Thursday, April 19, 2018

Forever in Our Hearts

It’s hard to believe that our 5 and a half weeks is already coming to an end. I can’t think of a better way to celebrate all the work we have done here better than some time at Coconut Grove Beach Resort! As we drove through the gates of the resort we were all mesmerized by the lush greenery and endless palm trees. After 5 and a half weeks in the hustle and bustle of several Ghanaian communities, this was true paradise! We stepped off the bus and were greeted by 2 employees of the resort with fresh coconut water straight from the coconuts.  I thought I was dreaming!!!
Fresh coconut water

The view at Coconut Grove Beach Resort from the restaurant
It wasn’t long until we all ditched our bags and headed straight for the pool. Needless to say, after 2 long days of travelling and a communal shower, we all needed a good dip! As I rushed to the pool I could feel the salty breeze against my skin and could hear the forceful waves crashing against the shore. Before jumping into the crystal clear pool, I threw my belongings onto one of the many lounge chairs lining the pool deck. The pool felt so refreshing after a long day on the bus, and the sound of the birds singing above us had a relaxing effect. I could have stayed in the pool forever! After a quick swim we all headed to dinner to fill our empty tummies. The table was facing the beach so that we could watch the turquoise tide make its escape further into the horizon. Talk about dinner with a view! 

After dinner I sat on a bench overlooking the ocean, this is truly the right place to sit and reflect on everything Ghana has taught me. Reflecting back I think I can speak for all of us when I say that this trip has been life changing! We have all had so many experiences that we will never forget. Although some may have been challenging, they have made us into stronger individuals and into stronger nurses. This practicum has opened our eyes to global health issues that are present around the world. I think we are all grateful to work in a health care system that has an abundance of resources available at hand. Though the resources are limited here, the nurses and other healthcare workers never fail to improvise with what little they have. An incredible thing the witness! One thing to say about Ghana is that they don’t lack the love! The people here are extremely friendly and welcoming. I could tell by the way the children waved to us as we passed by their community during our long bus journeys, and how welcoming all the staff were at every clinic, hospital, and school we visited. They made us feel like we were family and part of their team. We shared a special relationship where they learned from us and we learned even more from them! Not only did we form a relationship with the Ghanaian people, but as a group we formed a special bond. Before starting this practicum, all 14 of us were practically strangers, besides seeing each other in class, we didn’t know much about one another. And boy has that changed! The friendship that we created is one that will last a lifetime. I couldn’t have asked for a better group of women to laugh, cry and witness this  beautiful country with. We have a bond that can’t be broken and I wouldn’t change it for the world! Thank you Ghana, for all the beautiful experiences that you have given us. Thank you for expanding our minds and more importantly our hearts. Thank you for allowing us to view the world through a variety of lenses. You have forever changed us all and for that you will always hold a special place in our hearts. It’s not goodbye, it’s see you later..... 
Our Family

Posted by Hayley Stapleton 4th year BSN student UBCO

Wednesday, April 18, 2018

Project GROW Celebration!

Today is the day we have all been waiting for, Project GROW Day! GROW stands for Ghana Rural Opportunities for Women.  In 2003, Dr. Vida Yakong wanted to make a change in the community she grew up in. The idea of Project GROW was sparked when Vida was sponsored to complete her Master of Nursing at UBCO. How can we empower the women in my community? What do they need to make their own health decisions? After interviewing many of the women, she found that they needed resources in order to make them more independent. Some of the resources needed were goats. Goats are used as a form of currency. They are securement, should the people need money if someone gets sick, or they do not have enough to pay for their child's education. The women in the community decide who should get a goat based on need. They only buy female goats. Once a goat becomes pregnant, the woman must pass the first female baby back to Project GROW and the baby goat then gets passed along to the next woman who is in need. 
Giving the goats out at Project GROW Day

It’s a cycle of giving back! 

Now, since Project GROW is entirely volunteer-run, how do they acquire these goats and other resources? Back in Kelowna, each year as a final capstone project for 4th year nursing students, we work to fundraise for Project GROW. We sell donkeys, carts, baskets and shea butter.  Michelle and I had the privilege of doing this! Each year, the students and teachers who go to Ghana bring home hand woven baskets and shea butter from the village. The shea butter gets melted back down, essential oils added in for scent, and then placed into 2oz tins to sell. The baskets are part of the silent auction at the Global Gala.  In 3 months, we sold over $3000 worth of shea butter and baskets and these funds went towards the building of a roof for the nursing accommodation at the Nyobok Okanagan Community Health Centre.  The clinic was also built via fundraised money. 

