Friday, February 27, 2009

Project HOPE Volunteers Work with Stroke Victims and TB patients in Ghana

It’s funny how short days can turn into long days. Today we set off in our usual way to the different hospitals but we knew we would also be leaving early. Due to the USS Nashville’s schedule in order to get cash cards, the only way to buy items in the store or vending machines on board, we had to come back to the ship early. I thought this would be a good opportunity to hang out with Beth in the physical therapy unit. I am not sure I have mentioned how big the Effia-Nkwanta Regional Hospital (ENRH) campus is but there is one tall hospital building on a hill and below and around it there are other units attached by walkways. It is rather easy to get lost on the grounds and Beth and I spent about 20 minutes looking for the physical therapy unit but we did finally get there. When we arrived Mavis the local physical therapist, one of two, was working with a girl who looked to be about 10 years old but was actually 18. She was having trouble walking. Apparently the patient has sickle cell anemia which caused her poor growth.

A short time after another patient came in, a 44-year-old woman. She had had a stroke six years ago—many have noticed that people in Ghana seem to have strokes at a young age. She was complaining about pain in her back, neck and arm of the right side of her body. Beth started by asking her questions and testing the woman’s strength but soon the woman was complaining of pain everywhere and Beth was massaging her neck and back because the muscles were tense. Then the woman revealed she had fallen on her right side not too long ago but it was still a bit hard to pinpoint what was wrong. Finally Newton, another PT, came into the exam room and told us he had seen her before and that she was a patient who always came in with the same issue, her whole body hurts. He kind of hinted that she just liked the attention. Beth gave her some back and arm exercises so she could ease some of tension in her back.

The next patient that came in was accompanied by his son. The dedication family members have for their ill relatives is quite humbling. Sometimes they come from hours away just to help them with their physical therapy and spend hours in the gym with them. The pateint had a stroke and could not move his right side. He was still mostly paralyzed so he could not walk without assistance. Mavis brought him over to the bars and she and Beth began essentially showing him how to walk. Beth tried to emphasize that he use his pelvis to move him forward before he stepped. He would step with his left and she would position his pelvis forward and he would take a small step with his right foot.

Because the team is so spread out between the two clinics and the ENRH campus I have begun to give them each a slip of paper in the mornings that they can fill out about their day including unique experiences, prevalent diagnoses etc. I hope these can help me capture some of the things I miss as I move around both hospitals.

Donna Featherstone, an ER nurse from Southern California, is volunteering at the ENRH. Today while working in the ER a 28 year old man with TB came in. He had been abandoned by his family and practically had to be carried in. Perhaps he was abandoned because his family couldn’t afford to pay for his treatment. He was sent to the ER for a blood transfusion. Donna saw he really needed treatment fast so she convinced a Cuban doctor who is working in the hospital to see him so that he could be admitted to the isolation ward of the hospital for treatment. Now the patient may get treatment for his TB. Donna also saw a patient with a snake bite today.

So that was the short part of the day. What made it long was what happened after the hospital work. Because we had a little time on our side we decided to go out to dinner. We ended up at the Africa Beach Hotel and hung out a little, even though I probably should have come back to the ship to do some work but I didn’t know our dinner was going to take 2 hours to arrive. The restaurant was incredibly slow. By the time we got back to the ship it was 8:00 pm. I had some errands to run on the ship and was also informed that tonight was the night for Project HOPE laundry. I don’t think I have mentioned that because of a water shortage on the ship we haven’t been able to do laundry because it has been secured. They have also turned off the water during certain hours. So everyone rushed to get their clothes washed in the only two washers and dryers we had to use. Needless to say I wasn’t first in line so my laundry didn’t get done until 2:00 am. And to top it off the laundry room is located up four flights of stairs. It’s times like these when I am grateful for what I have at my disposal at home and I give credit to those who live on the USS Nashville for months. I am not sure how they do it.


