Avo.

"Avo". 

A word that I've heard countless times throughout the hospital. To indicate that the nurse is done taking a patient's blood pressure, to sooth a crying child by reassuring them the shot is over with, to discharge a patient when their stay is completed. "Avo" means "finished" in Ewe, and yesterday afternoon when I packed my bags into the big white CCS van for the airport, that word had gained another use - to indicate that my time in Ghana has come to a close. I am finished with my 4 weeks of volunteering. Finished working with patients at the hospital, finished washing my clothes by hand, finished going on those amazing tourist sites that Ghana has to offer. After months and months of planning and preparing, my adventure of a lifetime has ended, as I sadly knew that it had to at some point. 

Completing a trip like this had me full of such contrasting emotions: sadness at having to leave such a remarkable country after such a short time, excitement to see my friends and family that I had missed so much, regret that I hadn't stayed here longer, reassurance that I had stayed the perfect amount of time. It was just too strange that all of sudden I was done, and had to leave the place that had been my home-away-from-home for the past month. But I believe that most pronounced emotion of all was an overwhelming feeling of gratitude. I was, and will always be, so unbelievably grateful for the wonderful sense of welcoming I always received in this country, for being a witness to such a beautiful region and group of people, and so grateful for the amount of knowledge I gained from this trip - both from the volunteering aspect as well as the cultural immersion aspect. I could never put into words how significant this trip has been for me. I have gained more of a true cultural experience then I could have ever expected. Even in just a month's time I felt that I had become completely immersed in a culture so different from my own. The kindness of the people and the intense feeling of community that encased the town was such a refreshing change from the independent lives led back in the States. Even though these people have so much less then the average American, I truly believe that they are a thousand times happier because they value the really important things in life and understand how precious they are. I was able to gain such a solid understanding of how deep the Ghanian culture runs and how things like family, religion, and camaraderie are the most valuable things in their life. These people taught me so much about the simplicity and joy in life that I feel like what I gave to them through my volunteering could never compare. 

Of course I know that my volunteering had more of an impact than I expected it to. Carl confirmed this on my last day in the Diabetics Ward when he shared just how appreciate the entire staff was for my work and commitment to volunteering in the hospital. 

From top left: Carl (Nutritionist), myself, Nurse Freeman
From bottom left: Head Nurse Vida Quist and Nurse Caroline


But I think the most incredible part of the entire CCS program is how they combine worthwhile volunteering with incredible cultural exposure, giving the volunteers such a well rounded program experience. I would not trade this trip for anything in the entire world. It was everything I expected it to be and more. I can definitely say that I've caught the travel bug :) All I want to do is plan my next incredible adventure to continue to enhance my exposure to the world while giving back what I can in return. Thank you again to all who have been so supportive of this trip and to those of you that stuck with me through my blog posts. I appreciate everyone's excitement over my trip more then I could voice! Hopefully this isn't the last you'll read of me. Until next time :)

~ Sarah 

Saying Good-Bye to Sister Sarah

Wednesday (yesterday) morning was spent in the Public Health Unit of the hospital. I was there with two of the other CCS volunteers that came a week and a half ago. The Public Health Unit is actually just an extremely tiny room - the size of a large closet - with one desk, a filing cabinet and a sink, all in extremely close proximity. In the room was a nurse, Christie, and of course, my friend Carl. He seems to be in almost every single ward/unit that I work in. We chatted with Christie and Carl for a good two hours, learning all about their Public Health system and sharing with them the Public Health system of America. Christie is the only Public Health officer in the entire hospital. It was very interesting, and both parties discovered many similarities and several differences between each system. For example:


Both parties are involved in:

1) Basic health education talks, with regards to hand-washing, healthy eating, exercise, etc.

2) Increasing public awareness through community talks/discussion, signs posted around hospitals with reminders of basic health practices, etc. 

3) Giving immunizations to all infants of major diseases 

4) Struggling with obesity, hypertension and diabetes.



This last one struck me as most interesting and it is something that I have become more and more aware of throughout my stay in Ghana. When many people - including myself - think of Africans, they most likely think of poor, starving, skinny, malnourished people. While that definitely rings true for parts of Africa, I've noticed more-so that the biggest struggle here is with regards to obesity and heart diseases. The Ghanian diet is extremely heavy in starchy foods: white rice, potatoes, plantains, banku and fufu, which are doughy balls made of corn meal or plantain that are then eaten in a broth. The starch in the diet greatly outweighs the other food groups in each meal and this is a high contributor to their issues with weight. Their breads are also very white and sugary and they fry so much of the food that is eaten. Plus, traditionally it has been a sign of wealth and high stature if someone had a few extra pounds on, so people here are slow to learn that the extra poundage is actually unhealthy to them in the long run. This idea is partially why I have been so in love with the Diabetics Ward because so many people there did not know that their diet has been the cause of their disease, leaving many educational opportunities for me with those patients. 


