Hello family and friends! As crazy as it sounds, my time in Ghana is coming to an end. With that, I have already spent a week in the different departments. After finishing up my routine of mornings of watching wound dressings, and ending in the theatre, I am now free to go where I wish. With that, I have had the opportunity to watch consultations, do some vitals in OPD, and watch more surgeries and births. I cannot remember if I mentioned this already, but having Janet at the hospital this week has been so fun! Janet is my fellow NWC SOS member and a good friend. Today is Monday, so it was our last market day—bittersweet! There are also more lasts to come this week, and saying goodbye to the friends I have made here. Saturday morning, we will drive through Kumasi to Cape Coast. Our tentative plan is to walk on the canopies on Saturday, and then spend Sunday at Elmina Castle and the beach. Monday morning we will drive to Accra, and then fly out on Monday night! Do not worry though, I will post a few more times about this trip—maybe some of the things I have learned looking back. I haven’t uploaded pictures lately on my blog because it has taken much too long and ended in failure too often. However, I will also be posting pictures when I get back to my laptop again. Of course, I will have to talk about this past week on here also! If you had to ask me what was happening around Kasei, I guess the first thing I would say is Cholera. Yep. Cholera. I spent last semester reading The Ghost Map by John Snow. It outlined the Cholera outbreak that overtook London back in the 1800s. However, Ghana has been experiencing Cholera lately. I first heard about its presence in Accra, but it has reached the Ashanti region now. We had a 21 year old girl from a neighboring village die of Cholera at the hospital here on Saturday. It isn’t very common, as it is easily prevented. We have been extra careful washing our fruits and vegetables after market day. The other way to stop its spread it washing hands with soap after using the washroom, and before eating or handling food.  This is very easy to do, but when people fail to do these things, they have the potential to eat contaminated food. Cholera’s symptoms include both severe vomiting and diarrhea. The Cholera does not kill, but rather severe dehydration does. This morning on rounds, we did not have any more Cholera patients, but I will have to watch again tomorrow morning. It is hard to imagine coming home after being away so long. In our SOS meetings, we learned there can be a sort of culture shock again coming back into the American culture. I suppose I can see this happening when I adjust to having a car, cell phone, internet, laptop, hot water, air conditioning, my clothes, American food, and work. None of these things are bad things, but I think right now my perspective on them have changed. They are wonderful things, but I have also seen how having them has at times kept me busy and distracted me from the important things in life such as my relationship with God. I have been so blessed by this experience, and I am looking forward to looking back on my time and continuing to learn and process different experiences. Anyways, this is short, but time for bed. I want to be well rested to enjoy my limited time here. One week from now, I will be at the Accra Airport…crazy. 

Note: I wrote this on Friday, but I haven't had the chance to use the internet until now. :) This week I will write a little note a about my day in Kumasi on Saturday, Gretchen's Birthday, and the 4th of July. (I plan on making baked beans with brown sugar. :))

Dear Family and Friends,

Happy Friday! I just completed a week that was mostly spent in the theatre (aka surgery). We only had one surgery today, which was a right inguinal hernia surgery.  Afterwards, I had lunch with Stella and Gretchen and visited the dispensary during their busy period. This week Monday and Tuesday we were greeted by five wonderful people from Wheaton College in Illinois. They were all college students who were interested in medicine, and are serving with Pioneers ministry out of Orlando, Florida. They happen to be teammates with my friend Janet Pitsenberger, who is a fellow NWC Summer of Service member. I am told that she will also be spending time at St. Luke Hospital in the next two weeks! A few weeks ago I heard someone yell Abby while I was shopping in Ejura. Obviously it is pretty strange to hear my name in perfect American English in the middle of a busy African road, so I suspected it might have been Janet. Apparently it was! She had yelled my name, and then the driver of her bus had pulled over and tried to find me, but I had already left in a taxi. J Back to the five wonderful people…we were told they were coming Monday morning at devotions. Gretchen and I introduced ourselves, and then spent time taking them around the various departments in the hospital and giving them a brief overview. Monday the seven of us shadowed some surgeries, which consisted of one caesarean section, and many hernias. I think I mentioned this in my blog on Monday, but I do not want a Caesarean section. Ever. There is a lot of pulling and tugging and splattering that happens when trying to remove a baby from a uterus in which they were perfectly content in. Still, it was wonderful to see the baby after the whole process, especially to see he came out in one piece with everything intact. I held the mom’s hand and brushed her hairnet the entire procedure, and I was extremely excited to tell her it was a boy! J After getting her all sewn up, we were able to watch many hernias. While the Caesarean is done with spinal anesthesia, the hernias were all done with local anesthesia. I do not think I would be able to handle watching my intestines get pulled out of my body, but they all handled it very well. I almost always assumed position next to the patient’s head. At times I would have to hold them down, else offer assurance such as “Kafara, why” or “Bisikini” depending on their language. Dr. Opuni does a great job with the hernias, and they are always grateful afterwards. I have found that I really enjoy the patient interactions in medicine, so although theatre is interesting, it doesn’t really have the most patient interactions. Most of the time the patient is scared, grimacing, or just trying to keep their mind anywhere but where they are. However, the people who work in theatre have a great bond with each other. They spend a lot of time together, and have a daily lunch of peanut butter sandwiches and MILO which is quite delicious! J Besides hernias, I held two babies down while they were circumcised. The process produced a lot more blood than what I was expecting, but it was a pretty quick procedure, and they handled it pretty well. In the mornings I try to spend a little time in the dressing room. This is where patients come for changes of dressings, stitches, or treatment of cellulitis. Working in the nursing home, I am aware of what cellulitis is, but I always thought it was just red, painful skin. Apparently that is what it can be, but there are many stages. In Ghana, people are hesitant to come in, and they usually wait until their flesh is literally falling off. I will have to take a picture of it next week, but let’s just say it is probably the most gruesome thing I have ever seen. Even more gruesome than childbirth or surgery. I could see the tendons and the muscle covering, and held patients down while they cried, screamed, or yelled. A grown man cried as they scraped the dead skin and bacteria away, and a woman was literally holding onto my leg, slapping it, and squeezing my hand while she had her dressings changed. All the same, I do not blame them one bit, and I was more than happy to be there for them. If you are curious what cellulitis is, it is a non-contagious flesh eating streptococci bacteria. The treatment is removal and cleaning of the wound and antibiotics. For those with the worst cases of cellulitis, the process of healing takes anywhere around 3 months time, and it can occur in children or adults with most occurrences on the legs.

