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ghana in pictures

21 Jul

If you get a chance, visit the baptist medical center in Nalerigu, Ghana. You will fly into the capital of Ghana, Accra (a-craw). There you will be greeted by someone who is holding your name on a piece of paper. From here you will drive to the guest house. This is a great transition point for your trip because there are several comfortable amenities and different types of people. The amenities will make your transition a little less difficult and the people will tell you great stories or give out advice from their own experience. From here you can either take the bus up to Tamale or you can catch a flight. We took the flight and we were served tuna or chicken sandwiches with juice or coffee at 6:30 am. In Tamale you are again greeted by someone who will drive you to Nalerigu which is a two hour drive over paved and dirt roads. Upon arrival there is a quick drop off and they tell you your room. Pretty much from here on out, you are on your own, to work or find work or relax or build a door or work in the peds ward or farm with the locals or walk to the river or drive with the long-term missionaries to the escarpment. We did it all! Or at least we collectively did it all! Here is a great glimpse of our time at the BMC.

in accra! videos!

21 Jul

We’ve been away from fast reliable internet for 20 or so days now. But in the Accra guesthouse we are able to load and load well. So without further ado… here are some of our experiences!

When we first arrived in Tamale we were picked up by Issahaku. The drive from Tamale to Nalerigu had a portion that was dirt and was quite bumpy.

 

One of the first places we visited in Nalerigu was a food orphanage. (Adam and Aaron fixed the door.) They danced a really fun dance and one of the volunteers got in the line.

 

Chini was one of our favorite people and we miss him dearly already. Here is the day he brought over his guitar and played for Adam and Aaron.

 

The escapades with the monkey were a always entertaining. This one was a particularly funny interaction.

 

The peds ward was always slammed. Here is one corner with both the doctors working hard.

 

Devotionals for the staff were at 7:00am every day. Here is the First Baptist Choir at our devotionals.

 

A view of the escarpment where Ghana looks into Togo and Burkina Faso. Pretty impressive!

travelling in africa

20 Jul

We woke up around 2:30 a.m. this morning to get ready to leave Nalerigu.  It was hard to wake up, but of course we all planned to go immediately back to sleep in the van on the drive to the Tamale airport.  We packed up the rest of our things, got dressed, and waited for our ride.  He pulled up in a Nissan pick-up truck – about the size of the truck in the picture below:

Our hearts sank as we realized we would definitely not be sleeping since we would be crammed into the small backseat.  We loaded into the truck and started driving.  It became quickly apparent that our driver would not be using the A/C, and in fact, had what felt like the heater on low.  We were all getting warmer… and warmer… and then noticed that he reached down to adjust the temperature setting on the truck.  Sweet relief.  Or so we thought.  Within about 5-10 minutes, it was at least 15 degrees warmer and we were all sweating and sticking to the pleather seats.  Below is a sampling of the thoughts going through our heads on the drive…

Rachel:

“I’m going to suffocate.  I’m going to suffocate. I’m suffocating.”

“Why won’t Adam turn the A/C on?  We can’t breathe in here!”

“Where are we… HELL?!” (shout out to Chuck Jamison!)

“Lord, get us out of here, please.” (an actual prayer)

Adam:

“What is that smell? Is it somewhere between a fart and pleather?”

“I can’t breathe.”

“I think my left leg is falling asleep.”

“Where is Issahaku?  I don’t even like this guy.”

Courtney:

“Why in the world do cars have to have a hump in the middle seat?”

“Aaahh.  So comfortable (leaning her head back on the seat, waking up every 5 minutes when we hit a pothole).”

Aaron:

“Where’s the van?!”

“God, get us off the dirt road as quickly as possible.” (another actual prayer)

I realized I had a problem when I felt sweat dripping down my back at 3 a.m. in a truck with “air-conditioning” turned on.

My knees are literally bruised from banging into the seat in front of me with each bump.

“All I can smell is body odor and pleather… AIR! (after rolling down the window)”

If we hadn’t experienced Africa to the fullest before today, we definitely have after the truck ride.  We were dropped off at the Tamale airport and then waited for the plane to arrive.  We flew back to Accra which is about a 1.5 hour flight without problems and Solomon picked us up and took us to the guest house.  We were so happy to be done with travelling for a day.

