Entries tagged with “Ghana” from Nursing Students Without Borders

This is the first entry of my 2011 BLOG about Nursing Students Without Borders trip to Ghana.  I wrote a series of entries last year and I think they are still available to view.  There will also be a student BLOG written by a few students and I encourage you to read that at http://blog.uml.edu/nswb/students/  They will have a wonderful stories from a student perspective.

I must begin this journey by saying thank you to all of the people who helped us get to Ghana.  Of course top on the list are the families of the students and my own family who have put up with multiple fundraisers and meetings. None of us could do this without the strong support of our families.

University of Massachusetts Lowell has been very supportive. It would take me many pages to write accolades about everyone but I wanted to specifically thank Chancellor Meehan, Provost Abdelal, Vice-Provost Pierson, Dean McKinney of SHE. Christine Gillette, Karen Angelo, Elaine Keogh, Jeanne Keimig, Shaun Sullivan and most importantly Dr. Karen Melillo and all the faculty of the nursing department.  My colleagues have been very supportive of my efforts and those of all the students on this trip and previous trips.  As the politicians say, "it takes a village to raise a child" but I would like to alter that and say "it takes a village to educate a student."

My own church family at Central Congregational church in Chelmsford has been very supportive with prayers, encouragement and monetary donations to help further some of my special projects in Ghana.  We have had other church donations and I would like to thank the Lutheran church (Redeemer) in Woburn as well as Tewskbury Congregational Church.  These donations help us to truly make an impact on the people in Ghana.

I leave Massachusetts in a little more than 24 hours. I leave tomorrow with ten senior nursing students. We will be gone from January 2- January 19th. There is still much packing and preparation to do.  I am again joined by my friend Maura Norton from Chelmsford who is a UML alumna and has made this journey with me the last 2 years.  We have learned so much about the needs of Ghana but also how sometimes just a small little effort on our part can make such a huge difference in an individual's life.  We are truly blessed to live in America but I am fortunate to be able to travel to another destination and see another way of living and hopefully by my actions and those of my students be able to make some lasting impact in Ghana.  

Stay tuned for more stories and updates of our travels.  Sometimes the stories are joyful, sometimes they are sad. They are the story of our Ghana trip.

Today we are schedule to go to Nkonya.  This is the village that I fell at last year and suffered a nasty abrasion to my leg.  It took a few months for the scar to go away but I remember that village very distinctly.  It is extremely poor and has no source of regular medical care.  There is a clinic that is almost completed but the government does not have the money to support staffing and supplies. 


Today we are doing some preliminary work in preparation for our HIV education program and testing that will happen tomorrow.  Every action we take seems to require a lot of preliminary work before we can begin.  We must make our introduction to the community. 


There is a funeral happening to day. The town is very active with families dressed in black and red (traditional colors for funerals). We break into 4 teams and the students are advised to give out condoms and any related teaching to the men and women and young adults that have questions regarding the condom use.  We have been told that this community has a very high incidence of HIV. Because of the poverty many of the young girls are lured into being sex workers and often acquire HIV.  They bring these diseases home to their community and then infect the men there. 


There continues to be a huge social stigma for HIV.  People do not want to know if they are HIV positive because once you are a known HIV infected person you are shunned from the community.  It is not just you who suffers but your whole family suffers from the stigma.  So what happens is that people refuse to be tested and often if positive will refuse treatment. Last year we conducted an HIV testing clinic and one woman was found to be positive I was the one who had to tell her that she was positive.  I have learned today that she refused to acknowledge her diagnosis and would not take the antiretroviral medications.  She is dead now for a few months.  I recall her as a middle age woman with no other medical issues. 


The UML students last year did an HIV program for the youth and this year’s students will be doing a similar program.  It is hope that if we educate the youth then they may be more likely to engage in healthier behaviors but also serve as advocates for the people in their community.   


I am lead by Patrick who remembers me from last year.  He is a community leader and all of our negotiations have to go through him. He has also informed me that another patient that I told had likely advanced breast  cancer last year has died.  There is no such thing as regular mammograms for the women in this region.   I am a bit heartened to hear that one of the patients that I saw last year with an enormous rectocele has been seen by a physician and she is much better.  I don’t think she had surgery but she is in front  of me and appears well. He tells me that she was inspired to see the doctor at the hospital because I told her to go. 


