Rainforest Recap (Enchi)

April 13-20 - Enchi
Late entry (2nd post from the Enchi gals!)

The Presbyterian Health Centre is feeling even more like home. We took part in the outreach days where we visited remote villages outside of Enchi. Bouncing in the back of a truck through the rainforest with the wind blowing through our dusty hair, we continued to be in awe of the forest's deep lushness. We weighed hundreds of babies from a scale that hung from a tree or support beam before starting the child vaccinations. With monthly nurse visits to these communities, we were glad to discover that the majority of the kids were up to date and on track with their immunizations.

Back at the clinic we continued to teach, learn, and be involved in all the departments. We got quicker with dispensing medications, improved our antenatal assessments, dressed wounds, analyzed blood for lab work, observed malaria parasites under the microscope, and prayed and played with everyone!!

Our weekend was spent touring the cocoa farm (which is located just behind the clinic!), where the big cheery farmer took us through the process of fermenting and drying the cocoa pods. The white fleshy fruit surrounding each cocoa seed, whichyou eat by sucking off the seed, is delicious! We sampled the "palm wine," the sap siphoned directly from the palm trees and then tried the 50% palm alcohol- some powerful stuff! Madame took us to church Sunday- a joyful and lively service where we joined the dancing line and enjoyed the choir's loud and harmonious music. We were introduced to the congregation and had a prayer said for us for our health, safety, and nursing success!

After one of our days in the clinic, many of the staff got together in the clinic's front yard to unwind and play a football match! It was fun to spend time with the staff outside of work, getting to know them over tea or dinners out!

With much excitement, we presented our donation of health care items to the staff. They insisted on setting out all the items on the front steps for the staff to see, and they invited the Presbyterian minister to receive the gift! They were especially thankful for the nursing reference text books we brought and the fetal Doppler used for monitoring the babies' heart rate in utero.

The four of us gals, Robyn, Marisa, Rose, and Kirsten in the Western Region were sad to have to leave the green and gorgeous town of Enchi after only 2 weeks. We are forever grateful for having the life-changing opportunity to meet and work with our Ghanaian mother, Madame Philomena, and the unbelievably accommodating clinic staff!

We are off for a full day of bus travel to meet up with the rest of our sisters (as in true Ghanaian style, we have become used to calling everyone our sister or brother!) in Bolga in the Upper East Region. Depending on road conditions and bus timeliness this may take us up to 18 hours! Wish us luck!

Hello from the Upper West of Ghana (Kaleo girls yet again)

Yesterday (April 16th) we headed off with Muriel and Sister Edith to another town to visit a nursing school and hospital. We're nearing the end of our time as students and we were excited to have the chance to pass on some of our knowledge.   The night before we all did a brush up on infant rescuscitation as this was our teaching focus. With some of the fundraising money the group had purchased a few kits called "Helping Babies Breathe). They come complete with a model baby - NeoNatalie - an ambubag, and various other teaching props.  After meeting the school director we gathered in a room with 24 students and their instructor. The decision was made to include some students from every year so that these students could in turn teach their classmates. We spent about an hour teaching and taking questions and then gave each student a chance to practice on NeoNatalie with the bag and mask. We left the kit at the school in hopes that it will continue to be used to educate nurses on this important skill. The students were already somewhat familiar with the material we were teaching so it wax like a refresher course for all of us. We've been very impressed with the quality of the nursing education here in Ghana and we have a lot of hope for the future of health care here.   We took a brief tour of the hospital there and dropped of some more supplies at various wards.    We got back home and took a nap as we had been called to a 4 a.m. delivery the night before (a beautiful baby girl)! Our friends Hassan and Kamal came from Wa to cook us a traditional dinner of Red Red. Hassan made us the "best sauce in the world" to go along with the fried plantains. We all agreed that it was our favourite Ghanaian meal so far, and we've had some pretty great food. Muriel left on the bus at 3 this morning to go visit Tori and Megan in Bolga. We're looking forward to our last 2 days in Kaleo and then we'llbe joining everyone in Bolga as well. This has been a whirlwind trip and we can't believe it's almost done. T-12 days in Ghana. 