We had the privilege of watching how the women make the shea butter.  It is an extensive and labour intensive process! They begin by picking the shea nuts off the tree and peeling the outer layer (this is a fruit that they can eat) before placing the nuts into large bowls. Shea nuts are white and feel almost rubbery! Once satisfied with the amount of nuts, they will boil them for 4 hours before placing them out in the sun to dry for 2 days which tints the nuts to a dark brown. From here the women lay out cardboard and find good smashing rocks in order to crush the shea nuts.
Smashing shea nuts

Large bowl of liquid shea from the grinding
mill. This is very heavy!
Afterwards they take the smashed nuts to the grinding mill (another item that has been bought by Project GROW) where it is put through the grinding mill and becomes a dark chocolate coloured liquid! 

Making shea butter...or chocolate???!!!
In a shady area they bring out all the liquid shea and begin to mix it with water. They consistently add water and mix, to thicken up the shea. The women knead the now thickened shea butter for 3-4 hours, continuing to add water. This brings out the white colour as seen in the final product. Near the end of the process, a hardened oil separates from the water. The oil gets added into a pot and boiled down to a liquid. After this they cool it and pour it into the water bottles we take home! It was such a humbling experience to see the entire process of how it is made before coming to Kelowna to be broken down and sold. 
Hailey and Rachel mixing the shea butter
The first Project GROW day was 10 years ago and had 17 women. This year, there are over 950 recorded members, and  another 150 new women came to register. Since 2008, women are more empowered within their communities, there is education for them and their children, they are respected by their husbands, and are considered contributors to household income. Violence rates have decreased as well as death rates amongst women and children. 

As the day started, more and more women and men gathered. There were easily over 350 people attending. The beginning of the day started with the Chief of Sakote and one of the Project GROW women opening us in prayer.  Then multiple speakers shared their thoughts and Dr. Vida gave a very empowering speech. After the speeches, cultural dancers greeted the chief, Dr. Vida, and everyone else before the Project GROW team began distributing donkeys and goats. There were 3 donkeys and carts this year and 64 goats total (30 bought, and 44 newborns given back) - the most they have ever had! Near the end of the ceremony, the women came together for a dancing and singing collaboration, where we all got up to join them. The Chief joined too!  You could not have wiped the smiles off our faces!!!

The celebration at Project GROW Day

At the very end of the ceremony, the Chief handed each of us our own leather purses that the Project GROW women purchased for us. And then, right when things were wrapping up, we were hit with a very intense rain storm.  Everyone scattered!  Overall this is one of the best days we all could have ever been apart of. 

There are still women who want to join Project GROW and new communities who want to become involved.  These women and communities need resources.  Project GROW is a 100% volunteer organization.  There are no administrative fees involved.  Every single dollar you donate to the organization goes directly to the women who are members.  If you are intrigued, want more information, or perhaps feel a desire to donate check out their website:  

I am so grateful to have had the opportunity to work with Project GROW this year and to see the organization in action.  It inspires me!

Blog post by Rebecca Wheatley, 4th year UBCO BSN student.

