So, who added Kenney Chesney as one of my Blog Followers?!! Given how much money I have spent on that man he better be interested in my travels!! I luv u KC & can't wait 'til August to see u again! :)
Although the rainy season has arrived a little early, it doesn't do anything to quell the temperatures - our room still holds a steady 87-91 degrees (day and night) and the outdoor temps still average around 118 degrees during the day, although today is 127.5!
In an attempt to alter some of my experiences here, I changed hospitals a couple of weeks ago with the hopes of finding more of what I was looking for: the need and desire for assistance, along with the willingness of the staff to learn and teach. Although I thought I was successful at first, no such luck. I moved to St. Patrick's, a much smaller hospital, more dilapidated, with far fewer resources/supplies, with 28 beds and 4 doctors. There is a general women's/children's ward, a men's ward and a very small maternity ward. There is very little equipment and supplies are extremely limited - while I've been here there have been days where the hospital did not have any gloves or alcohol/swabs (so thank you Dave A. for your donation!). In my western mind that is a huge problem, however they do not seemed bothered by it at all! This hospital is privately owned and compared to the last hospital I volunteered at, it is much more expensive (however still only a fraction of the cost of US health care) for less trained nurses and far fewer resources/supplies. My first day was very hopeful -the doctors' English was pretty good, the nurses were very friendly, there were far fewer nurses and no nursing students. Most of this should have equated to 'yea! Kim will be able to communicate and participate'! However, the patients do not speak much English and therefore the nurses need to be involved in just about everything. The pace is still incredibly slow and again there is still not enough work for the number of health care workers present. After a few days, the same scenario occurred where much more of my time was spent staring at the walls than doing anything of substance. Even when attempting to create a project or organize something, it was not well received.
However, a work highlight that I have enjoyed is that I've been teaching CPR. Barely anyone here has ever heard of CPR, never mind know how to do it! First, I had to build/make a portable chalk board, which in this environment was a project in itself! I set up a schedule for all employees of the first hospital I volunteered at, Margret Marquart, which includes about 150people - head of the hospital even wanted administration and maintenance employees to attend. At first I did not have a CPR dummy so I was demonstrating CPR on a pillow! Crazy! Fortunately though, after the first week, the Administrator was able to locate a real, legitimate CPR dummy. And keep in mind that there are no AED/defibrillators here so it's an interesting concept to teach when the "end goal" isn't even available. This has been an enjoyable, unexpected twist, but it's a bit impractical here. People do not die from cardiac arrest; they primarily die from auto accidents, malaria and HIV. The impracticality is evidenced by the fact that none of the nurses/nursing students have ever been trained in CPR!
I've also been volunteering more at the orphanage, Hardthaven Children's Home, in the afternoon. Prior to my arrival, I was told that on my days at the home I would be there 8 hours a day. However, in actuality, volunteers are only allowed at the home between 3 and 5pm! Fortunately I am at the hospital in the morning, but many volunteers have come here just to work at the Home, so this is a huge point of contention for many. The home could certainly be in much better condition and actually there is another home currently being built (goal is to remove the renting factor to own instead). There are 35 kids who live here ranging from 2-17 along with 4 House Mothers. Fortunately all of the kids really appear happy and healthy. As my Mom says, "you really don't miss what you never had". And even though 6 of the kids have HIV, and many have lost their parents to HIV, there does not seem to be any segregation in the home. I also don't think any of the kids even know that some of the others are sick. The rooms are small, dark and dingy and numerous children are cramped into bunk beds side by side. The house Mothers sleep on the floor in between the bunks; boys and girls are separated. Very sad to see, but again, they see to accept the conditions without complaint. The Home does not have any running water so the kids walk to the town well every day to fetch water and carry back home on their heads.
The culture here has bred the kids to be very self sufficient - this is at the Home as well as all of the children I've seen/met here. The youngest kids feed themselves, dress themselves, fetch water and participate in household chores. There still is a good amount of time where they get to "be kids", that is, until they reach 10 years old or so. Then much of their free time is spent taking care of the compound (wherever they live), the household chores of cooking, cleaning and laundry as well as taking care of the younger kids. The lack of modern conveniences such as a washing machine, sanitary running water and cooking appliances makes the daily chores take forever!