The adventure continues... (Kaleo)

Part 2 from Wechiau: Well now that we're safely back in Wa we can laugh about our adventures in the last 24 hours. When we left off we were heading to the "hippo hide" to sleep on a platform in the trees. Getting there was an adventure in itself. Picture 1 motorbike, 1 Ghanaian man, 2 girls, and 3 mattresses. Now make it dark and muddy. Haha we made it safely back to the river side and climbed up into our giant tree fort. After setting up our mosquito nets and killing any bugs that had snuck it, we settled in for a good chat and some stargazing. We were so happy that it was finally cool although "cool" still meant being slightly hot while sleeping in shorts and a tank top and a light sheet. We couldn't believe that our guide brought a fleece blanket to sleep with. Ghanaians commonly say that they "fear the cold". Maybe telling them they should come visit us is a bad idea :) We woke up in the morning and repeated our motorbike ride from the night before. Believe it or not that wasn't the scariest transportation experience of our weekend. Our tro tro ride home was decidedly the most worried we've been this entire trip. Things were going well until we neared the end of the trip when we pulled over. We were sitting at the very back but definitely noticed a heat wave coming from the engine. Then we saw the smoke... And then the steam after something was poured over the engine. To set the stage, there are bars on the windows and there were 12 people between us and the door. We were all silently nearing a panic state as we thought the engine was on fire. The rest of the passengers seemed pretty relaxed so we stopped short of screaming and crawling over everyone. The van eventually started again and we headed off like nothing happened. From what we gathered the engine overheated and needed to be cooled down with some water.  Well like we said, we're here safe and sound and feeling slightly more like seasoned travellers. We just picked up Muriel from the bus and are looking forward to the next 3 days with her!  

Hello again from Jessica, Kristen, Lisa, and Crystal

Right now we are sitting outside waiting for some water to boil over an open fire. It's twilight, the crickets are chirping, and we can hear cattle in the distance. We're revelling in the fact that we're not sweating and are also excited that the clouds have cleared - we should have a great view of the stars tonight.  We are in Wechiau at one of the two hippo sites in Ghana. Earlier this morning we hopped into a tro tro and headed off on an adventure. There was no phone number for the tourist centre so we decided to wing it. Sure enough as soon as we stepped off the tro tro a man came and showed us to the visitor centre. We met our guide Luuta and headed off in a motorking to the hippo reserve. We've been wanting to ride in a motorking since we arrived and today our dream came true! It's like a motorbike with a trailer attached and you ride in the back. We were smiling and laughing the whole way. We headed down to the Black Volta river and got into a canoe for our journey upriver. We were on the hunt for hippos! And we were successful!! We got to sit and watch 10+ hippos bathing in the river. They were a bit shy and never fully emerged from the water but it was still so fun. I think it's the most peaceful place we've been to yet. It's lush and green here as we're hitting the beginning of the rainy season.  Once we're done cooking our gourmet dinner of instant noodles, we'll be heading back to the river and settling in for a night in the trees. We're going to be sleeping on platforms and hoping to hear some hippos having their dinner below us. We'll let you know how it goes!

Kaleo Update :)

Hello again from the Kaleo girls - Crystal, Jessica, Lisa, and Kristen. We briefly talked about our first week in Kaleo in our last post, but we wanted to give you a better idea of what we've been doing here. We live just steps from the clinic and a typical day begins at 8. The staff are just completing dusting and gathering to say morning prayers. We don't know the first one, but we join in for the Lord's prayer at the end. After that we do some little jobs like getting water from the tap outside so there's a way to wash our hands inside. During this first week we've all had a chance to cycle through the different areas in the clinic. A patient will first go to the OPD (outpatient department) to fill out insurance forms, have their weight and temperature taken, and give a brief history of why they are here. They will then have a consultation with a nurse and the medical assistant. Having a medical assistant is something new to the clinic and he is just settling in as well as he's only been there for 3 weeks. His role is similar to a GP at home. There is no lab at the clinic, although they are hoping to get services soon, so diagnosis is based entirely on presentation and assessment. We're definitely learning a lot and stretching our brains! After a diagnosis is reached, treatments and medications are prescribed and the patient heads over to the dispensary. They keep a stock of common medications and give them out right there. If any dressings are needed they are also done there. There is a room for people to stay overnight if need be. It is a 24 hour clinic so we've also had the chance to help with a few after hour cases such as accidents and snake bites.  The clinic has a big focus on maternal health and Mondays are prenatal assessment days. Postnatal check ups are also a common task at the clinic. We mentioned that we'd been a part of a few births here and we're loving these experiences. The midwife is wonderful and knowledgeable and has taken us under her wing. As you all know, babies don't pay attention to business hours so we've been called to the clinic a few times at late hours. We rushed there excitedly at 5 a.m. the other morning and were all a bit dissapointed to see a baby sitting there when we came in. This particular mother was having trouble delivering the placenta but had no other complications in the end. Home births are very common here despite the increased risks but we feel like this trend might be changing and we have to give credit to the clinic for this. Their skillful and compassionate care make birthing at the clinic a more attractive option.  On that note, we wanted to talk a bit about the attitudes at the clinic. The staff really seem to care for their patients which is wonderful to see. For example, the midwife was fanning a patient who was in labour as it was VERY hot in the room :) It's been very interesting to see how socially conscious Ghanaians are. We've seen signs up all over the country that talk about common issues such a TB, homelessness, mental health, and HIV. This continues on in the clinic where most walls display some informative poster. We also had a chance to visit a centre for people with disabilities that was founded by one of the former staff at the clinic. He is now in an administrative position but continues to work to further this centre in Kaleo. From what we gathered, the focus is on people with musculoskeletal issues such as polio and paraplegia. There are many different ways that the centre brings in revenue which include producing purified drinking water, making soap, weaving cloth, sewing clothes, and producing modified bikes for the disabled. We all took a spin on the bikes and had a good laugh over our lack of skills.  Muriel comes to join us for a few days this next week and we'll be heading to another town to do some teaching at a nursing school there. Aside from that we will spend the remainder of our practicum days at the clinic. We are bonding with the staff and starting to feel more productive as we get a sense of the workload here. It's starting to sink in that we only have 4 more clinical days before we graduate!!!!  Thanks for reading, we really enjoy the chance to share our adventures with you! 

