Thirsty Thursday

Today was an interesting and good day at the hospital. In the morning, I watched the surgical removal of a very large mass from a woman's abdomen. It was huge-about the size of a soccer ball. Afterwards, I went on rounds with Oppong and took patients with him in the afternoon. I am now the pro at travelling through Ghana, so I was responsible for ensuring that Megan, the newest intern, made it safely to the camp with me.

I am in the final countdown of my time here in Ghana. This is also the time when I realize how much I am missing at home. Tomorrow is my little brother's graduation and so I am missing that important event and the ability to spend time with my extended family. (Congratulations Patrick!) Also, I am going to miss my mom's birthday in the upcoming week. (Happy Birthday Mom!) I have enjoyed the past three weeks here. I have learned a lot and I have stepped far outside of my comfort zone. 9 more days-got to make them count.

Happy Hump Day!

It is Wednesday and yes, I am a fan of the term "hump day." I forgot to mention in yesterday's blog post that I made a fourth child cry because of my skin color and that I met the coolest set of twins. I saw 3 year old twin boys named Barack and Obama-America far from home. Today at work, I saw a patient with complications from enteric fever. He has an intestinal perforation and so the doctor is trying to determine the size of the perforation to determine whether it can heal on its own or whether surgery is necessary. Aside from that, it was a normal day at St. Gregory Hospital. I started asking some of the questions during the interview in Twi, but most of the people did not understand me. It was entertaining for the people in the room to hear my butchering of the language.

Last night, we had yam and fish for dinner. Angie got mad at me because I couldn't finish my food. She jokingly threatened to beat me. Douglas, Jen, and I got into an interesting conversation about Freemasons. In Ghana, there are apparently a lot of conspiracy theories about Freemasons in the music industry in the US. According to Douglas, Jay-Z, Rhianna, Beyonce, Lil' Wayne, and Kanye are all Freemasons. It was a very funny and interesting conversation. We got a new intern last night. She is a grad student from Tufts studying nutrition. Hopefully she doesn't feel out of the loop because of the number of inside jokes that we already have. Cheers to the rest of the week!

Tuesday

Today was another ordinary day at the clinic. I went on rounds with Dr. Senya and saw one particularly interesting case. There was a young girl with Sickle Cell. She is As, so she is a heterozygote. She has been having numerous hemolytic crises and has had 4 transfusions in the past few months, so the doctor wants to refer her to a specialist. I saw Dr. Senya counsel a man who just found out that he has HIV. It was hard to watch because I could tell that the man was struggling with the news. I also saw the ending of the removal of the placenta from a woman with an induced abortion.

Last night, I finished my first Ghanaian meal. Meals are so large that it has taken me two weeks to finish any of my meals. My favorite dish is "red-red" which includes fried plantain and beans. We had some last night and Angie was happy to hear that I finally ate all my food. Tonight we are receiving another intern, so we are heading into Accra. If I can sleep in the car, I will join Jen and Eric as they venture into the city to greet our newest member.

I hate Mondays

Today I went back to work after an exhausting weekend. I was hoping we could take the day off since today is an American holiday, but I decided that I should probably go to work. I went on rounds with Dr. Senya. The interesting case of the day was a retro patient who came in confused and aggressive over the weekend. We talked about HIV/AIDS on rounds. The diagnosis is a fungal infection of the brain. Oppong saw a record 91 patients today. Some Americans took a tour of the hospital, but I missed seeing them. I do not know what their affiliation is, but Dr. Senya made a joke about my kind being around. He also made a comment about how usually he is cautious of Americans because they "give one and take five." After work, I went to the office and got some work done. Angie, Douglas, and Eric entertain us in the evening with their Ghanaian jokes and laughter. The work continues tomorrow...

Where from is you?

