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dasuba (good morning)

2 Jul

Last night, we got our first full night of restful sleep… a full ten hours. It felt great to get past the jet-lag, and finally have some energy today.

This morning, we woke up unsure of what the day would bring. We enjoyed breakfast together (oatmeal we brought from home), then we headed up to the hospital to round on the pediatric patients. We started by seeing the three we had met yesterday, since we knew their stories. We saw each patient together, alternating jobs; one person reviewed the chart and wrote the note, while the other person examined the patient. Surprised to find ourselves comfortable with managing the patients, we continued on to patients that we had not already met. We took our time, reviewing the patients’ histories and making a treatment plan for each one. Some of the patients were straightforward (never thought I’d say that about a patient with malaria), while others were more sick or had unclear diagnoses. It was really fun to put our heads together, talking through each situation and looking things up in our life-saving blue book (a small pocketbook put together by the World Health Organization, called “Hospital Care for Children: Guidelines for the management of common illnesses with limited resources”). The medical students came into the peds ward, and started seeing patients as well. We saw a wide range of disease – of course malaria was the most abundant including one child with cerebral malaria, distended abdomens (not sure why yet, but maybe NEC vs typhoid), malnutrition, meningitis, and a premature baby born at 1 kg that is doing surprisingly well overall. A few of the supplies we brought came in handy today, including ointment, Motrin, and the betadyne we brought for lumbar punctures (aka spinal taps). Courtney volunteered to do a lumbar puncture on a 5 year-old who appeared to have meningitis. With no sedation, it was quite the challenge, trying to get a needle into the small space in the spine of a boy flailing around. Unfortunately, the procedure was less than sterile, despite our Betadyne, as he rolled around on a dirty table. Thankfully, with 4 people holding him and Rachel giving some good tips, the tap was successful, and we got clear fluid to send to the lab. Nothing like a flailing child to refine your procedure skills! We finished up around noon and were ready for lunch (chili over rice). In the afternoon, we went back to check on a few patients we were worried about, follow up on labs ordered in the morning and saw a new admission.

The boys spent their day talking with Pastor Rebecca, who they seem to adore and admire. She is the chaplain of the hospital and is clearly passionate about serving the Lord in this capacity. They talked about everything. One interesting fact they learned was that in Nalerigu, all the tribes have a chief and from one particular tribe, a paramount chief is selected who essentially governs over all other tribes in the region, settling disputes as needed. Adam is hoping to get to meet him before we leave.

We all had the opportunity to go to an “orphanage” today with other staff members and volunteers. The kids here have lost their parents but are in the care of extended relatives or family friends. However, they must come to the orphanage to get three meals a day because their guardians cannot afford to feed them. The kids were amazing – polite as can be and so loving both towards us and each other. They danced for us while one played the “drums” on an empty plastic jug with two sticks, sang, and played games with us. What a blessing it was to be with them. Of course, we wanted to take each and every one of them home with us!

The orphanage was located just outside the hospital.

The girls at the orphanage.

Adam at the orphanage.

Later, Aaron played volleyball with the staff while we watched with other volunteers and Ghanians. Ezekiel (a young boy who has made friends with many of the volunteers and often tags along with us) explained to Adam how babies are named in Nalerigu – the parents bring the baby to a party thrown by the paramount chief and everyone comes. All guests must pay to come, however, including the parents of the baby. If they cannot pay, then the baby does not get named until they can, and stealing becomes “overlooked” in this case in order for all babies to be named by the paramount chief. Interesting!

Aaron playing volleyball in Ghana.

We finished off the day with a party given in honor of one the doctors who has been here for 10 months and is leaving next week.

Going away party for Dr. Rich.

We are taking some video, but unfortunately our internet is not steady enough to load them. So we will keep trying, but we may have to load them all once we get somewhere with better internet connection.

– 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