            That is pretty much all for now, and I will try to post some pictures, but we are having internet issues so I don’t even know when I will even upload this onto my blog. How am I? I am doing wonderful, hopefully Gretchen and I will go to a friend’s place and watch the 2012 Grammy Awards tonight, and tomorrow we will be going to Kumasi, Lord willing. Yes I know the Grammy Awards are old, and I don’t even watch them that much at home, but it will be fun to watch some television for once and catch up on America. We will be leaving the hospital two weeks from now, and two weeks from Tuesday I will be home! I have been learning so much here, and I pray that God with give me the discernment to see what he sees. These last two weeks I will spend more time in dispensary, theatre, maternity, scan room, and consultation. Gretchen and I will hopefully spend some time tutoring next week and talking to the kids about finding a mentor and having goals. Gretchen has put a great talk together, and I am excited to be a part of it. Dr. John has been busy working out and about with the Luke’s Society, and his son Kwame, will soon be working at St. Luke’s as a residency doctor. I am getting used to life in Ghana, but I am definitely excited to see my family and friends back home. I feel as though all of my nieces and nephews will look a year older when I get back. Fourth of July will be strange without America. I am going to invoke our own little celebration. Hopefully we can have yam fries and chicken with ketchup on the fourth, and I will make some popsicles. I will miss the fireworks though. It is also Gretchen’s birthday on July 2^nd so we will have to celebrate Ghanaian style! I pray it will still be a great day, and a birthday to remember. My grandmother is also having a birthday on July 6, and I am sad I will miss out on it. That is all for now. Gretchen got some Ghanaian hair added to hers, and it looks great! I don’t think I can pull it off like her though because I feel as though my hair would rip out and be torn to shreds. J Have a great celebration of our country, and enjoy the fireworks! Love, Abby

PS I give up on uploading photos. Hopefully internet will be a little stronger later on this week. :)
Love,
Abby

Hello friends and family!

I guess by now you are realizing I am becoming less reliable for updating my blog. I usually complete my blog on Sunday if all else fails, but yesterday I spent my free time talking to my parents on the phone! :) I really enjoyed talking to them, and our hour went fast. I spent my Sunday at Lake Volta. The day started out with downpours much of the two hour journey there, and when we arrived it was sprinkling. I experienced the first moment I ever have wanted a jacket in Ghana. Yes, I wanted a jacket! We took a few pictures, hopped in our car, and then looked for a resturaunt. We ended up finding a resturaunt, but it didn’t serve fresh tilapia and banku, so after our Malta we boarded the ferry across the lake. We didn’t realize that the ferry, which included large trucks full of yams and other produce and travelers, was going to travel so slowly. There were a couple of times I felt the urge to jump in and swim to shore because it would have been faster. One and a half hours later, we reached the other side. By then the sun was coming out so we got off, bought some boiled peanuts, and got right back on the other direction. It was kind of refreshing, and I am pretty sure I sang as many songs as I could think of in my head on the way back. After arriving back at the port, we went and had peanut soup with rice balls, goat, and salmon—it was extremely tasty! Then we ended the day on the shore of Lake Volta in search of fresh tilapia. Since the presence of obrunees leads to an increase in price we stayed behind from the incoming boat. The sunset was beautiful, and since it was market day we had a huge crowd of people staring at us. So Gretchen and I just kind of sat there and tried to communicate a little, but soon found they did not speak a lot of Twi, but rather another tribal language. The day was very nice, and I snapped some gorgeous pictures on the shore.

Now for my week—maternity!!!!!!!!! I would like to say that I witnessed plenty of births, but I only witnessed one live birth! Apparently babies don’t like showing up in the morning shift which is from 8 to 2 pm. They all come in the evening and during the night! In spite of this, the birth of a baby boy on June 19 was truly remarkable to watch. Women in Ghana do not get pain killers of any sort during labor, and she wasn’t really yelling either. She just would lay on the table and snap her fingers. I talked to her a little, but I had no words of wisdom besides reassurance that today was the day she would get to meet her little baby. Besides sitting in the consultations with the midwives, I would often assist Dr. Anim or Dr. Opuni with scans. Once I had made sure they paid the cashier their 7 GHCED I would write them in the log book, and input their data into the ultrasound machine for the doctor. Besides the usual of looking at position of the baby, heartbeat, and position of the placenta, we would measure the femurs and crown to get an estimated date of delivery. Then we would try our best to get a good look between the two femurs at the sex of the baby. In one scan, we found TWO heartbeats!! J I was excited, but the poor lady was in her first pregnancy, and I felt a little sorrow thinking of all of the extra work this would mean for first. We also had a scan in which we no longer saw anything in the uterus. Thankfully, we don’t tell the women these things, but send them to the midwives to explain the results. As for consultation, I took a lot of blood pressures and weights. In one instance I had a lady with a BP of 180/100, which is not necessarily a good thing. I thought I was mistaken to be having such a high BP, but the other nurses confirmed it, and she was treated for her condition. It also was a shocker to witness some of the young pregnancy cases. In one case, a teacher brought in a 15 year old junior high student, and we found she was two months pregnant. There were also a few more girls in their late teens, and some in their second pregnancy! The sad thing is that the unwanted pregnancies are often terminated by the mothers using a concoction of African herbs. The midwives said a great deal of the problem is the youth are not educated well on sex in school. Since they are not taught about it in school, some girls enter into it blindly only to find themselves pregnant at a young age. I came into work to find a 20 year old on the table. She had just aborted her five month old baby, and even though she claimed it to be spontaneous, the doctor was not convinced as he was having issues removing the placenta. In the end she confessed that she had taken some herbs, as the man who impregnated her was married, and he did not want the child. She said she was not ready to be a mother. As the doctor was attempting to manually remove the placenta, she reached for my hand (She had no anesthesia.). I was told I could not touch it, as it was covered in blood. I ended up holding her arm, and talking to her. My heart went out for this girl, but it was hard to see how she could abort the beautiful little baby now laying limp next to her. In spite of all of these things, I still love maternity. I cannot help but praise God when I think of how intricate each little baby is. I held onto the little babies whenever I had the chance, and before I leave I plan on taking lots of pictures with the little babies in the maternity ward.