It is Sunday night and I am exhausted from the weekend. This weekend, Jen and I went into Kumasi, a city in the Ashanti Region, and Cape Coast. On Saturday, we set out to Kumasi early in the morning and rather than taking a tro-tro into Accra and taking a nice bus to Kumasi, we took an air-conditioned tro-tro to Kumasi. It was a crazy trip full of potholes, unpaved roads, and horns…lots of horns. On a side note, drivers in Ghana love to use their horns. I used to think obnoxious use of car horns was a characteristic of reckless driving in big cities, but Ghanaians use them all the time. Drivers use the car horn to tell people not to cross the road, to tell other drivers they are going too slow, to tell drivers they are in their blind spot, and to say hello. When we finally got to Kumasi after at least 5 hours in the tro-tro, we checked into a nearby hotel named Ashanti Gold Place. It was a two star hotel, but it had air conditioning so we were happy. Afterwards, we went to the Cultural Center, which houses local artisans. I was able to see some of them doing their trade and buy some gifts for home. Afterwards, we decided we wanted to see the Asantehene’s Palace. After walking through the city and being harassed by street vendors and children for money, I could not take it anymore. Blame me for being a sheltered child, but I cannot handle chaos. At one point, I caught a kid trying to unzip my backpack to try and take something from me. We went back to the hotel and relaxed for a bit before calling it a night.

This morning we left early for a ride into Cape Coast. After another long tro-tro ride in uncomfortable conditions, we made it to Cape Coast. A taxi driver said he would take us to Kakum National Park and wait for us and then take us back. We asked him to take us to a bank first because Jen and I were a little short on cash. After getting more money, the taxi got into a small accident. (Dad, I know what you are thinking-but the accident was nothing more than the incident where Michael messed up the Prius door. It just involved two cars instead of one car and a lapse of judgment.) The taxi driver hit an open door and so he called another cab driver to take us to the park. We made it safely and did the canopy walk. Canadian engineering’s finest. The bridges were pretty shaky, but we both made it. Afterwards, the driver took us to Hans Cottage where we were able to see tons of crocodiles. We did not get to touch any because the line was rather long and neither Jen nor I were dying to do so. Afterwards, we went to Cape Coast Castle, a slave castle owned by the British. The Cape Coast Castle was recently visited by the Obama family. It was a humbling experience to see the slave cells.

Now, it is back to the reality of work for another week before my final weekend trip.

View from the Canopy Walk

I survived the canopy walk!

Crocodile at Hans Cottage

Me at Cape Coast Castle

Me at Cape Coast Castle

Door of No Return

Cape Coast Castle

Canopy of the rainforest

Me with a statue at the hotel

Waiting to walk the canopy

Handmade crafts

Me with an African Elephant

Drum carving in action

Pretty Trees

Canopy Walk at Kakum National Park

Me at the Cultural Center in Kumasi

African Union Day

Happy African Union Day! Because it is a school holiday, I decided to take the day off. Most people do not do anything to celebrate the day. It is like Presidents Day or Columbus Day-schools are off but nothing special occurs. I did some laundry and had a Twi lesson from Eric. It is a very simple language to learn, but the sounds, letters, and words are so foreign, it makes it difficult to remember. My favorite aspect of communication in Ghana is the emotion behind the words. They are lively speakers. They also use noises to communicate points, like clicking their mouth and shaking their head to say no. My favorite expression is "ay" which is used to convey shock. I use it so frequently that it is now a joke. Angie, Douglas, and Eric get a kick out of it.

For the weekend, Jen and I are going to Kumasi and Cape Coast. We have to get up early for the long trip into Kumasi...a tro-tro to Circle and a bus to Kumasi. In Kumasi, we are going to see the Asantahene's Palace, the Cultural Center, and the Okomfo Anokye Sword. In Cape Coast, we are going to see Kakum National Park, Hans Cottage, and the different forts and castles in the area. Hopefully I will have some nice pictures to upload on Monday. I am halfway through my time here. I feel more at home than I did last week, but I still am looking forward to going home.

