~Stephanya Shear
Wednesday, January 23, 2008
Back to American Medicine
My first day back and a bit of craziness. My mailbox is full of administrative things to take care of that require thier "Chief's" approval. Acquainting myself with a new set of patients (I missed a busy Pedicatric week) and my 7 am conference took a few hours this am. The jet lag is not too bad, I just feel a little tired - then again it might have been the snow I shoveled this monring at 5am. In a few hours of busy work, Ghana seem so far away. I am carrying around in my white coat a patient card- just to show people that I was there and we did operate all those days. Plus I remind myself of what we all accomplished over the week.
Now back to daily labs, post operative epidurals, and multiple cather options- none of which existed in Ghana.
I down loaded all 415 pictures I took in Ghana. My last few posts will be pictures only. Now that we are all back, you don't need me to tell you the stories.
Thanks for reading.
Goodbye and Stay Healthy.
Stephanya
~Stephanya Shear
Now back to daily labs, post operative epidurals, and multiple cather options- none of which existed in Ghana.
I down loaded all 415 pictures I took in Ghana. My last few posts will be pictures only. Now that we are all back, you don't need me to tell you the stories.
Thanks for reading.
Goodbye and Stay Healthy.
Stephanya
~Stephanya Shear
Airport and then Home
It is 4 am and I am back in Rochester. I can’t sleep. That’s OK because all my belongings smell like smoke from the fires in Ghana and I really need to do laundry.
Most of the team was able to adjust to the time difference in Ghana, but some especially Nate and Danielle, would wake up at 2 or 3 am. No one could tell because they were fresh and alert all day and stayed up pretty late at night. Pretty impressive. Stacie and I had no trouble sleeping except the last night. She thinks we were both dehydrated and a little nervous we would be late for our 6 am pick up time. Good thing we all made it out early for it took us 2 hours to go about 20 miles to the airport. Traffic was horrendous. For an hour we stood in place and moved maybe 1 mile 30mins. Once we got past the worst, Mr. Houdo got us to the airport at 8:40. Then we waited in lines.
Line Dancing
One line at customs to check our passports and mark our bags with chalk. No one is sure what the chalk signified since no one checked for it later.
Another line to weigh our bags.
A third line to check our itineraries and passports (again).
Fourth line at Check- in to weigh our bags AGAIN and take our passports after issuing a baggage tag.
A fifth line to search thru our luggage.
A sixth line to wait for the return of our passports and obtain our boarding passes (which incidentally does not happen at the “Check-in” desk- very Ghanaian).
A seventh line for customs where they take our declaration forms and check and stamp our passports (third time).
An eighth line for carry on baggage check and security. They do not let women take off their belts so I beeped and got padded down.
An ninth line where they check our passports for a fourth time and our boarding passes again.
And finally a tenth line where they search our carry on (even after it has been x-rayed) and physically pad everyone down (my second time).
All the IVU bins went thru without any problem and I don’t think they were padded down once.
To the Plane
We all got thru the ten lines and even had time to spend the last of our cedis in duty free. I was able to score on some of that hot pepper sauce. I found the correct spelling is Shito (the name amuses Stacie to no end). Luckily the glass jar did not break in transit. Yum smoke and pepper sauce on my clothes.
Speaking of the smell of smoke. Dr Bellinger said he was almost knocked out when he opened the overhead compartment when we arrived at JFK. The smell of Ghana smoke was overwhelming and may permanently etched onto his nose he thinks.
In JFK- a rush to get Brent and Stacie to their gate for take off and all the bins out. Luckily they were checked all the way thru. In Accra my check in person could not figure out how to code Rochester and was only going to check me thru to JFK. Luckily I gave her the airport code and she checked it thru or I would haven been delayed in JFK.
Charles stopped at Dunkin Donuts and four other people stopped at Starbucks when we hit the terminal. Our first coffee in 12 days. It will surprise all my friends that I was not one of them. I was feeling pretty hypoglycemic and needed real food before any coffee. And I don’t support Starbucks. But I assure you now at 5 am I have an Americano next to me as I type this. It is 18 degrees- a day ago I was sweating in 85 degree weather.
I did not make it home until the wee hours of Tuesday am and after about 2 hours of sleep I was up at 4 am. When I got home I put my smoky bag in the laundry room and went right up to see my daughter who was asleep soundly in her crib. She looks bigger than when I left. Sometimes I would see a little girl or baby at the hospital that would remind me of her. I had pictures of her, but nothing compares to seeing and holding her.
It was a great trip but it is good to be home.
~Stephanya Shear
Most of the team was able to adjust to the time difference in Ghana, but some especially Nate and Danielle, would wake up at 2 or 3 am. No one could tell because they were fresh and alert all day and stayed up pretty late at night. Pretty impressive. Stacie and I had no trouble sleeping except the last night. She thinks we were both dehydrated and a little nervous we would be late for our 6 am pick up time. Good thing we all made it out early for it took us 2 hours to go about 20 miles to the airport. Traffic was horrendous. For an hour we stood in place and moved maybe 1 mile 30mins. Once we got past the worst, Mr. Houdo got us to the airport at 8:40. Then we waited in lines.
Line Dancing
One line at customs to check our passports and mark our bags with chalk. No one is sure what the chalk signified since no one checked for it later.
Another line to weigh our bags.
A third line to check our itineraries and passports (again).
Fourth line at Check- in to weigh our bags AGAIN and take our passports after issuing a baggage tag.
A fifth line to search thru our luggage.
A sixth line to wait for the return of our passports and obtain our boarding passes (which incidentally does not happen at the “Check-in” desk- very Ghanaian).
A seventh line for customs where they take our declaration forms and check and stamp our passports (third time).
An eighth line for carry on baggage check and security. They do not let women take off their belts so I beeped and got padded down.
An ninth line where they check our passports for a fourth time and our boarding passes again.
And finally a tenth line where they search our carry on (even after it has been x-rayed) and physically pad everyone down (my second time).
All the IVU bins went thru without any problem and I don’t think they were padded down once.
To the Plane
We all got thru the ten lines and even had time to spend the last of our cedis in duty free. I was able to score on some of that hot pepper sauce. I found the correct spelling is Shito (the name amuses Stacie to no end). Luckily the glass jar did not break in transit. Yum smoke and pepper sauce on my clothes.
Speaking of the smell of smoke. Dr Bellinger said he was almost knocked out when he opened the overhead compartment when we arrived at JFK. The smell of Ghana smoke was overwhelming and may permanently etched onto his nose he thinks.
In JFK- a rush to get Brent and Stacie to their gate for take off and all the bins out. Luckily they were checked all the way thru. In Accra my check in person could not figure out how to code Rochester and was only going to check me thru to JFK. Luckily I gave her the airport code and she checked it thru or I would haven been delayed in JFK.
Charles stopped at Dunkin Donuts and four other people stopped at Starbucks when we hit the terminal. Our first coffee in 12 days. It will surprise all my friends that I was not one of them. I was feeling pretty hypoglycemic and needed real food before any coffee. And I don’t support Starbucks. But I assure you now at 5 am I have an Americano next to me as I type this. It is 18 degrees- a day ago I was sweating in 85 degree weather.
I did not make it home until the wee hours of Tuesday am and after about 2 hours of sleep I was up at 4 am. When I got home I put my smoky bag in the laundry room and went right up to see my daughter who was asleep soundly in her crib. She looks bigger than when I left. Sometimes I would see a little girl or baby at the hospital that would remind me of her. I had pictures of her, but nothing compares to seeing and holding her.
It was a great trip but it is good to be home.