Thursday, February 26, 2009

Project HOPE Volunteers Begin Work in Ghana

These missions require some adjustment for Project HOPE volunteers including learning to live in small quarters, learning to love stair climbing and also learning to work on military time. What I mean by military time is the hours they use, 24 instead of 12 for the am and 12 for the pm, and also their really early rise and meal times. Hot breakfast is from 6:00 am to 7:00 am and you miss a nice, warm breakfast of things like eggs, bacon or sausage and sometimes French toast if you show up late. Also, dinner is from 4:00 pm to 5:30 pm which is probably early for most people. However, this schedule has been great for the volunteers as their work day hours, 8:00 am to 4:00 pm, seem to work well with the Ghanaian health workers they work with. Also, the whole APS team has been super accommodating to us and helpful.

Project HOPE volunteers began their first day of working side-by-side with their Ghanaian counterparts today. Although we all seemed to make it to breakfast on time we fumbled a little because our drivers were late and Michael was sorting medications this morning to take to both locations. Michael, like he did last year, brought some medications with him. He is an expert on tropical diseases, having traveled to many countries like Ghana to provide care to the communities. But they still made it to their locations and seemed to all have a great time. The people in Ghana are as friendly and lively as I remembered them from last year, so our volunteers are bonding really well with their counterparts.

After making sure everyone was on their way, I went with the second group to Essikado Hospital. This is a relatively small hospital that does see some emergency patients and also women in labor but functions more like a clinic. When we arrived we were taken to the hospital administrator’s office and met with the administrative staff and also the head doctor, Dr. Paul. They all seemed excited to have us there and asked where the volunteers would like to work. Dr. Paul seemed especially excited. Essikado is a 24-hour facility with two doctors, one dentist and an x-ray tech that doubles as a radiologist. After the meeting the volunteers were given a tour and lead to where they would be working.

Meanwhile, I went to go run an errand in the city of Takoradi. The goal was to purchase cheap phones for use while in Ghana and also the kind that can be used worldwide so we could keep them for Project HOPE and reuse them. We went to this area where lots of people, hundreds, had little shops along the roads and whatever other empty space they might find. They sold everything from shoes to jewelry and cell phones. The place is buzzing with people shopping, selling and also on their soap box. Along our route there was a gentleman, whom I couldn't understand, speaking excitedly into a microphone about something? I imagine he was either preaching or talking about politics. After trying to bring the prices for each phone down to 30 Ghana Cedi at three different stores we settled on two phones each for 40 Ghana Cedi. The same phone would have been 20 Cedi cheaper in Accra but we tried to bargin with multiple locations in Takoradi and could not get the same price.

When I got back to the Essikado hospital it was hard to find the volunteers. I should have gone on the tour. The first volunteer I found was Marina Rivera, the x-ray tech. Marina is a very fun person. She's pretty laid back and really enjoying sharing her knowledge with the x-ray techs she works with. This is her second mission with HOPE and she is very proud to be HOPE's only x-ray tech in the volunteer database. When I approached the x-ray room, I saw a light sign to the side of the door that lit up when a x-ray was being done so no one would walk in and even though it was off I still knocked because I just wasn't too sure. I found out later that the sign doesn't work so knocking was a good thing. In the room Marina introduced me to the x-ray tech. His name is Prince and he has a smile that just lights up the room. He's probably in his late 20's. Prince works everyday of the week but no weekends. However, he is on call since he is the only x-ray tech. Because the hospital is open 24-hours a day he is also on call every night.

The x-ray room at Essikado is nice. Their equipment is newer and works. Marina took the time to show me around and talk to me a little about x-rays and how they are made. Marina is not only going to be helping x-ray dental work she is also going to be helping Prince with the positioning of patients for the x-rays among other things.

Although the air in the x-ray room was really nice I went to find Lara, the midwife. As I was looking for her I ran into her and Michael. They had just assisted in two cases so I followed her to her next stop—the labor unit. The labor unit at Essikado is very small. The women who have had their babies were in a room next to the labor room, which only had two beds. When Lara began to work there was only one woman in the labor room. In Essikado they deliver close to 80 babies a month or three a day. The woman was 9 cm dilated. Every time she had a contraction Lara held her hand and told her she was doing great. Lara also learned how to use a tool that I had never seen before. It is used for listening to the fetus’ heartbeat. It was a long metal tube with a hole running through it, it almost looked like a clown horn without the squeeze top. I don’t know what it is called, so if you do, send me a comment. The baby never came while I was there but I had a good time observing.

