Sunday, March 30, 2014

Hospital Life, Clinic, and Weekend Adventures

Hello everyone back home!

It seems like it has been a while since we have given a really good thorough update about what has been going on for us here in Ghana. So we figure a long tro-tro ride back from our safari weekend would be a great time as any to brainstorm what has been going on for all of us.

To begin, this week we have all been working hard in the Tamale Teaching Hospital (TTH) on Numerous different floors. When we were first introduced to this hospital we were all amazed by the incredible improvements to the hospital facility. In the last year, they have added a large new building and renovated the majority of the hospital however there are still areas of the hospital that are in the old unrenovated areas.

Although the facility is much improved in its aesthetics there remain many challenges that I'm sure some of you have heard about:
- usually no running water
- numerous power outages
- lack of supplies or resources (sometimes even the most basic of resources)
- staffing challenges
- inability to provide care to some people due to a lack of finances to pay for care or supplies

We have all been working in different areas of the hospital:
- pediatrics, NICU, labour & delivery, surgical (trauma, neuro, septic, aseptic), ER, Gyne

Every area of the hospital has been challenging for students in numerous ways both emotionally, mentally, and sometimes physically. Many students have had a difficult time seeing some of the unfortunately advanced stages of preventable illness or disease, to struggle with the extensive loss of life on some floors, the lack of ability to provide care to the standards that all these people, children, and babies deserve. It has been an incredibly challenging last week of work for most. Many of us have expressed feeling "hopeless" at times because we don't see the normal return for all of our hard work with the patients we care for in Canada. In Canada, we see patients get better and go home, get washed, get fed, smile, laugh, get respected, cared for, and pass away in a dignified and hopefully comfortable way. Many times here in Ghana, we don't see that or we aren't able to provide that to our patients and so at the end of the night we go home and sometimes struggle at being able to settle down at the end of the day.

However, we often try and focus on the examples of perseverance, resourcefulness, bravery and positive contributions we made during our day. We thought we would share some examples with you:
- Hailley Gibbs holding and comforting a little baby as it passed away
- the NICU girls advocating for and ensuring that NICU babies were receiving their feedings ( Hailley, Bethy, Kym, Gabby, Caz, Bonnie)
- dealing with trauma patients from a large bus crash (Joanna, Madie, Gabby)
- Christy and Sam using a sterile glove as a makeshift catheter foley bag when there were none available
- Michelle running through the hospital to buy a patient having a severe asthma attack a Ventolin nebulizer - when the only Ventolin available spilled all over the floor.
- Kym realigning a motorcycle crash victims broken bones
- Stef and Beth providing comfort and care for child burn victims.
- Stef and Kym resuscitating a 6 month old child after he seized for an hour from typhoid and high fevers
- Joanna, Bonnie, and Emery each caught babies for moms on labour and delivery
- Kym, Bonnie, Caz resuscitated a baby post delivery in labour and delivery.
- Sam and Christy receiving and comforting a child with 3 venomous snake bites when no one was there. Sam continued the care and support for the child and family into the next day until the child passed away.
- Labour and delivery girls advocating and ensuring that moms were able to breast feed their babies ASAP after delivery and that they continued to receive their babies to feed throughout the shift (Christy, Stef, Kym, Madie, Bonnie, Emery, and Caz)
- Madie doing a thorough assessment on a comatose women and discovering that she was pregnant as a result. She then persevered past her emotions over the women's poor condition and prognosis and made sure to provide exceptionally compassionate care to the woman.
- Sam being peed on by children everyday (sometimes multiple times) and taking it like a boss. "meh, it will dry."
- advocating for surgical dressings, using impeccable sterile technique and smuggling much needed dressing supplies from our stash at home to provide dressings to patients that couldn't afford them (Christy, Emery, Beth, Stef, Joanna)
- recognizing, assessing, and initiating resuscitations on NICU babies that would have gone unnoticed (Hailley - all 3, gabby - for 1, Beth - for 1, Caz - for 1)
- Gabby continuing on with a graceful air and "extra pleasant" smile when an ER nurse spilled 900 mLs of gastrointestinal blood from a patient on her shoes.... Her shoes are cleaner then ever now because the nurse scrubbed them VERY clean. LOL!!!!
- Madie and Christy running up 5 flights of stairs to find a Foley catheter for a patient with a Head injury.
- Caz, Michelle, and Kym restraining and soothing a 5-year-old boy who was receiving a suprapubic catheter inserted without pain medication. His dad was very thankful to these girls for providing care to his son during such a difficult time.
- Christy DEMANDING a head CT scan for a 2 year old with exposed skull, exposed brain matter and leaking CSF fluid so that the child would be able to have brain surgery. (The child wasn't going to receive one and thus wouldn't have received surgery.)
- Kym, Bonnie, and Christy managing and caring for a woman with a severe post-partumhemorrhage
-  Sam being pulled into a pediatric emerg assessment room to assess an 8 year old patient in respiratory distress. Then demanding certain medication orders from the doctor and initiating and setting up for a code with Muriel and Madie. They all used their engineer and mechanic brains (they didn't know they had them) by taping together the broken suction equipment so it worked.
- Sam assessing and managing children with extreme fevers when there was no medication available. Holding naked babies in the air under the ceiling fan and wiping them down with cool water until their temps came down.

