Adventures with the Prof

It is Saturday, June 16, 2012. I have been in Ghana for half my stay and I already wish I was going to be here longer. I have really begun to love the food, and my love for the people here has also grown with time.

I just returned yesterday from Accra, the capital city of Ghana, where I spent three days with Dr. Valadares, Abhi, and Cecile. It was great to have some American visitors for a few days. I will try to give a short recap of where our time was spent while Dr. V and Abhi were here.

Tuesday, 6/5/12 – Dr. Valadares and Abhi arrived in Accra and made the 6-hour bus ride to Kumasi with Victoria and her daughter Tracy. Vic and Tracy also accompanied me on my bus trip to Kumasi when I first arrived in Ghana. Cecile and I waited up for their arrival which, as expected, ended up being about three hours later than planned. They came in around 9:30 PM with their 6 suitcases FULL of things. Let me tell you, Dr. V is not a light traveler… when he gives me free reign to tell him whatever I want/need him to bring. After finishing dinner he brought Cecile and I into his room and started opening the suitcases. It was like Christmas in America! He brought all the pens and pencils we would need for the children and extra for the nurses at the hospital. He brought Cecile more than enough paper to use in her teaching sessions. He handed us multiple bags of candy, chocolate, and USI apparel. He also gave me a suitcase full of textbooks for Mount Sinai Hospital (Thanks so much to all who donated them at USI!) and a care package from my Mom (Wonderful – my Mom is great). He also brought me my much desired jar of PEANUT BUTTER. We spent time sorting through all of the gifts and talking about his trip and my experience so far. He also was able to meet Mr. Boateng, who had been preparing for his arrival all day. We didn’t go to bed until after midnight that night, which is over 3 hours past my bedtime here, but it was great to see Dr. V and Abhi in Ghana.

Wednesday, 6/6/12 – I went to work at the normal time while Dr. V and Abhi slept off the jet-lag. We did rounds early that morning for some reason, starting around 10 AM. It was perfect timing, because Abhi and Dr. V visited the hospital later that afternoon. I was able to give them a tour and they got to meet Richard, whom I had told them much about. We ended the tour by visiting Mrs. Essien, the hospital administrator and Doctor’s wife. She told us about how the hospital was started and their vision for building a teaching hospital in the near future. Thanks to Dr. V, I even learned a lot about the structure and function of health insurance that MSH has. Before leaving, we ate Banku in the cafeteria. To my surprise both Abhi and Dr. V ate it efficiently Ghanaian style and they both loved it. We went back to Esaase after our meal and hung out there with Cecile and Mr. Boateng for the rest of the evening.

Thursday, 6/7/12 – I didn’t go back to work this day. I think I ran in the morning and we left around 8:30 AM to speak at Education USA, a center that promotes and assists Ghanaian students to pursue in the United States. This talk consisted of Dr. V, Abhi, and I presenting information about studying in the US, specifically at USI, to about 25 Ghanaian students.  

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We went to lunch after that with Guy (Mr. Boateng’s son and our personal driver for their stay) where I had my first Ghanaian restaurant experience. The food was very good. The only difference between this food and the food I’d eaten at home was that there were many dishes to choose from.

Later in the afternoon, we visited Kumasi South Government Hospital where Guy did his nursing clinicals. We saw some of the hospital, then met with some important people there to discuss Abhi’s research project. The meeting went well, and we left after meeting some of Guy’s nursing friends.

Our last stop for the day was the market. My last post was all about how I wish to avoid the market whenever I can. This visit was very different and I enjoyed it very much. I wanted to get fabric to have an African dress made, so Guy took us to his mother’s stamp stand near the tro-tro station. She called her friend to take us to the fabric market. While waiting, we visited a football t-shirt shop where the pictures below were taken. The first picture shows the tro-tro station to the left and a small part of the street market where all of the umbrellas are.

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We then visited the “fabric market” and it was amazing! We followed Guy and his mother’s friend through what I had previously thought the market was to the real market. It seemed that we were weaving through people in a small tunnel/maze passing a whole section of fish sellers, then jewelry sellers, then watch sellers and sunglass sellers before coming to the fabric section. Here, there were probably a hundred or so shops where women sold the Ashante fabric. We stopped at one or two shops and I, being the American that I am, took a while to pick out the perfect fabrics. Dr. V and Abhi also selected fabrics to have shirts made. Below is the only picture I have of the fabric shops. There is a yellow, green, and pink pattern in the lower left – this is the fabric I chose for my dress.