~Stephanya Shear
Interview with the Anesthesia team- Drs Semenov and Yang
Interview with the Anesthesia team
Ok I could not really interview them, they were pretty busy plus I think they thought it was a silly idea. Dr Semenov (Igor) and Dr Yang (Charles) however are two very funny guys and together they were like a non stop comedy duo. They also made a great team at the head of the table. They had the toughest most nerve racking jobs of the entire team. We are operating with different equipment and less than ideal catheters but they were putting children to sleep in challenging situations. They obviously are very experienced and really good at what they do, because they made it look easy- but we know better.
One difference here is that they us halothane for an anesthetic and no nitrous. It takes a little longer for the children to become sleepy, but Dr Yang like halothane as opposed to the much more expensive brand name stuff used in the States (halothane is generic). According to Dr Schneck, having our own anesthesia team made all the difference this year. They moved along quickly and were very focused. Both are pain specialist and they provided caudals and/ or epidurals on all the children. Dr Schneck noticed a considerable difference this year in both the efficiency of the OR as well as the tone. He said the children were all much more comfortable after surgery.
Igor spent a lot of time in the ICU taking care of our one ICU patient. She was the only patient who was able to keep her epidural after surgery. The other patients with large incisions were able to get some morphine on the wards.
Charles and Igor also did a lot of teaching. They were constantly teaching the CRNAs and even had Danielle doing caudals. I could not imagine the team without them. Note to the IVUmed staff- bring them back if not to Ghana to another country.
They were both helpful and kind and very generous.
They also ate fried bat. Honestly they ate it. And it did not taste like chicken.
~Stephanya Shear
Ok I could not really interview them, they were pretty busy plus I think they thought it was a silly idea. Dr Semenov (Igor) and Dr Yang (Charles) however are two very funny guys and together they were like a non stop comedy duo. They also made a great team at the head of the table. They had the toughest most nerve racking jobs of the entire team. We are operating with different equipment and less than ideal catheters but they were putting children to sleep in challenging situations. They obviously are very experienced and really good at what they do, because they made it look easy- but we know better.
One difference here is that they us halothane for an anesthetic and no nitrous. It takes a little longer for the children to become sleepy, but Dr Yang like halothane as opposed to the much more expensive brand name stuff used in the States (halothane is generic). According to Dr Schneck, having our own anesthesia team made all the difference this year. They moved along quickly and were very focused. Both are pain specialist and they provided caudals and/ or epidurals on all the children. Dr Schneck noticed a considerable difference this year in both the efficiency of the OR as well as the tone. He said the children were all much more comfortable after surgery.
Igor spent a lot of time in the ICU taking care of our one ICU patient. She was the only patient who was able to keep her epidural after surgery. The other patients with large incisions were able to get some morphine on the wards.
Charles and Igor also did a lot of teaching. They were constantly teaching the CRNAs and even had Danielle doing caudals. I could not imagine the team without them. Note to the IVUmed staff- bring them back if not to Ghana to another country.
They were both helpful and kind and very generous.
They also ate fried bat. Honestly they ate it. And it did not taste like chicken.
~Stephanya Shear
Interview with Stacie Pearce
My original interview did not load up, so here is my interview with Stacie Pearce, RN
Stacie Pearce is the team’s recovery nurse. Along with Dr Schneck she is the only returning member of the 2007 Ghana IVU team. Stacie is an RN in Salt Lake City where she has been working with children in the Rapid treatment unit (observation unit) and Emergency Department for eight years. She is also an instructor for the nursing school. When not at work she spends time with her husband Cody (last year’s Ghana mission secretary) and their many tropical fish tanks. She is also an avid dancer and musician.
In addition to the two IVU missions, Stacie has gone on numerous humanitarian trips. She organized several of the trips herself. She has traveled to Thailand and the Navajo Nation in the US.
Her assignment on the IVU trip is to take care of the children in the recovery room after their surgery. She also provides pain medications for the children when they are on the wards as well as making them comfortable in the PACU. It is often the case that IVU must provide medications for the children on the wards. She also gets a chance to come into the operating theatre and see the surgeries.
Stacie considers working with the mothers as a valuable part of her job. She has the job of explaining the surgeries and teaching them about the catheters. “The challenging part is to integrate their culture, traditions and expectations with our medical care.” This also goes for working the KATH staff as well. “There are things [in the recovery room] I would just do in the States, but here I must adapt to the Ghanaian way of doing things.”
“Here I really focus on the patient. Charting is minimal and we really only do what is necessary. I spend time with the children and not looking at monitors. When I come here I realize how in the States we are focused on paper not patients.” She also uses physical exam skills such as checking the color of the inside lip to check for oxygen saturation instead of focusing on a pulse oximeter. Another difference she notices is the lack of supplies.
She loves Ghana and the friends she has made. The genuine warmth and caring of the people here is what really impresses her. “People break into songs here and they are very grateful for what we do.”
Stacie is very humble but I can tell you she has been invaluable on this mission. Not only in her job as the recovery nurse but helping in the operating theatre and logistics of housing. She made sure we had a place to stay in Elmina and Accra. She has also been my roommate for the entire trip and she is a joy to be around. She is effervescent and very genuine. And she is one great barterer- this woman can really shop.
~Stephanya Shear
Stacie Pearce is the team’s recovery nurse. Along with Dr Schneck she is the only returning member of the 2007 Ghana IVU team. Stacie is an RN in Salt Lake City where she has been working with children in the Rapid treatment unit (observation unit) and Emergency Department for eight years. She is also an instructor for the nursing school. When not at work she spends time with her husband Cody (last year’s Ghana mission secretary) and their many tropical fish tanks. She is also an avid dancer and musician.
In addition to the two IVU missions, Stacie has gone on numerous humanitarian trips. She organized several of the trips herself. She has traveled to Thailand and the Navajo Nation in the US.
Her assignment on the IVU trip is to take care of the children in the recovery room after their surgery. She also provides pain medications for the children when they are on the wards as well as making them comfortable in the PACU. It is often the case that IVU must provide medications for the children on the wards. She also gets a chance to come into the operating theatre and see the surgeries.
Stacie considers working with the mothers as a valuable part of her job. She has the job of explaining the surgeries and teaching them about the catheters. “The challenging part is to integrate their culture, traditions and expectations with our medical care.” This also goes for working the KATH staff as well. “There are things [in the recovery room] I would just do in the States, but here I must adapt to the Ghanaian way of doing things.”
“Here I really focus on the patient. Charting is minimal and we really only do what is necessary. I spend time with the children and not looking at monitors. When I come here I realize how in the States we are focused on paper not patients.” She also uses physical exam skills such as checking the color of the inside lip to check for oxygen saturation instead of focusing on a pulse oximeter. Another difference she notices is the lack of supplies.
She loves Ghana and the friends she has made. The genuine warmth and caring of the people here is what really impresses her. “People break into songs here and they are very grateful for what we do.”
Stacie is very humble but I can tell you she has been invaluable on this mission. Not only in her job as the recovery nurse but helping in the operating theatre and logistics of housing. She made sure we had a place to stay in Elmina and Accra. She has also been my roommate for the entire trip and she is a joy to be around. She is effervescent and very genuine. And she is one great barterer- this woman can really shop.
~Stephanya Shear
Sunday, January 20, 2008
To the Airport
In 30 mins we begin our trip back to the airport. Becxause of traffic we will need to start out very early. It is midnight on the East coast so we all should be home in about 24 hours.
Last night we watched the foirst match of the Africa cup. It is ebing held here in Ghana at three sites- one being Kumasi. Accra hosted the opening game between Ghana and Guinea. The city was craazy everyone evene babies on thier mothers backs were dressed in gold, red and green. Go Black Stars (the Team ) was everywhere. We watched in a big screen in our hotel., It was a great match and Ghana won 2-1. We passed many groups of people- on in th e fields of a secondary school- probabaly close to a thousand people watching on a HUGE screen. The cliusters of people in a small shop around on television. IT was a great time to be in Accra.
We ate our last meal and now we are going home. Some of my posts never made it onto the blog site, so I will re-enter them from the States. It has been a good mission, a successful one and a lot of fun. I think I speak for the entire team when I say we made many friends and felt the world get a little smaller this week.
