Days 5-7

"Do not conform any longer to the pattern of this world, but be transformed by the renewing of your mind." Romans 12:2

It really is challenging to be living like the locals in a third world country and fighting not to keep thinking about how easy life is back home. In the end though, I know it will change me for the better. I have already gained a very unique and much deeper perspective of the Ghanaian culture than my first time here. I think because Projects Abroad is a developed program that allows volunteers to live together, make travel arrangements, and uses the same host families so they are familiar with Western lifestyles and are willing to let us go out. I honestly believe that by the time I come back to the states, my mind will have a completely different perspective on life altogether!

I have completed my first set of laundry- handwashing in a line with the other two volunteers in my house. There are three young girls who reside in our basement: Dell (7), Angel (6), and Mel (5). They all insisted on coming to help and show us the proper technique. It amazes me how young children are willingly doing what we would consider chores from their own desire. Right when we finished, a rain cloud rolled in and all the clothes on the line got soaked. Just my luck! I'm sure it was quite the sight to see from our front gate. I have also now had my first bucket shower. The water wasn't running at the time, so water was fetched for me to use. Although the cold water is refreshing, I still cringe everytime it runs across my body.

Mel and Dell

When walking through the center of town, I saw a group of people gathered around a small area. When passing, I learned it was just a tv show! I escorted one of the volunteers to the internet cafe a few days ago and I chose to sit outside to catch up on writing my journal. I could also watch what was going on in town. Almost every person who would pass would say "you are writing". Some asked if I was comfortable and one offered me a seat. They are all so kind and treat "white" people like royalty. I offer to help out but they insist. One woman gave up her taxi for a few of us to get in and she caught the next passing car. I often feel bad but they don't listen when we say it's ok.

My first day at the hospital consisted of a tour and setting up my schedule. The conditions were quite shocking as I was told Central Regional Hospital was the best and most advanced facility in Ghana. It really puts their standards and ours into perspective. The ED entrance was crammed with people. Every seat was full, people lined the halls, and some were even sleeping outside on the pavement. From first observation it looked like there were only 3 triage rooms so I am guessing the process is extremely slow and people make an entire day out of a hospital visit. Medical records were stacked in piles upon piles underneath the staircase, very unorganized with loose papers. The grounds was actually really big with about10 different buildings, each for a different ward. Each is set up about the same. Open "nooks" have multiple beds lined up in them. No curtains and no privacy. I didn't see any oxygen, suction hook up, or typical hospital equipment. I am aware of a scan and x-ray room though along with the surgical theater. I got curious about infection control, prevention of malaria as there are no bed nets, and what happens if the electricity goes out. In the lab there was a large canister on the floor with a tube connected to the tap and another running out. When questioned, I learned it's how they obtain distilled water. It was extremely awkward walking through the wards because everyone stares and it was like we were very invasive in invading their privacy. All of the medical staff dress really professionally; doctors are in slacks with a nice shirt and tie, nurses have on fitted dresses that cover the shoulders and knees and they wear a small hat. My simple scrubs and dress shoes from home seemed to be approved though!

My schedule is two weeks in Pediatrics, 3 weeks in the NICU, and 3 weeks in L&D unit for now. They seem really flexible though so if I want to change I think it would be alright. On arrival I was immediately greeted "broni" by a 2-3 yr old girl who grabbed my hand and had a smile that stretched ear to ear. She said "friend"! For my first day on the unit, I mainly did observations, with a few random tasks here and there. All of the mothers were at the patients bedside the entire day. They were really much more active in providing care than even the nurses. I counted 19 patients to 2 nurses plus the unit charge. I did rounds with the doctor and collected the finished files. I really could only understand every other word as they communicate in their local Fante/ Twi with broken English. In time, I will be more assertive in asking questions but I figured it would be considered rude on my first day if I kept interrupting or having them interpret. The issue to me of patient privacy is clearly not an issue in Ghana. They all share the open corridor, listen as the doctor makes rounds to every other child, even comment on statements. Mothers breastfeed with no covering and procedures are completed right there with everyone watching. A boy received a catheter right there too! It was a struggle to even obtain the right size and they resorted to an expired 2008 tube. I was pleased to see sterile gloves were used though and they made do with what was available at the time. I was able to hang IV fluid for a young baby with seizures. I was happy to see they have a dial to do the rate so I didn't have to calculate drip factor! To wash hands afterward, the towels are kept on racks between two wards to dry so everytime (which wasn't often) you have to run outside to dry your hands!

One case that stood out was what everyone generally thinks of when they think of starving African children. There was a baby who was frail and basically skin and bone. Her extremities were very thin and here stomach slightly descended. I would guess she should be around 1 year but her appearance made her look half that. She also had sunken temples and eye sockets. I obtained plumb nut, a highly nutritious and caloric snack, for her mother to provide. She too looked so skinny. I am assuming they had to travel in from a village for care.

My final part was beginning to pass medications with the nurse. They keep all the syrups in a basket on the counter with the child's name on it. Most medications are shared between children. There is no identification or allergy band, so the name is confirmed with the parents. Medications are distributed on basically an upside down frisbee as the tray! Most young children swallow pills. I joked with a 6 year old he does better at swallowing than I do but I don't think he understood. I know it will take time to learn their system and find my role as a nursing volunteer. They can't pronounce Heather correctly so I stated my Ghanaian name "Yaa" for Thursday born so I think I will once again be called Yaa for the remainder of my stay! I am really looking forward to becoming  comfortable and extending my horizons!