Of course the kids are adorable, and yes, there are 3 in particular that I'd like to take home, but this makes watching their traditions all that more difficult. The form of punishment is caining - it is an extremely rare occasion where I've seen an adult speak to a child and have a conversation about the particular behavior in question. Instead, there is yelling and hitting. The biggest problem that I see is that this is a way of life for all here. The adults cain the older kids and the older kids cain the younger kids. It is heartbreaking to see these 12-17 year olds have the responsibility of "disciplining/caining" the younger children. With this involvement the cycle will never end. And I can see it in the younger kids: when they are mad at a fellow child they will yell and instinctively hit them hard, repeatedly. And unfortunately, I have even seen this among the teen boys and girls.
In addition to my volunteer work, I've also been enjoying some travel lately. Along with some other volunteers, I've enjoyed trips to Tafi Atome Monkey Sanctuary - a bamboo forest where monkeys live in the wild. A guide walks you through and makes "monkey" sounds and voila! they all come running to eat bananas out of your hand! It is seriously cute - while hanging onto the banana, the monkey will peel it and negotiate to get your hand out of the way so that he can take the whole thing out of the peel! (See the pictures that I posted previously.)
We also did a weekend trip to Wlii Falls - one of the more "famous" touristy things to do in Ghana. We were required to hire a guide who led us to the upper falls and then to the lower falls. I generally consider myself to be in decent shape but I swear, I thought this was going to kill me! It only took about an hour and a half to reach the top but it was one of the most difficult hikes I've ever done! The seriously vertical climb on extremely rough, overgrown terrain was almost more than I could manage!! But it was definitely worth it! Absolutely beautiful with white lilies blooming everywhere around the falls and the basin! The forest was so dense and lush and green - quite a difference from the populated, dirty brown of Kpando proper! (See the pictures that I posted previously.)
Another weekend trip was to Ho Hoe..not so far away but a popular spot for Westerners to visit for some R&R. A hotel there offers "western" food along with a pool, lounge chairs, a bar and most importantly, indoor plumbing of a toilet and a shower! So we anticipated helping ourselves to some posh relaxation. Only problem was that there really wasn't any "western" food (mostly more of the same fried African starchy food we get at home), it started to downpour and thunder about an hour after we settled into our lounge chairs at the pool, and although our toilet was fabulous, the shower didn't provide more than a trickle so we still had to resort to a bucket shower... but I guess it was indoors....oh, and we had Air Conditioning!
Tomorrow I am leaving with another volunteer to explore Cape Coast - a beach town area about 8 hours from here, even though it's probably less than 200 miles away. Gotta love dirt, bumpy roads and not so great vehicles! We'll be staying there for 5 days and will be enjoying some beach R&R as well as exploring some of the castles from the slave trade era as well as a national park for some hiking.
Every week I am growing more fond of Ghana and especially it's people. Every day I am still affected by the extreme poverty here and the perseverance of the people. It is so refreshing to see that they are friendlier and potentially happier than many I have seen elsewhere in my travels. Again, perhaps they don't miss what they don't know....
Until the next time,
Kim
Monday, March 28, 2011
Wednesday, March 23, 2011
Saturday, March 19, 2011
Wednesday, March 16, 2011
Time keeps on ticking, ticking, ticking....
Some of you have been e-mailing me asking how I spend my days...well here's the loooooong version of it: Generally life here is very slooooow and very hooooot. I wake around 6:30am and by then the kids have already cleaned our compound (picked up the trash that people drop everywhere, swept every inch of the property focusing mostly on the goat/sheep/chicken feces) and done their laundry (hand washed in a bucket). I have my bucket shower in the outdoor stall (assuming there's water, which there hasn't been for the last 5 days!). We have breakfast delivered in a basket to our outdoor table at 7:30am - every day it is the same: white bread with Lipton tea. I have finally located a stall here who sells "peanut paste" (natural peanut butter) which I add to a banana sold locally as well. Off to the hospital at 8am, which is only a 5 min. walk - Margret Marquat Catholic Hospital, which is the largest facility within 100 miles or so, has about 150 beds, 4 doctors and tons of nurses and nursing students. My 1st two weeks were spent in the maternity ward - that was quite an experience! There is a delivery room which has 4 "stretchers" and there are 4 patient rooms, each which have 8 beds. There are no privacy curtains and when the women have to go to the bathroom they usually squat on the floor and use a bucket they brought with them. Unless a woman has a c-section (which is approx. 35% of the births), they are not offered any drugs - all births are 100% el natural!