We sat around for a short time, and then walked to the supermarket down the street from the guest house to pick up some refills on food items – namely oatmeal and peanut butter – to take to Guinea.  We are so excited to eat in Paris that we don’t want to chance getting “Guineabelly” (a well known phenomenon that occurs after eating food in Conakry for any period of time and consists of cramping and frequent runs to the restroom).  We also needed to get something to eat for lunch today and tomorrow.  Luckily, the supermarket nearby is one that imports many foods from Europe and theU.S.  We were able to find Jif peanut butter, Quaker oatmeal, and Reese’s pieces candy.  We also got deli meat and cheese, tomatoes and fresh bread to make sandwiches for lunch!  We picked up some pineapple and mango from some ladies across the street before heading home to eat.  The turkey sandwiches were amazing and the mango was sweet.  We went to sleep for a long nap with full and happy bellies.

We will eat dinner at the guest house tonight – pot roast and veggies.  We then hope to rest and watch movies and just relax.  We are looking forward to some down time over the next week before it’s time to get back to the grind at Children’s.  Our flight to Guinea doesn’t leave until 3 p.m. tomorrow, so we will get a chance to sleep in and pick up some more food items (the bread was so tasty that we think we might need some more).  We will continue to try to post in Guinea, but our access to internet will be limited – we will likely have to post several blogs at once.

– Rachel (with quotes from others)

de-swa (describes a person who was sick and now is better)

18 Jul

Yesterday, we all went to the escarpment with the Wilson and Hewitt families.  The escarpment is the one tourist attraction in this part of Ghana and was definitely worth the 45 minute bumpy drive in the crowded van.  It is a large cliff that overlooks a valley – you can see into neighboring countries from the cliff and it is just breathtaking.  To get to the cliff, you have to “hike” for about 15 minutes down a dirt path and over rocks through what seems like the jungle of Africa– very authentic.

Once at the top, there are two rocky cliffs to climb up and around.  The views are amazing and it was so nice to be outside in the fresh air.  We were glad we got the chance to see Ghana in this way.

The drive itself was also beautiful and interesting.  We passed through several villages with lots of waving children, huts, crops, goats, donkeys, etc.  We stopped in a few villages for snacks (cookies, peanuts, and dried dates) and sodas.  It was so fun to see a glimpse of the daily life of the people in the villages, sitting around selling harvested goods and enjoying each other’s company.

Today, we rounded on the peds ward in the morning after getting an amazing night’s rest due to a big rainfall with cool winds.  We finished early and had time for a short break before heading to clinic where we saw just under 100 pediatric patients.  Most were malaria or viral respiratory illnesses, and of course the rashes we still can’t diagnose with certainty.  We also had the joy of seeing follow-up patients from recent admission or clinic last week – most were doing much better with smiles on their faces.  We decided we should have had all of our patients come for follow-up so we could have seen then well and acting like children again.  Of course, that would mean seeing 200 patients in clinic, so probably not a good idea!  We’ll just be happy knowing that the majority of our patients go home and stay home, because they are well again.

Just an update – our two premature babies we have been taking care of are doing very well as of today.  One of them is 9 days old and the other is 5 days old (and feisty as can be).  The moms are so sweet and are doing such a great job of using the oversized diapers and clothing to keep their babies warm like we asked them to.  They are also trying to breastfeed them so the babies can learn how to, then cup feeding them so they can get the calories.  Both are on aminophylline (a medicine that helps them remember to breathe) and the younger is still completing a course of antibiotics (a measure taken here for all premature babies to give them the best chance).  We feel like we have finally gotten into the groove of taking care of these tiny babies in such a foreign way.  Because there are no labs or respiratory support or cultures, etc, we’ve decided they do best when you let the mom’s try to feed as best as they can and provided minimal support (a little IV fluids, antibiotics and aminophylline).  And so far, it seems to be working.  They still have a ways to go, so continue to pray for them and the moms, but we are happy with the progress they are making.  We took pictures of them side by side today and with their moms.  Adorable!

We had a term baby who had neonatal seizures and respiratory distress that we treated for pneumonia.  We were also concerned about brain injury during birth because she wasn’t feeding well and had abnormal muscle tone.  She got to go home yesterday after being weaned off oxygen, seizure free and starting to breastfeed.

Over the last couple of days, we have started to say good-bye to some of the people we have worked with.  We are sad to be leaving and feel like the time has passed by much too quickly, but have gained so much knowledge and understanding that will be priceless as we start to plan our future work overseas.