Speaking of the Diabetics Ward, this morning was my last visit in this department. Today was more of the same with health talks, exercises and observing more of the work that the nurses and Carl do here. It was actually quite sad leaving today because I had built such a connection with everyone in the department. They all had adopted calling me Sister Sarah and I really felt like I was part of their close knit group. Today, they said good-bye to Sister Sarah and we snapped a group photo to close the morning. I hope to keep in touch with them though, and I truly truly hope that this was not my last time ever visiting these wonderful people :)



Only this afternoon and tomorrow are left for my trip! Until then :)


Xede nyuie (Good bye),


~ Sarah

The Stairmaster From...Well....

This morning was hike number two of our trip. During my four week stay, they had scheduled two incredible hikes for us, and while I feel so lucky to have participated in them, two is definitely the max that I would be able to endure on this trip...

If I thought the first hike was hard, then I had no idea what "hard" actually meant. This second hike was up Mount Afadjato - the highest point in Ghana. It was much different from our other hike in the sense that was so much steeper and difficult to traverse.  Each step felt like a lunge onto either a huge rock or a root that was perfectly situated for our feet to step up on. We were essentially just walking up the stairmaster from hell, in my mind. The trail was nicely sheltered in the woods, so we were protected from the sun but that did not stop me from sweating through every light piece of clothing I was wearing. We would take breaks here and there to sit on a rock and catch our breath, so the hike probably took an hour on the way up and an hour on the way down. Reaching the top was pretty incredible. We were clambering up these enormous steps, using the trees and vines to help pull our upper body and - like the other hike - we came to the top clearing at the most perfect moment. We turned one sharp corner and saw the light flow through an opening just a few feet above us. It's funny how these moments of relief tend to creep up on you. From the top you could see everything! Little towns scattered about and beautiful green hills could be seen for miles, rolling their way into the foggy distance. The mountain immediately next to us was the neighboring country of Togo, so that was a pretty amazing thing to see. The view at the top made the hike more then worth it, in spite of the sweat, bugs, and dirt that was endured on the way up. 

It's events like this that are the most rewarding, in my mind. Being out there in nature, and just having your own body and physical/mental strength to help you accomplish a grand feat gives you the most empowering feeling once that task is completed. Though I was pretty miserable on the way up, it still was such an adrenaline rush to stand up there overlooking such a vast countryside with the sun glistening off the bare, rocky point of the mountain. And how many chances to have to go on two legendary hikes in West Africa? :)

Tomorrow I am back at placement in the hospital. I cannot believe that my month-long trip here is winding down so fast! Only three more full days in this incredible country, and I am prepared to soak up every last bit of it. Until tomorrow!

Fie (Good Evening),

~ Sarah

I Now Pronounce You...

Yesterday I was working in the Physiotherapy Department of the hospital. This was my first time actually seeing how this department is run. I was quite surprised at how modern and relatively up to date this ward was, compared to the other ones that I have been in. This room was equipped with certain physical therapy tools and exercise equipment that we might have back in states - free weights, exercise balls, work out machines, and those sets of railings that allow recovering patients to practice walking upright again, for a certain distance. 

When I entered the room the first patient I saw was a women sitting in a chair in front of a mirror doing different facial exercises. I chatted with her doctor, and he informed me that she is suffering from Facial Palsy and these exercises are helping her to strengthen the muscles on the left side of her face (the side that is affected) as well as helping to increase blood circulation. He attributed her facial palsy to her high blood pressure and persistent hypertension, saying that she is not receiving enough blood flow to her certain parts of her body, and now her face is the first to be affected. I was lucky enough to be able to sit with her and address her nutritional needs in this area. Gotta love all these impromptu counseling sessions :) I think our chat went very well. I learned how she eats rice, bread, and banku (a doughy ball made of cooked, fermented corn dough and cassava dough, that is eaten by hands within a soupy base) for breakfast each morning. Her lunches and dinners look quite similar, with bits of fruits and vegetables thrown in here and there. Unfortunately, this type of starchy diet is a favorite of most Ghanians, and one that I have addressed with many clients in terms of educating them on the importance a less starchy and a more nutritious/well rounded diet.