Everybody's working for the weekend

I deserve a nice weekend after working so hard for the past four days. Today, I saw patients with Oppong and went on rounds with Dr. Senya. The only interesting case was the girl who came in yesterday with abdominal pains. According to Dr. Senya, the girl has a large mass around her ovaries and bladder. He is unsure about what it is exactly, but he thinks that the mass is causing the pain and urination problems. Dr. Senya also talked to me about the social aspect of medicine. He said that once you understand where the patient is coming from, you can understand why they are in pain. Dr. Senya said he has seen patients who are experiencing pain from their social condition in life, such as marital problems or financial problems. I did not make any children cry today for being an Obruni!

After work, Jen and I came back to the office. Once again, children were dancing in the mirrored windows. It is still entertaining to watch today. I am taking tomorrow off because it is African Union Day. African Union Day celebrates the creation of the African Union (AU). Schools are out for the day, so I decided to follow suit and take the day off. For the weekend, we are going to Kumasi on Saturday and Cape Coast on Sunday. I will  hopefully have tons of pictures from the touristy sights. Also, I am getting my souvenirs at the Cultural Center in Kumasi-last call for requests!

It comes to bite you in the butt...

Wednesday means I am halfway through the week! Thank goodness! Also Friday is African Union Day, so I might have the day off. Last night, I was talking with friends from ND. One of them asked me if the clinic can get in trouble for letting me write prescriptions and taking patients. I said that I wasn't sure who oversaw everything but that thus far, nobody has said anything. When I went into the office today, Oppong told me that for legal reasons, I cannot take patients and diagnose as I had been doing previously. I totally understand the legal reasoning behind it, so I did not take offense to it. I sat and observed Oppong work and went on rounds with Dr. Senya. The most interesting case was a girl who came into the clinic with severe abdominal pains. She was screaming and falling to the ground. I had to leave before he could finish diagnosing her, but it was interesting. There was also an overdose patient in the ER today. At one point, she fell off her bed and that pulled the IV partially out. 

After work, I took a taxi home and met Jen at the office to get on the internet. The children spotted us and one was dancing outside the window. It is really entertaining. I am not sure if she is dancing to see herself in the mirror or if she is dancing for us. I tried to get it on camera, but she stopped before I could do it. 

Work is exhausting. I find myself tired frequently and I go to bed really early. I was even dozing off at work today. I need to investigate the local NGOs more in the next two weeks to give myself a better understanding of healthcare in Ghana and the role that medical NGOs play in the system. According to Eric, there is a national coalition. At the district level, there are 30 medical NGOs, including the Cheerful Hearts Foundation. At the national level, there are approximately 500, but even more want to register. There are numerous applications and forms at the national level that must be filled out to join the national coalition. Cheerful heats does public health activities like lectures on different diseases like malaria and typhoid. They also have free medical screenings when they have a medical team from the US to help them. I am interested in knowing what other NGOs do and whether the NGOs coordinate activities among themselves. 

No rest for the busy

Tuesday was another long and busy day. I took patients with Oppong in the morning and then I went on rounds with Dr. Boadum. There were two interesting cases on rounds. One was a diabetic woman who came in on Friday. Today, after being in the ward for nearly 5 days, the doctor noticed that she had a stroke. I was surprised that it had not been realized before. The stroke occurred nearly 3 years ago and she has not had a CT yet. She had gone to an herbalist and he had been giving her medicine that helped her regain some strength on her left side. Dr. Boadum made a comment about how Ghana's biggest source of poverty is a lack of knowledge. The second interesting case came from the male ward. An old man, whom I saw on rounds yesterday, has characteristic signs of Parkinsons. His hands have tremors, his wrists have rigid movement, and he had the characteristic gait. Dr. Boadum was saying that in the US, that would be diagnosed as Parkinsons, but in Ghana, it is rarely ever diagnosed. Yesterday, Dr. Senya made a comment about how in the US, medicine is more laboratory based whereas medicine in Ghana is more clinically based. As I spend more time in the hospital, I notice more differences between the diagnosing and treatment of different illnesses. Additionally, communicating can be very difficult. Many of the patients either don't understand me or cannot hear me. A Liberian family got frustrated with me and asked Oppong to talk in English with them. He laughed and said that I was speaking English to them and could understand them, so why couldn't they understand me. Some of it is the phrasing-do you have a fever vs. does your skin get hot. Other times, it is just difficult to understand one another because of accents. It is going to take a lot of time. Also, the crying child at the sight of an Obruni count is up to three. I think I'm doing pretty well. The little child running into the street singing Obruni count is way higher, so I'll take that as a plus.