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The pictures below are of us visiting “Betty’s Mom” the tailor. We were invited by the men there to eat some cassava and stew.

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Friday 6/7/12 – On Friday we visited the Royal Ann Health Academy (RAHA) in the morning. Dr. V had been invited to lecture on Friday, Monday, and Tuesday and was given a 3-hour block of time each day. We did not know what to expect or what was expected of us before showing up, but we just went with it.

I don’t really know how to describe how well we were treated at RAHA, but I will try my best. Basically, we were treated like kings. We were ushered into a nice office by Mr. Richard Obuagye, the director of the school. Introductions took place between Dr. V, Abhi, and Mr. O. I had met him once or twice before at MSH because some of his students are doing clinicals at our hospital. He had introduced himself to me then and asked me if I knew Professor Kevin. I could tell even then that he was excited for us to come speak. Anyway, after introductions we were told the history of the school. The school trains Medical Laboratory Technicians and Healthcare Assistants. They plan to have future programs which include: Registered General Nursing, Medical Laboratory Technology, Health Assistant, Dispensing Technician, and Optical Technician. In fact, information on the school can be found at www.royalannhealthacademy.edu.gh. Eventually we made our way to the classroom full of students, as seen below.

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Here, Dr. V delivered a lecture during which he presented a few ethical cases involving tro-tros and men working on the road. The students were very intrigued by his method of teaching, and were also very interactive. Mr. Obuagye expressed later how well they responded to having a foreign professor come in and ask them questions which put them on the spot.

After the lecture, we ate a delicious lunch with Mr. Obuagye. Below are some pictures of lunch over the three days we were at the academy.

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After RAHA and lunch, we visited Jesus is Lord Family Hospital (JILF). It was a lot like Mount Sinai, but not right off the main road. Because of its location, there were not very many patients like there are at MSH. We talked to the doctor who shared a passage from Acts with us when we asked how/why the hospital was started. He acknowledged that healing power ultimately comes from God the Father and that his practice is founded on this principle. He went into telling us how the hospital was built and his vision for the place. He gave us a tour – the hospital is much bigger than MSH and very nice. He said that when finished, the hospital will have between 80 and 100 beds.

Saturday 6/8/12 – Sunday 6/9/12 – The weekend was spent at Cape Coast, about a 5.5 hour drive south of Kumasi. We set out at 6:20 AM on Saturday morning with Guy as our “taxi” and made it to Kakum National Park around noon. This rainforest is very neat, and below are some pictures from the bridges that we walked across along the top of the rainforest.

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On the way back, I had real coconut and coconut milk for the first time – it was delicious. For lunch, Cecile and I ordered a pizza at the restaurant there. It was not much different from American pizza, except that the green pepper that we ordered was actually green onion… AND it took over an hour for them to make the pizza. No kidding – meals here last, at the very least, 2 hours. And that is probably talking “fast-food.”

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We continued to the coast and eventually found a hotel that was not too pricey. We stayed in The Village, a part of a very nice resort that simulated village houses. We did have electricity and AC but no hot water. Good thing all three are luxuries not necessary for a good vacation. The Village was a short walk from the resort pool and the beach.

The next morning I enjoyed a short run on the beach as the sun rose, then spent time reading in a chair right off the beach. The ocean waves at night or early morning are probably my favorite noise. We just lounged around that morning until about noon. Below are a few pictures from the beach area.

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We set out to visit the castle at Elmina before heading back to Kumasi. The castle was a huge center for slave trade during European rule. History about the castle and slave trade can be found by visiting http://www.elminacastle.info/.

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6/10/12 and onward to be continued…

The Market - 6/4/12

I have had the chance of frequenting the market in Kumasi since I have been here. Let me just say, I already don’t enjoy shopping back home… where it’s simple to know where to look for a certain item, you can drive to Walmart in 3 minutes on a nicely-paved road (I am even talking about the Lloyd), and people do not touch you, grab your arm, yell at you, or offer you a marriage proposal. I’m sure these things happen on rare occasions back home, but it doesn’t even come close to the market experience. My USI friends who came to Ghana for two weeks at the beginning of May were able to experience the market at least once, but it certainly is a new experience every time.

