Tuesday, March 31, 2015

The Outreach Lunch Program

Today (March 31st) we returned to Doctor Abdulai's clinic. For the first half of the day Nicole assisted in the dispensary and Kyla and I assisted in the out patient department (OPD) where we took vital signs. Kyla and I really enjoyed interacting with all the people and practicing our Dagbani , the local language.  We also had some fun with the children that arrived for treatment and handed out Canadian stickers; they loved it!

We were again struck by the sheer volume of patients (especially kids) sick with malaria or enteric fever (tyhpoid).   It is so interesting that we (the western world) have ideas around how to solve the "malaria problem".  We've asked about mosquito nets, as they are provided free at many clinics and outreach centres, but are not being used.  The answer didn't surprise us.  The temperature here is close to 40 degrees Celsius through the day, and "cools" off to 35 at night.  With the mosquito nets up, there is absolutely no air flowing and it becomes stifling.  Not practical.  We have the best intentions, yet we often provide solutions that just don't meet the needs of the population. 

After we finished up with the patients in OPD we joined the volunteers in the outreach lunch program. Dr. Abdulai's clinic provides lunch in the community to people who are homeless and/or suffer with mental health issues.  One of the mandates of the clinic is to reduce the stigma faced by people with mental health issues.  We were all struck with the quiet, non judgmental way they go about this work.  This was an amazing experience to be a part of, which we enjoyed while riding in the bed of a truck. The truck drives along it's route and the volunteers leave packages of food and water for the people.  The food is all donated, and is prepared by volunteers. 

We were all touched deeply when we stopped to deliver a meal to a man who was naked and confused, sitting by the side of a building.   The volunteers found a shirt and without making a scene carefully dressed the man and left him with food and water for the day. One volunteer mentioned to us the importance of maintaining the dignity of these people, caring for them, and keeping them safe and we witnessed this in action. 

We continued on with the deliveries, and made a stop at the Tamale General Prison to leave food for the prisoners who do not have family bringing them in food.  The volunteers at this clinic ensure that no one goes without and the work is beautiful!

We were so privileged to see a living example of de-stigmatizing mental health issues.  Our healthcare system at home could learn so much from this simple practice of loving compassion and service.  James, one of the volunteers who supported us these past 2 days shared that everyone can heal when they are treated with care, dignity and LOVE.

We certainly witnessed this today.

Christina & Jeanette


Thursday, March 26, 2015

Our Time in Enchi

We are now settled into Tamale and ready to begin our work here.  I wanted to share a few remarkable pieces from our 10 days in Enchi.  We travelled in relative comfort the 5 hours from Accra to Kumasi and then piled ourselves and all of our luggage into a van to finish the journey.  We we were never really clear on how long it would take.  It was another 6 hours.  We turned off the main highway and travelled up and over a "pass".  It was a red clay "road" that became more of a trail and took us through some very rural and remote areas.  It was pitch black, but we could see with the headlights some very small villages beside the road.  The most remarkable thing we noticed was how clean and pristine everything looked.  Philomena commented that that area is considered "environmentally pure" and is protected by the government.  They are all subsistence farmers and they have a very strong sense of community.  We were only able to travel at about 30 km/hour and so we had a good chance to take in the surroundings.  It was a beautiful sight after the noise and chaos of Accra.

It then felt a bit like the twilight zone as we then popped out onto another main highway and completed the final hour into Enchi.  Our hotel was up another trail, a bit outside of Enchi.  The wonderful staff met us and helped us unload.  The "lights" were out, meaning there was no power.  This was a daily affair we were soon to find out.  We also found out that Enchi was without power until 1997.  Remarkable! 

Enchi is a very small town, with limited resources and we struggled a bit to find food we could eat.  I must admit, it felt a bit like survivor.  We would have plain rice and "sauce" and cut up avocados and tomatoes.  It was very hot and humid and we saw a couple of really great thunderstorms with torrential rain.  It is the middle of the rain forest after all!

The Presbyterian Health Clinic is a wonderful place.  It is a primary health care centre, and it is a shining example of this type of care.  They are staffed with a Physician Assistant (Phillip), who really functions in a similar manner to our Nurse Practitioners at home.  They have a lab that can do basic blood work.  In 2009, UBCO donated a microscope that enables them to do some additional tests for malaria and infectious diseases.  This has enabled them to reach the standards required for the national Quality Assurance program, as they are now a recognized lab.  They have done over 24,000 tests using this microscope this year.  To put this in perspective, these clients would all have had to access healthcare at the hospital.

