1/17/11

We are leaving tomorrow evening to fly back home. We are all homesick and officially drained from the work we have been doing here. The past two days were enjoyable, we visited Cape Coast to see the slave castles (including Elmina) and paid a few dollars to visit the pool of a local resort.

The slave castles were incredible. It is amazing to think of the wars Europe fought over this coast line in order to secure their position in the slave trade. Everyone should visit Elimina once in their lifetime to get just a shade of understanding for the power of evil in this world. One thing that stuck out to me was how slaves were kept for three months in a very dark dungeon with little food or water. Unable to leave their cell, they had to manage in their one small room with two hundred others. The tour guide taught us how even today, we could test the soil under our feet and find evidence of blood, vomit, feces, etc, on the ground.
 
This morning was difficult. One of the girls was unable to find her iPhone last night, and the ten of us students turned her room inside out looking for it. The room got turned over again this morning, and then it was finally reported missing to the desk. The cleaning/support staff was brought into the room and intergated by our guides and the manager. Yelling and screaming erupted as people started making accusations. The manager, and our guides, pressed the support staff to come forward and get it over with. We just wanted her phone back and to move on with our day.
 
No one came forward. The staff was starting to get angry with us and even approached one of the other girls, raising his voice. All the while people were screaming back in forth in their local languages. One of our girls happened to come across a bag that looked funny, opened it, and found a bunch of items including: my bathing suit, one of the girls People magazines (adressed to Billerica, MA), and her headlamp. All these were stolen and we never realized it. The bag belonged to the mananger, who was the same person who was accusing his staff as thieves.
 
One of our guides grabbed the manager around his beltloop and threw him on the bus. We were heading to the police station to get this guy prosecuted. I went with the bus, Val & Maura, our guides, and the girls who had things stolen from them, to the local police station. After interrogating the manager, and him admitting to it all except the phone, we could either 1.) stay and press charges 2.) have them pay us for the stolen phone and return the items.

We are leaving tomorrow night, so we drove back to the hotel with the police inspector.  The hotel director showed up and reluctanty handed us 600 Ghanian Cedis, which is less than we requested-and much less than we spent to stay there for two nights. The manager is apparently related to the director, and has been working their for eight years. I bet you he will still have a job tomorrow.

We all piled into the bus with the detective, criminal, guides, students, and teachers for the station. Val went in with the guides, the criminal, and the cop. We made it clear we did not feel fully compensated. The icing on the cake was that the detective asked for bribe when they went back inside to finalize the report. Val immediately took the student, the guides, and we left. We did not pay the official and contribute to the corruption and just left the Gold Coast.
 
We never got that bag of stuff back (bathing suit/magazine/headlamp) and who knows how far the 600 Ghanian Cedis will go towards offsetting the expensive phone, we should be thankful for getting out of there without a larger crisis. No one threw a punch, and no one had a heart attack from screaming. This event is such a shameful way to end our trip. I haven't had the chance to write about 98% of the wonderful experiences the Ghanians have shown to us. You wouldn't believe how wonderful these people are. Our guides mean more to me than ever before. They advocated hard for us, took us through the difficult situation, and seriously fought for us. The people who work through Africed are truely noble and wonderful human beings to help us in their home.
 
We are glad for this trip to come to an end. We all gave so much to come here, gave so much while we were here, and are still asked to give more. Today we stopped someplace, and while I was waiting to use a bathroom (that had running water!), a young boy came up to me and just said: "give me something." Everyone looks to us like we have bank accounts with endless money. Now at the end of our trip when we are completely empty, still their is infinite amounts of need. It is discouraging when we have to deal with issues like corruption in addition to the emotional drain of seeing the poverty here.
 
So tomorrow we check out of the hotel early, and will try and get some shopping in to buy gifts for everyone back home. We will leave Accra around 2300 for Washington DC, then we will end up at Logan Wednesday morning. I am most looking forward to being back in our culture back home.

I want to be back to our standard of living with a bunch of Bostonians-though I feel guilty for leaving Ghana when so much is needed. I plan on getting a roast beef sandwhich when we land in DC, to get one of my only real meals in for the past two and a half weeks. We start school in seven days, and will be graduating this May. This trip has been the most important experience of my time at UMass Lowell, and I hope to find more time to write later. Thank you for your readership. I hope whatever I write has helped to inform our loved ones back home information about our status and will encourage future giving to those in need.

1/13

It is Thursday morning and we are prepping to do a blood pressure clinic and make donations to the local hospital today. We have been in Kpando for about three nights and we are starting to get used to life here.

Shortly after we arrived here, I asked one of our guides what previous groups of nursing students did that had the most major impact. I was expecting the former nursing students made big strides through teaching and donations, but my mouth fell open when he said it was our compassion. He said Ghanaian nurses do not have the same compassion and caring that has been a part of American nursing for generations.

Our observation in the local hospital was eye-opening. It would be inappropriate for me to cite short-comings in their hospital model if I did not say they did a lot with very little. There were some very sick patients in the hospital, such as a women who presented with a perforated appendix or the severely sick children with end-stage malaria and HIV.

The interaction with the patients left all of the nursing students sick to our stomachs. While I can say some of the healthcare providers treated the patients with respect and dignity, we saw a lot of terrible things. We watched a woman get a c-section only to have the Spanish-speaking doctors verbally assault her in a different language, a midwife screaming and slapping a patient while she was vaginally delivering her baby, and many patients with dry IVs and no fluids at the bedside who were exibiting signs of dehydration.