Everyone of us has been doing very thorough assessments for our patients, advocating for them whenever we can and doing our best to provide patients at least some form of care. We have taken opportunities to take the Ghanaian nursing students under our wing to teach them how to nurse responsibly.

Though it has been very hard and frustrating clinically we have met some hidden shining star nurses that provide excellent care with even the most unbelievable odds against them.

This week on Thursday and Friday, Hailley, Caz, Sam, Beth and Michelle went on an adventure of their own:
       On Thursday morning, we went to Dr. AbdulIai's clinic. He provided us all with a much needed lift in our spirits. He is a doctor that provides surgical services to patients for free. His clinic is run by monetary9 and supply donations. It was so inspiring to meet a man that carries the same core values of caring for others that is the norm in Canadian healthcare. He inspired us and made our eyes well up with happy tears. If anyone is looking for an amazing cause to donate money to - this man is THE REAL DEAL! We were able to give the 3 suitcases of medical supplies to him and his gratefulness was radiating from every pore in his body.
       Thursday afternoon, we went off to Changshegu village to spend the night. We started the afternoon by heading out to the building site of the Changshegu clinic that Sam Waller, Caitlin Robertson, and Sarah Duddle headed off the fundraising for this year. Construction has been happening swiftly since we arrived in Tamale thanks to the watchful eye of Wade. The foundation was completely poured and the walls are going up quickly. Sam found the experience to be very surreal, emotional and exciting to be standing in the middle of the clinic that she, Caitlin and Sarah had worked so hard for and thought about for such a long time. This clinic is a huge huge gift to this community and it's amazing people. They have expressed unbelievable gratitude for what the people in Canada are doing for them. So for all of you that have fund raised or donated to this clinic project, you are absolute life saving angels.
       Thursday evening we gave out gifts (books and toothbrushes) to the orphans in Changshegu, we played games, sang songs and cuddled some kids that needed some loving. Sam has now got a cult of children that chant her name like a song over and over "S- A-M SAM, S-A-M SAM". We stayed in the chiefs compound with him and his family, where we were served the Ghanaian dish of Bangku.... Not our most favorite dish (it's more of a swallow and don't chew ... Kind of thing) but we went to bed with full bellies to have a goodnight sleep (or so we thought).
       Changshegu has no electricity, no running water and no bathrooms so before bed we ran off into the forest equipped with our toilet paper from home. We thought we were well hidden - Sam, Hailley, and Michelle all squatting to pee in a row (what a bonding experience). When a Ghanaian man walked passed us all, looked at us, and said "good evening".... Oh JOY!
        We settled into bed in our little turquoise mudhut which quickly turned into a long sleepless night in a house that felt like a sauna set to the highest setting! We have never sweat so much in our entire lives. We were drenched head to toe. To add to it, we ran out of water and had to ration ourselves.
        At 4 am it was time for the "call to prayer" (aka the soundtrack to our lives in Ghana) it tells all the Muslim people that it is time to pray. We normally hear it echo out of speakers around town but in a rural village with no electricity it was up to a man to stand in the centre of the town and sing as loud as he could. Off in the distance we could also hear someone else singing for another village. It was so beautiful!
        In the morning we came home to our luxurious showers with no curtain and ceiling fans. We were reunited with our beloved Ghana family of nursing students.

Friday night we had a celebration!! Megan is a nurse that accompanied us to Ghana and she was a student on this trip last year. She is getting married to Sinbad while we are here so we threw a bachelorette party for her complete with dessert, games, lots of laughs and love.