My last entry will be from the States.
~Stephanya Shear
Last night we watched the foirst match of the Africa cup. It is ebing held here in Ghana at three sites- one being Kumasi. Accra hosted the opening game between Ghana and Guinea. The city was craazy everyone evene babies on thier mothers backs were dressed in gold, red and green. Go Black Stars (the Team ) was everywhere. We watched in a big screen in our hotel., It was a great match and Ghana won 2-1. We passed many groups of people- on in th e fields of a secondary school- probabaly close to a thousand people watching on a HUGE screen. The cliusters of people in a small shop around on television. IT was a great time to be in Accra.
We ate our last meal and now we are going home. Some of my posts never made it onto the blog site, so I will re-enter them from the States. It has been a good mission, a successful one and a lot of fun. I think I speak for the entire team when I say we made many friends and felt the world get a little smaller this week.
My last entry will be from the States.
~Stephanya Shear
Back to Accra in the road
Back to Accra
As we left Kumasi, we went to the Cultural center and picked up some gifts for friends and family at home, all those who have been taking care of all our families and patients while we were away. We had a long bust ride to the Coast. We did make one stop at the site of the Last Bath. This was where slaves from West Africa were washed before they were taken to the castles on the coast. No one knows how many Africans were sold into slavery or the number who died before being sold. Our guide left us down to the water. As it is the dry season, the water was far below the bank. Also at the site are the re-interned remains of one woman slave from Jamaica and a man from the United States. Both were reentered her in 1998. On Sunday we visited the slave castle at Elmina, the oldest European castle on the West African coast. Four hundred men were housed in one small square space with only a few small windows. No food, no water, little sunlight. They could be there for months. There were also one hundred and fifty women in a smaller room. When the boats arrived, they were shacked together in groups of ten and loaded onto boats. Originally the castle was for trade in gold and other items, and then it was used exclusively for the housing of slaves. After the abolition of slavery, the castle was used by the British for administrative purposes and was also used for training Ghanaians to fight for the British in the world wars. The Castle is now a museum. We spent about an hour there before leaving for Accra. It was a very moving tour and as our guide stated- it is not old wounds we seek to open but to speak to the enduring strength of the African people and to ensure that such a horrible event never occurs again.
~Stephanya Shear
As we left Kumasi, we went to the Cultural center and picked up some gifts for friends and family at home, all those who have been taking care of all our families and patients while we were away. We had a long bust ride to the Coast. We did make one stop at the site of the Last Bath. This was where slaves from West Africa were washed before they were taken to the castles on the coast. No one knows how many Africans were sold into slavery or the number who died before being sold. Our guide left us down to the water. As it is the dry season, the water was far below the bank. Also at the site are the re-interned remains of one woman slave from Jamaica and a man from the United States. Both were reentered her in 1998. On Sunday we visited the slave castle at Elmina, the oldest European castle on the West African coast. Four hundred men were housed in one small square space with only a few small windows. No food, no water, little sunlight. They could be there for months. There were also one hundred and fifty women in a smaller room. When the boats arrived, they were shacked together in groups of ten and loaded onto boats. Originally the castle was for trade in gold and other items, and then it was used exclusively for the housing of slaves. After the abolition of slavery, the castle was used by the British for administrative purposes and was also used for training Ghanaians to fight for the British in the world wars. The Castle is now a museum. We spent about an hour there before leaving for Accra. It was a very moving tour and as our guide stated- it is not old wounds we seek to open but to speak to the enduring strength of the African people and to ensure that such a horrible event never occurs again.
~Stephanya Shear
Friday
Friday night.
Rounds we done by 6:30, so we had time for a walk before our good bye dinner. The Staff of KATH held a nice dinner in our honor and many nice speeches were made. They presented us with a gift of appreciation after a delicious dinner of traditional Ghanaian food. We had given our gifts earlier to various people. We gave gifts of scrub outfits, hats, polo shirts, pens, books and water bottles we all individually brought.
The food was very delicious. OK so I now know what jollof rice should taste like now. Not unlike a tomato rice dish my mother used to make, just the Ghanaian version has more spice. Speaking of spice, I have really enjoyed this hot sauce that I think has ground bean in it- Sheento. Very hot and really good. The ingredients in Ghanaian foods are a mix of indigenous foods, foods from the Caribbean, Asia and the Americas. We had the best plantains at the going away dinner. A jazz group played and we ate outside. Fastina said the closing Thank you and our surgery resident and guide Dr. Yankey said the final prayer.
But to me, the most moving and meaningful moment on our trip would be Saturday when a patients mother said Thank you to the Team for tasking care of all the children. She spoke with great warmth as she shared her appreciation for the care we had given the children and for the healing work we had done.
~Stephanya Shear
Rounds we done by 6:30, so we had time for a walk before our good bye dinner. The Staff of KATH held a nice dinner in our honor and many nice speeches were made. They presented us with a gift of appreciation after a delicious dinner of traditional Ghanaian food. We had given our gifts earlier to various people. We gave gifts of scrub outfits, hats, polo shirts, pens, books and water bottles we all individually brought.
The food was very delicious. OK so I now know what jollof rice should taste like now. Not unlike a tomato rice dish my mother used to make, just the Ghanaian version has more spice. Speaking of spice, I have really enjoyed this hot sauce that I think has ground bean in it- Sheento. Very hot and really good. The ingredients in Ghanaian foods are a mix of indigenous foods, foods from the Caribbean, Asia and the Americas. We had the best plantains at the going away dinner. A jazz group played and we ate outside. Fastina said the closing Thank you and our surgery resident and guide Dr. Yankey said the final prayer.
But to me, the most moving and meaningful moment on our trip would be Saturday when a patients mother said Thank you to the Team for tasking care of all the children. She spoke with great warmth as she shared her appreciation for the care we had given the children and for the healing work we had done.
~Stephanya Shear
Back to Accra
Saturday.
Another early morning after packing until late in the night. No breakfast and we hit the wards at 8 am. I am the IVU resident scholar. This means that my application was chosen amongst the many and the IVU paid from my travel to Ghana. My contribution to the Team has really been in rounding. Danielle Sweeney, the Pediatric Urology fellow, has been the most help in the OR. So it was my job to find the children when they got to the wards- remember who was who (with the help of cards that had their pictures on them), now what surgery was done and when, and when the catheters should come out. I also had to keep track of who had medical issues or needed labs. Pretty much the standard job of any resident. Just remembering who is who and who had what was a big part of it. Drs Schneck and Bellinger did the exams, removed bandages and took out catheters. Danielle had the hard job of preparing the doses of medications we gave out. She also managed the ICU patient we had.
The entire team came to round the last morning. The bins, now empty were packed in the bus. I found myself a little sad to leave some of the children, as I had gotten very found of the little ones and their mothers.
After that, some went to see the site of the sword of the Asente people which is right next to the hospital in front of the new trauma center which really is under construction. One final good bye to our host Dr. Aboah, and we drove out of KATH for the last time this year.
The sign over the Gate says “Good Bye and Stay Healthy”.
~Stephanya Shear
Another early morning after packing until late in the night. No breakfast and we hit the wards at 8 am. I am the IVU resident scholar. This means that my application was chosen amongst the many and the IVU paid from my travel to Ghana. My contribution to the Team has really been in rounding. Danielle Sweeney, the Pediatric Urology fellow, has been the most help in the OR. So it was my job to find the children when they got to the wards- remember who was who (with the help of cards that had their pictures on them), now what surgery was done and when, and when the catheters should come out. I also had to keep track of who had medical issues or needed labs. Pretty much the standard job of any resident. Just remembering who is who and who had what was a big part of it. Drs Schneck and Bellinger did the exams, removed bandages and took out catheters. Danielle had the hard job of preparing the doses of medications we gave out. She also managed the ICU patient we had.