We break into 4 teams and go into the village to distribute condoms and check BP.  At every home they are desperate for any thing you can give them.  I have some Tylenol, Motrin and vitamins that I give out if necessary.  Even if they have no pain or hypertension they want medication.  This is a real big problem here. They want to take the pills short term to solve the problems but are not willing to make the long term lifestyle and sanitation changes that need to be made for overall improvement in their health.   It can be discouraging to see so much need and to realize that we are only making a very small dent in their existence. 


Patrick has many needs and wants me to help him find a medical provider that will stay and work in their clinic.  I struggle with the notion of foreign countries providing aid to these people when their own government needs to make sweeping changes to ensure that there are personnel and supplies available to provide care.   I am taken from home to home to home and the story and the people are the same.  We are supposed to meet with the chiefs but I don’t believe that will happen.  They have had a big funeral  today and many of them are at that ceremony.   


As word gets out in the village that nurses are in town the number of patients amazingly increases about 10 fold.  At every corner there is a cluster of patients wanted some of this ‘free medical care.” At one point we have to physically be directed to our awaiting Tro tro to go home. Tomorrow we return to Nknonya for the HIV program and another stationary BP clinic.  I am dreading that day because I remember last year and it was a mob scene. 


By Valerie King

Today is my first day at Margret Marquat Hospital.  For those that know me this is not my area of expertise.  I am a community based nurse. I am much more comfortable going from hut to hut than to try to serve a purpose in an acute care hospital.  I had hinted at my desire to stay at the outpatient health center but Maura thought my assessment of the nursing care at the hospital would be helpful. 

We have been asked by the new medical director, Dr. Lucy, to do an evaluation of our experience at the hospital.  She wants to make some changes so our input is solicited.  We are treated very kindly by the nurses but there are significant deficiencies in the nursing care that goes against everything that we have been taught as an American Nurse.  The contents of our report are too lengthy to go into in this Blog but suffice to say patient safety, infection control and issues related to competent and compassionate nursing care were some of our biggest observations. 

Later on this evening I created with Maura and the students, a 4 page document that we will use to present our findings to Dr. Lucy.  I am reminded of the comments of my teacher and friend Dr. Geoff McEnany-Phillips when he taught me about evaluation.  It is important to be truthful but we have to be mindful of the stakeholders in this situation and try to present our findings in a thoughtful and professional manner. We create the document over a bottle of wine and with very insightful comments from the students.  I am not sure how Dr. Lucy will use the information but we felt it was our duty to be advocates for the patient but also to help promote professional development of the nurses in Ghana.

To help with our goal of professional development I gave a 2 hour lecture today at the Kpando Health Center on a few topics.  I presented a lecture on the assessment of the geriatric patient and also diabetes mellitus.  The audience of mostly nurses but some other staff seemed to be very much engaged with the lecture.  I had to slow my rate of talking and to try to use appropriate and understandable terminology.  I tried to lose my New England accent. 

The time flew by and I was encouraged by the thoughtful questions that were asked by the participants.  I have truly come to respect these Ghanaian nurses.  They work with such limited resources but have such potential for improved care if only they are given the education.   Throughout my lecture I keep repeating that they have incredible power as nurses to make a difference in their patient’s lives.  I think the nurses could play a larger role in the care of the patients but am limited in their knowledge and sense of responsibility when it comes to patient outcomes.  I pretty much told them that they are much more important than the doctors (my apologies to my physician colleagues).  I think there is a vast difference in the way that Ghanaian nurses and American nurses are educated based on my observations.  

I would like to see these nurses claim their autonomy and professionalism.  Change comes slowly.  I think having the UML nurses work with them opens the door to comparisons, questions and emulation of behaviors.  We have witnessed an obvious change in the demeanor of the patients when the UML nurses address them with respect, touch them and provide the level of compassionate care that is the trademark of the American nurse. I have such personal pride in the accomplishments of the student nurses from UML.  We have had many thoughtful conversations at night about the comparisons of the two countries and their ideas for improvement.  I am proud to be a graduate of UML and I am equally proud to be a nurse educator who will have a role in creating the future American nurses.  I will end now on that positive note.  There are still many more stories to tell but again I am burning the midnight oil and tomorrow is another busy day. 