When I went back to Michael he was sitting in the office of Dr. Paul and they were both seeing patients together. They would share information with each other and try to help the patient together. A woman in who was pregnant and complaining of a pain in her stomach. After further investigation they realized that she had not been taking her medicines for hypertension for two weeks even though it was a risk for her baby.

Towards the end of the day I went outside. The hospital is made of small rooms and offices facing courtyards. Gabriel was also outside because her “shift had ended” and sitting next to a little girl named Amrita. She was showing Amrita how to spell her name, the abc’s and numbers. They were inseparable until we had to leave.


Wednesday, February 25, 2009

Recruiting Volunteers for Upcoming Mission to Latin America

Just added several new positions today for the upcoming mission to Latin America onboard the USNS Comfort.

ER/Trauma Nurses
Critical Care/PACU Nurses
NICU Nurses
Perioperative Nurses
Pediatric Surgeons
General Surgeons
Pharmacy Techs
Adv X-Ray Techs

Support Project HOPE's volunteer missions to provide health care and lifesaving heath education to those in need around the world.

Monday, February 23, 2009

Technology and Fieldtrips in Ghana, all in a Sunday's Work for Project HOPE Volunteers

It's Sunday but there's no rest for the weary today if you are part of Project HOPE or any Africa Partnership Station Staff. Tomorrow volunteers start working in their respective places so everything that can possibly be in place needs to be. This meant today we had to get our Internet access from the USS Nashville staff so we could access email and such and then head out to the different locations Project HOPE would be working.

Group one which will be lead by Dr. Brian Crawford, an emergency medicine physician from Colorado, will be working at the Effia-Nkwanta Regional Hospital (ENRH). He will be joined by ER nurse Donna Featherstone, midwives Lara Holbrook and Jennifer Oh, pharmacist Earl Rogers, and physical therapist Beth Habelow. ENRH is a big hospital that also includes a nursing and midwifery training college where the midwives will be training students (for this component they will also be joined by Ruth Madison, MPH). They will also be helping deliver babies or as some midwives say "catching babies". Brian and Donna will be working in the small emergency room; Earl will be working with the 9 pharmacists. Beth will be seeing perhaps both in and out PT patients.

We actually got to meet the health administrator today for the hospital. A couple of things Mr. Micah told us about ENRH are:

  • the name of the hospital means on junction of two cities, it was named that because of this place between Sekondi and Takoradi
  • it has 416 beds, 35 doctors including a medical director
  • the hospital serves two counties and therefore is represented by two members of parliament and is state hospital
  • while it is not a teaching hospital it takes new medical school graduates for one to two years for training
  • ENRH was established in 1938 by the British as a transition point for the British Military before they went on to other countries, the hospital's age and the fact that was created to be a hospital means its infrastructure is a problem
  • 135,000 people receive outpatient care per year, 14,000 are admitted into the hospital and about 2,000 babies are born a year or 5.5 a day
  • ENRH serves a whole state which means some of the population who would get services there would have to travel from as far as 9 hours away to get them
  • impressively they give free treatment to TB and HIV/AIDS patients, free prenatal care, have one 24 hour pharmacist with one pharmacy especially dedicated to neonatal care, and 24 hour emergency obstetrics

The ENRH campus is quite large, with lots of buildings serving different purposes and while it is worn it is in much better shape than other places HOPE volunteers have worked.

The second group will head right down the road to the small Essikado Hospital. The group working at the pink, grey and other bright colored building will be lead by Dr. Michael Polifka, an emergency medicine physician from Vermont. He will be joined by pediatric nurse practitioner Gabriel Seibel, certified nurse midwife Marilyn Ringstaff, registered nurse Joanne Machin and x-ray technician Marina Rivera. Although the place has an operating theater it functions more like a clinic. Because it was Sunday we got a tour but were unable to meet with someone like Mr. Micah at ENRH who gave us more information about the facility.