The entire team came to round the last morning. The bins, now empty were packed in the bus. I found myself a little sad to leave some of the children, as I had gotten very found of the little ones and their mothers.
After that, some went to see the site of the sword of the Asente people which is right next to the hospital in front of the new trauma center which really is under construction. One final good bye to our host Dr. Aboah, and we drove out of KATH for the last time this year.
The sign over the Gate says “Good Bye and Stay Healthy”.
~Stephanya Shear
Glimpses of Kumasi
Some glimpses of Kumasi.
There is not a huge middle class here. There are people who are comfortable off but no one we have seen is exceptionally well off. We have managed to find a few nicer areas, but they are exceptionally modest by our standards. It would be more encouraging to see people who are able to get out of the poverty around us. It is also unclear how much of an infrastructure exists if people do become more prosperous.
After one week, all of our clothes smell like smoke. Trash is burned here. Now with more cheap products from China, there black plastic bags everywhere and mound s of plastic trash that does not burn completely. Even on the college campus, there are bins next to the professor’s homes that are used for burning trash.
Many of the areas power share. That means one night they would have power and the following night the next street over would have power. Water is usually piped into a central area of a compound or group of home. There are no toilets in most communities. Instead there are shared latrines. Some apartments have bathrooms but since a majority of people live in groups of wooden, cement, or stone small homes, most do not have indoor plumbing.
For this and other reasons, all children stay in the hospital until their catheters come out, unless they are well off and have a way to keep everything clean.
There are a lot of unfinished buildings- building with no sign of construction. We are not sure of the story behind this as UI have been told- “Oh they are under construction”. Very Ghanaian. It is true they are under construction, but that is not really what you were asking. All along our routes we see these unfinished buildings.
It a very safe here. Until late you see many people out on the streets, even children with their parents are out after dark.
IN the mornings on our way to the hospital we see many children off to school. All schools, private and public have uniforms. They get to school by walking, taxi or some of the private mini buses fill with school children and drive them. And there are parents who walk their children. Fathers as well as mothers get them to the primary school. They prefer to eat their lunches form one of the thousands of food stands along the road rather than take a lunch pail. Salmonella infections are very common here.
Also common as you can imagine is malaria. So common that the blood bank does not screen for malaria and it is common for people who receive a blood transfusion to react to the malaria and get what is called a “blood fever”.
~Stephanya Shear
There is not a huge middle class here. There are people who are comfortable off but no one we have seen is exceptionally well off. We have managed to find a few nicer areas, but they are exceptionally modest by our standards. It would be more encouraging to see people who are able to get out of the poverty around us. It is also unclear how much of an infrastructure exists if people do become more prosperous.
After one week, all of our clothes smell like smoke. Trash is burned here. Now with more cheap products from China, there black plastic bags everywhere and mound s of plastic trash that does not burn completely. Even on the college campus, there are bins next to the professor’s homes that are used for burning trash.
Many of the areas power share. That means one night they would have power and the following night the next street over would have power. Water is usually piped into a central area of a compound or group of home. There are no toilets in most communities. Instead there are shared latrines. Some apartments have bathrooms but since a majority of people live in groups of wooden, cement, or stone small homes, most do not have indoor plumbing.
For this and other reasons, all children stay in the hospital until their catheters come out, unless they are well off and have a way to keep everything clean.
There are a lot of unfinished buildings- building with no sign of construction. We are not sure of the story behind this as UI have been told- “Oh they are under construction”. Very Ghanaian. It is true they are under construction, but that is not really what you were asking. All along our routes we see these unfinished buildings.
It a very safe here. Until late you see many people out on the streets, even children with their parents are out after dark.
IN the mornings on our way to the hospital we see many children off to school. All schools, private and public have uniforms. They get to school by walking, taxi or some of the private mini buses fill with school children and drive them. And there are parents who walk their children. Fathers as well as mothers get them to the primary school. They prefer to eat their lunches form one of the thousands of food stands along the road rather than take a lunch pail. Salmonella infections are very common here.
Also common as you can imagine is malaria. So common that the blood bank does not screen for malaria and it is common for people who receive a blood transfusion to react to the malaria and get what is called a “blood fever”.
~Stephanya Shear
Interview with Nate Cook
Interview with Nate Cook.
The next person in our team was Nate Cook. Nate has been a pediatric general surgery tech for over eighteen years. He is the proud father of two teenagers. This is his first trip with IVU med. His role here is to “make sure the cases go smoothly and help with the equipment, both ours and the KATH equipment” He also scrubs in as the nurses some when Afia and Fastina need a break. Those two have been a valuable part of the team, staying late with us every night and became close friends of Nate’s. Nate spends a lot of time adapting equipment and supplies. He shuttles back and forth from our store room and the theatre. He has a calm disposition which helps when things get challenging.
The biggest differences in the operating room that he noticed were fewer choices such as fewer suture options, a general lack of instruments. There are no “packs”- groups of supplies and instruments packed together. Most of what is here is linen. There are few disposable drapes.
“Ghana is great,” he says. “But not what I expected. It is more technologically advanced than I thought it would be.” Ghanaians have access to some technology thought the infrastructure is sometimes inconsistent. Our hotel’s internet being a prime example. The best parts of the trip have been the way the IVU team and the KATH staff have come together and work as one. The sense of brotherhood in Ghana is what stands out to him.
He would recommend An IVU trip to anyone. Nate believes that you find out what kind of person you really are when you are put in a new environment. From what I have experienced of Nate, he is generous, intelligent, resourceful and very considerate. We have been lucky to have him on our mission.
~Stephanya Shear
The next person in our team was Nate Cook. Nate has been a pediatric general surgery tech for over eighteen years. He is the proud father of two teenagers. This is his first trip with IVU med. His role here is to “make sure the cases go smoothly and help with the equipment, both ours and the KATH equipment” He also scrubs in as the nurses some when Afia and Fastina need a break. Those two have been a valuable part of the team, staying late with us every night and became close friends of Nate’s. Nate spends a lot of time adapting equipment and supplies. He shuttles back and forth from our store room and the theatre. He has a calm disposition which helps when things get challenging.
The biggest differences in the operating room that he noticed were fewer choices such as fewer suture options, a general lack of instruments. There are no “packs”- groups of supplies and instruments packed together. Most of what is here is linen. There are few disposable drapes.
“Ghana is great,” he says. “But not what I expected. It is more technologically advanced than I thought it would be.” Ghanaians have access to some technology thought the infrastructure is sometimes inconsistent. Our hotel’s internet being a prime example. The best parts of the trip have been the way the IVU team and the KATH staff have come together and work as one. The sense of brotherhood in Ghana is what stands out to him.
He would recommend An IVU trip to anyone. Nate believes that you find out what kind of person you really are when you are put in a new environment. From what I have experienced of Nate, he is generous, intelligent, resourceful and very considerate. We have been lucky to have him on our mission.
~Stephanya Shear
Friday
Friday
Very early day. We skipped breakfast and rounded as quickly as we could. This morning at the general surgery grand rounds, Dr. Bellinger and I gave lectures. There were medical students and attending surgeons in attendance there. As before, there was a prayer at the start, but we needed to get back to the theatre before the Thank sand closing prayer. At this point, we have only had one no show and one cancellation. But we have also had a few add on surgeries to fill the places.
We lost power both Thursday and Friday. Not for very long. The anesthesia machines were on battery back up. We lost the electro cautery and no lights. The theater lights are not that powerful anyway, but all we had was ambient lighting for a while.
There is a man in our theatre who has been helping us. He is never said one word, but followed everything we do and anticipated what we needed. His name was Sunday and he tried to run a few goose neck lamps off of a backup outlet when he lost light. Those lights did not work but they thought was great. The power came back on but we lost a few lights.