"Tears, Smiles and Tears"

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By Valerie King

Today we are scheduled to go to the Hohoe Christian Children’s Home. Before we leave Kpando we have become aware of another acute public health problem. We drive a very short distance behind the health center and we are in a small village.  We depart from our Tro Tro (which appears to be held together by not much more than duct tape and rust).  We are visiting a watering hole. We trek into the woods about ¼ mile along a rutted path and we meet many people, mostly children, coming out of the woods with various water containers on their heads. It is amazing that these people have to walk such lengths to get their water. 

Our true shock comes when we come upon the watering hole.  There are actually 3 holes. The first one can only be described in one word. DISGUSTING.  It is a large hole in the ground filled with putrid green water.  We do not see people collecting water from this hole but we are told that people do use it if the other holes are low. We come to the second hole.  I have to tell you that the next part is pretty gross.  If any of you have the seen the movie The Ring you will recall that there was a deep well that a little girl was drowned in.  Well this “hole” is exactly like that movie and the saddest part of all is that over the last year six children have fallen in and drowned and only one body was recovered.  The other 5 bodies have sunken to the bottom of that well and supposedly not retrieved.  These families have to continue to draw their water from this well.  Part of me doubts this story but if it is true I can only imagine the anguish a mother must feel as she has to draw water for the rest of her children from the very well that took the life of her other child.  The third hole is quite active today and surrounded by about 20 people who are drawing up the water using buckets and ropes.  You can see how a small child could fall into these wells and if no one was around there is no way to climb out.  It is a pure vertical cylinder of old stone. The village has been trying to get some funds to dig a bore hole but the government is not listening to their request.  They have asked for our help in this project.  We are unsure what we can do to help them but we will be visiting them on Saturday for a demonstration about boiling the water that they are pulling out of the holes before consumption.  We will see what the costs are for a bore hole.  This is a perfect project for our engineering students at UML and I hope to bring this to their attention.

After our walk out of the woods we load back into the Tro Tro.  We are like little sardines squeezed into a small tin can. Hohoe is about a 30 minute drive down bumpy roads.  We arrive at the orphanage to be greeted by the loving arms and hugs of 30+ children. They are all so happy and affectionate and give freely of their hugs.  One of the Community Projects is implemented today with the orphans. 

The UML students are presenting a dental health program today.  They have donated samples of toothbrushes and paste and have developed a whole program that is flawlessly implemented for the attentive audience of children ages 3-15.  It is interesting to note that even the older children are interested in the coloring pages that are given out. They do not consider them to be juvenile and my impression is that they are sweetly naïve to all the usual American teenage angst.  I am joined at the hip by my new “son” Francis.  He has stayed with me all day today and at our previous visit.  The founder, Nicholas is married to an Australian woman who is back in her country for a Christmas visit.  She is a white woman and I think the children are missing their white mother.  I am missing my own children so it is a nice way for me to give and receive affection.

There is a cute little three year old girl named Lee and she has a very obvious bald spot on one side of her head that appears to be a healed burn.  We ask for her story and it is the most tragic story I have heard yet.  She is from the region of Tamale and has only been in the orphanage for about a month.  She used to live in a village that was very superstitious.  Her parents died, of causes unknown to me, but her grandparents believed that this little girl is a witch and she is to blame for her parent’s death. They chained her and starved her and burned her head with some type of hot metal to get rid of the witch. She was found by a census worker who rescued the child and gave her to a Peace Corp volunteer who in turn brought her to the orphanage.  You can see the fragile bones of this dear child who appears to be thriving in this caring environment but one wonders about post traumatic stress disorder and what type of psychological issues will arise for her in the future.  She is affectionate and loves the clothes and underwear that we have brought with us.  This horrific story has me near tears.

The young boys seem to gravitate to Maura and me probably because we are mothers.  They want to tell us about themselves and share their colored pages with us.  My buddy, Francis is staying close to me and insists on carrying one of my bags. We take multiple pictures and I cannot wait to load them onto the BLOG site.  Our Tro Tro arrives and the children hover around us. Francis is holding tight to me and crying into my shirt.  It breaks my heart to leave him but I am not in a position to take him with me.  I would like to continue to communicate with the director and hopefully Francis will write to me as he has promised he would.  There are so many children here who need a home.

