Day 23-26

The best way to find yourself is to lose yourself in the service of others!  ~Mahatma Ghandi

I have nothing to share related to distant travels in a beaten up tro-tro or my trek through the villages of Ghana, but rather to take you through my daily life while here. That is because I chose to stay local and relax at home to get to know my host family a bit more as well as explore the streets of my suburb, Abura.

Every day of the week, including weekends, I wake up to the sound of a chicken right outside my window. And everyday I look at my phone to check the time- 5:26 am! I try to sleep a bit longer but the town pretty much goes to sleep and rises with the sun. Nobody sleeps in, including the children. They are up early to prepare for school, help their family set up goods to sell for the day, wash clothes before leaving, sweep, etc. My host family makes breakfast to be ready around 6:45 and then I am off to work around 7:45. It takes only 15 minutes to walk to the hospital from where I live. The nurses on day shift only work for 6 hours so I am off between 2-2:30. My host sends us all with a juice box and either cookies, pastry, or spring rolls for a snack. I am always sure to open a sachet of water and pour it in my water bottle for my walk to and from. It's not uncommon to be stopped at least twice by either school children just wanting to say hi or men wanting you to marry them. You are forced to lie and either say you have a boyfriend, you don't have a phone, etc. I am considering buying a cheap ring so I can flash it up really quick and say, "sorry I'm engaged" just so they leave me alone!!!

Friday at work I was a bit irritated with the staff concerning my "oburoni" name and obviously not understanding Fanti. The doctor asked the nurses if they could speak in English so I could understand but their reply was "Why? We are in Ghana- in Fanti land- not in U.S." They would only mention a word here or there in English but then continue to give report in Fanti, making it difficult to learn or even think of questions to ask. It was like I didn't even exist. Everyone besides the doctor also call me oburoni on the unit if a task needs done. It's cute when the children do it but for adults and in a professional environment, I find it totally disrespectful and impersonal. I have stated my name numerous times and even given them the option of calling me by my Ghanaian name (Yaa) if it's easier. I guess it was just one of those days where it was hard to keep positive.    

Saturday I promised my host family I would try fufu- a staple dish that is made from cassava and plantains- served with soup and fish. Although I did eat this my first time in Ghana, it had been a long time and I thought out of respect it would be best to eat the local cuisine with everyone else. Either I'm not as adventurous with my tastes as before or I have just been really spoiled with my Western style foods because I barely ate anything and the fish was the best part, which if you know me that isn't saying a whole lot. I was praying my host wouldn't be offended and it turns out she is actually really accommodating to our different likes and said next time I can have rice! I am fed fairly well here but the food is mainly made up of carbohydrates and fried foods. I am actually starting to miss fruits and vegetables, more meats, and milk. I tried to find a carton of skim cow's milk but can only find manufactured flavored milk or powdered milk. It satisfies the craving though for the time being. It was also my washing day. You begin by setting up one bin with soap and water, another with just water, and a third with nothing so that the clothes can be contained after being rung out. I got the stool to sit so I wasn't bending over so much to wash. I know it makes me sound so weak, but my knuckles ended up cracking open a little from all the scrubbing. To give me the benefit of the doubt, the soap and water constantly on your hands does soften up your skin though! Another volunteer had a lump on her arm that was filled with pus. She went to the doctor and they pulled a WORM out. He said it was from wherever she hangs her clothes to dry and then she doesn't iron them to kill the larvae. I discussed the situation with my host family and they said our line is "clean" but you should hang the clothes inside out and also shake them out to get any bugs off. You better believe I shook my clothes like no other before folding them and putting them away!

Preparing Fufu (Auntie Comfort, Sofia, Nanaba, Mel, and Del- in background)

 Sunday I enjoyed the subtle breeze outside although the humidity can still be suffocating in a way when you breathe in. I also had the opportunity to attend church service with part of the family. We arrived late so I only had to sit for about 1.5 hours instead of over 3. I was very happy about this because the service is in broken English and they basically repeat the same thing over and over again. The music is nice for a short while but again I can't understand the majority of it. I heard "oburoni" part way through the service and everyone turned and looked at me. The pastor then said if it's your first time attending to please stand and stay after church. Before I knew it, a line of random people came and started to shake my hand saying God Bless you and you're welcome! It was so nice:)

Today at work, I was quickly notified of three deaths that occurred over the weekend. The 27 weeker, who had actually survived for about 18 days, passed away, along with the boy who had a congenital heart defect and another new admit who suffered from severe pathological jaundice. It's very difficult to face deaths while here especially concerning babies/ children because you relate back to medical care in the states and know more could have been done. They have ET tubes but I'm not sure why because there are no ventilators. I held a discussion with my favorite doctor, Dr. Makafui, and he said most don't even like attempting to intubate. Rather they wait until the person has died and then use the body as "practice". He said they do intubation, lumbar punctures, etc. on deceased bodies either on the unit or in the mortuary. I asked about permission from the family and he said it's not necessary. I'm glad the deaths didn't happen while I was there so I didn't have to go through more unsuccessful resuscitation efforts like in the previous week. I suggested to the staff to cover the babies eyes who are under heat lamps in addition to the one under phototherapy because it is the same concept and they should be concerned about damage to the eyes. The nurse basically shut down my concern and said they protect them by turning those under heat lamps to the side position so the light isn't directly in their eyes. I watched a NG tube be placed on the NICU. They use olive oil as lubricant but then just shove the tube down without any prior measurements. The nurse who completed the procedure then irrigated it with water and the baby began to cough like he was being drowned- more than likely it was actually in the lungs. I was able to explain how we perform it to a pre-med student which made a lot more sense to both of us. The last point to make about today was a discharge that occurred. I am beyond amazed that they would send this child home at this stage in treatment but he only weighed 0.975 kg which is less than 2.2 lbs. Although he currently wasn't receiving airway management of any kind, the only orders were for the mother to do kangaroo care (hold between breasts which promotes warmth) and give multivitamin and caffeine drops daily. They are then to just return in one weeks time for a follow up. I started to think about all the tests that need done in the U.S. before a baby could be sent home. I remember hearing they need to at least be like 4 lbs, pass a carseat test, able to breastfeed or suckle a nipple effectively, not have any decelerations in heart rate, etc. Then the whole issue of parent education and bonding comes in which I saw nothing of. It really gives an entirely new meaning to survival of the fittest because I honestly believe that is the mentality here and if the babies survive with limited interventions then great but if not then it wasn't meant to be. I feel so horrible saying that but it seems like the truth.    

Vision without action is merely a dream. Action without vision just passes time. Vision with action can change the world.   ~Joel Barker