This week I am in theatre. Today I witnessed a caesarean section, and I held the mom’s hand and brushed her head as I watched. I do not want one. Ever. The amount of tugging, and ripping did not look enjoyable. Theatre will be really interesting this week, but I won’t spoil my next blog by telling you about it now. :) 

Today five people from Pioneers came to the hospital. They were all students from Wheaton College, and they are teammates with my friend Janet, a fellow SOS member! It was fun to talk with them, and I was told I will probably see Janet soon too! Gretchen and I gave them a little tour, and they watched surgeries with us. They plan on coming tomorrow, too, so it should be fun. Today was market day, and I am really tired. I was going to tutor tonight, but no one was there so I headed back. Gretchen came back and told me they were coming now, but I think I am going to have to go to bed and come tomorrow night. Life is busy here, but prayers would be that I accomplish what God has in plan for me while I am here, and I continue to push myself out of my comfort zone. I hope you are all doing well, and that you are enjoying time with friends and family this summer.

Abby

 Well, I finally got my pictures to load. I started this process way too long ago. :) #1 A picture of the school children during the ceremony where the books were given to the teachers and students. Originally I was trying to upload a picture that included the village chief. I think I will go and take a very nice picture with the village chief at his house instead.

 #2 Just another day in the kitchen. This picture was taken after I had completed the process of washing the dishes from breakfast and lunch, and all of our produce we had bought at the market in Ejura. Hot and sweaty is a constant state here. :)

 #3 A picture of me counting pills. I do not remember what kind of pills those were anymore, but like I had said earlier it has always been a dream of mine to count pills. Actually this is a staged photo. I am not counting these, but just pretending to for memory's sake. My photo from lab didn't load, so maybe next week? See those syrup bottles in the background? A large bottle of Alvite Syrup fell out of the bottom of the box. (Note this is not something that should happen.) They didn't fire me after this incident, but laughed at me so it is all good.

 The village children on Wednesday morning when we went with Rev. Jerry to do a felt picture story of Moses and the Red Sea. There are a lot of them! Somewhere hiding in this mixture is my dear Mother Theresa. She loves these kids, and she teaches in that classroom on the right, and the kids love her.

 Just another Monday in Ejura. Monday is market day so we travel to Ejura to get a week of supplies. There are too many things here that I could comment on so I will just let you interpret what is going on however you want.

This picture was taken today...June 15! I am holding a very small baby squirrel that the kids gave to Gretchen and I. Except, they aren't all looking in this photo. The squirrel was adorable, but I told the kids that I heard his mommy missed him so hopefully they gave the little squirt back.

Greetings! Sorry this blog is once again overdue. This week has been a very fun week! I have been working the medical laboratory here this week. Before coming here I would have guessed that I would find the laboratory more enjoyable than dispensary, but it is actually just the opposite. However, I still have learned a lot. In the laboratory patients come for us to draw blood samples, test blood sugar, test urine and stool samples, and receive some vaccinations. I have spent time this week pricking fingers to test for malaria—even little babies! I have found that sometimes I don’t prick deep enough to really get enough blood which probably comes from not wanting to make them wail. Sadly, the babies with severe malaria don’t care half the time. I also drew some larger blood samples from the arm using a syringe. These samples can be used to test for sickling (Sickle Cell Anemia is more prevalent in African communities because it helps with resistance to malaria.) . They can also be used to look for protozoans in the blood (which I have seen this week!), and to group the blood and test for STD’s such as syphilis, hepatitis B and C, and HIV. I have had at least one patient who tested positive for HIV. The test involves using serum from the blood, and if someone is found to be positive, then they are sent on for further testing in a larger hospital.  On Tuesday we went to the ward to get a blood sample from a 2 month old baby girl. Her mother sat beside her on her bed crying, and even though I couldn’t  understand what they were saying, I could tell that everyone in the room was yelling at the mother. It sounded like the mother had not brought the child in until the child was severely anemic and pale. Priscilla and I pricked the little baby over twenty times in her fingers, toes, and heel trying to get just four large drops of blood to check for malaria and group her blood.  We finally got enough blood to test her, and she received a blood transfusion. I kept checking her ward throughout the day, and even that night to see if she was still alive. The next morning when I returned to her ward to take samples of more sick kids she was gone. This is not a rare event, but rather a weekly event. These things are rare where I live. If a child dies it is because of an accident, cancer, or genetic abnormality, but not just because the family didn’t bring in a sick child soon enough.  Another exciting thing was seeing strongulitis of the liver. In other words, the stool sample was full of little worms crawling back and forth under the microscope…yuck! The people in the lab were very nice though, and I really have enjoyed their company. They have a wonderful new laboratory room that will soon be complete! This will help them to be more sanitary, and they cannot wait to use their new machines! They do a great job, but because of limitations of supplies and budget, they are unable to have the type of sterilization that would be found in an American hospital laboratory. This was something they knew, but the reality was it just couldn’t be that way. I appreciated their work, and the way they did the best with what they had because I do not think I would be able to be as frugal as they were.