My day ends on a bright note.  I have been able to use my own laptop in the internet café and the access seems a bit quicker.  I have been feeling a bit lost without communication from friends and family and I hope it will improve a bit.  It is now about 11:30 pm and tomorrow will start early so I will go to bed now.

“Sunday is a day of rest”

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By Valerie King

After our lack of sleep last night we are a bit sleepy today and I think many of us could use the rest.  We wanted to go and visit the Fesi Pottery and the Lourdes Grotto today but there was some confusion in our schedule and it never happened. We had also hoped to see the children drummers from the local church but that also did not happen.  I did some administrative work for NSWB and around 2 pm we walked to the local carver, Papa Bones and Billy the Tailor.  The students are buying and ordering some wood carvings and also getting some fabric for dresses to be made. The day is quickly passing and after a brief session at our meeting spot across the street we make the 1+mile hike to Shine and Bernard’s house.  We have been invited to supper.  The students are amazed that Maura and I made that walk every night in the dark.  It is treacherous in the beginning due to the auto traffic and treacherous at the end due to incredibly uneven terrain.  I am again amazed at the air quality here. It is such a poor quality due to burning and engine emissions.  We are all feeling in our lungs and most of us have a dry cough.  Our clothes and hair seem to absorb these smells and there is a huge drying effect upon our hair and skin.

 We have a great meal of Pasta and Sausages which reminded me more of a spicy Pad Thai and fried Kielbasa.  We are all very weary due to poor sleep last night.   We leave and journey back home.  I try to take some of the walking time to get to know some of the UML students a bit better.  They are all lovely so far and I am enjoying my time with them.  We walk past the dim and dirty shack where Hannah (age 6) Michael (age 10) and their mother Edith.  We have gifts for them and we bring them to their home.  They are so appreciative. Edith wants us to take pictures of her officially receiving the gifts.  She is also talking about a plan that she would like us to set up a school in her village which is further away.  We are constantly overwhelmed by needs that this country has but we tell her that we do not have the resources to start a school. 

As I near our guest house I have one last stop.  I must meet with my new friend Foster Dominics, who is trying to enroll at UML in the nursing program.  I have given him some admission information and he has to wait now to take the SAT and TOEFL test. That will not happen until December 2010.  Until then he plans on working and saving money for his dream to get a US education.  I told him I can assist him with making connections in the US but I cannot be a financial sponsor of his education.   He is a gentle young man that appears to have the intellect and desire for a nursing education.  He has a twin sister, Fostine and his mother died about a year ago.  I told him I will do whatever I can to help him with this processs.

As I type this my eyes are very tired from lack of sleep and also the effects of the smoke in the air.  I am going to bed.  Tomorrow is our first day in the clinic.

We drive a bit through Accra but the hour is getting late and we are hungry, hot and tired.  We are taken to Frankie’s which was the local restaurant I went to last year on my last day in Accra.  It has wonderful American type food and I am thrilled because I know this will probably be my last Diet Coke for a while. 

We are brought to a newly renovated hotel in Accra. We drive down a rutted dirt road and I am questioning the locale as safe destination but soon we drive into a courtyard with brick pavers and a hotel that has obviously undergone some recent renovations.  We are surprised to be treated by private rooms for each student.  The rooms are clean and new sheets, bathrooms and best of all, air conditioning.   After carrying in our 44+ boxes and suitcases we retire to our rooms for a long awaited shower and rest.   I guess the water fairy is not on my side again this year because I have a lovely bathroom with new tile and sink but no running water.  I sneak down to a student room and after trying 3 different rooms I finally find one room with a trickle of cold water.  At this point it feels like a luxury and I quickly shower.  I hope this is a minor plumbing glitch that can be resolved in the morning.   

Prior to my shower I start to give out some of my gifts to Kwadwo and his wife (who has joined us tonight).  I have given him a used laptop for which he is very grateful for.  It will help him with his work with AFRICED.  I am feeling bad because it is a few years old and not too fast.  If anyone has the inclination to donate a newer or new laptop to AFRICED I would be happy to arrange for shipment to Kwadwo.  I will tell you more about AFRICED in another entry.  

I reflect upon the day’s events that we have experienced.  Some of the sights, sounds and smells are the same. A few of the roads appear better but then very quickly they deteriorate into a rutted dirt road.  Ghana is making progress but it is sporadic in some areas.  We are stopped by the local police at least 5 times as we travel to our hotel.  It is a bit unnerving to be stopped at a roadblock with police in combat fatigues and large rifles on their shoulders.   It is the Ghanaian form of police oversight but it feels a bit weird to be stopped and have the flashlights shinned into the vehicle. 