I took a taxi home today, which was the first time Eric did not come to pick me up. It was an interesting experience and I made it home safely. Eric talked to me yesterday about going to other hospitals in the area to see how they are run. I also asked him about talking to other NGOs to see how they function. Thus far, I have gotten great information about healthcare in Ghana, which will be useful in my report. The only thing I am certain of, however, is that these days are exhausting. I want to curl up in my corner and nap, but instead, I have to keep pushing through the tiredness and "do good work."

My favorite school-Peculiar Academy

Most businesses, taxis and tro-tros have religious names like this

Road littered with trash and rocks

A school gateway

Consulting Room

Patients in waiting area

Road conditions

Lack of sewers creates numerous problems

"You are welcome"

After a relaxing weekend, I was back to the grindstone for Monday. I arrived before Oppong and took some patients without him. When he finally arrived, I said, "You are welcome." He laughed. In Ghana, the greeting for welcome is "you are welcome." It has taken awhile to get used to, but now I find it funny. I took patients and repatriations until rounds. I went on rounds with Dr. Senya today. The most interesting cases of the day were in the maternity ward. A woman came in with clear liquid coming from her vagina. Her amniotic fluid is leaking and in order to ensure the health of  the baby, they need to perform a C-section. The woman does not want to have a C-section, but she has not gone into labor on her own. The second interesting case was a newborn baby. The limbs of the baby are abnormal. Dr. Senya was explaining that when one abnormality is observed, it is necessary to check for other abnormalities. The baby appeared fine, but Dr. Senya says that the flat nasal bridge is a characteristic of Downs. He also said that when nothing is life threatening for the child, it becomes most important to counsel the mother and reassure her that her child is well despite the abnormalities. I visited the lab today and saw the tests that I have been ordering actually being performed. The most interesting is the Widal test, which is no longer used in the U.S. It is a test for enteric fever (typhoid). It shows the amount of antibodies for the bacterium present in the blood. It is not used in the U.S. because it is not specific enough. Multiple bacteria produce the antibodies that the test exploits.

During the afternoon, there was a bad storm. Wet season is starting to reveal the source of its name. The storm was so bad that it was difficult to communicate to the patients because the rain and wind were so loud. A simple storm like this in the U.S. would not create havoc. Occasionally on the news, a tree falls or a tornado touches down. Here, every storm turns the roads to mud and as a result, cars frequently get stuck. There are large puddles of still water. It is hard to imagine how life can continue when the storms that would not create any havoc in more developed countries are creating numerous issues for Ghana. All in all, it was a good day. Jen and I have started planning for the weekend. I think that it will help get us through the week.

Sunday=Laundry Day

Sunday, finally a day for rest. We slept in a bit and then decided that we desperately needed to do laundry and get access to internet again. Laundry is quite a different process here. There are no laundry machines, so Jen and I had to learn how to do laundry by hand. It is a painstaking and long process. The laundry detergent doesn’t smell good and the clothes don’t feel clean. I think the water quality makes getting soap out of clothes and off your body difficult. There are a lot of differences here that make me miss the amenities of home. I do not have air conditioning. In the hospital, there are multiple fans, but at home, there is only one fan that moves locations. Every half of a rotation of the fan, the breeze takes away the sting of the Ghanaian heat, but the rest of the time it is hot and sticky. Additionally, we have to take bucket showers because the water pressure is not high enough to take normal showers. It is quite the experience and I do not think that in the next month I will ever get used to it. The toilet does not have enough power to flush toilet paper, so toilet paper is placed in a waste bin. Compared to the majority of Kasoa, this house has numerous amenities that none of them have. Some people do not have a roof over their head, so I am very thankful to Eric for his hospitality. He has been so gracious for opening his house to both myself and Jen. Another missed luxury is clean drinking water. All of my drinking water has to come from bottles. I came with some bottles from home, but now I have to buy bottles. Thankfully, the water is cheap. Bottles are more expensive than bags of water, but the bags of water are allegedly less clean. I try to minimize the number of times I drink bagged water because I do not want to get sick. In order to brush your teeth, I have to pour bottled water onto my toothbrush and rinse with the bottled water. It makes brushing your teeth more of a hassle. Majority of the roads are unpaved and filled with trash. I do not wear sandals outside because I am worried about the amount of bacteria outside. I cannot even imagine what is in the ground. Anyways, I have survived my first week here. I have had a lot of great experiences thus far, but of course there is no place like home. I am 25% of the way there. 