In spite of wanting to be done early- we finished with rounds at 6:30.
~Stephanya Shear
Very early day. We skipped breakfast and rounded as quickly as we could. This morning at the general surgery grand rounds, Dr. Bellinger and I gave lectures. There were medical students and attending surgeons in attendance there. As before, there was a prayer at the start, but we needed to get back to the theatre before the Thank sand closing prayer. At this point, we have only had one no show and one cancellation. But we have also had a few add on surgeries to fill the places.
We lost power both Thursday and Friday. Not for very long. The anesthesia machines were on battery back up. We lost the electro cautery and no lights. The theater lights are not that powerful anyway, but all we had was ambient lighting for a while.
There is a man in our theatre who has been helping us. He is never said one word, but followed everything we do and anticipated what we needed. His name was Sunday and he tried to run a few goose neck lamps off of a backup outlet when he lost light. Those lights did not work but they thought was great. The power came back on but we lost a few lights.
In spite of wanting to be done early- we finished with rounds at 6:30.
~Stephanya Shear
Thursday
Since the internet was down, I kept a journal with hopes to down load entries.
Thursday
So we have been operating for three days now. Wednesday was another long day as we left the hospital close to 10. We could not find the restaurant we wanted so we went back to the p lace we had eaten at the night before. Our driver Mr. Houdo tried very hard to find the place and we rode back and forth on the same road a half a dozen times before we gave up.
There are only a few road signs (that we can see) and we do not always go the same way each day. Without our driver we would get lost not to mention by at the mercy of the taxis. Mr. Houdo has to put up with a lot. He must pick up us early and be available to get us home late at night. He has dinner with us every night and has to take out time to get us back to Accra. So for the week, he too is away from his family.
We have now seen some Westerners, mostly school tours. There are a few European medical students at KATH. There are not a lot of tourists in Kumasi.
We stopped operating early to give two lectures. The medical system is based on the English system, so the operating room is called the “theatre”. So we are in the Main Theatre. I have not seen the secondary one. Once we left the theatre, two of us went to see all the patients and give out evening doses of antibiotics while the others were finishing the last procedure of the day. Dr Schneck and Danielle each gave a lecture.
The ether screens do not work very well and the first few days I was pretty lightheaded. We all got used to it after a few days, so by Thursday we were all fine. Those of use used to caffeine in the am, have gotten through our withdrawal phase. However a nasty head cold is making its way though the group. It lasts about three days, no cough but a lot of sinus congestion and runny nose.
All the meetings we have attended start with a prayer. Some one is chosen to say the prayer and they have all been oriented towards the meeting. After the meeting, some one is designated to give Thanks. This is not a prayer- but the person thanks the speakers, the people attending, perhaps the hospital for giving the room. After the Thanks, another prayer is given and the meeting is over. Ghanaians are very respectful and polite. The men are all very respectful towards the women in our group and all the people we have met have been genuinely appreciative of what we have done.
~Stephanya Shear
Thursday
So we have been operating for three days now. Wednesday was another long day as we left the hospital close to 10. We could not find the restaurant we wanted so we went back to the p lace we had eaten at the night before. Our driver Mr. Houdo tried very hard to find the place and we rode back and forth on the same road a half a dozen times before we gave up.
There are only a few road signs (that we can see) and we do not always go the same way each day. Without our driver we would get lost not to mention by at the mercy of the taxis. Mr. Houdo has to put up with a lot. He must pick up us early and be available to get us home late at night. He has dinner with us every night and has to take out time to get us back to Accra. So for the week, he too is away from his family.
We have now seen some Westerners, mostly school tours. There are a few European medical students at KATH. There are not a lot of tourists in Kumasi.
We stopped operating early to give two lectures. The medical system is based on the English system, so the operating room is called the “theatre”. So we are in the Main Theatre. I have not seen the secondary one. Once we left the theatre, two of us went to see all the patients and give out evening doses of antibiotics while the others were finishing the last procedure of the day. Dr Schneck and Danielle each gave a lecture.
The ether screens do not work very well and the first few days I was pretty lightheaded. We all got used to it after a few days, so by Thursday we were all fine. Those of use used to caffeine in the am, have gotten through our withdrawal phase. However a nasty head cold is making its way though the group. It lasts about three days, no cough but a lot of sinus congestion and runny nose.
All the meetings we have attended start with a prayer. Some one is chosen to say the prayer and they have all been oriented towards the meeting. After the meeting, some one is designated to give Thanks. This is not a prayer- but the person thanks the speakers, the people attending, perhaps the hospital for giving the room. After the Thanks, another prayer is given and the meeting is over. Ghanaians are very respectful and polite. The men are all very respectful towards the women in our group and all the people we have met have been genuinely appreciative of what we have done.
~Stephanya Shear
FINALLY INTERNET
I am so sorry. The internet has been down since Tuesday. For all those families and freinds checking in, we are fine. We have been exceptionally busy but we are all OK. SO let me catch you all up- Tuesday was a busy OR day. We closed a 21 year old woman with bladder extrophy and that took one table all day. The other table was busy wth some tricky reconstructive issues as well. The tally for the for entire trip- Dr Bellinger said "I have never seen this before" five times, and Dr Schneck said a similar thing three times. MOst of the time he just shook his head. The days have gotten hotter and there are some occassional flies in the OR. But we have settled into a routinue and move smoothly. The resdients at KATH faculty scrub in foe most of the cases if not all after 10 am. There are currently no urology residents but the general surgery residents have been assisting. The recovery room has gotten very crowded. There was a man boarding down there for days- pretty much fending for himself. I think at one point some one gave him water. No one rounded on him and he just lay there. The second day a dorsal slit was performed on him by the general surgeons for a paraphimosis. We heard about that after the fact - poor guy. What was more heart braking was a baby there fro three days- no one held him or bathed him. We gave him water and some toys and one of the nurses gave him one meal a day. We never say his mother. We were told it was because there was no room upstairs- but since some of our babies were sleeping only one to a bed- that could not be true. We alos were told his mother was waiting outside- but our mothers were allowed to come back and be with the babies. So either they were treating our children differently or there was something up. We all agreeed it was the later with a samll element fo the former. But finally the nurses from the wards came to collect him. The nurses here are very dedicated but they do less nursing and caretaking that in the states. IN our wards the mothers take care fo teh children and the adults have to be pretty sufficent and take care of themselves. Stacie Pearce and Mrs Bellinger have been doing a great job in recovery room. They have been caring for the children as well as educating the mothers. IN addition they have been dealing with a lot of the logistics and helping find our supplies. The do a fair amount of trouble shooting. We finished late on Tues and left the OR at 9:30. Our dedicated driver took us to dinner and we got a little carried away with a lazy susan on the table and a few dishes went flying. We do not stop for lunch and a fwe mornings also had to skip breakfast. We much on granola bars between cases and then wait to dinner to eat. Just like resisdency... If I SEE ANOTHER GRANOLA BAR IN THE NEXT THREE WEEKS I am going to scream.
~Stephanya Shear
~Stephanya Shear
Monday, January 14, 2008
OR Day One
Well this is what we came here for- operating Day One. It is now 11pm and we left the OR at 9:30 this evening. A long day in the OR. We started a little late after going to Surgery Rounds. Surgery is surgery everywhere. The resident was being pimped in front of everyone. And I saw the pit they were digging for him- I was thinking "Don't jump". It is so sad. They are like sharks as soon as a little blood is out- they circle around. Made me feel right at home...
Our first two surgeries were surprises in fact Dr Bellinger said in TWICE in ONE DAY "I have never seeen this before" . Truly some rare and surprising things, but then again some typical pediatric urology such as hypospadius and UDT. The kids are just a little older than we usually see. The OR staff is great-- we have two scrub nurses assigned to us all week, two CRNAs for the morning and Pam our PACU nurse is still here. Today was really busy with medical students, nursing students, and residents in the room all day. The first few surgeries took longer for the surprises but we managed to get thru the rest in good time. Our Ghanian lunch was welcome at about 2 in the afternoon since we had been working all day. Very good and spicy rice with chicken.
