-mail from Ghana today. I was supposed to fly into the capital, Accra, then catch a flight to Tamale, and finally take a 3 hour ride to Nalerigu. Well, today I was offered to drive the whole trip to bring supplies from Accra to Nalerigu with an office assistant. It'll take 14+ hours. It seems a little crazy, however I think it is a great opportunity to see more of Ghana, not to mention it's cheaper.

I have opted for the ROAD TRIP Ghana-style!

Thursday, February 7, 2008

Where is Ghana?

This is a frequent question I've answered since telling people I'm heading to Ghana. Here's a little geography lesson.

Ghana is located on planet earth.
On the continent of Africa
I will be in the Northern Region, which on this map, if you find Tamale, I'll be 3 hours north of there. I'll be at Nalerigu.




There now, don't you feel smarter!

Let's start at the very beginning...

"Life is a daring adventure or nothing. Security does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than exposure."

-Helen Keller

Before I start the story, let me just say...thanks for reading! Welcome! I haven't a clue what I'm doing with this whole blog thing, so please bare with me. I intend to use this blog to keep friends and family updated about my trip to Nalerigu Baptist Medical Center in Ghana.

A week from tomorrow Lord-willing, I will be boarding a plane, and 24 hours later I'll be in Accra--the capital of Ghana. I'll stay there for a day or so at a mission house, then I'll fly to Tamale (the 3rd largest city in Ghana). Finally, someone from Nalerigu Bapist Medical Center will pick me up, and we will take a 3 hour drive to get to my final destination for the next 8 weeks! You can check out their website at http://www.baptistmedicalcenter.org/.

So how did I work this all out???

Ultimately it's God, who opened up every door because there is no way I could have worked out the intricate details myself.

A year ago, my school sent me to Island Falls, ME for the month of February, it was freezing! It happened that a friend in the class ahead of me had stayed at the same house and worked with the same doctor. Brooke had also inspired me to go to El Salvador with Global Health Outreach during my 2nd year. So I e-mailed her to tell her I was at the same site she had been to. When she wrote me back, she told me about MAP.

MAP--Medical Assistance Program--funds a fellowship for 4th year medical students and residents with an interest in missions to do an 8 week rotation overseas.

I suggest you look at the MAP website too, http://www.map.org/. They are a very cool organization! Without making this too long, I won their scholarship! I originally planned to be heading to Papua New Guinea, however my school squashed those plans. The scholarship actually supported me to find a new location.

Finally, God opened up the door to go to Ghana. I'll be at a 123 bed hospital, with 2 American missionary doctors. There will be alot more about the hospital in upcoming posts.
Since I finalized my location, I also won two other scholarships to help defray the costs. I won the Humanism in Medicine Scholarship from SOMA and the Westra Scholarship from CMDA. Let me tell you, it's all God, because I've never been a big scholarship winner, then to win, three national scholarships in 1 year is CRAZY!

PS Upcoming posts will have alot more pictures, but my computer is crashed at the moment.