An Update from Bolgatanga

As it has been a whole week since our group of ten divided into three groups, we (Megan and Tori) felt it was time to give an update on what has been happening with us. Currently we are sitting in our guesthouse after having just finished a mango (amazingly fresh one!) and are munching on ground nuts, a nut very similar to the peanut. Anyways, back to our update: After a three hour bus ride north from Tamale, we arrived in Bolgatanga (often referred to as Bolga) which is located in the Upper East Region of Ghana close to the Burkina Faso border. In true Ghanaian style there was no shortage of people to help us, and our many bags (we still have an extra one full of medical supplies) off the bus or to help us find a taxi. Once the taxi driver had clarified via phone with our contact Florence, a local nursing instructor, where our guesthouse was, we were on our way.

Megan riding her bike into town

The next day we met up with another contact, Josbert (Joesbert is Vida’s nephew. Vida is a Ghanaian nurse who did her masters and now her PhD at UBCO and is one of the founders of the Project GROW charity- for more information visit - www.projectgrow.ca).  Josbert was an invaluable guide that day as we traveled to meet first, the regional director of Health Services of the entire Upper East region, and then the district director for the region that the clinic we would go to is in.  The director welcomed us into his office, and after finding out where we were staying offered us to stay at free Guest House in the doctors bungalows. We were driven out to our new house to make sure it was ‘acceptable’ which we assured the director it would be. John, the caretaker, and his daughter, Doris, who live in a room beside the Guest House, greeted us warmly. The house it self was luxury compared to what we were staying at, three bedrooms, a kitchen living room and two toilets! The only draw back is that it is a distance outside of town so to rectify that situation; on Monday afternoon we bought bikes! Josbert accompanied me when buying the bikes and assured me that I can donate them to the bike project that is associated with Project GROW after we are gone. Both very excited about our new found opportunity to cook our own food in our kitchen, we went shopping! Like the rest of Ghana, most of the food is bought at the local markets and so Megan and I bought some vegetables and fruits that we recognized (and some that we didn’t).The Regional Director invited us over to his house for dinner the following night as he was having some visiting nurses and doctors from Accra over. It was a lovely dinner and very interesting to hear about the health promotion projects going on around Ghana.

On Tuesday and Thursday we went to a health clinic in a neighboring village called Nangodi.  There we were able to witness the workings of a rural clinic. Because it is not the wet season the clinic was not very busy, with around 10-15 patients a day. Even so we got to participate in many of the health promotion and interventions that the clinic does. I was able to go on an outreach trip to a smaller village to weigh babies and immunize them. Unfortunately, the nurse I was with forgot the scale so we just verified that the babies that came to the out reach had up to date immunizations (which they all did, so that was great to see!). Not so great to see was that a lot of the babies growth charts are not on the normal curve and there was little the outreach health workers could do except recommend that the mothers feed their children more… We also got so see the maternal check up day. Every Thursday pregnant women come to the clinic to get their b/p, fetal heart rate and weight checked. They are also all given free multi vitamins, folic acid and iron, which was great to see. Another part of the clinic we got to see was the out patient department, where walk in patients with any sort of health concern can come.  It was interesting to see the different approach to health in rural settings vs the urban we were used to in Tamale.

Nangodi Health Clinic

The rest of our week we spent at home and at internet cafes preparing for our presentations that we have next week. We are presenting sex education material at four jr high and elementary schools in the beginning of the week and then doing a presentation on the nurse patient relationship at the local nurses collage (where Florence teaches) on Wednesday. It was a bit of a shock to the system to be reading journal articles again in preparation for our presentation at the nurses collage!