My first visit to the market was the weekend after I came to Ghana. My friend Cecile and I decided to go into Kumasi so that I could exchange my traveler’s checks and we could buy some sugary food items (which they don’t seem to eat often here). I basically just followed Cecile through the market, praying that I would not lose her among all the people and that I would not get pick pocketed. I had been warned to hold my bag closely to my side if I went through the market. I think I was probably a bit too paranoid during that first experience, because it was uneventful in the sense that nothing out of the ordinary happened. We even found a supermarket and were able to buy raspberry jam and juice. Since Cecile had been in Ghana a few weeks before I arrived, she knew the ropes pretty well. She knew the ATM machine that worked for Mastercard, so we went there to withdraw money. Unfortunately, this past week I found out that the banks have stopped accepting traveler’s checks altogether (we went to about 5 banks before someone told us this), so I have been living off of the money of my friends and that which I was given when the USI group was here. Fortunately, the Ghana cedi is worth less than the American dollar, so money here goes a bit farther than it does back home.

This past weekend we went into Kumasi to the market twice. On Saturday, I brought my credit card to withdraw money from the ATM that worked for Cecile a few weekends ago. As we tried the machine and realized it wasn’t going to work, a kind man named David informed us that the bank for that ATM had moved locations and the working ATM for Mastercard was on another street. He offered to take us there, so we followed him. We walked about ten minutes before coming to the health food store that we had wanted to find (the one good thing about that trip!). We kept walking past it and finally came to the bank. The bank had a line of about 25 people waiting for the ATM. We decided to wait. After a few minutes of standing in what I thought was the end of the line, a man came up to me and told me that I had to stand in the back of the line. I was very confused, as I thought that’s what I was doing. Apparently in Ghana they don’t stand in the sun, so there was another whole line of people standing in the shade of a big sign on the street. When they noticed that I was not understanding the concept, all of the people started climbing the stairs and taking their place in line, in front of me. I ended up waiting over an hour to use the ATM, and when I finally tried my card, the machine ate it. So there we were, 3 hours after leaving home, and we had accomplished nothing.

After going to the health food store where we purchased Millet and honey, we made our way to the cultural center and browsed around. We didn’t have enough money to buy anything, so we left and promised to be back the next day. The cultural center was much different from the market. We were the only two people in the store at one time – it was nice for a change. We decided that since we were nearly money-less we would make our way back to the tro-tro station and head home. As we were walking along the busy street, two kids came up to us – a boy about 9 years and a girl that looked 12 – and latched onto our arms and started grabbing at our clothes. They wouldn’t let us go so we both pushed them off of us and told them “no,” and hurriedly went on our way. Luckily we still had our phones, cameras, and the little money we had with us.

Then, at the tro-tro station we found the line for the tro-tro to Esaase-Akropong. It is always the longest line. There was a man working there who grabbed Cecile’s arm and would not let her go. He was asking her, “Wo din de sen? (What is your name?),” and telling her that he wanted to marry here. Usually we can just ignore those things and walk by, but he would not let go of her arm for some time. Finally I tried to pry his hand away and she kept pulling away from him and he relented and let her go. We saw him a few more times waiting in line.

All that to say, it was not an enjoyable market experience on Saturday. We returned Sunday to go to the cultural center and this worked out better – we didn’t spend much time in the market or at the station. Below is a picture of one of the tro-tro’s that I have been talking about. They are the cheapest form of transportation here (about 80 pacewas – less than $0.80 – to Kumasi). I rode in one of these with 39 passengers at one time, amazing!

Mount Sinai Hospital

I want to mention something about what I have been doing the past few weeks in Ghana. I have been privileged to work at Mount Sinai Hospital, a small, year-old hospital between the villages of Akropong and Koforidua. Below is a picture of the Out-Patient Delivery, the entrance to the hospital. The building looks unfinished, because it is. This is how most building projects in Ghana work. They build some and continue building as they use it. The plan is to have a three-story hospital at its completion. The wing to the left of OPD extends beyond the boundary of the photo and contains all four wards as well as the nurse's station.

