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