The other highlights of my week included playing volleyball in the red African dirt in the middle of a downpour, and going to the school!! I cannot put into words what it was like to see so many kids from the small village of Kasei. Jerry and Loyce from BASIC ministry partner with the Kasei village to help improve the educations. They have a scholarship program to eligible students which helps them attend the high school in Ejura. This year their first scholarship recipients will finish high school. Some of them will still not receive their diploma because you must pass the national tests in all subjects first. English can be a struggle for these students as they have grown up in homes where their parents do not know English. I think I have mentioned this before, but English isn’t prevalent here. Yes, English is the national language, but like many African countries English is only prominent in the big cities such as Accra and Kumasi. Today Loyce presented new books for the primary and junior high school in Kasei. The village chief, queen mother, and archbishop of Kumasi were present for the ceremony, and I was able to sit right in front next to them! Afterwards, the kids ran up to us, and we shook countless hands. The kids were fighting over the right to touch our white hands—what a strange feeling! Dr. John introduced us as soon to be doctors, and I pray with all of my heart that might come true! I trust that God knows what is best for me though, and I am willing to follow His leading. If I do not get into medical school for fall 2014, then this experience has still solidified to me that the healthcare field is where I want to be. This weekend I will be traveling to Kumasi, and tomorrow I will be attired and in attendance for a Ghanaian funeral. One story as I close up: Yesterday an elderly man was hit and killed in Ejura by a passenger van. Many young men from the city were angry, and they were trying to attack all of the passenger van drivers because they wanted justice. There are even rumors they attacked the policeman. In the end, the passenger driver turned himself in at a different town because he feared his safety in the Ejura Police Station. Also, the Ghana Newspaper Association was at the school today for the ceremony, so maybe you will see a video or article online! It would be something about BASIC ministry and Kasei schools. Hope all is well. I enjoy hearing from you all! Abby

Quick update! I am feeling better. Thank you for your prayers and support, I can only begin to see how much I am learning about myself, God, and cultures. This week is dispensary which means pharmacy!! I have never really thought of being a pharmicist. Some of you might know I really don't believe in taking a lot of pills so I am very slow to take a pill for anything. However, there are times when they are very important. I am able to help fill prescriptions right off of the doctor's notes in a patient's folder. Of course, the pharmacy workers always double check my work before the patient receives the pills. Sometimes when we are less busy, I call the patient to the window, and explain their pills to them. The people here are so kind because often I do a terrible job with their name, and then they still listen to my rusty Twi as I say simple things such as. Bagko anopa, bagko awia, bagko ayunume. (one morning, one afternoon, one evening). However, my counting skills are improving this week in Twi so that is a plus! The people in pharmacy are really a joy to work with. They are very patient with me which I cannot thank them enough for. They also talk about different aspects of Ghanaian and American culture with me, and I love hearing their opinion on American things such as celebrities, the president, and sports. There really isn't a huge love of American football outside of America, but I bet most of you would have trouble remembering that in 2010 Ghana defeated the U.S. in soccer (except I know Kayla would know that if she is reading this. :)) They are pretty proud of this fact, and the fact they beat us once in South America, which I never was aware of until now. Today in dispensary I was able to use one of those pill counting things to fill bags with 30 fersolate pills (given to pregnant women). I have always wanted to do that, and I enjoyed every minute of it. Most days a majority of the pills are p'mol, fersolate, and folic acid for pregnant women or Malaria pills. I have been able to see more antibiotics go out now. This often happens with hernia surgeries as a good preventative measure, and I saw a very minimal amount of antibiotics for a respiratory and one ear infection. I went over to maternity to see a friend, and I was able to hold a one hour old baby and bring him to his mother after she returned to the ward. I know this is a small deal, but I was extremely happy to do this small deed.  A huge dream of mine is to witness some childbirths here, and today I came one step closer. That is all I really have to share. I am going to try and find my laundry. It rained like crazy today, and now Theresa and I are trying to figure out where my clothes went. Don't worry, I am sure they are in a very good location. Then I need to go and make some pizza dough so we can share some pizza with our friends later this week. Yesterday I made guacomole for Charles and Constance who are the ones who make the homemade fufu. They do not have such a thing here, but they said it was good once they got over the fact it was a smashed avocado rather than a nice and firm one. :)
I will say I miss the pool this week. It is supposed to open on Saturday, and I have thought of the possibility of a new pool back when I would come to the pool as a kid. I hope everything is going well, and the facility is able to fulfill its purposes. No one here knows how to swim, which makes sense because there isn't a lot of water besides what pours from the sky.
PS The moon here was very full last night, and I love looking at it as it is the same one back at home.
God is Love,
Abby

 The least gory picture of my knee. Theresa did a great job taking this picture and was very zoomed in which means you can all see how hot and sweaty I am. Proof that I was playing and that it was humid. I didn't play today, but I hope to get back out again next Sunday!

 Note my hesitance to get really close to the monkeys. This was one of my first times, but they were sure friendly. There was a whole crowd, and I have some cool videos that with better internet connection will give a better idea of their friendliness.

 I took a picture of the kids from the Kasei village who were chasing us yelling Brunee!!!! They are adorable, and when we stopped and talked with them they kept following us. The camera made them jump and yell, and then laugh when I would show them the picture afterwards.

 I know it is hard to see, but that blue fogginess is like a valley of trees. I found it beautiful, and I loved that the land was not FLAT! :) My head was glued out the window the entire way to and from the monkey sanctuary.

This little fellow and I were shaking hands. He really let me get a good look at his hands which were all black, but the size of a little babies. Note the slight height difference.