I have had a conversation tonight with our new friend, Nicholas, from the Education Ministry( I think he is some sort of protocol officer).  He is trying to educate me about the relative safety of Ghana but also some of the traps that are present for the obviously white tourists.  I am encouraged again by the attention that NSWB has garnered from upper levels of government here in Ghana.  There will be more to report on that later. 

We also met a Ghanaian woman in the airport in London who is a nurse at Johns Hopkins hospital.  She is home for a holiday and has invited us to come to her home.  I am reminded of the friendliness of the Ghanaian people.  This woman, who is a stranger to us has just invited 11 of us to her home.   I also am reminded of the poverty as the people swarm our bus as we disembark and try to ask us to purchase little trinkets or just to give them some money.  It is a bit of a shock for the students to have this so visible on their first few hours in Ghana.  The students will have many more eye opening experiences and I can see them trying to acclimate to this type of human suffering that is not so apparent in their comfortable suburban life.

The halls are quiet. It is about 3 am and I need to wake up by 7 am for a 8 am departure.  I am sure my body will crash sometime tomorrow.  All the students are in bed and I am now going to sleep myself.  Tomorrow will be a busy day and I will have a second entry later on tomorrow as long as I can stay awake to write it later tonight.

Leaving on Jet Plane

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We are leaving today from Logan Airport to go to Ghana.  Please check back later for a posting about our trip and the begining of this blog.  Don't forget to look to the tab on the right and check out the student entries to their blog. More to come..........

Valerie's Story

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So the journey begins again for me.  I am again traveling to Ghana Africa.  Many of my close friends and family wonder at my decision to return.  I made the journey last year and it was an incredible experience but not without some challenges. The assumption last year for my friends, family and yes even for me was that I would probably not return.  For me it was” been there, done that.” 

As time elapsed after my trip I had a chance to reflect upon my experience there was a seed that was planted and it grew very slowly.  That seed was “are you going to go again?" I will be honest with you and tell you that I did not nurture that seed.  I hoped that someone else would take that seed from me but like a dandelion weed, even when deprived of water and nourishment seems to grow.

So after some soul searching and I decided to return to Africa.  I feel that we (UMass Lowell) made a commitment to the people of Kpando and surrounding villages that we would return.  If I returned with the new group of students we would be fulfilling our commitment to them.  

Last year I vividly recall a ceremony with some of the village elders (the Chiefs) of Nkonya.  It was a very symbolic moment marked by speeches by the chiefs and a UML student and the ritualistic consumption of Schnapps.  Their comments to us were that many groups have come to their village but not too many return.  I saw that ceremony with us as their effort to solidify the relationship and encourage a long term relationship.  

This has stayed with me and this is one of the big reasons that I return.  I will have new stories and insight this year.  Part of me is dreading some of the living conditions because it is not the nice comfortable life I live in at home. The other part of me is looking forward to seeing how this trip can be even better than last year.  It was life changing for me and the students last year and I don’t expect this year to be any different.

I sent email reports back to family and friends about my experiences.  This helped me sort thru my emotions that I was going thru and was a great way for me to document my trip.  The recipients of the email stories told me that they read each entry with interest and requested that I do the same thing this year.  I have decided that a more efficient way to do this is the have a BLOG (which you are reading now).  

This will be like my personal journal and I am sure throughout this journey you may see me in a different light depending on my words and recollections.  Comments are welcome but please note that they will be read by anyone who reads the BLOG.  I also hope to be able to download some photos to go along with my stories. The internet accessibility and speed is not very good here.    Lastly, I try to give a title or theme to each of my entries.  Last year I had “Toto I don’t think we are in Kansas anymore” or “Mr Toad’s Wild Ride”.   It helps me to keep my creative juices going and I had a blast trying to think up the themes or titles.   

I wanted to thank all my friends and family for their support during the planning process and now while we are away.   I hope to say a bit more in a later entry about some of our generous donors and their stories.      Thanks for being interested in the BLOG.   Feel free to forward the link to anyone whom you think might have interest    The link to the site is  http:// www.blog.uml.edu/nswb

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