Saturday, we headed off on our Safari weekend at Mole National Park!!!! We travelled 3 hours in a tro-tro and ended up covered in red African dust. Our skin ended up 5 shades darker then it had been when we started thanks to our nice coating. We all showered off - or used our toilet flushing buckets to wash ourselves because our water didn't work. We jumped in the pool (yahoo a pool!!!) tanned in the sun and looked out over the delightful views. We went on a jeep safari where we all sat on seats on the roof and we were driven around for 2 hours to check out the animals and sights of rural Africa. We saw antelope, warthogs, baboons, birds and flowers... But no elephants. We sang, laughed, relaxed and enjoyed our nice carefree relaxation time.

Today (Sunday), we started off the morning bright and early with a 2 hour walking safari. We walked along a little bit groggy and all of a sudden we saw what we all had been waiting for.... AN ELEPHANT!!! Our only rule was that we had to stay 50 feet away from it but we enjoyed watching it and taking photos. On the rest of our tour we saw antelope, crocodiles, warthogs, and another elephant. We had such a great time. When we came back to the hotel in the park we all headed for the pool and suntanning spots. Hailley and Sam added a new credential to their repertoire, as "firefighters", when a women came out screaming there was a fire in her room. They ran into her room and used the toilet buckets of water to put out the fire consuming her large air conditioning unit. We all enjoyed a swim and some tanning and then it was time to go back to our Tamale home.

We have just returned home to the catholic guest house and we were welcomed by some of our favorite staff members Don, vice and Lydia who ran out to our car to meet us. They hugged us all and told us they missed us while we were gone. It was just like our families were welcoming us home. What amazing people we are meeting here.

This week we are looking forward to:
- a change of clinical scenery
- cuddling some babies
- catching babies
- running triage
- working in mental health
- staying overnight in the village
- spending time together

This blogposts shoutout goes to all of our families and friends that have had to listen to our frustrations and sometimes sad phone calls this week and providing us with the encouragement to keep moving forward.

Also, shoutout to ourselves for making it through a tough week and continuing to laugh and support each other through each moment. TEAMWORK!

Until next time. We miss you and love you all!!
Ghana Gals 2014

Monday, March 24, 2014

A big hello to all of our loved ones back home!

It has been a stretching and adventurous time in Tamale since we were last able to update our blog. We have begun our first week at Tamale Teaching Hospital.Between the 13 of us we are working on labour and delivery, NICU, emergency, ICU, pediatrics, surgical, medical, and gynecology wards.While we are thoroughly enjoying being back in the hospital, we are struck by the prevalence of suffering amidst the beautiful Ghanaian people. We are astounded by the strength and courage our patients demonstrate during their time in the hospital. Many go without pain medication, travel long distances (we see patients who have come from Togo and Burkina Faso), and make do with limited access to resources, which back home we take for granted. The resourcefulness of the nurses, doctors, and other health care professionals amazes us. Many patients access the hospital services without health insurance, and thus must pay for all medications supplies, procedures, and generalized care. If the patient is unable to pay for these services, they often go without. It is something we are all struggling to witness. It's hard to process holding a baby who will likely not survive the night or knowing that someone will die from an infection that could have been prevented given the proper care. Words can not express how we feeling right now, but it is times like these that bring us together as a group. We are so thankful for all the support we are receiving from all of you back home!

On a happier note, we spent the weekend touring Tamale and spending our Sunday day-tripping to Kintempo Falls. It was a joyous day spent singing, laughing, and slip n sliding! It is always an adventure traveling the Ghanaian roads - dodging pot-holes, motorbikes, goats, falling yams, and women with pails of various merchandise piled high on their heads.

Today we were overjoyed to receive our bikes from Bikes for Humanity. Somehow all 13 of us made it back to the guesthouse alive after surviving our first bike tour on the Ghanaian roads. It was a blast.

Shout out to Kym's family (Tyson McMullen). You are a wonderful gem. We have thoroughly been enjoying your weekly treats! You are the best.

Much love to all.