I don’t know what I expected at the beginning of this project… When I initially met with Dr. Essien and his wife (who is also a doctor, not currently in practice) they explained to me briefly about the hospital and asked me about my resume. Imagine me sitting in an air-conditioned office room in Africa with two Ghanaian doctors and two other Ghanaian men, one of which I had met that morning and one two days prior. Honestly, I was very intimidated in my new environment. After reviewing my resume, Dr. Essien explained that since I am not yet a medical student, his knowledge base and my own do not overlap. Also, unbeknownst to me, I would have to pick up some basic Twi because that is the primary language of most, if not all, of the patients that come to the hospital. Patient interaction would be nil if I was not willing to learn the local language.To sum it up, my first contact with the hospital left me humbled and wondering what I had gotten myself into.

That very morning, I was ushered to Consulting Room 2, where “Captain” Richard was seeing patients. I was able to sit with him for most of the morning and watch him gently speak to patients in Twi, diagnose their condition, and prescribe the due medications. Between seeing patients and during lunch, he taught me some basic Twi words and we got to know each other a bit. His kindness gave me a spark of reassurance that I was in the right place for the summer. Below is Richard setting up for surgery.

Since then, I have spent two weeks in the Males Ward and I am currently serving in the Childrens Ward. Below is a picture of sweet girl Jennifer, whom I got to know and practice my Twi with throughout the day, and nurse Lydia.

While working in the wards, I have been acquiring some basic nursing skills ranging from cleaning the windows to administering medicines and setting an IV. Today was my first time successfully finding a vein and setting an IV on my first go-around. I got my Certified Nurses Aid (CNA) certificate last summer, which I thought would have prepared me for working at Mount Sinai. Basically, most of the technical things that were taught for the CNA certification are useless to me here. Here I don’t need to know that supine is a 30-45 degree angle—most of the beds are rarely raised. It’s not necessary to know the perfect way to fold a bedsheet—many times the patients don’t even use one. Who cares what side or at what angle you’re to stand at when walking a patient to the toilet—if they can’t do it themselves here, a family member is typically standing by to help. Many of the basic things that we consider a “necessity” in the States are not even thought of here. Surgical, sanitation (of drug administration), and certain clinical procedures seem to be universally similar but beyond that, healthcare here is much less formal than it seems to be in the States. Unfortunately, I haven’t spent this kind of time in a hospital back home, which leaves me quite unqualified to contrast the two settings of healthcare.

I have found a few terms humorous in respect to how I initially perceived them…

-In the States we use “Isopropyl Alcohol” with cotton to sanitize something. Here, they use “Spirits.” If you think about it, it makes a lot of sense. When you drink the alcohol, you have a lot of spirits. This seems to be their reasoning for calling it this. From patients to doctors, this is the term they use.

- The nurses and Dr. Essien kept mentioning to me that they’ll be in the “Theatre” on Friday, asking me if I wanted to attend. Every time I would walk by the room labeled “Theatre” I would think to myself: Why in the world would they put money toward a theatre in a newly established hospital?? Perhaps I am just naïve, but I finally asked Richard why Mount Sinai had a Theatre, and that gave him a good laugh. He explained to me that the Theatre is the surgical room/OR. Since then, I’ve been able to stand in on all of the surgeries including a few C-Sections, an appendectomy, and a herniorrhaphy. Tomorrow is another hernia repair and Friday another CS.
In regards to the surgical procedure, it is almost identical to what I have seen in the U.S. The scrubbing in, the washing hands, sanitizing instruments, etc. all seems to be the same. Two things are drastically different, however. One, music is always playing during surgery. The anesthesiologist brings his mp3 player and dock and plays tunes ranging from “Heart of Worship” to African hip-hop. During surgery, it’s not surprising to find someone singing along or dancing to the beat. The other thing that caught me off guard but which I admire is that someone—either an individual of the surgical team, the patient, or me—prays before and after the surgery. They usually pray in Twi, so I don’t generally understand what is being said, but Dr. Essien seems to hold true to the mission statement of the hospital (of which I will try to take a picture in the next few days). I have been asked to pray for the surgery once, and I appreciated that they offered me that opportunity to talk to our Father in their presence.

I think I will add a few Twi words that I have picked up. Twi does not seem an easy language to learn. Perhaps if I had a book that taught it to me it would seem more structured, but I can’t pick up on any patterns or “rules” that the language follows. Below are some basic words that we use almost every day. -

 - Akwaaba = You are welcome (a greeting)
 - Responses to Akwaaba:
        - Yaa Agya (“Yah eh chuh”) = I accept you (to an elder man)
        - Yaa Ena (“Yah en uh”) = I accept you (to an elder woman)
        - Yaa Nua (“Yah new-uh”) = I accept you (to someone your age)

- Me daa wo ase (“May dah wo see” or “Medassi”) = Thank you

- Obruni = white person

- Ete sEn? (“ehh tay sen”) = How are you?

