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