Ghana Gals

Saturday, March 22, 2014

Kumasi to Tamale

It's been a short 12 days since leaving Canada. Life in Ghana has had its challenges but We think it's safe to say that we are all adjusting quite well. In our first week in Ghana we spent every two days traveling from city to city. On March 16 Our group packed a Tro Tro with windows rolled down and baggage packed to the roof headed towards Kumasi.  We traveled north-west for 4 hours into the town of Kumasi where we stayed in a Presbyterian church guest house. Just outside the gated area was the perpetual reality of heat and dedication. We have notice that the same people are at their vendors on every day of the week. Some people here explain that after working Monday to Sunday for a couple weeks straight they might consider taking one afternoon to sleep because of exhaustion. Could you imagine working so hard?

After we settled into the guest house, we set off to find some food. While walking to the local restaurant The clear sky's turned dark and the clouds rolled towards us. We expected a down poor of rain to cool our bodies from the intense African heat but were only entertained by large bolts of lightning. Our next adventure in Kumasi took us to the cultural centre where we could find a variety of different items to buy for ourselves or maybe even a couple special people back home :)

Before we could even blink an eye it felt like we were loading another bus up; on the road to Tamale. Kumasi faded out leaving behind Palm trees and dense humidity. Driving to Tamale, grass huts and the country side became obviously apparent as we made our way North. After 6 hours in the bus, we arrived safely to the Catholic guest house where we would call home for the next 2.5 weeks. The temperature here reached a staggering 40 degrees on our first day as if Mother Nature was welcoming us with a tease.

It was on March 19 when our group had the privilege to go into the Chenshagu village. Our professor Muriel Kranabetter has been designated King here. All who resided in the village came to see us including the traditional drummers, dancers, elders, children and parents of the village. Driving through the rough red sand and into the village we were greeted with enthusiastic, bright-eyed faces. Children from all over the village came to greet us and would yell from the top of their lungs about our arrival. One-by-one our group of girls piled out of the bus and into the hands of the children. Every girl in our group had 10 little hands holding each of our fingers. Although we weren't able to hold each hand in the village, our hearts poured out love and kindness with the smiles, songs and games we shared. Even though there may be language barriers, we've learned that every culture shares a common ground for love and compassion.

At a quick glance you can see that the struggles are more pronounced for those living in the village. Many of us girls witnessed the harsh reality of how people treat themselves without access to health care as some children and adults would fill their gaping wounds with the dry soil to keep flies and other bugs out of their sores. Defying the odds, the children remained lively while traditional dancers and drummers followed behind us and performed in the +40 degree weather. We shared in the celebration when the dancers strongly encouraged each and everyone of us girls to dance and shake what booties we have. All people in the village were embarrassed for us, as evidenced by their intense laughter and cheers. Unfortunately, we all have incriminating footage of us attempting cultural dances.

After we got our fill of cultural dancing, we loaded the bus to head back home (catholic guest house). Muriel had finally gotten in contact with the nursing director at the Tamale Teaching Hospital where we would begin the last clinical practicum in this program.

The next 2.5 weeks will be filled with adventure and heartache as we gain insight into the developing healthcare practices in Ghana.

P.s. Photos to come when we have better internet connection. Sorry about that.

Tuesday, March 18, 2014

Home Sweet Home

We've arrived to Tamale! After a comfy bus ride and buying some delicious dough-balls off the street out our bus windows we've now checked into our rooms at the Catholic Guest House.
It's even hotter here than anywhere else we've been to yet! But less humid fortunately. So we have more of a "purer" sweat going on.

We are all very excited to to settle in, as we will be here for 2.5 weeks. Thursday we will hopefully have our hospital tour and introductions to staff. Tomorrow we are looking forward to exploring the city more and tracking down a store. Tomorrow evening will will attend a welcome ceremony for us at Sinbad's (our friend and guide) Village - Chanshegu - which we are very much looking forward to!

It feels like we've been here for weeks! We have been able to do so many things.
On Saturday we went to the Slave Castle Memorial in Cape Coast. We took a tour around the location thousands of slaves got sent off from their homeland to various countries. We were shocked at the atrocities that took place, and horrified at the awful conditions they were forced to live in. It was helpful to see more of the history of Ghana and many other countries. A taxi driver shared a wise and optimistic perspective with some of the girls of the good things (infrastrucure, culture, etc.) that came out of the exploitation.

Sunday we went to Kakum national park. We went on the sketchy Suspension bridges way up in the trees, and had a nature walk tour through some rainforest areas. We learned about some traditional plants that are know for their various healing properties. Unfortunately we didn't see any monkeys there, but someone claims to have seen some hanging around the side of the street on one our our trips!