The OR room can get crowded with 2 tables and all of us around both- not to mention HOT. I managed to stuff cold towels down my clothes to stay cool. We also drink alot of bottle waterIN THE OR. The insanity of the OR is nothing comapred to the Wards. There is one big room, filled with beds and cribs- no dividers no seperate rooms, most of the time two kids in one bed. First you have to find your patient among the seventy kids in teh room and since we have only seen them twice and the room is packed with kids it gets a little crazy. We have cards that indentify the pateint and list thier medications (we give out the pain meds for the first night) and when the catheters come out. All the kids come in the night before and leave 2 days after for the small surgeries. There are no IVs in the floor- those are removed in PACU. All medications are oral. Tomorrow is our first big surgery- an extrophy in at 21 year old girl. We pretty much have one or two big procedures each day- and a list of smaller ones on the same day.
The parents, usually moms, wait in the hall on benches all day. Often in thier fine clothes in the heat, they sit first with thier child and then alone. They help bring thier child up to the wards with the nurse. They are truly a patient lot. They get no calls during the procedure, they are not seeing the doctor before hand, they just wait. And wait. And still at the end of teh day when we are leaving they say "Goodnight, Thank you, and God bless."
We fixed alot of kids today and on the rest, we started the reconstructive process. WE will do that again tomorrow and for teh next three days after then.
~Stephanya Shear
Our first two surgeries were surprises in fact Dr Bellinger said in TWICE in ONE DAY "I have never seeen this before" . Truly some rare and surprising things, but then again some typical pediatric urology such as hypospadius and UDT. The kids are just a little older than we usually see. The OR staff is great-- we have two scrub nurses assigned to us all week, two CRNAs for the morning and Pam our PACU nurse is still here. Today was really busy with medical students, nursing students, and residents in the room all day. The first few surgeries took longer for the surprises but we managed to get thru the rest in good time. Our Ghanian lunch was welcome at about 2 in the afternoon since we had been working all day. Very good and spicy rice with chicken.
The OR room can get crowded with 2 tables and all of us around both- not to mention HOT. I managed to stuff cold towels down my clothes to stay cool. We also drink alot of bottle waterIN THE OR. The insanity of the OR is nothing comapred to the Wards. There is one big room, filled with beds and cribs- no dividers no seperate rooms, most of the time two kids in one bed. First you have to find your patient among the seventy kids in teh room and since we have only seen them twice and the room is packed with kids it gets a little crazy. We have cards that indentify the pateint and list thier medications (we give out the pain meds for the first night) and when the catheters come out. All the kids come in the night before and leave 2 days after for the small surgeries. There are no IVs in the floor- those are removed in PACU. All medications are oral. Tomorrow is our first big surgery- an extrophy in at 21 year old girl. We pretty much have one or two big procedures each day- and a list of smaller ones on the same day.
The parents, usually moms, wait in the hall on benches all day. Often in thier fine clothes in the heat, they sit first with thier child and then alone. They help bring thier child up to the wards with the nurse. They are truly a patient lot. They get no calls during the procedure, they are not seeing the doctor before hand, they just wait. And wait. And still at the end of teh day when we are leaving they say "Goodnight, Thank you, and God bless."
We fixed alot of kids today and on the rest, we started the reconstructive process. WE will do that again tomorrow and for teh next three days after then.
~Stephanya Shear
Sunday, January 13, 2008
The campus
This morning I had the opportunity to run thru the campus. We are the KN Univerisity of Science and Technology in Kumasi. We are not far from the hospital- perhaps 30mins in our bus, given the traffic. Early in the run the sky and air was clear and I could hear birds the the loudest frogs I have ever heard. But after 30mins, the smog and smoke from burning trash gave the air thick quality. I see trash burning every where. Even behind out hotel which is very nice. There is very limited trash collection and people burn trash in piles or in cement boxes. The campus is large but most of the students are on a long break. The African Cup is being hosted by Ghana and the games are being played in Accra and Kumasi. The streets are all cleaned up and posters everwhere. The campus will house many of the teams in the dorms, so the campus will not open until Feb 5th. Isaw a group of players on campus on my run, stretching and running. There were other Ghanian people running too, just like me out there sweating before it got too hot.
I saw the dorms, some pretty old but some very new and nice. They are building all over the campus. New dorms, a new law school, a new technolosy building a new agriculture building and that was just on my run. I am sure there is more. I also saw the art college and the sculpture lab. Next to it was a impromptu sculture garden where dozens of sculture are just lying in the grass. The grass is growing around them and it gives it a mysterious quality. I saw the small health clinic and a new student center that is styled after the newest buildings in US campuses. It is not in use, in fact the lights are still wrapped up in plastic.
The run took me over a bridge over water. The vegetation was dense and lush and the smog was just coming in- and the frogs were singing. After a run uphill to the end of one long road I turned around and went back to our guest house. I ran past the professor's homes (thier names are on the outside of the houses). Very modest by our standards, but they were nice homes with porches, yards with grass and windows. The kids were outside and people where getting ready for church.
It was a nice run and I was happy I did not get lost.
~Stephanya Shear
I saw the dorms, some pretty old but some very new and nice. They are building all over the campus. New dorms, a new law school, a new technolosy building a new agriculture building and that was just on my run. I am sure there is more. I also saw the art college and the sculpture lab. Next to it was a impromptu sculture garden where dozens of sculture are just lying in the grass. The grass is growing around them and it gives it a mysterious quality. I saw the small health clinic and a new student center that is styled after the newest buildings in US campuses. It is not in use, in fact the lights are still wrapped up in plastic.
The run took me over a bridge over water. The vegetation was dense and lush and the smog was just coming in- and the frogs were singing. After a run uphill to the end of one long road I turned around and went back to our guest house. I ran past the professor's homes (thier names are on the outside of the houses). Very modest by our standards, but they were nice homes with porches, yards with grass and windows. The kids were outside and people where getting ready for church.
It was a nice run and I was happy I did not get lost.
~Stephanya Shear
Saturday, January 12, 2008
Clinic Day
I wish We could send you some pictures, but the internet connection is just not able to handle that much information. The sights here are amazing
We had clinic today. We saw 38 children (well one was 30 years old) and we scheduled surgeries on 34. Monday will be busy with eight procedures and the rest of the days will have fewer but longer and more complicated procedures. The families were all very pateint as there was a lot of wiating. After we saw them, then the waited for us to organize the OR week. Some need studies so we needed to arragnge those today. There is a CT scan and MRI here at KATH. We can also get VCUGs which took one phone call to arrange. The children are mostly older than we see in the US and they are all small for thier age. But act like kids- once he pulled out our camera's they were all little hams. They were very good too, since they had to wait with their parents and sometimes siblings too. All the kids get admitted the day before and stay for days after surgery. Old school yes but they need to be watched and since I doubt many of thm have access to clean water all the time.
We worked thru the day (taking a quick break for lunch) and then late afternoon we did a little sight seeing to the Kente village to see the cloth being made and get some gifts for people back home. I bought a little trinket in return for asking a 19 year old boy about his school and his livig conditons and a sign of the times he wanted my email address to write me. I was not bold enough to ask him if he went to the doctor at all for check ups. After all that is was late so we traveled back to the guest house. The streets were calmer than in the morning.
One the way to KATH we drove through the heart of Kumasi. It is a busy place in the morning. A lot of people selling out of there shops or on the street- people waiting for buses, on buses a lot of people out on the street. People everywhere. Traffic traffic. We saw teh new trauma center they are building- in one eyar they have made a lot of progress.
The OR is set up and we just have a few things to do before Monday.