What a busy week! I can hardly believe another week has gone by already. I am very sorry about the lack of communication lately, but I seriously have been busy that I haven’t touched the computer since my last blog entry. To make up for it, I will try and get the computer to allow me to upload a few photos. This week I spent Monday through Wednesday in consulting, which I already spoke of, and then Thursday and Friday I took vitals. I really enjoyed my two days in vitals because I felt like I was doing medicine. J With my CNA training, I learned how to take blood pressure and temperature is pretty self explanatory along with weight. At first, I helped the nurse take temperature, and recorded blood pressure and weights. Pretty soon I was doing more to help out when we were busy, and then when it was slower I spent some time solo. I would call the names, tell them to stand on the scale, and take their blood pressure or temperature if they were under 18 years of age. All in Twi! One aspect that is different is that after calling their name they come to the front of the waiting room for their vitals. The scale is like a bathroom scale, and the thermometer is the typical under the arm one. Except here we have kilograms and Celsius. Children with temperatures are immediately given what is referred to as p’mol either orally or rectally if 5 or under. On Thursday a little girl came in with her mother with a pretty high temperature and looked close to convulsions. I brought her folder and her and her mother straight into the consulting room, and she was admitted with severe malaria. I saw her after my lunch break in the children’s ward with an I.V., but that night at dinner the nurse I was eating with told me she had passed away later that afternoon. It made me more aware of how serious Malaria can be, and a greater realization as to how many children die each year from Malaria. There is talk of a new Malaria vaccine in the making. Even though it is only found to have 50% success rate, they say it might still be used just because that is still 50% less children dying each year from Malaria.

Megan and Larry came Thursday from Roanoke, Virginia. Megan is a first year medical student from Virginia Tech doing some research on Caesarean sections and their prevalence in the hospital here. She is looking into how often they are done, and whether or not there is a difference in rate from America. Here Caesareans are done with local aneshetic or a spinal aenesthesia, but not an epidural. She is looking at whether or not this reduces their rate compared to their commonality in the States. Larry is her research advisor’s husband who comes here with his wife every September and is known by many here. They are leaving tomorrow, but it was nice to talk with them and share some meals. I also enjoyed their gift from Dr. John. (See below.)

Saturday we went to Fiema Monkey Sanctuary by Nkoranza-Kintempo. It was a once in a lifetime experience that I will never forget! J We walked through the bush with a tour guide, Christian the driver, Stella and Tena our Ghanaian coworkers, and Gretchen and myself. It felt much like a hike, and I loved the TALL trees like off the Lion King, and I was reminded of third grade learning the different layers of the rainforest. We saw a tree that was kind of hollow all the way up because it was 50% a strangling tree (sorry for the odd explanation here). Gretchen being the adventurous woman she is climbed as high as she could get, but I managed to get ½ up with my fear of heights and the fact that Gretchen was still in the tree. J We then learned how the village was settled in 1827 and a hunter found a Fettish priest in the bush (I think this is an idol.). When he brought the priest back, the monkeys came because they were his children. Some of the villagers worship the monkeys, and are highly respective of the monkeys who come in the village to eat throughout the day. Whatever harm that is done to the monkeys will be reciprocated to the humans. There is also a belief that an elder in the village will die after the monkeys have shrieked for 7 nights in a row. A virgin nun who lived to be over a hundred was spoken to by the monkeys and was always by the fettish priest. When she died she was buried in the monkey cemetery with the other monkeys, who always come to the village to die, and are buried like the humans. All of this was very interesting, and brought a closer understanding of some of the different religious tribal practices as this is a religion for some of the Akkans that are part of the larger Ashanti group. Back to the monkeys…our guide bought some bread in the village, and we fed the bread to the Mona? Monkeys who ate right out of our hands. The Colobus? Monkeys are more shy, and we saw their white tails high up in the trees, but they are afraid of humans. The ?’s refer to the fact that I am not 100% on spelling and the two species could be switched. J I loved feeding the monkeys though, and I think my mom would have loved it. They would nibble on my fingers if I held onto the bread tightly, and I was able to see their little hands—they have fingernails! After our adventure, we ate JIF peanut butter and jelly sandwiches (which Larry and Megan brought from Accra!) and then ate at a hotel restaurant. Gretchen and I had fish, rice, and salad, and were told to finish our plates. I felt extremely full, and didn’t really eat anything after that for the rest of the day. I ate it all, but when I was done with the meat of my fish, the Ghanaians got to work on the head and skin, which I had shied away from. In the end all that was left was the spine, tail and jaw with teeth. Yes, Ghanaians eat the eyes-a man once killed his wife because she wouldn’t share them with him!

Other than that, I haven’t felt the greatest today. This week has been very busy, and I think I am simply exhausted. We went to Lighthouse Chapel International in Ejura for church this morning with Dr. Ponei. It was in English, which was refreshing, but when I stood after the sermon I almost passed out. Needless to say, I have been dizzy ever since, and not hungry. We had fufu for dinner tonight, and I did not pull my weight. Hopefully lots of sleep tonight will put me in better terms. I ask for prayers for health and strength as my stomach has been a little touchy lately forcing me to pile up on antacids, and a peace of mind as I have felt a little more stressed lately. We are very safe here, but there were apparently some robbers two villages down along the highway this afternoon. I feel very thankful and blessed as we have passed through Mampong four times in the past two days and were safe each time. The police went out, so I am pretty sure the whole thing is over by now, but just a prayer for peace of mind would be appreciated. Two other prayers for Ghana would be the Cholera outbreak in Accra (which is no threat to us, and preventable by simply washing hands), and there are elections here this year. We pray for this every morning at devotions just that Ghana would be peaceful throughout election season, and there will be a peaceful handing over of power as this is the president’s last term. Ghana is a very safe, strong nation so please do not fret. J I pray each of you is doing well, and have had a wonderful Memorial Day! Also shout out to my sister, I am proud of her! God is Love, Abby. 