The fan-the only relief from the heat

Laundry old school style

Bucket showers

End of the Week and Labadi Beach

I would like to apologize for not fully uploading the pictures and for not posting in a few days. I was not able to get into the Cheerful Hearts office for internet because I worked a long time yesterday. As a result, I have a couple days to update you on. On Friday, I went into work and took patients with Oppong again. I also went on rounds with the other doctor, Dr. Senya. I asked him a lot of questions about the cases and he also quizzed me on my knowledge. There were a few interesting cases. One was about a child with blood in her urine from an infection. The doctor blamed it on the mother stopping breast feeding in the young baby (2 weeks old). Ghana, like most of the world, practices exclusive breast feeding. The doctors do not show or talk about formula because the best nutrition for the baby comes from breast feeding. It is heavily encouraged in this developing country because of the lack of sanitation. Another interesting case was about a young girl with a rash from her diaper. This particular rash occurs because of skin contact with urea for prolonged times. Dr. Senya said that before modern diapers came, parents would use cloth diapers and could afford to clean them when they got wet. When modern diapers came, parents started buying them, but because of the price, they could only afford one per day. As a result, parents keep the dirty diapers on the baby even if they are wet, which has increased the number of rashes. The last interesting case was an elderly woman with an infection of the foot. She was diabetic and did not manage her blood sugar well, so the infection caused a large pustule to form.

After work, we came back and relaxed. I am very excited for my first weekend. I am going into Accra with Jen, a MPH from Yale. One of her friends from Yale is working in Accra with an NGO there. We are going to the beach in Accra. Hoepfully we will be able to go into the city to see the museum and other tourist sites. If not, there is always next weekend. We are going to be taking the tro-tro into the city. Two Obrunis navigating the city-it could get interesting.

We made it on the Tro-Tro. It was a very stressful experience. We ate at Labadi Beach Resort in Accra. It was a nice taste of luxury. It is odd to see such a luxurious resort inside Ghana, particularly after we have been roughing it in Kasoa. We also saw other Obrunis for the first time since we arrived to the country, which was a luxury in itself. Majority of them were British, but any Obruni is welcome. We met Jen’s friend, Adam, and some other Americans in the area. Of the eight of us at lunch, six were University of Michigan students or grads. I made sure it was known that I am an ND student, but I enjoyed the company despite the fact that so many of them were Wolverines. During lunch, there was a bad storm, which caused the power to go out for a bit. I have come to embrace power outages because “such is Ghana.” The storm ruined our plans of going to the beach. We decided to see the National Museum instead. Unfortunately, it was closed by the time we got there. We went into Accra and just wandered for a bit. I do not enjoy walking through the city because the men hiss and make kissing noises, shouting Obruni. It gets annoying quickly. While we were wandering around, we realized how bad the storm was. Trees and signs had fallen. Roads were blocked and street vendors were left to pack or deal with the mud and water. We decided to look for internet because I have not updated my parents since Thursday. Unfortunately, we had difficulty finding an internet café because we were far from Western luxuries. We decided to take a taxi to a hotel near the airport. Eric was driving a former intern, Hannah, to the airport and picked us up. For the second time in one day, we were in an air conditioned building with normal bathrooms and other Obrunis.