Sunday, April 15, 2018

Religion, beliefs, and what drives culture

            I was recently speaking with someone from home and they asked me to share the one thing that had been most surprising or interesting for me about the trip so far. My initial answer was a very challenging still birth that I had been involved in during my labour and delivery placement. This event is what has left the most vivid imprint on my mind. I can still recall the smells, sounds, emotions, and stressors of the specific event. But, as I gave my answer to the question, I realized that it wasn’t the only thing that had been significant about my trip so far. A common theme that strings itself throughout the most impactful personal moments of this trip is the culture of Ghana. Ghanaian culture is vastly different to Canadian culture in almost every way imaginable. As a visitor, it is a constant struggle to navigate, but learning the intricacies of a new culture is one of the most enriching pieces of travel. When I examine all that I have learned of Ghanaian culture over these weeks, religion is the piece that stands out from the rest. To be specific, the relations between the Christian and Muslim populations.
I come from a household where the radio is nearly always tuned to CBC Radio 1 and, consequently, I am used to hearing the world news at regular intervals. When I think of Muslim and Christian relations, conflict is the first thing that comes to mind. I am sure that I am not alone in this. The news that we hear impacts the lens that we view the world through and my understanding of these two religious groups was tainted by the news of conflict that I am so used to hearing. Ghana is a country of strong faith, and the Islamic and Christian religions are the two most popular in the country, but I have seen none of the conflict that I have heard so much about. Don’t get me wrong, I understand that this conflict is terrifyingly real in many parts of the world but what I have seen in Ghana has greatly shifted my lens. I have seen people of deep Islamic faith and deep Christian faith working and living their lives side by side in harmony.
The Ghana flag
Ghana is a place where religion is talked about frequently and passionately, with none of the taboo of Canada. In Canada, if someone were to ask me what religion I was upon first meeting me, it would be considered a rude question. In Ghana, I have been asked this same question numerous times. It is a cultural difference that I am slowly adjusting to. I do not identify with any religion, nor was I brought up with one. When I share this here it is often met with perplexity and many, many follow up questions. The individual is not trying to pry into my personal business but instead is trying to understand my perspective and my reasoning. As I have said before, Ghana is a country of strong faith. Religion runs deeply throughout the culture here and it has great meaning to many people.
Walking home from church on a Sunday morning
         On our first Sunday in Tamale, we were invited to attend the Catholic service at the University of Developmental Studies (UDS). That morning, I woke up to the call to prayer drifting through my window on the warm morning breeze. As I lay in bed, I knew that Muslims all across Tamale were kneeling in prayer. Within two hours of this morning prayer, I was filing into the Catholic church, warmly welcomed by the large congregation. Ghanaians live and breathe faith, and with this faith comes many wonderful things like a close-knit community and a strong and clear purpose in life. Religion and culture also play a very significant role in health.
            We were fortunate enough to have a personal lecture on the culture of Ghana by Dr. Glover, a professor of social sciences at UDS. Dr. Glover is known for his thought provoking and sometimes controversial assignment topics. He isn’t afraid to ask his students the difficult and uncomfortable questions. During the lecture he brought up a marginalized population in Ghana: men who have sex with men (MSM). Homosexuality is illegal in Ghana and therefore, the MSM population faces many challenges and receives inadequate health care. These men are living at risk everyday. Dr. Glover explained that the men usually come into the emergency department of the Tamale Teaching Hospital in the middle of the night. Safety in numbers and under the cover of darkness. He also explained that they are refused care in many places. During this discussion, there was a Muslim individual in the room. His discomfort about the subject matter was visible. He was shaking his head and speaking under his breath. After several minutes he walked out of the room, clearly having had enough of the topic. I share this piece, not to shame this individual, but to show the cultural and religious hurdles that the MSM populations faces in Ghana. Dr. Glover spoke passionately of the need for health care workers to move beyond their religion while caring for a person. He spoke of the duty to health and healing coming first with every single patient. This message is relevant in every culture and country. Every culture has its own biases. Every country has marginalized populations. Health care workers need take time to identify their biases and preconceptions before they will be able to provide the best possible care to each patient.
Sophie, Awal, and Camille at the Shakhinah clinic
          I have seen this model of healthcare in practice at the Shekhinah clinic. At this clinic, people of no faith and people of deep faith work together to provide wonderful care to any patient that comes to the clinic. The clinic was built on the foundation of faith in god, yet none of the volunteers are asked to follow any specific rules or system of belief. There is only one thing that each volunteer is asked to do and that is to provide compassionate and loving care. It is a space that transcends religion and cultural bias. All are welcome, and all are treated with respect. It is a model of health care based on pure human compassion, where the person comes before their religion, social status, or sexual orientation. This is the kind of system that I want to work within.

            From observing and learning about Ghanaian culture I have come to understand that every person comes with their own bias and that this bias alters the lens in which they see the world. There are parallels that run between health challenges in Canada and Ghana, even though at a first glance, the two health care systems could not seem more different. Health care, anywhere in the world, is about health and healing. It is about the patients and the care and compassion that they need. Culture shock has lead me to examine my own culture and biases more closely. While trying to understand my place here in Ghana I have been given the privilege of distance from my own Canadian bubble. This distance has lead me to question everything I know and take for granted back home. I am thankful to have been so thoroughly welcomed here in Ghana and to have had these open discussions about marginalized populations and religion. These aren’t always comfortable discussions to have but in this discomfort lies personal development. Culture is ingrained in a society and I encourage you to try and take an outsiders perspective of your own. Try and identify your biases and think of what it means to move beyond them. Learn to find comfort in the discomfort and to continue to question what you take for granted.