Time to update my blog! I haven’t been on the computer for a while, sometimes I feel it is really refreshing to be away from internet, phone, and electronics (except my ipod-I need music!). Of course, when I go on I love having letters to read so I feel in touch so thank you! It is an extremely humid afternoon, and all I can do is type and hope the rain doesn’t fall until my clothes have dried on the line. There are women who do laundry for us, but then we have it hanging in our “porch” to dry. “Porch” refers to the room that is enclosed in the house, but is kind of a veranda type location with cement floor, brick wall, and a clothesline for laundry. There are no chairs, because it is either too hot, or there is the threat of malaria at night. The laundry is done by hand, and the only thing I have washed by hand is a dish towel. Apparently you rub the clothe against your wrist, but I am not sure on this because I pretty much rubbed my wrist raw trying. If I had to choose between a dishwasher and a washing machine the decision wouldn’t take me a second. Washing machines are an amazing invention, and among nations where the women are working many hours, I don’t think life would be enjoyable without.

One thing I wanted to share about was Sundays in Kasei. Sunday morning I overslept (side fact) because I failed to set my alarm for 3:00 AM. You see, my alarm is my ipod, which is stuck on Iowa time, and when I am tired, I forget that I can’t set my alarm clock for 8:00 AM, and expect it to go off until it is actually 1 PM. Don’t worry though, the chickens always make sure I wake up. We attend the Church of Pentecost here, and Miriam told us that this church is known for “speaking in tongues.” Apparently if they believe in all three parts of the trinity, they are able to speak in tongues in prayer to God. I guess the reason Gretchen and I have never realized this before is we never know what they are saying in the first place, so to us it is all the same. I have never heard of this before, and Theresa tried to make me do it, but I think if I did it would fail just because I still don’t think I can. If anyone wants to let me know more about this church please let me know! I am open to learning about it since I have to go to the church for the next two months. J After some delicious jell-of-rice (that is not the correct spelling) and plantains, I spent some time reading. I am reading the book Who I am in Christ my Neil Andersen, and I highly recommend it! When I speak at morning devotions at the hospital, I am pretty much going to retell his introduction to the people, and of course give him credit. Then I went to the school for volleyball! There were only men playing when I came, and I just stood watching because none of them were speaking English. They were playing teachers vs. students but honestly I don’t know which side was which. The best part was when they disagreed on a play because both sides would start yelling at each other and pointing and lines and indents in the dirt. I asked someone if they wanted a referee, and for the next five minutes all of the guys who talking to eachother and laughing. I am pretty sure they were laughing at me. Oh well, after they went to play football, the high schooler guys asked if I would play with them (I played with them last week.) Funny thing, throughout the past week I noticed a few kids would come up to me, and try to look at my elbow or knee. I was kind of confused by this, but I realized they were looking for my battle wounds. Last week I left with a bloody knee and elbow. This week, I succeeded in cutting open my knee. It kept bleeding, but I just kept playing. By the time I left, blood was down to my ankle, and everyone I walked past would stare at my knee. As of now one cut is healing, and the other one is infected despite my constant ointment application. To all the medical worrisome people out there do not worry. I am working at a hospital so if it gets worse I will have no problem finding a bandaid. :) After a dinner I talked to my family on the phone for the first time! It was definitely nice to hear their voices, and the wonderful static our home phones possess whenever they go outside. 

Monday I started consultation!! I am watching a man whom I call Professor. He is the head of the nursing department, and he has some sort of masters in nursing. Most of the cases are malaria. Don’t worry, I am fully capable of diagnosing malaria: fever, chills, loss of appetite, diarrhea, stomach pain, and headache. Primary malaria is treated with an artesnate/amodiaqin combination pill, but secondary/severe malaria is treated with quinine. 

John taught me all of the right words to say: Bra. Tenase. Den na eye wo? Wo fe? Wo bo wa?. 

Consultation is set up differently here. The patients wait outside with their own folder and insurance, they get vitals in the waiting room with everyone else, then they wait for their turn in consultation. They sit in a chair and see Professor, his two insurance, surgery consent, and diagnosis form fillers, and me. Then they leave and go to either Lab, Pharmacy, Theatre, or home. Besides malaria, hernias are very common. Men here do a lot of physical labor and they can get different types of hernias such as chronic and acute cases. It definitely looks painful, but many come in and have the surgery done the same day. What is the most interesting part of consultation to me? First, I love diagnosis. I love going through the signs and symptoms, and figuring out what is wrong. Second, the people intrigue me. If you took out the malaria and hernias (which are preventable) and pregnancies (Muslims are very reproductive) there are not a lot of issues. Spend a day in an American consultation room and you will see countless colds, earaches, flu, etc. That to me is fascinating. What are the things that make America so sickly? Ask Ghanaians and they will say, “All Americans do is eat salt and sugar which makes them get sick all of the time.” Other reasons? They get physical activity walking around for transportation, doing laundry, washing dishes, running after their children, cooking, and going to the market. The food they eat is fish, rice, beans, and lots of fresh fruit and vegetables. They aren’t eating packaged foods and processed foods with added sugar and salt, and their meat comes from animals who have been running around the village and road all their life. I am not saying this is the answer to all our problems, but I think it is definitely interesting. :)

Anyways, I will close with the end of my journal entry last night: 

PS There are trails of ants crawling on my walls, a lizard, and a spider in my room. Thank you for making Raid, Lord. May it be your will that the lizard leaves by himself back outside without touching me, and my room does not give me cancer.  

My camera is locked in Dr. John's home, so expect a picture later tonight. (Probably just my bloody knee.)