 This is Michael Safu,  the head of the laboratory and our tour guide of the cocoa farms,  with the UBCO microscope (you can see the inscription on the microscope if you look closely).

They have a maternity ward where midwives deliver babies, provide pre and post natal care, and family planning.  There is a casualty department (treatment) and female and male wards as well as a pediatric ward.  Clients are "detained" if they require IV antibiotics or are too sick to leave.  As they are a primary health care centre, they can only be detained for 24 hours.  If they require additional services, they are sent to the public hospital.  They have a dispensary (pharmacy), records and registration department.  The staff is all very warm and welcoming and were supportive of our time there.  We rotated through each of the departments.  We were able to see first hand the devastating effects of malaria and typhoid.  The majority of the patients were receiving treatment for these two diseases.  

The clinic receives  funding from the Ghanaian Health Services and resources are a constant struggle.  They have not been paid for any of the services they have provided since July.  Philomena says it is due to some government restructuring and the clinic will manage.  "It's in the hands of God".  There is such strong faith in the community.  At the clinic every morning, they pray for the health and healing of the patients and the guidance and support of the staff.  What a wonderful way to start the day!  The level of commitment and service we witnessed are something we rarely see at home.

We were invited to the Presbyterian church service on Sunday as honoured guests and were part of a 3.5 hour service. There was singing, and dancing,  and a lot of talking (very little in English).  We were brought up front to introduce ourselves and speak about our mission.  Thankfully, we had remained for entire service, as this was done near the end. Again, we were struck by the very deep faith of the people here.   They live their spirituality, it's not just something they do on Sunday.

I believe we're all caught up now.  We'll keep you posted as things unfold here in Tamale.


Outreach to Nyameboame

Nicole and myself had the amazing opportunity to go on an "outreach day" to the small village of Nyameboame to weigh and vaccinate young children ages 0-5. Nyameboame (which translates to "God help me" in English) is about 20 minutes outside of Enchi (the town we were residing in at the time). The outreach nurses visit Nyameboame once a month to keep up to date on vaccinations and ensure adequate weight gain of the children.

I had the opportunity to be at the 'weighing station' where a scale (resembling produce scales back home) was hung from a door frame. Moms provided their own slings and would hang their child, and I would then record the weight. Each mom provided me with their child's health record book (which they are expected to keep safe at home). Nicole was ensuring the children's records were up to date, and kept track of trends in regards to weight and amount of attendees. Specifically, Nicole was determining which children were of normal weight - unfortunately, all of the children were moderately to severely underweight.

The children were shy, but so adorable. Many school aged children were waiting outside the clinic the entire time we were in there as they wanted to know our names and say hello (this is common here - we feel like celebrities!) The moms were then provided with a 'health promotion talk' regarding child nutrition. One of the women attending the clinic was considered their leader, so she was speaking on behalf of the mothers and would pose and answer questions to the nurses in English. She would then relay the information back to the women in Twi (the local language). It was nice to see this kind of advocacy on behalf of the women in the village.

During the clinic, Philomena asked the women in attendance why there were no men present. The answer was that it is not that they did not want to attend, but that they were working in the farms .in preparation for the following day's Market.


We then checked the child's immunization records and proceeded to assist the outreach nurses in preparing the vaccinations. We were taught the technique and landmarks of child vaccinations - the nurses are very experienced and knowledgeable.  We definitely learned a lot!

Overall, we both thoroughly enjoyed our experience, and it was a nice change from the routine of the clinic in Enchi!

Samaya and Nicole.

Amonie Outreach Clinic

Myself and Christina had the opportunity to go to a Amonie, one of the Presbyterian Health Clinic's outreach centres that was located in the center of multiple villages. The location's accessibility allowed for easier access to those in the surrounding villages. We learned that the staff at this clinic are quite dedicated to their work as they do not take breaks, they work 24 hours a day, seven days a week.  Their days off are few and far between and not scheduled into a "rotation".  They arrange rides into town when able and when they can be absent from the clinic.  We found the staff members to be devoted and caring towards their patients and they were eager to teach and help us learn about their mission at the clinic. This is something we rarely see at home! The clinic was quite small but had six different sections of expertise. The six sections included casualty, maternity, dispensary (aka pharmacy), two gender specific lay in rooms, records,and consult.
Once a month the clinic hosts a Child Welfare Clinic and we were fortunate enough to be arriving on this day. At the clinic babies are weighed and the information is documented and monitored on a growth and development chart, as well as routine vaccinations. On our outreach day 139 babes with mothers arrived at this very small clinic for their checkups. We will admit that we felt quite overwhelmed with the noise, heat, and confined space, but we pushed through it! Christina was in charge of weights and documentation. We rather liked this station as the scale looks like one you may find in a produce section back home. While Christina assessed weights and growth Kyla helped to review vaccination history, documented history of vaccines for use of statistics, and confirmed vaccine scheduling. After these two stations we were both able to assist with the baby vaccinations. Once vaccinations were finished everyone was able to go home.   We pushed through from 0900-1400 and it was nice to hear that the clinic was done early that day as they had the extra help.