All of our volunteers will be working side-by-side with their counterparts to provide training and mentoring to them while still offering care to the local population.

When we got back to the Nashville it was close to dinner time or chow time as they call it here. Some volunteers made and excursion to a place called “Monkey Hill” which is suppose to be a place to see monkeys but from what I have heard they only saw two monkeys and one headed up the tree as soon as they saw it. The guide they negotiated with said it was because of the color of their white skin. None the less they had fun hanging out, as did the rest of the volunteers. I believe we are all ready to get started tomorrow.

Thanks for reading!


Sunday, February 22, 2009

Being a Project HOPE volunteer can be a bumpy road

All of the Project HOPE team woke up early this morning to head out to Sekondi-Takoradi, Ghana. Sekondi does not have an airport so everyone had to fly into Accra but we couldn't leave last night because it would have been too dangerous to travel the 4 hours to the town.

The road to Sekondi-Takoradi is two lanes, paved but riddled with speed bumps every 20 minutes along the way. Maybe this is why it takes 4 hours? Anyway, driving at night on the road can be hazardous, so in the morning we piled into two vans and headed on our way. However, it took us at least one and a half hours to get out of the city of Accra because traffic was very heavy. Once we got outside the city the road was full of speed bumps. This road passes through many little towns, markets set up on the side of the road, women selling local goods and also lush green landscape. Along the shoulder people were selling everything from fermented corn and caskets shaped like animals to smoked grasscutter. Once you enter Ghana's Gold Coast you begin to see the shore and the beaches lined with palm trees.

We stopped halfway along the bumpy road just before we got to Cape Coast. Here I bought something I hadn't even seen the first time in Ghana. One of the very helpful military guys, who happens to be American military but Ghanaian by birth, introduced me to the Ghanaian sweet bread. It looks just like a loaf of bread but tastes so much better. We all enjoyed the whole loaf until it was gone.

Just before we arrived at the Ghanaian Naval Base, where the USS Nashville is in port, you could see rows and rows of Ghanaian fishing boats on shore. These boats actually go out in morning to fish and you can see them from the Nashville. It is really an impressive site. We finally arrived at the Ghanaian Naval base where the Nashville is the biggest ship there. This is my first time on this kind of ship and I think for most of the volunteers it is too.

Once we unloaded the vans we were met by the very friendly Sergeant in charge of helping us with logistics. He quickly gave us some information and then led the women down, yes down, to our berthing (or place we will sleep for the next two and half weeks). The USS Nashville is about 40 years old so she looks a little weathered and also I think I was spoiled by the newness of the HSV Swift and other volunteers by the space of the USNS Comfort and Mercy. We, the women on the Project HOPE team except Admiral Johnson (she's an admiral so she gets a better room), are in a cozy area with our own designated bathroom, racks (bunks), lockers and also a table. I have to say even though we are all women and the space is small, two showers for the bathroom, we all seem to have adapted well to the space. We are all just happy to be here. I haven't seen the men's berthing, for obvious reasons, but I assume it is the same.

The ship is full of stairs, or more like ladders. We got a tour today and if we don't get in shape working in Ghana's heat, we will definitely do it climbing these ladders. We go down for our room, then up one flight to exit the ship, four flights to eat, five to use the computer room, and if we want to go to the big gym we go up from our rooms and then down a ramp. It's quite the workout. And not just for the body but also for the brain because we have to remember how to get to all these places and everything looks the same. But the crew has been exceptionally nice and polite to us, pointing us in the right direction if they see us wander aimlessly.

After all the orientation of the ship and getting settled some of the HOPE team went on a trip around the Sekondi-Takoradi area. The Navy has provided buses for their crew members who are on liberty (or off) to visit various locations in the city. Others, me included, went to dinner at a local plaza. We wanted local Ghanaian fare. It was all really good and of course they give you massive amounts of food for very little cost. Dishes included the famed fufu mentioned in the earlier post, rice, fish, meat, most of it in a red sauce and plantains.