Both a little worried...but it didn't bite!

Today (Sunday) we made it out to Paga – a village about a 45min drive away on the border with Burkina Faso.   It is famous for its crocodile pond. To enter the pond you buy your entrance and a chicken (a live one!) and then your tour guide calls the crocodiles by shaking the chicken up and down to make it squawk (we feel like this type of operation would not be allowed in Canada…) Sure enough crocodiles slowly emerge from the lake to come see the chicken. Unfortunately (or maybe fortunately, we can’t decide) the crocodiles weren’t that hungry so they didn’t eat our chicken and we were able to go and touch them without being worried about being eaten (ok we were still a bit worried, as we saw, they can move fast!). We then visited and leaned how an old slave camp functioned, which, as always, is a humbling and haunting experience.  There are no words to describe how you feel standing beside mass burial sites or beside a punishment rock that countless people had taken their last breath on. It makes us even more thankful that we don’t live in an age where slavery is acceptable.

We are both a bit apprehensive about our presentation this week but excited to try our hand at being teachers.  

Until next time!

- Tori and Megan

Welcome to Enchi!

April 7,8, 9th 2013 - Enchi

After a memorable last day in Tamale, our smaller group (Robyn, Rose, Kirsten and Marisa) headed south on the next part of our African adventure to a smaller town called Enchi, which is in the south west.

Our trip involved a nice luxury bus ride back to Kumasi, where we were warmly welcomed back to our previous guest house and went for a delicious dinner at our 'favourite' local restaurant. We also did some shopping and improved our bartering skills while adding to our growing collection of souvenirs. A big challenge was once again switching languages- just when we were getting used to Dagbani, now it is back to Twi! Luckily Kirsten was very faithful about keeping a notebook with common phrases for us to use.

The next morning we woke up at 4 am and hopped on a tro- tro for the five hour ride to Enchi! When we arrived, we were in awe of the scenery that surrounded us- gone were the busy streets, buildings and noise of the city, and instead there was dense rainforest and rolling hills all around us. We immediately felt at home! Philomena, the director of the Presbyterian Health Centre we will be working at, came to pick us up and quickly adopted us as her 'four new daughters.' And we sure felt like it as we were taken to our cozy guest house (complete with air conditioning and a fridge!!!!!!!) which she had already stocked with snacks and water! She took us for a lunch, where we were introduced to some of the friendly medical staff we will be working with over the next two weeks. Feeling sleepy but very much at home, we settled in for our first night. We unfortunately got a bit too excited about our air conditioning (which we hadn't had since our first night in Ghana) and spent the night shivering under as many blankets as we could find.

Our first day at the clinic was a thorough orientation where we were introduced to all the staff (and patients!). We were given a very warm welcome! For our first taste of the clinic, we decided to sit in on some consultations to familiarize ourselves with the process and common conditions seen in this area. Many of the common complaints included symptoms of malaria, irritation from pollutens, gastrointestinal illness, and antenatal issues. Even though it was our first day, we were involved in the assessments and even got to lead some of the consults!

Now, after our second day we have each began to rotate through the lab, antenatal clinic, medication dispensary, and minor treatment departments. The health centre is refreshingly different from the hospital we were in, as each day they begin by bringing the staff and patients together fora time of worship and prayer where they pray for all the patients, pregnant women, and clinic staff. We can already feel the atmosphere of community and caring in this place and are so excited to be a part of it for a short time!

While we see what positive things this clinic offers to the community, we were saddened to hear of some of the challenges they are facing when we sat in on a staff meeting this morning. These included a struggle with water shortage, lack of available insured medications, and financial challenges. Again, we were made aware of how lucky we are to be able to take these things for granted as nurses in Canada. However, despite these challenges, the staff are positive and dedicated to keeping the clinic running at its best! The meeting ended with laughter as a recent wedding was discussed and the 'wedding torch' was passed to the next most eligible staff members.

Every patient who comes in for care will see a professional, even if it means some skipped lunch breaks and longer days! In the words of one of the staff, 'you will feel your conscience before your empty stomach.' No skipped meals for us though, as in Canada our stomachs have become far too accustomed to our generous and predictable breaks:).

We are all very excited to be in a smaller clinic setting with the strong sense of genuine concern for one another. We're also looking forward to our outreach days where we will accompany nurses to provide health care and immunizations to people in smaller villages in the area.

And because we can't have all work with no play, we will also be going to visit a cocoa farm (one of the main crops in southwest Ghana) as well as a local market to satisfy our shopping cravings.

We are looking forward to getting to know the clinic community better and seeing what the next two weeks will bring! We miss the rest of our Ghana girls but are also enjoying the quiet and serenity of this chapter of our journey.