God is Love,

Affia Boatema

Here is Charles, Stella, and "Momma" smashing the yams for the fufu. The soup was on a gas stove behind the brown towel. This is at the Vogel Nest in the inner porch.

Homemade Fufu

Well there is not much new to say today...maybe I should have spaced out all of the new information. :) Tonight we went over to the Vogel nest for some REAL fufu. Real refers to the fact that Charles smashed the cocoa yams with a long stick and a wooden bowl. It was wonderful, and I took pictures I will put up later when the electricity is working. Fufu is like a dough, but consists of smashed yams. They are large balls and are considered the dish of the area. The balls of fufu are in a large bowl with soup. Tonight the soup consisted of crushed peppers, tomatoes, some other ingredients, and tilapia that was bought at the market. The tilapia was dried, and the meat is very good! It does not have the fishy taste that I am not fond of. The soup has a consistency similar to what you would see with strained chili. Also, in the traditional way we ate the fufu tonight, we sat around a large bowl with the fufu and soup, took some of the dough with our right hand, dipped it in the soup, and ate it. The tricky part was that you do not chew the fufu, but simply swallow it whole. I was able to do this, but sometimes I would forget and they would laugh at me. The clinic is going well, we are still in the OPD, but tomorrow is one of our last days before moving onto vitals and consultations. Tomorrow is a national holiday known as African Union Day. I am not sure exactly what it is, but some people don't work. I don't mind working since I wouldn't know the difference anyways. Twi is coming with time, but still have a long ways to go. Gretchen and I are the only white people around the village, and it is kind of a weird feeling to walk and have small kids stare at you and yell abrunee!! (this is white lady in Twi) I also had a little girl at the market look at me, scream, and cry to her mom which was a little sad, but once again we are adjusting! Tonight I began using my filtering water bottle so that I can take the water, and drink it without constantly using up plastic water bottles. So far so good! I guess we will see how I feel tomorrow. Well, that is all I really have. The electricity is out again tonight, but hopefully this will not be a common occurance. I am learning a lot in the morning devotions at the hospital. The entire staff is to come to devotions around 7 am every morning, and I am enjoying the messages, even if they are shortened translations. There is great devotion spent on prayer every morning, and a faith in God's provision in guidance that is very inspiring to me. God is Love. Abby

 This is Mother Theresa's guesthouse. She is pictured below with a far away view of our beloved scorpion whom Gretchen did not even get scared about. Gretchen and I both have our rooms in here (on the left). Every morning chickens somehow appear right outside my two windows (ok I don't actually know where they are, but they are loud.) and wake me up by doodling. Actually, I find it much more peaceful of a way to wake up compared to just hearing a loud alarm clock. :)

Hey family and friends! Sorry I have not posted in a while. I am trying to keep up to tabs with family emails, writing a personal journal, and my blog without having too much technology around. Actually as I am writing this I am listening to my ipod for the first time since leaving my home last week. J Also, as I am writing this we just got the power back on after it shut off after dinner. I washed the dishes by the faint moonlight, and now at 9:00 pm the electricity is on, but we do not have internet so you are reading this after I posted it. Where to start…Saturday Kwame took us to the Accra mall after a breakfast of beans and scrambled eggs, delicious muffins (I have no idea what the flavor was though), and some instant coffee. The Accra Mall is actually really modern. It has a Puma store, Apple store, a cinema (theatre refers to the operating room J), and a game store which is a South African Walmart. Yes, it even had the low prices logo! It was the only place to find lasagna noodles before heading to the village. We ate outside the mall and had some pizza! This was actually the first pizza I have had since my food sensitivities a year ago, and it settled perfectly well…praise the Lord!!!  After some vegetable pizza, we traded some money in for cedas (Ghana currency) and headed to the Ghanian military base to try out for the army!....just kidding…Don’t worry mom and dad I only went there to visit Kwame’s pastor who is in schooling to be a chaplain. Kwame’s pastor is part of the Church of Pentecost, which is also found in America in places such as Houston, California, South Carolina, Minnesota, and New York and he was proud to say he has visited them! Except he said driving on American roads was crazy because we are not nice drivers. I can explain…you see this is a “hot” culture based on relationships, and we live in a “cold” culture based on how fast, efficient, and quick things can be checked off a list. Driving here is fast, but people pull out in front of other people because they know the other person will wait, you never drive to fast to not be courteous and yield for others. The church here in Kasei is also of that denomination.

Back to our visit to the pastor…his wife served us guava juice which was delicious, and Kwame, Gretchen, the pastor, and I talked about the church, culture, etc. All of the sudden the electricity went out and the long curtains to the floor were flying everywhere. It is so hot, that suddenly it just starts pouring, blowing, and thundering as is what happened tonight. Once the rain slowed down, we left to catch our flight to Kumasi at 4. We cut it close, but we got through a scan of our bag and pat down at 3:53 pm. Then we waited for an hour in a general waiting room because they were afraid the storm would hit Kumasi. That hour was interesting as everyone around us spoke Twi, a common Ghanaian language, and they continued to speak Twi on the bus that shuttled us to the plane when they wouldn’t let us out. In the end, Gretchen and I boarded the plane, slept, and arrived in Kumasi!!!! Dr. John told us the plane came to Kumasi, turned back around to Accra, and then decided to come to Kumasi after they decided it was safe to land. What a day! We then drove with Dr. John, his driver, Estella (a young, newly certified as of today, nurse midwife) to Kasei. Along the way we stopped for “biscuits” aka crackers J. At each village we drove through on the way people were crowded along the road watching the BIG football game outside on small televisions…by the way Ivory Coast won….Yay! J (This was the clear choice for everyone as they have a Ghanian player. The lights just went out again….I will finish tomorrow.