The morning starts with nurses rounds - we fly through each room with very few words being exchanged with the patients. Although Ghana's national language is English, everyone here speaks Ewe. So it is very difficult to follow any communication because it's mostly in Ewe. The nurses will answer any questions I have in English but it gets rather tiresome to have to ask a million questions to understand what's happening with each patient! Nurses' rounds through 25-30 patients usually takes about 15 minutes. A doctor usually arrives around 8:30 or 9 and then we all do Doctor's rounds. This time each patient is "addressed" by the Doctor however 3 of the 4 doctors are Cuban and their English is...well...let's just say not understandable. So each patient is asked "Are you fine?" and if they do not respond with something convincing then they are often discharged. To watch the attempt of English dialogue between the local nurses and the Cuban doctors, it's a wonder why more patients aren't actually harmed by the miscommunication! Most of the time I have no idea what they are saying even though it's a mixture of English and body language!
I have now watched/participated in a good amount of deliveries and c-sections. It is so incredibly different than the US. Here, most women are not involved in their healthcare. Procedures are not explained to them and they just do as they're told, often without understanding why. The lack of respect that the women receive during their labor, delivery and very short stay is shocking! It is common for the mid-wives and doctors to yell at the women because because they have not positioned their body appropriately for an exam or during delivery, or because they've groaned during delivery, or because they have items on their bed after they've been admitted. A common procedure here, done almost daily, is an EOU - evacuation of the uterus. This is done when a woman has a miscarriage which results in too much bleeding or, more commonly - almost daily- when a woman tries to self-abort. Women here are able to obtain cytoxin, a prescription used to induce labor at term, without a prescription. So a woman will take this at home, deliver the fetus usually without the placenta which will cause hemorrhaging requiring emergency care. When they arrive at the hospital, it is common that they will not admit that they were pregnant, never mind that they have self-aborted a fetus at home.
Another very different aspect of labor here is that the husbands/fathers are never involved in the delivery. Mother's or Auntie's bring the pregnant woman in but even they are not allowed to stay in the delivery room. Instead the patient is brought to the communal delivery room where she will join everyone else in labor without any privacy - there are no dividing curtains nor any sheets provided and the sarong style dress that most women wear upon arrival is removed as they hit the later stages of labor. They each lie on stretchers/tables that remain flat - no elevation of their back nor anyone or anything to help hold their legs. Even after birth when the Mother is returned to the Maternity ward patient room (shared by 7 other women, again without any privacy curtains), the husbands do not come to the hospital.
Each woman is responsible for bringing just about everything needed for delivering a baby. In the delivery room they must bring a small plastic sheet, an absorbant square pad and a "sheet" for the delivery table/stretcher (a piece of fabric). Also a smaller sarong of fabric to swath the baby in, as well as another sarong of fabric for the nurse to clean up the baby and the mother following delivery, is also required. They must also bring their own blade for the nurse to shave them (not a razor, but an old fashioned blade), as well as a bucket to urinate in, petroleum jelly to rub all over the baby and more plastic and sarong sheets for the bed that they will transfer to in the maternity ward after delivery. Sanitary napkins are also required....graphic/rated R info here....these are used to stop the bleeding after giving birth or any other situation where a woman may be bleeding vaginally. Those of you who are Mom's or are in the medical field should be feeling appalled right now....they insert the sanitary pad into the vagina, through the cervix and to the uterus to stop any bleeding. They leave this in place and instruct the Mother to remove this pad an hour later when she is back in the communal maternity ward! Can you even imagine!!
After the birth, the baby is immediately taken away from Mom, and is not returned for at least half an hour or so. They wait until the placenta has been delivered and until both Mom and baby have been cleaned up. During that time, Moms rarely ask about the baby - what the sex is, is s/he healthy etc etc?