– Courtney & Rachel

shopping in ghana

16 Jul

Leave it to Courtney and Rachel to find ways to shop in the middle of nowhere.  We went to the market on Tuesday afternoon to look for fabric.  Aaron drove us, but of course stayed in the truck rather than shopping with the girls.  He handed us 25 Ghana cedis (about $20) and said that was all we could spend.  Courtney found her favorite fabric in the first “shop” we stopped in, but unfortunately had to walk away when the ladies refused to sell us anything less than 6 yards.  We continued to walk around to different “shops” and Rachel came across a really fun navy, green and red fabric she likes.  Luckily, the lady agreed to sell her only 3 yards and cut the fabric in half (because all the pieces come in 6 yard sections apparently).  She paid 15 Ghana cedis – such a good deal.  We continued to wonder quickly through more shops since Aaron was waiting patiently on us in the truck.  Finally, we spotted the same fabric she liked from the first shop!  We were so excited.  We had to bargain with the lady selling the fabric, but eventually talked her into selling us 2 yards for our remaining 10 Ghana cedis – again, what a good deal!

We then brought the fabrics home and asked Joyce, Issa’s wife (Issa is the cook in our house at the BMC), to make us skirts.  She measured us quickly and took the fabrics home with her.  The skirts were delivered to us two days later, and she only asked 6 Ghana cedis for each.  So all total, our skirts cost about $15 each to make and are very fun.  We feel very African in them!  Rachel had left over fabric and so Joyce also made Adam a cover for his Kindle to protect it during our coming travels.  Overall, a very successful shopping adventure we think.

– Courtney & Rachel

keeping secrets

12 Jul

On a couple of occasions Adam has given some of the local kids gifts. These gifts usually consist of crayons or a coloring book or simple black pens. Each gift is given in complete discretion. In fact, when Adam gives the gift to the children he lowers his voice, almost like a secret, and explains to them the importance of this gift being only for them. He stresses the importance of secrecy because if everyone knows about our stash then we will have requests all the time for gifts which can be overwhelming if not unfair. Two separate occasions have been particularly revealing.

The first time Adam gave a gift, the child promised that he would not tell anyone where he got his new supplies. He promised that, even if his brother asked about the origin, he would tell him that the people he received this gift from had already left and thus there is no chance of getting the materials. Adam made sure the child understood and asked one more time for confirmation and the child promised again assuring Adam he understood the importance of the secret. Literally the next day another different child came and asked us for new crayons because his friend had had new crayons at school and told him where he got those new crayons.

The second time Adam gave a gift, he gave it to the child who asked for new crayons after finding out from his friend at school that we were gifting new materials. So, once again Adam sat down and had a talk with the child about the importance of secrecy. The child left and met some of the volunteers right outside our house. He asked them if they could also give him new crayons but not to tell Adam because he made him promise that he would not tell anyone where he obtained his new exciting gift. The child lasted maybe two minutes with his secret.

And as Jesus passed on from there, two blind men followed him, crying aloud, “Have mercy on us, Son of David.” When he entered the house, the blind men came to him, and Jesus said to them, “Do you believe that I am able to do this?” They said to him, “Yes, Lord.” Then he touched their eyes, saying, “According to your faith be it done to you.” And their eyes were opened. And Jesus sternly warned them, “See that no one knows about it.” But they went away and spread his fame through all that district. Matthew 9: 27-31

As Christians, we carry an important secret with us all the time. We hope that this secret is revealed to everyone. We hope that others will understand the importance of the secret once they hear. But how quick are we to reveal our secret? Are we so excited about our secret that we can hardly walk out the door without telling others about the information we know? Does the excitement of this love just spill out of mouths?

Aaron & Adam

 

 

 

al-la-fia bene (“i am feeling strong” – a common response to how are you)

9 Jul

Yesterday was an especially trying day.  The peds ward was completely full and many of the kids were very sick or had confusing/unknown diagnoses, so it took a long time to see everyone and get orders written (not to mention it was the first day that no other physicians came by to see peds patients).  Clinic starts at 10 a.m., but we didn’t make it there until 1 p.m., just to give you an idea of how far behind we were.  In the midst of rounding, two medical student volunteers came to tell us that there was a premature baby in the maternity ward that was having trouble breathing.  Rachel went with them and arrived to find a blue, floppy baby in the incubator next to our other premie; the nurse was trying to resuscitate the baby using a bag-mask and she was told the heart rate was “good.”  The Ob-Gyn doctor, Lynn, told her that the mom had delivered the baby (estimated to be around 28 weeks) in a village around 6 a.m. that morning and had just arrived with the baby at 10 a.m.  She took the baby’s heart rate and found it to be 50 (not good) and so started compressions.  The baby died about 15 minutes into our resuscitation efforts.  The mother had lost her first pregnancy the exact same way.  We called the chaplain to come pray with the mother.