~Stephanya Shear
We had clinic today. We saw 38 children (well one was 30 years old) and we scheduled surgeries on 34. Monday will be busy with eight procedures and the rest of the days will have fewer but longer and more complicated procedures. The families were all very pateint as there was a lot of wiating. After we saw them, then the waited for us to organize the OR week. Some need studies so we needed to arragnge those today. There is a CT scan and MRI here at KATH. We can also get VCUGs which took one phone call to arrange. The children are mostly older than we see in the US and they are all small for thier age. But act like kids- once he pulled out our camera's they were all little hams. They were very good too, since they had to wait with their parents and sometimes siblings too. All the kids get admitted the day before and stay for days after surgery. Old school yes but they need to be watched and since I doubt many of thm have access to clean water all the time.
We worked thru the day (taking a quick break for lunch) and then late afternoon we did a little sight seeing to the Kente village to see the cloth being made and get some gifts for people back home. I bought a little trinket in return for asking a 19 year old boy about his school and his livig conditons and a sign of the times he wanted my email address to write me. I was not bold enough to ask him if he went to the doctor at all for check ups. After all that is was late so we traveled back to the guest house. The streets were calmer than in the morning.
One the way to KATH we drove through the heart of Kumasi. It is a busy place in the morning. A lot of people selling out of there shops or on the street- people waiting for buses, on buses a lot of people out on the street. People everywhere. Traffic traffic. We saw teh new trauma center they are building- in one eyar they have made a lot of progress.
The OR is set up and we just have a few things to do before Monday.
~Stephanya Shear
Friday, January 11, 2008
Travel
The FDA inspects all the IVU bins one week before departure. They are sealed at that time. Going thru cutoms in Ghana was easy. As we traveled o Kumsi we passed many housing areas groups of mud or cement brick homes. We also passed many shops. It is customay to put a religous message in the business name- God is truth brake shop, God is stable cold foods, God is good salon.
The roads were underconstruction most of the way- part of the time we were on diort roads.
Better go- losing connection
~Stephanya Shear
The roads were underconstruction most of the way- part of the time we were on diort roads.
Better go- losing connection
~Stephanya Shear
Arrival in Ghana and Kumasi
We all arrived safely in Ghana and Kumasi. There is so much to tell in only one day but since email connection is iffy, I will try some small posts. Other people will be posting as well. Our gear arrived as well- six tubs of IVU eqiment and 2 large duffel bags. We all managed to sleep some on the plane so we were all not too tired. The weather is a warm 74 degrees.
The people are lovely here and vert sweet. Our host Dr Aboa was happy to see us and his resident Yoyke was a weath of inforamtion about the medical insurance for Ghanians as well as medica education. Everyone i Ghan had access to health insurance. It is free for those people who pay into sical security and 12 US dollars per year for a family for those self employed. It covers everything but plastic surgery and some rare congential syndromes. I also saw examples of public health measures- for HIV and TB as well awarenss for prenatal care.
It si a rough here by Western standards. Ghanias have a higher quality of life than may W Africans, but it is still alow standard of lining. Most homes have no electricity, no water and no sweage. The bigger cities have more amenities but not every day. The infrastructure is also inconsistent. We traveled on some very rough roads and we stood in traffic a lot. Everytime we were still however gave many young women and boys opportunity to sell us all sorts of things- most resting on there heads. Water, plantains, some small fried bird, palm nuts, fried cake, boiled eggs, and planety of thoer things we could not identify.
These children should be in school-there are public schoold that are mostly free- but I have the feeling they are working for thier families either selling or hauling water from a well or pump, burning trash or the like. There have been some imporvments froma report I read in 2000 about city governemnt and povery in Kumasi. Some of the services may have improved and at least now health care is covered for all. There is a doctor shortage outside the teaching hosptitals in the districts, but the governemtn is working on sending people there.
We start tomorrow at 6 am and start clinic we hope at 8am. There is more surgery here than we can hope to do in one week, but after we meet the children we will plan to rest of the week. One half the staff will unpack the OR and set up.
The food is pretty good but we only had one meal given we were on the bus for over 6 hours. They have this awesome hot sauce that reminds me of a spicy Chinese bean paste. It is really good on fried potatoes.
~Stephanya Shear
The people are lovely here and vert sweet. Our host Dr Aboa was happy to see us and his resident Yoyke was a weath of inforamtion about the medical insurance for Ghanians as well as medica education. Everyone i Ghan had access to health insurance. It is free for those people who pay into sical security and 12 US dollars per year for a family for those self employed. It covers everything but plastic surgery and some rare congential syndromes. I also saw examples of public health measures- for HIV and TB as well awarenss for prenatal care.
It si a rough here by Western standards. Ghanias have a higher quality of life than may W Africans, but it is still alow standard of lining. Most homes have no electricity, no water and no sweage. The bigger cities have more amenities but not every day. The infrastructure is also inconsistent. We traveled on some very rough roads and we stood in traffic a lot. Everytime we were still however gave many young women and boys opportunity to sell us all sorts of things- most resting on there heads. Water, plantains, some small fried bird, palm nuts, fried cake, boiled eggs, and planety of thoer things we could not identify.
These children should be in school-there are public schoold that are mostly free- but I have the feeling they are working for thier families either selling or hauling water from a well or pump, burning trash or the like. There have been some imporvments froma report I read in 2000 about city governemnt and povery in Kumasi. Some of the services may have improved and at least now health care is covered for all. There is a doctor shortage outside the teaching hosptitals in the districts, but the governemtn is working on sending people there.
We start tomorrow at 6 am and start clinic we hope at 8am. There is more surgery here than we can hope to do in one week, but after we meet the children we will plan to rest of the week. One half the staff will unpack the OR and set up.
The food is pretty good but we only had one meal given we were on the bus for over 6 hours. They have this awesome hot sauce that reminds me of a spicy Chinese bean paste. It is really good on fried potatoes.
~Stephanya Shear
Wednesday, January 9, 2008
Last Post Before Leaving
Preparation for this mission to Ghana began months ago. Once the date was set, I began the process of getting time off from residency, compiling a to do list and begin investigating Ghana. My first stop was the library where I found the most useful books in the Children’s section. Short books, concise and perhaps a bit rosy (one paragraph on the slave trade out of Ghana), they set the stage for at least some basic information. Also I found two great picture books, both Asante tales. One about a spider who learns the value of sharing and the other about a Leopard who was boastful and greedy.
I tried making a few Ghanaian dishes- Jollof rice and Groundnut (Peanut) Stew. The rice, well I need to work on my recipe. It was a thick gob of tomato and rice- I think too much tomato paste. The stew was good (Black beans, carrots, peanuts and tomato) but very rich compared to my usual diet. Dr. Schneck said he knows of a place that sells fried bat. I have eaten insects, but I draw the line at flying mammals.
The CDC site was also helpful (yellow fever vaccinations are required for entry) as well as a local travel agency that specializes in trips to Ghana. Our host site- an engineering college also had a web site. Very happy looking students go there. December was my month for vaccinations and we had a conference between team members and Josh Wood, the IVU director. I was so busy doing everything BUT pediatric surgeries, before I knew it; our trip was two weeks away. I began my lists of things to get, things to do and now there are so many notes around the house now it looks like a post-it note factory exploded. I was able to get a least a few pediatric surgeries in before today, so at least I can operate with my surgical magnifying glasses (aka loops).
What I learned about Ghana-
It is in on the southern coast of western Africa, next to Togo and Ivory Coast. It is about the size of Missouri. Accra is the capital and Kumasi, where we are going, is the second largest city. Accra is on the coast and Kumasi north of there but not quite at the center of the country. It is a tropical place and some of the trees are the most ancient type of grass-trees. I hope to see sausage and baobab trees there. Elephants were once plentiful but are now gone. There are still a lot of snakes.