Another oddity is that most medication needed is the responsibility of the patient. If they require anti-biotics etc the doctor will write an rx and the patient or a family member has to go to the hospital pharmacy to purchase the medication. It seems the only medication that the nurses provide are IV blood, saline or Ringers lactate etc.
This hospital is in much better condition that I anticipated. There may be 8 patients to a room in all wards (surgical, medical, maternity, children's and outpatient) and only 4 doctors for 150 beds and only 1 mercury blood pressure monitor per ward but it has running water, real toilets, normal walls/ceilings/floors, overhead fans for most rooms, A/C in the operating room, latex gloves, 1 x-ray machine, 1 ultrasound machine, 2 ventilators, an oxygen tank in each ward and some rather sophisticated eye exam equipment. Although many of their techniques are antiquated or unsterile by western standards, I'm still surprised at the relative cleanliness of everything, especially given that everything outside the hospital is layered with dirt and grime.
The biggest challenge that I am having thus far is that I am very much under-utilized and therefore I may, in fact, die from boredom! I work at the hospital from 8-12:30 M-F and usually do not return after lunch because I have spent much of the morning doing nothing. Of course there are births etc but there is so much waiting for.... nothing! I have found that the hospital is really overstaffed! There are only 4 doctors but there are lots of mid-wives and nurses, and at least a gazillion nursing students. So it is actually hard to DO anything when there are so many healthcare workers present, and this leads to a lot of sitting around. So many of the white volunteers (there are 5 of us in the hospital currently) are resigned to watching rather than actually participating - not exactly what I had in mind for this venture!This has lead to frustration in areas where I had never expected 1) Even though this area is very poor, there really is not a need for more healthcare workers 2) It is very difficult to learn anything because, although the national language is English, everyone actually speaks Ewe and 3) It is very difficult to share anything with the nurses because, for the most part, they do not care about learning or improving. They are not interested in learning how to keep equiptment sterile or how to educate their patients etc etc. So all in all, I am not doing as much as I'd like, I'm not learning as much as I'd like and I'm not sharing as much as I'd like....hhhhhmmmm....what's wrong with this picture??!! :)
Over the past week, I've taken some steps to hopefully improve my experience here....I'll write more about that the next time.
Miss you all!!
The morning starts with nurses rounds - we fly through each room with very few words being exchanged with the patients. Although Ghana's national language is English, everyone here speaks Ewe. So it is very difficult to follow any communication because it's mostly in Ewe. The nurses will answer any questions I have in English but it gets rather tiresome to have to ask a million questions to understand what's happening with each patient! Nurses' rounds through 25-30 patients usually takes about 15 minutes. A doctor usually arrives around 8:30 or 9 and then we all do Doctor's rounds. This time each patient is "addressed" by the Doctor however 3 of the 4 doctors are Cuban and their English is...well...let's just say not understandable. So each patient is asked "Are you fine?" and if they do not respond with something convincing then they are often discharged. To watch the attempt of English dialogue between the local nurses and the Cuban doctors, it's a wonder why more patients aren't actually harmed by the miscommunication! Most of the time I have no idea what they are saying even though it's a mixture of English and body language!
I have now watched/participated in a good amount of deliveries and c-sections. It is so incredibly different than the US. Here, most women are not involved in their healthcare. Procedures are not explained to them and they just do as they're told, often without understanding why. The lack of respect that the women receive during their labor, delivery and very short stay is shocking! It is common for the mid-wives and doctors to yell at the women because because they have not positioned their body appropriately for an exam or during delivery, or because they've groaned during delivery, or because they have items on their bed after they've been admitted. A common procedure here, done almost daily, is an EOU - evacuation of the uterus. This is done when a woman has a miscarriage which results in too much bleeding or, more commonly - almost daily- when a woman tries to self-abort. Women here are able to obtain cytoxin, a prescription used to induce labor at term, without a prescription. So a woman will take this at home, deliver the fetus usually without the placenta which will cause hemorrhaging requiring emergency care. When they arrive at the hospital, it is common that they will not admit that they were pregnant, never mind that they have self-aborted a fetus at home.