- Response to above: Eye (A yuh) = I’m fine.
- Bra ha = come here
- Ko = go
- Didi = eat
- Ye twa sue [don’t know spelling] = Continue treatment

And so it begins.

Today I present my feeble attempt at beginning a blog. I must preface this endeavor with a few things: (1) I can’t promise regular updates, as internet in Ghana is unpredictable and free time to blog seems hard to come by. (2) I seem to be losing my creative writing capabilities as undergo my metamorphosis into a scientist, so readers must forgive me for that. And (3) I do not normally enjoy writing for the reading pleasure of others, but I have found this endeavor to be important, as I wish to keep up with all my friends and family and have found it impossible in the past two weeks to do so. Therefore, blog it is. I also appreciate all of the inquiries I have gotten and messages I have received from back in the States. Hearing from friends and family made my first week here even better.

I do not know where to start, nor do I have time to write about everything I have seen and experienced this first week. To be honest, I think it would take me well over a month to type an update about my first week here. For tonight, in the ten minutes before I hit the hay, I will offer a summary of a normal weekday.

The sun rises here around 5:30 AM, so I typically rise with it. I have a window in my room that opens to the east, which is perfect. I dress for the day, grab my coffee cup, Bible and book, and make my way to the table that sits in a room open to the front “yard.” I pour myself some tea, cut a piece of bread (for which I bought some jam at the market last weekend – a taste of the U.S.) and enjoy the cool morning for a while. Usually I see my new Swiss friend Cecile leave with the school bus to pick up the children. We stay at the Esaase School and Orphanage in the small village of Esaase, very close to downtown Kumasi. I will tell more of her and Mr. Boateng, our host, when I have more time. They are both fantastic.

Usually around 7:45 AM Mr. Boateng or his son Guy is ready to take me to Mount Sinai Hospital, where I have been spending the majority of my time in Ghana.

The drive is about 3-5 minutes, and we go through the village of Akrompong (I will have to check on the spelling). My first 2 weeks I am stationed at the Males Ward, so I make my way there and help the morning nurses clean and set up for the day. I stay in that ward until somewhere between 12:30 and 2:00 PM, when I take my lunch. I will have to tell more about lunch. Actually, shouldn’t take long – lunch is always the same! I cannot believe it has only been a week and I’m missing real American food! It is either rice or banku with some type of sauce or stew. The food isn’t at all bad, it’s actually pretty delicious. I guess I always took for granted the fact that my Mom wouldn’t make the same meat, vegetable, or side dish for dinner or lunch within three days of having it!

After lunch, I head back to the Males Ward where I help administer medicine, do patient records, or take BP and temperature of the 8-10 patients in the ward. Richard, the head nurse at the hospital, usually calls for me between 2:30 and 4 PM to accompany him and Dr. Essien on rounds. There are a total of 4 wards in the hospital: Males, Females, Children, and Maternity. I follow Dr. Essien as he talks to each of his patients and explains their condition and treatment to the nurses and me. When rounds are through, I call Mr. Boateng or Guy to pick me up. I say this is a typical day at the hospital, but I have only had one or two days that consist of what I have presented. Most days have exciting cases, surgeries, or conversations that I cannot cover at the current time. They will come.

I return to the school maybe around 5 PM, although it has been as late as 6:30, and catch Cecile to go for a run. We’ve been finding new routes to avoid the Tro-Tro’s and crazy drivers that take these small bumpy roads pretty fast. We usually run for 30-60 minutes and call it a day.

When we get back, dinner is waiting for us, and it is always exciting when rice or oil is not included. We eat together, sometimes with Mr. Boateng, and the children are usually swimming in the pool out front or crowding around us. It is a joy to be loved by so many kids!

I usually have my chance at the internet in the evenings after dinner. I get enough time to catch up on important e-mails and possibly post a few pictures on facebook. Unfortunately, I am out of time tonight, and must hit the hay. Long day ahead of me tomorrow – after work at the hospital we are going to meet the chief of Esaase!