After a nice meal and great conversation we came back to our temporary home and there was a gathering outside, with music and people playing basketball. There is a basketball hoop were the boat is docked. We hung out a little bit and walked down the pier to see a tiny lighthouse at the end of it. It was a nice night for a walk and the great way to end a long day.


Project HOPE Volunteers Arrive in Ghana

After much waiting and excitement the day the Project HOPE volunteers would be arriving finally came. Although Ruth and I had been accomplishing a lot while in Ghana, including a meeting with USAID to hear more about their maternal and child health programs in the country, I knew as soon as the volunteers showed up it would be all go and no stop. 11 of the volunteers would be arriving on the 6:35 pm flight and one had already arrived in Ghana, having explored other areas of the region ahead of this time with HOPE. Because the volunteers were arriving in the evening it was decided that we should not travel 4 hours up to Sekondi-Takoradi (twin cities in Ghana) where we would board the Nashville and also work in two local hospitals and a midwifery school.

After switching hotels so that the entire HOPE team could board in the same location, we headed off to the USAID meeting and then stopped at a market on our way back to the hotel to meet the rest of the folks heading to the airport. The market was big and filled with color outfits, crafts and fabrics. We didn't want to spend too much time there because we had to pick the volunteers up. I wanted a nice outfit from Ghana but as soon as I got in there I was looking through fabrics. I was then surrounded by lots of Ghanaians selling fabric. I waited until Ruth was done buying something, because I am not a good bargainer, and then moved on to the stand of the niece of the lady who sold something to Ruth. The niece showed me all sorts of beautiful, bright two piece outfits while her brother, Doug, tried to bargain with me. He was a hard bargain but the funniest point came when he was trying to still sell me some fabric and when I told him I didn't have anymore money he tried to barter with me. He said he wanted my blackberry. I told Ruth, whom I had been consulting in Spanish this whole time, and she told him I would get fired if I gave him blackberry. He felt bad and stopped pushing to make the sale. The Aunt also said she would make FuFu for Ruth, a traditional Ghanaian dish.

We made it to the airport on time to pick up the volunteers, us in one car, a truck for luggage and two vans for the volunteers. And then we waited, and waited some more. Their flight was late too but not as late as ours. When we finally heard the loud speaker call their flight we stood there with our Project HOPE shirts on waiting for them. One by one they emerged. Some of them already knew us and were easy to spot others looked a little bewildered at the amount of people waiting at the airport. Michael, a seasoned volunteer, again brought suitcases, 4 total, of medicines to use where he will be working and luckly he got through customs smoothly.

After a long day we finally got them to the hotel, which by the way was not a new building but a new hotel. It had been a known to be a brothel previously. Some of volunteers went straight to bed others went out to dinner. There was a restaurant near our hotel named Captin Hook's. It looked nice and well lit so we went.

Like the previous restaurant we went to the night before this one was also slow in serving the food. It seems everything is so fresh, an delicious, that it takes a while to cook. Captin Hook's, however, didn't take 2.5 hours for the food to arrive as did our meal the night before. We still had a great time getting to know each other and telling stories while we waited.

Soon after we got to the restaurant a gentleman from the embassy who had been helping us with logistics showed up. He has traveled and volunteered extensible through Africa. We wanted to hear some stories so he told us a few. The one that really stuck out and kind of grossed some of us out was the one about his encounter/hosting of a Putzi fly. At some point in his stay in Africa he went hiking. He got hot, and not thinking, threw his t-shirt in a pool of water. He then put the t-shirt back on. Not too long after he grew a bump on his back that he assumed was a bug bite, but it would sometimes be hard to the touch and sometimes soft. Soon he picked at it and out came our friend the Putzi fly as a larve. I have to admit it grossed me out a little but it is not the worst thing could happen and everyone who heard that story that night learned you should never put on any wet clothes that have been hanging outside or in a pool because you might end up hosting a Putzi.

