Nearing the end

1/18

Today at the hospital Dr. Boateng’s lesson was on religion. One woman said she has been fasting and praying hard to get better. Dr. Boateng went on about how God is at your side whenever. You do not need to make a show to get him to listen to your prayers. It was actually a very good soapbox! This afternoon Dr. Gyasi and the anesthesiologist came in for a hysterectomy. The woman was 41 and had 1 daughter. Dr. Gyasi said she was still young and wanted more kids so his goal was to salvage the ovaries as best he could. They used spinal anesthesia so she was only numb from the hips down. Unfortunately the incision and work was done about the area under anesthesia. After the incision she started screaming and moving her hands to the cut. They tied her hands down. Dr. Gyasi continued operating. He found the tumor and stuck a probe into it to hold it in place and be able to pull up on it. At this she began to go into a kind of shock because of the pain. I had to hold her arms down. I tried holding her hands and stroking her arms to calm her down, but you could tell she was feeling every bit of it. They finally put her under general anesthesia before they started removing the tumor. The tunor was about the size of a melon and was situated just between the ovaries. After removing the tumor he also removed her appendix. Her chart said nothing about it being a problem, but maybe he just wanted to save her another operation sometime possibly in the future. 

the operating room

When I left the hospital it was getting dark. A man was pulling out of the hospital and asked if I lived in Atonsu, which I do, and gave me a ride all the way to the house! He has a mother-in-law and a friend in Atasemanso Hospital. He knows a lot of Peace Corps volunteers and works with the road designing and engineering. He was very nice and saved me a tro ride and a walk in the dark. Two weeks from today I will be home!

1/19

Today Dr. Boateng would not let me leave the hospital until I took some medicine for the bites on my legs. I had to get a patient card and be registered in the system. Then I sat in his office and he took my blood pressure. Then wrote a prescription for an antihistamine, cortisone cream, and an antibiotic. He did not ask if I had any allergies or if I was currently on any medication. I took the antihistamine and applied the cream, but did not take the 1000mg Amoksiklav tablets.

1/20

Today outreach was again just me. Enoch and Chief came, along with the medical supervisor for Ghana from Accra. The kids were crazy today! They were all huddling around me. One little girl asked if I was from America. I said that I was. She then asked if that is where Jennifer Aniston lives. When I said yes she got so excited and went running to tell her friends. A lot of these kids had ring worm…more than usual. But most of the kids had tine scars, that I could do nothing for but clean off to make them feel better. Some kids even pick off scabs so they have a reason to come to us. I usually give those kids a lecture about how an open wound just leads to infection and by pulling the scab off they are increasing the chance for a scar. I don’t think they really understand the danger of having an open wound here, but it makes me feel better letting them know. One girl had what looked like a tiny cut on her elbow, but when I went to clean it off puss started coming out. Then I realized her whole elbow was swollen and this was a boil. I pressed the edges to get as much puss out as I could, then put some cream for boils on it. Most kids, like her sit there with terrible wounds and don’t even flinch. Other kids have a scar or tiny scab I barely touch to clean and they pretend like it hurts so bad. Overall I am really impressed with the pain tolerance of these kids. American kids should take note!

the table with equipment at outreach

treating fungus

the kids are crazy about the obruni

1/21

Today Louise and I met in Kejetia. We went to a little street place for some breakfast. We got fried egg on bread with coffee. The people on the street that make these do such a good job and it is super cheap! For 2 eggs mixed with onion and pepper, fried, with bread and butter, coffee with milk and sugar-I usually like black coffee but they make it without asking how you take it-is only GHC2! Which is about $1.30. 

goats on the roof of a trotro

We then went to find a tro going to Essase so we could go to Owabi Wildlife sanctuary just outside of Kumasi. We were sent all around Kejetia to find the tro. Finally we found a tro going to Essase. We paid and got on and waited for it to fill up. The town is only about 13km outside of Kumasi, but after almost 2hours we were getting worried. Finally after traveling through the middle of nowhere on dirt roads the tro stopped and said, “last stop.” We asked the driver if this was Essase. He laughed and said that we passed Essase a while ago. He took us back and told us that a little town with maybe 3 buildings was Essase. We got off and started asking some locals how to get to Owabi.. None of them knew what we were saying much less what we were talking about. Finally one man spoke some English and said that he did not know Owabi. We pulled out the Bradt guide and showed him a map with the names of where we were trying to go. He laughed and said there are about 5 Essases is Kumasi and we were at the wrong one!! Abouit 3 trotros passed going away from town but when they came back by they were full and did not even stop. We waited for about 2 hours.

waiting in one of the Essase towns

 Most of the people we very friendly, but this one man was obviously on some kind of drugs and came up to us. He was trying to speak English, but was mumbling and not coherent. At first it was funny messing with him, but then we tried ignoring him and I was talking to someone else about how to get home if a tro did not come soon. The other guy came over and grabbed the nice man and started saying stuff and all we got were a few 4 letter words. Finally a big truck with a 15 foot trailer came by. We all jumped on the trailer. He would take us to the main road where we would be able to get a tro for sure heading to town. About 20 people jumped on. The crazy man ran towards me as we were about to drive away. He yelled something and grabbed my back. He scratched my back and ripped my shirt. The car pulled away so nobody could do anything, but I was very shaken up. I have never felt that scared or helpless this whole trip. Everyone on the truck felt very bad for me. They paid our way home and one woman gave me a rag to wipe all the dust off of me. –Being on the back of a truck on dirt roads means we were COVERED in dust! When we got back into Kumasi we were too exhausted and freaked out to go to the REAL Essase and to Owabi so we just scratched that trip and went for a cheap dinner and went home.