Something that caught our attention, at both clinics we have been to so far, is that family planning is offered.    Ladies are educated on birth control options and given a choice on whether or not this is something they would like to take part in. The clinic works very hard to try to include the husbands as well. They have seen success with this approach as birth rates have decreased. This is still a work in progress as it can often be difficult to incorporate the husbands into care or they deny the wife access to this care. The hope is with more education to both males and females there will be a further understanding to the importance of family planning. Overall we had a wonderful learning experience and are very pleased with the work that is being done. We are looking forward to the next adventure!
Kyla and Christina

Wednesday, March 25, 2015

We're alive and well!!

Yes we are alive and well!  Internet access was challenging in Enchi.  We had an amazing 10 days filled with beautiful and challenging experiences. The Presbyterian Health Clinic exemplifies how to provide care with limited resources. We were able to work with the staff right in the clinic, and we also had the experience of doing community outreach visits. The level of service and dedication of the staff is humbling. Philomena is a model of caring leadership. 

We endured our 8 hr bus ride from Kumasi today and are now in Tamale. We will share pictures and more details when we get internet access. 

The girls are doing well.


Friday, March 13, 2015

A Teacher's Perspective

I wanted to add to the earlier post and share that we have prepared these girls well.  They couldn't help but notice the similarities between the stories we heard in the slave castle in Elmina today and our own history with the Aboriginal people in Canada.  The many hours we spent in the classroom with Eric Mitchell and Chris Marchand working through the Aboriginal Health Modules certainly helped our understanding today.

 It was a difficult day...we had heavy hearts, but our guide Richard, and our colleague Vida helped us put it into perspective.  Vida brings the voice of the women of Ghana and she taught our guide a bit of history today.  We are so fortunate to walk this journey with her.



After a long 23 hours in London and a 2 hour delay on the plane, we finally arrived to Accra Ghana! Vida and her sister Philomena welcomed us at the airport. It was nice to be welcomed by our Ghanaian friends. On our first day we toured the city and got ourselves sorted. We were and still are very hot and very sticky from the heat and humidity, but that doesn't stop us from having a good time! The power went out on us a couple times but luckily not for long. Today we took a "2" hour bus ride, which ended up being 4.5 hours to the slave castles. It was very educational for us and heart aching to hear the history. But we are very thankful for the opportunity. As our tour guide said "it's okay to be sad because its just history and we need to know it to learn from it". That will stick with us forever! After the castles we had traditional food like banku and fufu in ground nut soup with fresh tilapia. We ate it with our hands and it went over with varying opinions. We can't forget about the bathrooms... We had the good, the bad, and the ugly. Thank goodness for hand sanitizer and toilet paper. A couple of us were forced to go in the bush as there was no bathroom. Unfortunately it was in front some villagers (kids). We are thankful they may not see us again. This is our last night at our hotel with air conditioning before we leave for Enchi at 6 am sharp with Philomena. Goodbye Accra and hello Enchi!

Monday, March 9, 2015

We're on our Way!!!

We've had the most amazing experience, and we're not even in Africa!
We all flew out of Kelowna this afternoon and were treated like royalty.  Pat, our Air Canada ticket agent put all our bags through.  Yes all 10 of them....5 of them overweight....and 2 VERY overweight (those were mine).  She printed our boarding passes right through to Accra, and our luggage will meet us there. We don't have to pack those bags through ANY airports.  We don't have to clear security, we don't really have to do anything other than show up for our flights!  Life is good.

Pat is indeed an angel.  We're going to bring her something back from Ghana.

Here we are at Vancouver airport, just waiting for the flight to London.

Jeanette and the Ghana Girls 2014.

Packing time!

A few days ago we got together with the Zambia group and packed our bags full of donations! Thank you to everyone who donated, we are very grateful. There was so much stuff that the left overs were donated to the women's shelter. We are getting very excited to leave!
-Jeanette, Christina, Nicole, Samaya, and Kyla