After such a tiring morning, we decided to have lunch before clinic.  We then saw patients with rashes (again, not sure what all of them were), lots of malaria, viral URI’s, etc.  The translators in the clinic teased Courtney about her catarrh (their word for a cold, but actually just a horrible all-day allergy attack, which only made a long day longer).  Before heading to dinner, we rounded on 12-15 new admissions in the peds ward – there were people standing, sitting, and laying EVERYWHERE.  We ended up having 46 patients total (with only 36 beds to put them in).

After dinner, we were called by a nurse in the pediatrics ward to tell us that a child who swallowed kerosene had just been admitted to the ward and was in respiratory distress.  Rachel went back up the hill to the wards to find a 2 year old girl lethargic and breathing very hard.  The nurse had already suctioned out her stomach and placed her on oxygen (the only respiratory support we have here).  She got two boluses and was placed on IV fluids, and we all hoped for the best, though had a bad feeling about her outcome as she was spitting up blood.  Overnight, Courtney was called to the delivery of a premature baby, who is doing okay, but has a long way to go.

Our new preemie.  We are using diapers to keep her dry (and thus warm), but unfortunately, we only have one size… obviously, it’s a little big on her.

Courtney then got called again early this morning because our 30-week preemie (the one we delivered last Monday) was having trouble breathing.  In the short time it took for Courtney to make it to the hospital, the baby no longer had a pulse.  Again, resuscitation was too late, and the chaplain was called to come pray with her mother.

So needless to say, we were a little down this morning.  But the patients were doing surprisingly well today on the peds ward.  Many went home, including the one who swallowed kerosene – she was sitting up eating porridge when we arrived.  Our little boy with the distended belly and meningitis is doing so much better and will likely go home within the next couple of days – Dr. Hewitt even complimented our management of the child this afternoon.  And we somehow made it down to around 30 patients by the end of the day.  The only one we are worried about today is a little boy that had two abscesses to drain and is very malnourished.  His HIV test is negative, and we’re treating for parasites just to be sure.  But we also got a CBC today that showed significant pancytopenia (aka, his cells that fight infection are low, his hemoglobin is low, and his platelets are low), which makes you worried about cancer or something else scary.  Unfortunately, there’s nobody that can do a good blood smear and certainly not a bone marrow biopsy.  Even if they could, there is no chemotherapy here.  We’re hoping it could be temporary marrow suppression due to some kind of infection…

After rounds, we had lunch and then went on a walk down to the river with the boys.  It takes only about 10-15 minutes to get there and is a beautiful walk – open fields and trees on either side of the dirt path with rolling hills ahead.  The river itself was nothing spectacular, but it was still fun.  There were women and kids washing clothes in it, and some tried to take our picture with their phones while we were looking away – they thought it was hysterical.  On our way back, it started raining, so we had to run back home.  But praise the Lord for the rain!  The temperature dropped from the 90’s to the 60’s in about 2 minutes, and it has stayed cool the rest of the day.  We all took long naps in our seemingly air-conditioned rooms.  It was wonderfully needed!

Keep praying for our kids and their families.  Pray that they would see God’s love in us and that we would be able to hold onto the hope we have that one day, there will be no more suffering.  What an awesome and powerful God we serve, that He could overcome death to save us.