Anyways, after the two hour drive to Kasei, we arrived at St. Luke Hospital!! J I honestly feel close to home here, besides St. Luke Hospital, we have the Demco patient ward, and the Vogel home. Not to mention Dr. John has a Northwestern College glass plate, and love for the college…did I mention he has been to Orange City and is a fan of Foreign Candy and the Pizza Ranch? J

This is a long post, I am sorry for all of you slow readers, but I have learned SO much the past few days. Sunday morning after egg omelette sandwiches, we headed to church. Dr. John gave the message because the pastor was in Kumasi, and it was mostly in Twi. We introduced ourselves as Affia (me) and Accosia (Gretchen). There was lots of singing, dancing, and praying. The message was how we are all unique, and can use these gifts to serve God. Dr. John said we had no fear, which was crazy because I feel like I can be a scaredy cat…I can’t even make it through an episode of Monk without being scared of the dark. J The afternoon was spent visiting Stella’s friend, Winifred, and playing volleyball with some young men from the village. We played right outside the primary school using two tree stumps as poles and an old net. There is definitely a new meaning to the “talking” on the court after playing and seeing the difference when we don’t speak the same language! I scraped my knee and elbow, and they were worried about me, but I was perfectly fine. The parents were on the other side watching the adult men play a very intense, professional soccer game. Then it was time for dinner. We had fufu and some soup with hedgehog (0% fat!), entire crabs, and snails. I did my best on the fufu, but I struggled with the seafood portions. Hedgehog tastes like chicken! I think my dad should start bringing it home for my mom to cook for dinner J.

Today we started at the hospital with 7 am devotions. I spent time in the front where patients come, and I learned all about filing insurance. There are the capitated, re-capitated, and new capitations to fill out along with activated/deactivated insurance. I really enjoyed learning about their insurance computer system, and I will begin here this week before moving onto consultations, maternity, surgery, etc. Then we headed to Monday market…wow is all I have time for now, but I am sure a later Monday post will explain, but there is nothing like being in a huge market, and being one of two six foot tall white people (aka abrunee). Love you all, and sorry for the novel!! (The saddest part is I could have said so much more. J) 

PS Yesterday there was a lizard next to the toilet, I think I killed it without knowing it which is kind of scary. Today there was a scorpion in the door of the guest house, and Theresa (our mother) was surprised it didn’t run away and hide…..I do not know what to think of this piece of information. Needless to say, it is dead, and she has checked all around and now found anymore….and we have a picture!!!!!!

My tilapia with bunka, Gretchen's barracuda steak, and Kwame's grilled chicken and fried rice (right).

Gretchen, Kwame, and I eating along the ocean. The malt beverage is an non-alcoholic energy drink for all of you who were able to read it. Also not the wind.

Hello!
This is my very first post from Ghana! Gretchen and I were able to meet in Chicago at the airport. We bonded over some Burrito Beach which of course included guacomole, and I am so excited to get to know her better-she is wonderful, and we are quite similar in many ways. :) What a blessing! After flying overnight from Chicago to London, we spent a few busy hours in London first on a bus, then going through customs, and finally buying a camera card since I forgot one at home. I cannot say that it was easy for me to sleep on the red-eye flight, but by the time we flew from London to Accra I was falling asleep reading. When we arrived at the airport we were hit with a wave of humidity. Gretchen and I stuck together, and were met with a greeting card that said: MR ABBY GRETCHEN. From there Monica, an airport worker, guided us through customs which was a blessing, and we met Dr. John's son, Kwama outside. Kwama brought us back to their home in Accra which is a very beautiful lime green stucco home. We slept in until 11:15 am, Kwama had set breakfast out before work of eggs, muffins (which he admitted were from the bakery), coffee, and beans. After work Kwama took us out to a restaurant right on the ocean. Needless to say, I gasped when first seeing the ocean, because of course that is always a winner with me. :) The resturaunt was a hotel/spa place and we sat right next to the ocean so we could smell the salt and watch crabs walking on the poles in the water. My mother would be very proud to know I ordered tilapia and bunka. When my plate arrived so did the entire tilapia, but I did a very good job (according to Kwama) of eating the meet from one side, and flipping it over to do the same. It was very good! (I took a picture before and after.)The bunka is kinda like corn dough that you then dip in sauces that were hot. :) The waitress brought our a bowl and soap for me to wash my hands, but Kwama said I could just use my knife and fork instead.
Tomorrow after Gretchen and I do some shopping for food to bring to the village, we will be flying from Accra to Kumasi, where Dr. John will pick us up. We have talked to Dr. John on the phone a few times, and we are excited to meet him! So far Gretchen and I are doing well, and we really don't feel like we are in Africa too much, but we are excited for all of the possibilities of things we might be doing. Prayer requests would be for safe travels through the airports again tomorrow, and continued health as we adjust our diets.
I will try to blog again soon, probably after we are settled in Kasei. The local time here is 8:19 pm, but I am already tired! I must transition from late nights to early nights, and earlier mornings. :) Plus, Gretchen is waiting to use the computer. Hope all is well for everyone. If you would like to get a hold of me, I am communicating via facebook and my email address: abbyjh3@gmail.com. God Bless!

Welcome!
So if you are looking for Abby's blog about her adventure in Ghana you are in the right place! I am not the most techonological savvy person you have ever met, but I am going to do my best to keep this updated on what is going on with me. Right now I am getting ready to leave, and I have a lot to do yet! I am not into packing, I am a bad procrastinator simply because I do not like packing things I still need. Hopefully, I get the ball rolling so I can leave in less than three days! :)
My prayer for this trip is that God uses me for His purposes. I also want to continue to grow in my relationship with Him, as I am continually learning to trust Him even when life doesn't always make sense. My theme verse for this trip is Joshua 1:9 which says, "Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you go.” This verse not only extends to this trip, but also my prayer for my life: that I am prepared to follow God's calling wherever He leads me. Well...I should probably get some sleep. I will blog once I get down to Ghana else once more before I leave.