"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.