“Christ Jesus, who died – more than that, who was raised to life – is at the right hand of God and is also interceding for us.  Who shall separate us from the love of Christ?  Shall trouble or hardship or persecution or famine or nakedness or danger or sword?… No, in all these things we are more than conquerors through him who loved us.  For I am convinced that neither death nor life, neither angels nor demons, neither present nor future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.” (Romans 8:34-35, 37-39)

– Courtney & Rachel

market day

3 Jul

This morning was busy at the hospital with several new admissions yesterday and overnight. We had planned on rounding and then going to church with the boys, but we had a patient get pretty sick on us right before leaving and so stayed at the hospital until lunch time. We were pleased to see that our little boy with cerebral malaria had greatly improved and was sitting up, eating breakfast with his mom after we switched his medications yesterday. The little 2 month old with a distended abdomen was also looking much better after we held his feeds yesterday due to our concern for NEC (necrotizing enterocolitis). Unfortunately, we had to hold feeds later this afternoon after his belly became distended again with small feeds through the morning. We are still baffled by the boy with fever for 10 days – we at least were able to figure out his abdominal pain today and added some antibiotics to broaden his coverage for possible bacteria. He received 3 boluses total today, and his blood pressure remains a little scary tonight – pray for him to heal. We were able to use more of our supplies today – formula for a premature baby that has lost weight because mom’s milk production has slowed, and Miralax for significant constipation causing severe abdominal pain. We also passed out stickers today – most of the kids didn’t quite know what to do with them, but some of them at least smiled. [The children here are incredibly well-mannered and so sweet – but in the hospital, they all seem very shy, and are especially timid – probably a little fearful of these white people who are examining them.]

After lunch (vegetable and noodle soup with biscuits), we all went to the market. We bought onions, peppers, garlic and coconut. We had planned to make guacamole, but avocados won’t be sold until the next market day (Wednesday), so that will have to wait. We hope to make yummy omelets in the morning for breakfast. The market was very busy and full of vendors selling food, fabric, and clothing. It smelled of smoked fish, herbs, peppers, and smoke from the women cooking over an open flame.

This evening, we had a 4th of July celebration – baseball, burgers, watermelon, baked beans, cole slaw, apple pie, and the most amazing mango cobbler. Afterwards, we spent some time looking up answers to questions we had on the wards today… it’s amazing how much motivation there is to learn, when we’re in charge of our patients!

– Courtney & Rachel

akwaaba (welcome)

1 Jul

We left the guest house in Accra this morning at 4am for the airport with our driver, Solomon (so incredibly nice and helpful!).  We arrived when it was still dark and a friendly Ghanian helped us with our bags, then managed to squeeze a $20 tip out of Adam, which was absolutely hilarious as he sorted through the bills in Adam’s hands and picked out what he wanted.  The plane was full and hot, but the ride was smooth.  The view of northern Ghana from the plane was amazing – you could see the savannah landscape with scattered crops of huts with thatch roofs.

After landing, we gathered up our luggage and met Issahaku, our driver, who brought us the rest of the way up to the BMC.  The drive took about 2.5 hours, mostly over asphalt roads with about 1/3 on bumpy dirt road.  It was a lovely drive with tons of green trees, rolling hills and plenty of smiling and waving kids along the way.  Most of the people here live in thatched huts built in groups with a central clearing for cooking.  It’s amazing how difficult daily life is here – washing clothes in the river, cooking over an open fire, building homes from mud and trees, working in the field to feed your family.  And yet, life moves very slowly at the same time.  The poverty level is clear here, but the community is friendly and hospitable.

After arriving at the BMC, we met several guests and full time workers who gave us a tour and had lunch with us (traditional Ghanian food with chicken and potatoes in a spicy sauce).  During our tour of the peds ward, the nurse asked us to see the 3 new admissions for the day.  We realized our need to read up on malaria (and other tropical diseases) as we knew nothing about how to manage the new patients, and had to ask a lot of questions.

In the midst of feeling very inadequate, however, we went to watch a c-section, and had the opportunity to use our skills as pediatricians, stepping in to help resuscitate the newborn baby (in other words, we gave her a little help to breathe, with a bag/mask and some positive pressure).  God definitely blessed us with this experience to remind us that we’re here for reason and have a lot to contribute, even if we are incredibly inexperienced with the diseases we’ll see.  By the end of the day, we realized that we do know general pediatrics, which they need just as much as quinine and fansidar for malaria treatment… we just have some reading to do.

The boys had the opportunity to play soccer with the kids around the BMC (a few missionary kids + many Ghanian kids) in the afternoon.  Unfortunately, the World Cup repeated itself, and the Americans lost to the Ghanians.  But all was well, as the boys thoroughly enjoyed the opportunity, and the kids were thrilled.

Tomorrow will be the first day of true rounding on patients… pray for us!

– Rachel & Courtney