With that story we all headed back to the hotel for a goodnights rest since we would be heading out early to Sekondi-Takoradi.


Thursday, February 19, 2009

Volunteer Missions Require Stamina--Project HOPE team visits 4 continents in 24 hours to get to Ghana

Hurry up and wait, that’s all I can say about Ruth’s, Project HOPE’s resident expert on maternal and child health, and my journey across the Atlantic Ocean to Ghana. I was super excited to be heading out on Tuesday for a three week health education and humanitarian assistance mission with Project HOPE volunteers. I had been packing for days as had Ruth. I should have known there were going to be bumps along the trip after I ran from my gate to meet up with Ruth at hers because the folks at my boarding gate forgot to mention that our flight would be taking off from the another terminal. I ran as a fast as I could because we were soon going to be boarding. When I reached Ruth the boarding area was full of people just waiting. The flight was late due to a malfunction. Usually this is not a big deal but when you are catching a connection across the pond this could be a little tricky. And it was because our two hour delay at Dulles International Airport cost us our connecting flight from Frankfurt, Germany to Accra, Ghana.

We arrived in Frankfurt just as our plane was leaving. We thought we could probably catch a later flight never thinking that another connection would send us to yet another time zone. It turns out the flights to Ghana only happen once a day every two days. What this meant for us is that after 7 hours on a plane from the US to Germany we had to wait 3 hours to catch a connection to Dubai. Yes, Dubai. Dubai added another 5 hours to our trip. Then once we get to Dubai we had to wait another 7 hours overnight to catch a 7 hour flight to Ghana. We were so beat we booked the hotel in the airport, or should I say giant duty free shopping mall, for a couple of hours. That’s 29 hours of travel time, and 4 continents visited in a little over a day.

I am really glad Ruth is here and that she was able to be my partner in crime as we hopped from continent to continent. She made things less stressful. I hope our volunteers have better luck with their flights in tomorrow.

While I am exhausted from the trip I am pumped about meeting the volunteers tomorrow when all 11 arrive and we head to the USS Nashville to join the rest of Africa Partnership Station. The USS Nashville sounds like a huge ship from all the information I have received. It has workout rooms, mess halls, decks. It even has a store on board. I hope to have lots of interesting stories to share with you all. Thanks for reading!


Tuesday, February 17, 2009

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Friday, February 6, 2009

Project HOPE Volunteers Return to Ghana in February

It’s that time of year again as Project HOPE gets ready to begin a lengthy season of humanitarian missions with our U.S. Navy partners and other non-governmental organizations. This year brings our second trip to West Africa for Africa Partnership Station and yours truly will once again be joining our volunteers in Ghana documenting their three week mission. Ghana will be our only stop this time around and our wonderful volunteers, all 11of them, will be integrated into three different locations to provide health care professional education, mentoring to their local counterparts and also providing care to the local populations. Our team consists of both new and returning HOPE volunteers as well as our own maternal and child health expert Ruth Madison. Some names our faithful readers might recognize from previous posts include Michael Polifka, Gabriel Siebel, Joanne Machin, Marina Rivera, Joyce Johnson, Brian Crawford and Earl Rogers. Earl, a pharmacist from Richmond, VA, is by far the volunteer with the most HOPE memories as he was on the original SS HOPE in 1972 in Brazil and has continued to volunteer since. This is also Vermont ER doctor Michael’s sixth mission with Project HOPE so you see we have some seasoned folks on this trip.

New HOPIES joining us are a certified nurse midwife Marilyn Ringstaff, ER nurse Donna Featherstone, nurse educators Lara Holbrook and Jennifer Oh, and physical therapist Beth Habelow.

This is my second time with Project HOPE in Ghana. My first trip was also the first I was able to spend time with volunteers and shadow them as they worked in the community providing education and health care. It was a really rewarding experience with lasting memories. I am excited to again be visiting Ghana and its lovely people. Once the mission gets underway I hope to write more about our new and returning volunteers and about their adventures and experiences as they work in and with the community in Ghana. Make sure to check back in mid-February for updates!


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