I got a phone on Thursday and decided I should call my parents. I have to admit that hearing my parents on the phone brought tears to my eye. As a result, I have decided to try not to call them. (Sorry Mom and Dad!) It is not that I am hating my time here. Calling home reminds me that I am missing out on a lot at home and that I am very far from home in a foreign culture and environment. One week down and three weeks to go. Oh, and I forgot to mention…HAPPY BIRHTDAY PATRICK!! 

A real toilet at the resort

The Restaurant

African decor 

Jen and Douglas

Me and Douglas

Labadi Beach Resort

Waterfall

Me in front of the waterfall

Pool at Labadi

Area for wedding reception

The Beach

Palm Trees

Labadi Resort

Do you know Twi yet?

Today was another long but good day. I spent most of my day with the medical assistant Oppong receiving patients. He lets me take the history and diagnose, but I still don't have their drugs down yet. I still need him. All of the drugs seem so foreign to what I know in the US. I am sure they are mostly just different names, but it is still hard to get used to. I went on rounds with Dr. Boadum and spent some time in the pharmacy today. After working yesterday, I met one of the pharmacists. She was asking me questions and trying to teach me some Twi. We went over all the Day of the Week names, but I still forget. I usually just start saying something with an A for the girls and make up sounds for the rest of the name. The nurse taught me some Fanti, a different local dialect, but once again, I quickly forgot. I tried to explain that the language is in a different family than any language we have been taught, like Spanish, French, and Latin. I don't think she bought my excuse. I am still trying to pick up the language. Most of the time, the only word I recognize is Obruni, and then I know they are talking about me. Speaking of Obruni, it is still a concept I cannot understand. Some children are so excited to see me they run out onto the streets and follow me for a bit. Others are terrified because I am the only white person they have seen. I made a young child cry out of fear today. The most interesting case of the day was a woman who was admitted to the hospital for a swollen jaw. She had an aching throat so she and her husband turned to homeopathy. The homeopathic doctor stuck his fingers down her throat, and as a result Dr. Boadum believes that he ruptured her inflamed tonsils. I also saw another wound get stitched. It is very odd to see because it literally looks like you are taking a fish hook attached to wire.

When I spent some time in the pharmacy today, I was talking about my inability to determine age. There were 3 pharmacists working and I thought two of them were younger than me and that one was slightly older than me. To my surprise, they were all older than me. One of them was even a mother of two. Ghanaians do not age. Apparently, I look like I am 25, so the pharmacists were surprised that I am only 20. The pharmacy is a lot different than American pharmacies. The pharmacists have less schooling and the patients are essentially given boxes of drugs. There is no transferring of medications into a personalized bottle with directions for how to take the drugs. They are just given bags full of boxes of medications.

I was able to take pictures of the hospital today. It is very different than an American hospital, as is evidenced in the pictures. It has been a long week and I am looking forward to the weekend. Hopefully I am able to see some sights in Ghana. I think I might be going into Accra with Jen, who is meeting a friend in Accra.