Blog post by Sophie Garmulewicz, 4th year UBCO BSN student 

Saturday, April 14, 2018

The Nangodi Clinic: Teaching about "The Birds & The Bees"

Our group at Nangodi Health Clinic
We were welcomed into the Nangodi clinic with open arms and open hearts. This clinic is located about an hour outside of Bolgatanga (in the Upper-East region of Ghana), down a very dusty and bumpy road. The Nangodi clinic receives referred patients from the surrounding rural clinics that require a higher level of care such as complicated deliveries, laboratory diagnostics, and overnight monitoring. We were privileged to spend five days at this clinic and were able to be involved in an array of experiences including: assisting the midwives with births and antenatal care, teaching sexual education at one of the nearby junior high schools, and working alongside the physician assistant with patient consultations.

The role of the midwives is to provide family planning, prenatal care and ensure safe deliveries. Family planning in Ghana is very different in comparison to Canada. The midwives discussed with us that women who come to the clinic for family planning prefer to use a method of birth control that is more discrete (such as the Depo injection rather than the Nexplanon arm implantation).
Birth Control Implant

This is often because men believe that once women start using family planning, it will ruin the women’s chances for future pregnancies and it is also assumed that when their wives use birth control that they are being ‘bad’ (having other relations). The midwives discussed that, majority of the time, the husbands will be angry with the midwives for providing these services. We also had the opportunity to assist with a birth in the clinic. The mother in labour came in the night before around 9pm and spent the night on the two-bed unit so the midwife could monitor her. It wasn’t until the next day at 2:30pm, that the mother was finally ready to push. It was amazing to see these two midwives work together. They were both so knowledgeable and reassuring to the labouring mother. This was refreshing for us to witness as our other colleagues did not have such a positive experience at the hospital. The birth went flawlessly, and I couldn’t have been happier to have been there to witness it.

Labour & Delivery Room
Many families and schools do not teach children and young adults sexual health education. On our last day we had the opportunity to speak at the Kongo Senior Secondary School, to a divided group of boys and girls. Some of the key topics we enforced were of sexual consent, pregnancy, safe intercourse, and women empowerment. Some of the questions regarding partner consent trended towards the traditional acts that a woman is expected to engage in intercourse after receiving gifts, after marriage, and at the male’s desires. When speaking to the male students, we asked if any of them would be able to provide a baby with food, clothes, medicine and a home; all of them answered no. We educated the students around how to prevent contracting a STI (sexually transmitted infection), HIV and AIDs. We taught both groups cheers, the boy’s cheer was “NO MEANS NO!”, and the girls was “WE ARE WOMEN! WE ARE STRONG! MY BODY IS MY OWN! NO MEANS NO!!!” Both groups got a kick out of them and were singing them as we left the school. 

Sexual Health Education at a senior school
We had the opportunity to work alongside the clinic’s physician assistant, Alucious, in the consulting room. Alucious is the main care provider that diagnoses, prescribes, refers and educates approximately 50 patients a day seeking health care at the clinic. Throughout each patient consult we collectively collaborated together in ways to provide the best patient care possible with the limited resources available. Patients travel long distances to seek health care and traditionally will come to the clinic as a last resort as other cultural/spiritual practices have failed. Alucious brought to our attention some of the challenges they faced as health care providers. One was of language barriers, as there are multiple languages spoken in the surrounding areas. Another one was that patients typically would often not return for follow-up due to various reasons. There were multiple situations where patients would present with malarial symptoms but would test negative on the rapid malaria test. Unfortunately, this test only screens for one strain of malaria, therefore further testing would be required by the laboratory technician who usually is not available. When this scenario was presented to us, the question was to treat for malaria or to not treat, and hope the patient returns tomorrow when the laboratory technician could be available for testing. All in all, we treated for malaria as this is the standard practice in Ghana as they treat patient symptoms based on a flow chart.

Malaria test

Malaria algorithm
The experiences at the Nangodi clinic remind us how privileged we are to live in Canada, a place where medical resources and health care is available to all Canadians. We are thankful for the opportunities given at the Nangodi clinic and have gained a new perspective and appreciation for global health. These new insights will allow us to become stronger nurses in our future nursing careers and endeavors.
Wheelchair at the clinic

Blog post written by: Katelyn Cowley and Rachel Kinvig, 4th year UBCO BSN students