The ancient kingdom of Ghana was actually more north than the modern country and refugees from a bloody revolution in 1100 settled in present day Ghana and four of the original tribes are still present. Ancient Ghana was conquered by the Mali Empire, which was then overtaken by the Songhai kingdom. Eventually the Moors led by Prince El Mansur captured Ghana in 1591. The arrival of the Moors, led to a strong anti-Moslem faction and tribes were brought together, and the Asantes, an Akan people, became very powerful.
The Portuguese came to trade gold, ivory and pepper and then slaves. Eventually after Great Britain outlawed the trading of people, Ghana found economic success in exporting agricultural products such as palm oil, cocoa, cotton, rubber, and gold. Left to govern itself until the late 1800s, exports made some Ghanaians very wealthy. In 1872, Britain expanded its African colonies and went to war with the Asante people. In 1874 the British entered the heart of the Asante people, Kumasi, where a terrible bloody war ensued. The Astante confederation was broken and the king was exiled.
The British controlled the politics of Ghana and excluded any native person from holding any office. The only education was from missionary schools as the British government feared a revolution would occur if the Ghanaians received any formal education. This did not stop them from conscripting Ghanaians to fight with the Allies in World War II. Returning form war the feeling of the Ghanaians began to change. The United Nations was recognizing small countries and the United Gold Coast Convention was born from that came the leaders of free Ghana. In 1960, Dr. Kwame Nkrumah became the first president when Ghana became the first former British colony to gain independence. Ok so there were a lot of coups and rebellions and makes for a brief early history especially when I am reading from a few books at the seventh grade level.
So that is some of the basics. I have only started reading about Kumasi in earnest. So perhaps I will write about that next. My next post maybe from Ghanaian soil as we head to the heart of the Akan- Asante people.
~Stephanya Shear
I tried making a few Ghanaian dishes- Jollof rice and Groundnut (Peanut) Stew. The rice, well I need to work on my recipe. It was a thick gob of tomato and rice- I think too much tomato paste. The stew was good (Black beans, carrots, peanuts and tomato) but very rich compared to my usual diet. Dr. Schneck said he knows of a place that sells fried bat. I have eaten insects, but I draw the line at flying mammals.
The CDC site was also helpful (yellow fever vaccinations are required for entry) as well as a local travel agency that specializes in trips to Ghana. Our host site- an engineering college also had a web site. Very happy looking students go there. December was my month for vaccinations and we had a conference between team members and Josh Wood, the IVU director. I was so busy doing everything BUT pediatric surgeries, before I knew it; our trip was two weeks away. I began my lists of things to get, things to do and now there are so many notes around the house now it looks like a post-it note factory exploded. I was able to get a least a few pediatric surgeries in before today, so at least I can operate with my surgical magnifying glasses (aka loops).
What I learned about Ghana-
It is in on the southern coast of western Africa, next to Togo and Ivory Coast. It is about the size of Missouri. Accra is the capital and Kumasi, where we are going, is the second largest city. Accra is on the coast and Kumasi north of there but not quite at the center of the country. It is a tropical place and some of the trees are the most ancient type of grass-trees. I hope to see sausage and baobab trees there. Elephants were once plentiful but are now gone. There are still a lot of snakes.
The ancient kingdom of Ghana was actually more north than the modern country and refugees from a bloody revolution in 1100 settled in present day Ghana and four of the original tribes are still present. Ancient Ghana was conquered by the Mali Empire, which was then overtaken by the Songhai kingdom. Eventually the Moors led by Prince El Mansur captured Ghana in 1591. The arrival of the Moors, led to a strong anti-Moslem faction and tribes were brought together, and the Asantes, an Akan people, became very powerful.
The Portuguese came to trade gold, ivory and pepper and then slaves. Eventually after Great Britain outlawed the trading of people, Ghana found economic success in exporting agricultural products such as palm oil, cocoa, cotton, rubber, and gold. Left to govern itself until the late 1800s, exports made some Ghanaians very wealthy. In 1872, Britain expanded its African colonies and went to war with the Asante people. In 1874 the British entered the heart of the Asante people, Kumasi, where a terrible bloody war ensued. The Astante confederation was broken and the king was exiled.
The British controlled the politics of Ghana and excluded any native person from holding any office. The only education was from missionary schools as the British government feared a revolution would occur if the Ghanaians received any formal education. This did not stop them from conscripting Ghanaians to fight with the Allies in World War II. Returning form war the feeling of the Ghanaians began to change. The United Nations was recognizing small countries and the United Gold Coast Convention was born from that came the leaders of free Ghana. In 1960, Dr. Kwame Nkrumah became the first president when Ghana became the first former British colony to gain independence. Ok so there were a lot of coups and rebellions and makes for a brief early history especially when I am reading from a few books at the seventh grade level.
So that is some of the basics. I have only started reading about Kumasi in earnest. So perhaps I will write about that next. My next post maybe from Ghanaian soil as we head to the heart of the Akan- Asante people.
~Stephanya Shear
Preparing for IVU-Ghana Mission
Day before our Trip
Preparing for any overseas trip can be significant, but what every preparations I might personally be doing, it is nothing compared to what IVU has done. The work to prepare for any teaching mission starts with the planning and organization at the IVU office in Salt Lake City. And this could not happen with out the support of all our donors. This is not a solicited thank you, but honestly, I know what I have had to do to prepare for this mission and any teaching trip would not be possible with out the financial support of our backers.
Think about moving a house across the country- then think about moving a functioning operating room to a remote location. My own teaching hospital has a hard enough time having all the ducks in a row some days. I can only imagine the tough work Nate Cook our surgical tech, Stacie Pearce our recovery nurse and Brent Nelson our circulating nurse has been doing- instruments, catheters, tape, gloves, and even an autoclave. You name it, they has it worked out.
In addition to my preparing, the rest of the team is working hard. Our Team Leader Dr Fran Schneck went last year to Ghana. Going him this year is Dr. Bellinger and Dr Sweeney. Both Dr Schneck and Dr. Bellinger are faculty in Pediatric Urology at Pittsburgh Children’s Hospital. Dr Sweeny is their current Fellow. Also from Pittsburgh come our anesthesiologists, Dr Yang and Dr. Semenov. Me, I am a resident at University of Rochester and I was fortunate enough to obtain a travel scholarship from the IVU.
So that is our Team. With all the help from the IVU, we start off tomorrow to Kumasi Ghana to the Komfo Anoyke teaching hospital (KATH).
~Stephanya Shear
Preparing for any overseas trip can be significant, but what every preparations I might personally be doing, it is nothing compared to what IVU has done. The work to prepare for any teaching mission starts with the planning and organization at the IVU office in Salt Lake City. And this could not happen with out the support of all our donors. This is not a solicited thank you, but honestly, I know what I have had to do to prepare for this mission and any teaching trip would not be possible with out the financial support of our backers.
Think about moving a house across the country- then think about moving a functioning operating room to a remote location. My own teaching hospital has a hard enough time having all the ducks in a row some days. I can only imagine the tough work Nate Cook our surgical tech, Stacie Pearce our recovery nurse and Brent Nelson our circulating nurse has been doing- instruments, catheters, tape, gloves, and even an autoclave. You name it, they has it worked out.
In addition to my preparing, the rest of the team is working hard. Our Team Leader Dr Fran Schneck went last year to Ghana. Going him this year is Dr. Bellinger and Dr Sweeney. Both Dr Schneck and Dr. Bellinger are faculty in Pediatric Urology at Pittsburgh Children’s Hospital. Dr Sweeny is their current Fellow. Also from Pittsburgh come our anesthesiologists, Dr Yang and Dr. Semenov. Me, I am a resident at University of Rochester and I was fortunate enough to obtain a travel scholarship from the IVU.
So that is our Team. With all the help from the IVU, we start off tomorrow to Kumasi Ghana to the Komfo Anoyke teaching hospital (KATH).
~Stephanya Shear
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