Another very different aspect of labor here is that the husbands/fathers are never involved in the delivery. Mother's or Auntie's bring the pregnant woman in but even they are not allowed to stay in the delivery room. Instead the patient is brought to the communal delivery room where she will join everyone else in labor without any privacy - there are no dividing curtains nor any sheets provided and the sarong style dress that most women wear upon arrival is removed as they hit the later stages of labor. They each lie on stretchers/tables that remain flat - no elevation of their back nor anyone or anything to help hold their legs. Even after birth when the Mother is returned to the Maternity ward patient room (shared by 7 other women, again without any privacy curtains), the husbands do not come to the hospital.
Each woman is responsible for bringing just about everything needed for delivering a baby. In the delivery room they must bring a small plastic sheet, an absorbant square pad and a "sheet" for the delivery table/stretcher (a piece of fabric). Also a smaller sarong of fabric to swath the baby in, as well as another sarong of fabric for the nurse to clean up the baby and the mother following delivery, is also required. They must also bring their own blade for the nurse to shave them (not a razor, but an old fashioned blade), as well as a bucket to urinate in, petroleum jelly to rub all over the baby and more plastic and sarong sheets for the bed that they will transfer to in the maternity ward after delivery. Sanitary napkins are also required....graphic/rated R info here....these are used to stop the bleeding after giving birth or any other situation where a woman may be bleeding vaginally. Those of you who are Mom's or are in the medical field should be feeling appalled right now....they insert the sanitary pad into the vagina, through the cervix and to the uterus to stop any bleeding. They leave this in place and instruct the Mother to remove this pad an hour later when she is back in the communal maternity ward! Can you even imagine!!
After the birth, the baby is immediately taken away from Mom, and is not returned for at least half an hour or so. They wait until the placenta has been delivered and until both Mom and baby have been cleaned up. During that time, Moms rarely ask about the baby - what the sex is, is s/he healthy etc etc?
Another oddity is that most medication needed is the responsibility of the patient. If they require anti-biotics etc the doctor will write an rx and the patient or a family member has to go to the hospital pharmacy to purchase the medication. It seems the only medication that the nurses provide are IV blood, saline or Ringers lactate etc.
This hospital is in much better condition that I anticipated. There may be 8 patients to a room in all wards (surgical, medical, maternity, children's and outpatient) and only 4 doctors for 150 beds and only 1 mercury blood pressure monitor per ward but it has running water, real toilets, normal walls/ceilings/floors, overhead fans for most rooms, A/C in the operating room, latex gloves, 1 x-ray machine, 1 ultrasound machine, 2 ventilators, an oxygen tank in each ward and some rather sophisticated eye exam equipment. Although many of their techniques are antiquated or unsterile by western standards, I'm still surprised at the relative cleanliness of everything, especially given that everything outside the hospital is layered with dirt and grime.
The biggest challenge that I am having thus far is that I am very much under-utilized and therefore I may, in fact, die from boredom! I work at the hospital from 8-12:30 M-F and usually do not return after lunch because I have spent much of the morning doing nothing. Of course there are births etc but there is so much waiting for.... nothing! I have found that the hospital is really overstaffed! There are only 4 doctors but there are lots of mid-wives and nurses, and at least a gazillion nursing students. So it is actually hard to DO anything when there are so many healthcare workers present, and this leads to a lot of sitting around. So many of the white volunteers (there are 5 of us in the hospital currently) are resigned to watching rather than actually participating - not exactly what I had in mind for this venture!This has lead to frustration in areas where I had never expected 1) Even though this area is very poor, there really is not a need for more healthcare workers 2) It is very difficult to learn anything because, although the national language is English, everyone actually speaks Ewe and 3) It is very difficult to share anything with the nurses because, for the most part, they do not care about learning or improving. They are not interested in learning how to keep equiptment sterile or how to educate their patients etc etc. So all in all, I am not doing as much as I'd like, I'm not learning as much as I'd like and I'm not sharing as much as I'd like....hhhhhmmmm....what's wrong with this picture??!! :)
Over the past week, I've taken some steps to hopefully improve my experience here....I'll write more about that the next time.
Miss you all!!
Subscribe to:
Posts (Atom)