Day 8-12

 We ourselves feel that what we are doing is nothing but a drop in the ocean, but the ocean would be less because of that missing drop! 


It's hard to know what kind of a difference you are making in someone's life when you don't establish some huge movement, donate thousands of dollars worth of goods, or even see the immediate results of your services. To me, it's like you have to have this superior faith that your purpose serving is to create ultimate good in the world, no matter how small of an act you have. It's a matter of having the right mindset to serve with endless compassion and honor the life you have been given, because there are millions of people who have been given no choice to be raised in such poor conditions. My place in the hospital is so small that it is hard to know if I am really changing someone's life or if I am serving mainly to benefit myself by gaining a cultural experience and new perspective of medicine in developing nations. What I have to constantly remind myself is that, I probably will in fact impact someones life somewhere along my stay here. It might be so small that I don't even realize it at the time, but I just have to know that every small thing does make a difference.

I have experienced my first outreach day, which is when you travel to a rural area to provide medical care. During my time in the Cape Coast area, I will be going to a Leprosy Camp Tuesdays and Thursdays, located about 20 minutes away from my host house. It's a very secluded village because of the stigma associated with having the disease. Most of the people living there have suffered wounds or amputations as complications from leprosy. Our makeshift clinic is in an open building with concrete walls about waist high, a tin roof, and little subgroups that remind me of animal stables. We carry our supplies in a brief case everyday that is passed between volunteers and drag a bench to use as the work space. The medical supplies we used are in such short supply and poor quality that to a Western trained medical professional, you can't help but to think about the introduction and transmission of infection between wounds and patients. We were instructed to wear one pair of gloves for the day, meaning you take the dirty dressing off, reapply a clean piece of iodine soaked gauze, wrap it up, and move to the next patient all without changing gloves or washing hands once. The gauze is so loosely wrapped that it really isn't effective in serving the intended purpose. Instead, it acts as a temporary cover so the wound isn't open completely to air and the flies can't land to feast on the secretions. I really think I will enjoy this experience though because it will give me a chance to get to know the people, since they get dressings changed daily by a group of volunteers and it will give me a chance to see how things might be improved. My favorite patient was a 3 year old girl who had three different wounds on her legs. She wore a pink ballerina dress backwards that was filthy. She had no shoes and we learned she was actually an orphan. Abandoned by her mother in a pot of water as a baby, the village took her in to look after her. She likely will not receive an education. I carried her down the street until we reached our last patient who wasn't able to walk, but she cried as we were leaving. It was heartbreaking that you could fall in love with a child in seconds from meeting her.

Makeshift clinic at the Leprosy Camp

In the hospital, the nurse manager of the pediatric unit called Auntie Jane has started to warm up to me being available to help. I have ran small errands for them i.e. taking patients to x-ray, dropping off order forms at the pharmacy, picking up sterile equipment, or escorting patients back from surgery. It has been nice to learn my way around the hospital a bit, but the safety of patient transport is non-existent. They sent me to get a 2 year old boy from the OR after he had surgery for a hernia. He received general anesthesia but on the transport bed, I wasn't even supplied with oxygen equipment nor given any sort of report for how the surgery went or any complications. It actually made me nervous to be transporting a patient alone because if something happened on the way, I wouldn't have the means to resuscitate. Their IV's do not have any clamp or saline lock to them, so when you take the cap off blood will come leaking out of the catheter. I learned this the hard way after practically scaring the mother and child with the sight of blood. Now I have mastered giving the IV pushes by occluding the vein proximal to the IV site. They don't label the syringes after medication is drawn up nor do they flush between medications. I feel very unsafe giving the drugs and am breaking almost every rule I learned in nursing school. I am forced to put my faith in the Ghanaian nurses that an error will not occur. For the IV dressings, they wrap tape around the circumference of the child's arm and over the entire IV insertion site so it's impossible to know if there is any infection i.e. phlebitis or infiltration. I guess they don't appear too worried about the possibility of obstructing blood flow either. I learned the most common diagnoses for pediatric admissions. Basically all the children have malaria on top of something else i.e. anemia, malnutrition, bronchopneumonia, seizure disorder, nephrotic syndrome, sickle cell disease, and neonatal sepsis. It's sad though because you don't see any extra precautions for prevention such as bed nets for the patients or mosquito repellent. There is only the one ICU room which has the only oxygen tank on the unit. The mothers stay overnight with their children and must be there during the day as well. This means they either sleep on the floor of hunched over in a chair with their head resting on the child's bed. It's no wonder why they all look exhausted during the day. A really innovative idea the doctor had was related to a child being discharged after having an acute asthma attack. He told the mother she would need to buy a spacer for the inhaler because the hospital doesn't provide them. If she couldn't afford one, he said to use an empty pop or water bottle and cut a hole at the end for the inhaler to fit into. The child could then inhale through the mouthpiece and have the same benefit as a manufactured chamber. It was really cool to realize how they make do with what is easily accessible and cheap.  

All the children here have so much respect for adults. They run errands, jump in to help wash clothes, say please and thank you, and get up with the sun to begin the days work. My only complaint is they are raised to associate white people with money. When passing a girl about 10 yrs old, she said "give me five." With the Western attitude, we were like oh she knows what a high five is! So we slapped her hand and she said "no, give me five cedis (currency)!" It took all of us off guard. One night a group of children entered the gate to our house and were acting really sneaky and nervous. I thought they were playing a game but then our hosts made a bunch of racket and made them line up outside, state their names, and what grade they were in. We were all confused as to what was going on and then we heard a girl say, "the white woman called us!" In Ghana, when you wave bye bye as to a baby it actually means come so the whole time they thought we were calling them. Turns out they actually just wanted to come meet us!

My weekend was really fun! I felt like a true tourist and had the most amazing experience! On Friday we went about 30 minutes away to a resort called Anomabo. There were white sandy beaches and cots to lay out in the sun. It was really relaxing and a good way to escape town. I actually forgot I was even in Africa when I was there because it was so nice. Then on Saturday we set off to visit Kakum National Park. On the way we stopped at Hans Cottage and saw some crocodiles. I was all about going on the walk around the pond until I stepped foot inside and noted a croc about 3 feet from me and he opened his mouth. There was nothing separating us so I changed my mind and chickened out. Thanks to all the American TV shows like swamp people and crocodile hunters! On arrival at Kakum, we arranged for a guide to take us on a night hike, sleep in the treehouse, and wake up for a sunrise canopy walk. It was quite tiring but well worth the money. I didn't see any animals but was able to go to sleep to the sound of birds chirping, insects flying, and different types of animal calls in the distance. The canopy walk was a series of 7 suspended bridges that gave off beautiful views of the lush rainforest. I didn't want the experience to end!

View from Canopy Walkway at Kakum National Park