Maternity Ward

St. Gregory Catholic Clinic

Second floor outside the Children's Ward

St. Gregory Catholic Clinic

How patient records are kept-composition notebooks

Male's Admitted Ward-Hold about 6 Patients

Consulting Area-3 Consulting Rooms

Pharmacy-Notice the old computer

Day 2 in the clinic

Today was my second day working in the clinic. Instead of following the doctor around, I stayed with the medical assistant, Oppong, and helped him with the patients. On a given day, Oppong sees more patients and writes more prescriptions than Dr. Boadum. There was a constant stream of patients. Majority of the patients were diagnosed with a combination of malaria, gastroenteritis, or heart burn. The communication barrier was difficult to deal with at times. When I was asking for a medical history and diagnosing, Oppong frequently had to translate into Twi. On top of the normal patients, there are Liberians seeking clearance to travel. They come in with forms that clear them of any serious medical conditions. The patients were constantly streaming in from about 9:30 when I arrived at work until 2:30 when Oppong decided to stop taking patients. He did not take a break between those times, and neither did I. It was exhausting at times. The medical examination is very different than what I have come to know in the US. In the US, the standard medical examination is heart rate, blood pressure, temperature, examine eyes and ears, and test reflexes in certain cases. Here, Oppong literally just touches the person's eyelid to check for anemia, looks at their eyes and hands to check for jaundice, touches the person's neck to feel the temperature, and then decides based on the conditions what to prescribe. I thought the use of penicillin was high in the US because of parents insisting to the doctor that their child is sick. Here, almost every person was asked to get multiple labs done and given multiple medicines. Almost every one is given anti-malaria medicines and tested for malaria with a widal test, FBC, and mps.
At the end of the day, one of the nurses, Gifty, and the pharmacist were talking to me about music and dancing. I told them I had heard of Azonto and they asked me to dance. I showed them my American moves (aka the shopping cart and lawn mower). They were also teaching me a little bit of Twi, the local dialect. I took two emergency patients after Oppong left. Finally, at about 4, the day was over.
Today, I found out a bit more about education in the medical field. For a doctor, after senior high, they go to medical school for 7 years. To become a nurse, they go to nursing school after senior high and either receive a certificate (less time required) or a degree. One of the nurses, Aggie, is working on her degree. The degree is accepted in the US and she is hoping to move to the US because her fiance is currently there. To become a pharmacist, after senior high you go to Pharmacy school for about 6 months. Medical assistants have not gone to university, but they are more qualified than nurses. Based on my time with Oppong, it is apparent that he sees and prescribes like a typical American doctor in an office. According to Aggie, one of the nurses, nurses in Ghana do not make nearly as much money as the doctors. She said it is less than half of the doctors salary and less than 1/4 of what nurses make in America. The nurses previously went on strike and as a result, their salary was increased slightly.
It is still pretty astounding how different both the education and the facilities are between the US and Ghana. I will work on providing pictures, but essentially the clinic is a building with two stories and other trailers set up outside. There is no air conditioning. There are very few electronic pieces available. The doctor has an old GE sonogram and has a better heart rate monitor for surgery, but aside from that there are no big electronic pieces. I think that temporary hospitals in war zones that US military doctors use are better equipped and have better facilities. Despite all this, the hospital makes it work. They are supported by the Point Hope mission, which donates equipment and sponsors patients who cannot afford their bills.

Hitting the Pavement Running

Today was my first full day in Ghana. I woke up this morning and went to work at the St. Gregory Catholic Hospital in the Liberian Refugee Camp. Dr. Boadum was very friendly and kindly showed me around. I followed him on rounds and he asked me questions about diagnosing. He was a very good teacher today and the rest of the staff, particularly the nurses, were very patient with me as I attempted to get the hang of things. The most interesting parts of the day were a wound and a C-section. A young boy was carried into the Emergency Room with a wound he got from a nail. It was about 9 inches long and was very deep. It took a while to get everything started for the stitching of his leg, but the entire time he was not crying. Once the doctor started stitching his leg, he was screaming and moving so much that they had to  put him under. The room was hot and filled with people for so a moment, I needed to step outside and get some air. Later, I watched Dr. Boadum perform a C-section. This C-section was particularly interesting because it was done on a HIV/AIDS patient. Majority of the other patients seen today had gastroenteritis or malaria.

Outside of work, we have been adjusting to life in Ghana with the help of Eric and Douglas thus far. The past two meals I have had were plain rice and chicken. The food so far has been very good, just a bit more spicy than I am used to. Tonight, we are having ripe plantain and beans. Dr. Boadum said I have to try fufu, but that I should wait a week before trying it. Jen, the other intern, said she tried fufu today and said it was interesting.

Thus far, everything is going well. I have not had any issues, but if something comes up, "no shaking" or don't worry about it.

Eric's House

The View of Town from the Road

A Goat in Kasoa

A Scary Herd of Goats