1/22

This morning Louise and I went to Kumasi Polytechnic to watch Anthony play volleyball. After spening a few hours there we went to Bonwire. We were hoping this day would be better than the day before. Bonwire is one of the five original Kente weaving Stools in Ghana. On the way the trotro broke down. Thankfully after about 10 minutes the driver got it started again. We were dropped off in a little town. A man came over and took us to a building where some weavers are. There were about 10 weaving stations. The thread is stretched out about 15 feet in front of the weaver. The weavers toes go in little hooks that separate the strands of string after each pass by the bolt of colored string. Then a piece of wood packs the string after every pass. For single weave you just thread the string back and forth. For double you can alternate the colors and finally for triple, the most complicated, they thread some colors only partially through the strings to make the patterns. The walls were covered in fabric. Some fabric was single kente with a print or painting on top of it.

weaving kente

me weaving!

me and our guide

1/24

Today I spent my time in the consulting room at the hospital with Dr. Boateng. When he went on ward rounds I stayed and check BP, pulse and respirations for all the patients waiting to be seen. The doctor’s office doubles as the examination room. Dr. Boateng sits at his desk and the patient sits in a chair at the side of his desk. The assistant in the room who puts all the information from the chart onto a computer system rings a bell for the next patient to come in the room. Sometimes there are 2 patients in the room: one being seen and the other waiting. Because Dr. Boateng owns the hospital, he not only sees and oversees treatment of the patients but also signs checks for both the hospital and the restaurant he is opening, checks over receipts, reads all scans and does the work of what it takes a whole administration at a hospital to do. So while a patient is in the room a number of people wanting check signed and other things tended to, walk in and out. I was getting frustrated at all the interruptions, but he has been doing this for several years so I am sure he was not phased.

1/25

Again today I sat in the consulting room with the doctor. Before he arrived I went around to visit all the patients. There was a boy admitted after I left yesterday. There were about 7 nurses standing outside the male ward. They all told me to go check out what was going on inside. There was an 18 year old boy sitting on one of the beds with his knees up. It looked like he had a huge dressing on his knee, but then I realized it was not a dressing and was a HUGE tumor. It was mostly white with some bloody spots and a little bit of skin. It was probably the size of a small watermelon. I walked over to talk with the boy. I asked him how long this has been here and his answer was, “yes.” I then asked if he spoke English and he said, “no.” haha His chart said he had the tumor for 2 years. It was removed once but has since grown back, obviously. The doctor diagnosed it as sarcoma. They have not done tests to see if it is malignant or has metastasized. The tumor smelled so bad! It looked like there was still some gauze wrapped around it. I pointed it out to the nurse doing the dressing. When he pulled it off, I realized it must have been from a very old dressing because a layer of skin had grown over it and a huge part of skin was torn off when he removed the gauze. The boy was in so much pain. He was trying not to grab his leg and was crying. It was very sad, and got even sadder when they said his only option might be amputation. They are going to test for malignancy and then make a decision. Right now his Hb is 3, which means he is very anemic, so the doctor is giving a total dose infusion of iron and erythropoietin and hoping to raise the hb some so they can operate. There is also a man in one of the special wards from Kentucky! He is a missionary and had been here with his wife fro 5 years. He came in complaining of abdominal pains and chest pain. The ECG revealed a minor MI. He and I were talking about how many people come into see a patient with the doctor. Along with Dr. Boateng and myself about 10 nurses go on rounds with the doctor. This would be a rare occasion at home. Recently I realized that my host family gets the E! channel. I have been watching Kendra, the Kardashians, E! True Hollywood Stories, and Behind the Scenes episodes. The other day I walked in the room and the family was watching it too. I love watching those shows, but I also know that is not a depiction of typical American life, but when that is the only view some Ghanaians have of America, it is no wonder they think we are all rich and crazy!

1/26

Today was my last day at Atesemanso Hospital. I cleaned the wounds and did the dressing for the man with the bed sores and the boy with the sarcoma on his knee. They determined the tumor was malignant and decided to amputate. Sometime this week or early next week when his Hb is high enough they will amputate. 

me with one of the patients

the nurses

me and Dorcas

the Hospital entrance

the female ward

a typical patient chart

looking down the hall between the female ward and private wards

For lunch I ate with one of the nurses. I bring a lunch that my host mothers packs, this week was fried egg sandwich and I also brought nuts and dried fruit mom and dad sent from home. She was eating fish with kenkey and spicy chili. She ate the fish eye the backbone and every part of the fish. 

her food....

She asked what the nuts and fruit were and she tried some and said it was not very good. I tried to refrain myself from commenting! Today was also the last Projects Abroad meeting. Most of the volunteers are new so it was not too difficult to say goodbye to everyone. 

Gabby, me and Anthony

1/27

outreach