It is hard to find our place here. Taking in cultural considerations and the fact that we are visitors, making suggestions does not seem possbile. Our suggestions do not seem to be welcomed. While we may seem like all-knowing visitors, our comments are intended to benefit the patients.

American nursing standard of practice is to be advocates for the patient. We are charged with keeping the patient safe and in the best possible state of health while in our care. This means we question the care the recieve, strive to provide the best, and struggle to implement changes for the better. Every time we ask why the doctors abuse the patients, healthcare providers screaming and hitting birthing moms, or patients being neglected and being withheld fluids, we are advocating for the patient. This practice is so fundamental in nursing care that the absence of it is sickening. This is why we find ourselves either intervening in into awkward situations, or leaving the room in frusteration - and even sometimes in tears.

We met an American nurse in the US Embassy here. She said that she originally went into developing nations to provide healthcare, but got tired of "slamming her head against the wall." We met her a few days into our trip, and I think now we understand what she was saying. Our medical and nursing models just seem so different, though I am trying to focus on the fact that no matter where we are from, we are all here for the patient.

I have to leave and post the blog entry stat, as we are about to board a bus to a small, poor fishing village. There we will be screening blood pressures, passing out some medications with our family nurse practicioner, and basically trying to provide first-line care. Honestly, besides bringing down dangerously high blood pressures (some were above 220 systolic), one of our biggest goals in bringing compassion to the patients. We focus on our eye contact, touch, comforting words, etc, to provide for these patients. Many of these people have never been touched by a healthcare providers, and seriously need just the phrase: "your heart is strong and you are healthy."

I will try to write as soon as I can.

 

Today we implemented our Community Health projects in Ghana. We take a Community Health course during our senior year at UMass Lowell, which teaches us to be a nurses outsides the halls of the hospitals. While still at home, my group of four assessed a small village, decided their largest problem was malaria, and provided teaching and supplies to mothers with young children. Our setting was a small village out in the Volta region, which is eastern portion of the country.

Our intervention went extremely well. Through the use of a translator, we were able to interact with mothers to teach about malaria, prevention, treatment, and usage of a bednet. They were all taught to use thermometers to assess their children for fever, and many left with either a thermometer, a bednet, or both. While we asked for only twenty mothers, closer to forty came to the classroom for teaching. While we could not provide equipment for everyone, at least everyone was able to leave with knowledge. We gave bednets to mothers with the youngest children first when we realized supplies would not be sufficient. While I am upset that not every mother could leave with a net, none of the mothers had or could use a net prior to our lesson. Tonight thirty families will be protected from a potential fatal disease due to our being here. That is a very powerful feeling.

Our debriefing/evaluation was done with our group leader, Maura, who is currently in her third visit to Ghana after her daughter started NSWB three years ago. My group and her were sitting outside the classroom where we gave our presentation discussing what went right and wrong. While it is academically, professionally, and even socially, pertinent that I sit there and engage in the conversation, I was completely not paying attention. It bothered me they could.

We are sitting in a small village, hours away from the capital, with no running water, no sewage systems, no internet, little electricity, thousands of miles away from home, teaching an extremely under serviced population through nursing. The town, a part of Peki, it situated at the foot of one of the many mountains in this region. From where we were sitting, I was watching a group of Ghanaian children playing soccer under the shadow of a the mountain, with even younger children curiously poking their heads around corners to catch glimpses of us American visitors. This trip is completely surreal.

Not many people are lucky enough to be in this situation and have this type of impact. I am completely humbled to be in a profession where I can better the health of people from all across the world. While I have taken care of hundreds of patients back home, I cannot believe I can fly across the world and serve people here.

Our group of students and instructors talk a lot about how our pictures cannot justify our experiences over here. It doesn't matter how many megapixels my camera has, how big the memory cards get, or how eloquently I can write and express myself. If you have not visited this wonderful country: you have no idea what we are experiencing. While we are only a week into the trip, the growth is monumental. We are developing professionally as nurses in addition to our emotional, social, and personal character. And let me again thank everyone person, and organization, who has come through to help us get here. Our parents, friends, faculty, employers, strangers, and more, have all contributed to something extremely special. You have a share in the responsibility for everything we do and become over here, and that may be one of the greatest legacies of all.

After sitting for nine hours from Washington DC to Accra, none of us knew what to expect. After the seatbelt sign blinked off, everyone stood up to grab our carryons, and they opened the doors. Immediately the heat hits you. We were led into the heat, right onto the tarmac. There was no gate or anything, just a short walk into airport to go through customs.

Surrounding the runways were trees, and the sky was filled with haze from the dry season. There were no buildings poking above the horizon line of the trees. I was struggling to pull my sweatshirt off while I pulled my yellow fever vaccination card out so I could enter the country. I was nervous about how I would be greeted at customs, but walking through the door I saw Christmas decorations still up. There was red and green fabric everywhere in the airport, and we've seen pictures of (African) Santa Clauses throughout the city. I was so happy to see one of our guides at the airport who led us through customs while he was barking orders in a walkie talkie.

Leaving the airport felt so surreal. We walked out of this huge building with nothing across the street. Beyond the parking lot, it was all trees. I am used to Logan, where real estate is pricey for the surrounding fifty miles and completely over-developed. Maybe this observation will not come accross in prose, but the cultural shock is astounding. It is rare to see a building above two-stories. It felt like I was watching a movie from the first-person. This is truly a very different continent.

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