We are currently in an air-conditioned internet cafe (Hallelujah chorus!!). We got downtown by 6 of us piling into a taxi to the size of a Fiat! There are very few driving rules here and every ride is filled with constant honking and dangerous maneoveurs.

Note to Emery's family: Yes, your daughter successfully touched one of the crocodiles! And ate fruit off the street. Look at this girl go!

That's all for now! Looking forward to so much more to come!!

Friday, March 14, 2014

Tro-Tro Adventures!

Caz with some new friends

Day 3 in Africa:

We arrived in Cape Coast this morning! Considering the chaos at the bus station, the fact that all 15 of us and our luggage made it is miracle! We got off our bus and were greeted by friendly taxi drivers who remembered the nursing students from last year. We arrived at the beautiful Hans Cottage Botel! Yes Botel. This afternoon we had a glorious swim so we are all refreshed and loving life. We also got connected to some quality WiFi so we enjoyed connecting with families and friends again. We are all sharing one big dorm room tonight. We had more people than beds in our last hotel, so a single bed per person will be wonderful. The Hans Botel also happens to be a crocodile farm, so we’ve already had fun watching the crocodiles and naming them. Some of us are hoping to get a chance to pet them, some of us are not so excited about the prospect. Our last two days were spent in Accra, the capital city of Ghana. Two days were full  of sightseeing and new experiences like driving in some of the sketchiest transportation on the scariest roads ever seen in Tro-Tro’s  (basically a hollowed out van packed with as many people as possible like a can of sardines), eating delicious freshly chopped mangos and pineapples from the side of the road, being constantly sweaty and sticky 24/7, taking showers with an intermittent water supply, using some of the most creative “bathrooms” we have ever used,  dodging marriage proposals like never before (“I love white women! You are so beautiful”), learning how to eat beside open sewers, receiving legitimate hissing cat calls (we’ve learned that being hissed at is only a way of getting one’s attention in Ghana), witnessing an enormous tire fire that seems to concern no one but us, making friends which a school full of enthusiastic and beautiful children, and getting some the whitest and brightest smiles we have ever seen. Also, we’ve had a lot of good conversations with the locals considering there is no way a group of 15 white women walking around Ghana cannot draw a TON of attention.  And so many more new experiences! Basically we’ve had a lot of TIA (This Is Africa) moments.

                Yesterday we had an afternoon that would leave us all dumbfounded and lost for words. Throughout our first few days here, we have all been very surprised by how unbelievably well dressed and clean the Ghanaian people are when they live in homes/shanties that would be inexcusable as a home in Canada. We have constantly been hopping over open sewers on the sides of the street which at first was shocking but now we are starting to get used to them... (if that’s really possible). Many of the working people in Ghana live in conditions that we can’t even fathom. Yesterday afternoon, we were taken down to the slums in Accra where hundreds of thousands of people live that have no job and no money. We all were shocked at what we saw for the few hours we were down there. No amount of reading books could have prepared us for what we saw for ourselves. Crowded living conditions, people living among overflowing raw sewage, children running around with no clothes on, playing in the dirt that was difficult to distinguish between sewage, stray animals everywhere, lots of overwhelming smells and stares, piles of garbage and tires burning everywhere, people picking through the garbage in the garbage dump and through the sewage canal for things to salvage. Very hungry children and families. People attempting to funnel crude oil into large barrels – the ground was saturated with oil, the people funneling it were covered head to toe in oil, people and children were walking through it with no shoes on. Children were playing on the ground among garbage and dirty soil. There really are no words to describe what we saw down there for the hours we spent there. It is something that is very difficult to process and we all have been trying to do that in our own ways. It was very important to see.
                Note to Christy’s family: She’s almost fallen in the sewer numerous times and has required rescuing. You are eternally indebted to us J.

Overall our experience has been filled with laughter with the Ghanian people and rapidly growing love for this country and each other. We are heading off on some more adventures this afternoon. Sending  love to everyone that we left back home! Talk to you soon.


2014 Ghana Gals 

Tuesday, March 11, 2014

Time to Take off!

All packed up and ready to go! Hailley, Beth, Michelle, Bonnie, Sam, Gabby, Christy, Emery, Stefanie, Madie, Kym, Caz, Joanna, Megan, and Muriel left Vancouver on March 10th and arrived in London early this morning.  Tired but excited, one more plane until we touch down in Accra, Ghana! Feeling surreal.