This morning I was lucky enough to go a Ghanian wedding! My roommate and I were invited to the wedding of a cousin of a man named David, who we met in town earlier that week. Sounds sketchy...but he was very nice and welcoming and our country director talked with him to be sure that it was a legitimate thing. Turns out our country director knows the family that was hosting the wedding so he gave us the all clear to go :) David told us to be there at 9:30 am sharp for the start of ceremony. Being the punctual Americans that we are, we arrived right at 9:30 to a nearly empty ball room. Little by little, the seats began to fill until about almost 11 when the official ceremony started. Classic Ghanian time. The ceremony was interesting to say the least. It was an absolute blast with all the dancing and singing that was happening, but it was also extremely lengthy with regards to the sermon that was given and the constant pauses to pray and pray and pray for the couple, for the guests, and for anything you could think of. The passion in the room reminded me of the passion at church. The guests were all dancing and singing and shouting praises to the bride and groom. These parts of the ceremony were so much more fun then the American ceremonies I've been to. While the weddings we have back in the states are absolutely beautiful and momentous, these weddings felt more like a true celebration, and the bride and groom seemed like A-list celebrities to all the guests. The biggest downside to the wedding was that from start to finish, the ceremony and reception stretched out to a lengthy 6 hour service. In this kind of heat, it is something I could probably only sit through once in my life. 

Overall though, it is has been an incredible start to the weekend. Until next time!

Hede nyuie, (Goodbye),

~ Sarah

"Which is Better: Diabetes or AIDS??"

This morning I was back in - you guessed it - the Diabetes Ward. I've been building great rapport with the staff who works there, including Carl (the nutritionist). Today was much like the other days in that ward. I gave another health talk on living with diabetes and maintaining a healthy dietary lifestyle. The talk was received quite well. After the health talk, I sat and chatted with Carl and Nancy, the head of the department. Nancy was telling me a story of how she was working with a patient the other day who came to her with a very odd question: the woman was describing how her neighbor is living with HIV/AIDS, yet seems on the outside to be perfectly healthy and happy. The women was saying that she herself is diabetic and feels terrible all the time even though she is taking her drugs. She doesn't understand why both herself and the HIV/AIDS neighbor are taking their drugs like they are supposed to, yet the HIV/AIDS woman seems so much better off then the women living with diabetes. Her question was this: "which is better: diabetes or AIDS??". Nancy chuckled a bit at this question, but also explained that the biggest problem that she has with patients in this ward is they have a hard time comprehending that diabetes (especially Type 1) is a life-long disease that they cannot just reverse by taking their medicine and insulin shots each day. These patients need to really learn that it is their diet that is the major factor in determining their health status and that the drugs just make it easier for them to live a normal life. I've also noticed this problem first hand. When I was giving my health talk they kept asking things like, "is it contagious?", "can I ever get it rid of diabetes?", and "if we are taking drugs then why are we still sick?". The women who asked Nancy about diabetes vs. AIDS had not been following a specific, healthy dietary plan and was only relying on her insulin shots and medication to make herself feel better. This is just one of the struggles with nutrition that Carl educates his patients on day after day, because they are in such need of nutritional knowledge. 

It's days like today that make me feel like I really am doing something worthwhile here. Though the information I am sharing with them seems basic, it is information that they do not often hear and are so desperately in need of understanding it. All of the diabetic people I have met are terrified of getting sicker and suffering from diabetes related complications. Though they might seem ignorant of their disease at times, they are still eager to learn and to change their behavior to help better their illness. I've realized that with these people, it's not a lack of desire to change their habits, it's a lack of knowledge of how and why to do it. For this, I cannot blame them. The only times they are provided with such basic health care information is once they are already sick and suffering. If I have even helped one person, diabetic or not, grasp a more clear understanding of why nutrition is so vital to one's health and happiness, then I can say that this trip has been completely worth it :)

Until next time! 
Fie (Good Evening), 

~ Sarah

Problem-Free Philosophy

Hello! Sorry for the lengthy absence, the care-free Ghanian time has gotten the best of me. To recap the past few days:

Friday:
This morning I was back in the Children's Ward. To be honest, I've realized the Children's Ward may not be the place for me. As much as I absolutely love being with kids, when they're sick/confined to their beds, and overseen by a busy nursing staff it is not easy to interact with them and make yourself feel useful. I spent this morning folding a few towels then I sat and watched the nurses discharge their patients. Though I wasn't able to do much to help, I did get to spend quite a bit of time hanging out with this 2-year-old boy named Peter. He was really enjoying a game of "open the door and slam it shut till mommy runs and grabs me". He was absolutely precious though and I was able to hang out with him  and exchange talk of Ewe-gibberish and my own English, with neither of us understanding the other. I think we were having a very great conversation though :) That afternoon I went into town with some other volunteers to do some more souvenir shopping. While we were shopping at this store called "Akuna Matata", a HUGE storm rolled in in the blink of an eye. But that is how the rainy season works here: one minute the sky is a beautiful blue, the next it is covered by dark storm clouds. We were stranded at the shop, but it was surprisingly wonderful because we were able to chat with the shop owner and get a further feel for the intense culture that Ghanians so richly posses. He shared with us the importance of their strong Christian religion and gave us the Ghanaian view of how politics should be run. He was saying that what makes the most sense is for people to "spread the wealth". He argued that there is no sense in letting the rich get richer and the poor get poorer, and he cannot understand how so many Americans feel so entitled to their paycheck that they cannot fathom donating portions of it to those people who are really in need. "Crazy Americans", he was calling us with a laugh. In my mind, the words he was saying were the most clear and easily understood of most things that I have heard in my lifetime. Ghanians are the happiest, most laid back people I have ever met, and they live with so much less then we do. Why is that so? These people get it. They get what the simplicity of life should truly feel like and appreciate its wonderfulness...why don't we?

Saturday/Sunday:
I decided to stay in town this weekend, as opposed to traveling, because 4 of our 8 total volunteers were heading back to the US. We spent Saturday hanging out at the home base and said goodbye to the people we have spent the last 2 weeks with. After saying goodbye, we killed some more time around town until the new volunteers came. At about 6:30, right after dinner, we heard 2 vans pull up and we rushed outside to greet the newcomers. 15 people emerged from the vans, (13 girls and 2 guys) and we were so excited to meet everyone. We spent the night meeting and greeting, and then let the newcomers settle in for the night. Sunday was further hanging out and getting acquainted, and we ended Sunday night by going out for my roommate's 21st birthday :)

Monday:
Today I was back in the Diabetics Ward! This is definitely my hot spot. Today was incredible for 2 reasons: 1) I finally learned how to manually take blood pressure! Now I can be so much for useful in other parts of the hospital. 2) I was able to actually counsel a diabetic patient and put my dietetics skills to the test! This man's blood glucose levels have been high the past few weeks and he was frustrated because he had not been able to get them to go down. He expressed how worried he was because he knew the terrible effects that diabetes can have on one's body, and he feared for his overall health and wellbeing. Carl, the nutritionist on staff, and myself sat with this man, ran through his usual diet and developed a better dietary plan for him. He was so excited to learn from us and understand why we recommend certain things and not others. One thing that I found extremely interesting was how Carl was referring to an American slice of bread vs. a Ghanaian slice of bread. At first I thought he meant that Americans take huge slices of bread compared to Ghanaians, because of how notorious we are for being so unhealthy and overweight. It was actually the complete opposite. Apparently Ghanians love to take huge slices of bread when they eat it for a snack or for breakfast, and Carl recommends taking an "American slice" which is just a thin, normal slice of bread. The patient we were counseling was a bread fiend, so he and Carl were chuckling when discussing how he must resist the urge to eat so much of a loaf of bread when hungry. Overall it was an incredible experience. I really felt like this man was so eager to hear what I had to say because he was so worried about his disease and wanted to make sure he was doing everything he could to avoid future complications. Patients like that remind of the importance of my future career path.

Tuesday:
Tuesday was another observational day for myself and the 3 new hospital volunteers. We were all together in the HIV testing/counseling unit. It was a very interesting day, as always, but not much to tell besides the observing that we did. Yet there was one incident that has been engrained in my mind: There was a women with her baby there who was being counseled by one of the nurses. It was all in Ewe, so I did not understand what was being said, but the women was crying and clearly distraught. Later the nurse informed us of what had happened: apparently both this women and child have been found to be HIV+. When her husband found this out, he immediately abandoned the two of them. She has not been able to make enough money as a single mother and couldn't pay her taxes so the government took her seamstress shop. She is so distraught because she is terrified that she will not be able to provide for both herself and her child, especially considering their health status. It was heartbreaking to see, and just an inkling of the terrible sadness that so many of these HIV people experience every single day.
This afternoon we went back to the monkey sanctuary and the drumming/dancing lesson. It was just as good the second time around :)

Wednesday: 
This morning I spent time volunteering in the Out Patient Department. Today was incredible, because it was the most hands-on that I have been. Right when I got there, the nurse pulled up a chair for me at the main check-in table and left me in charge of taking the vitals of all the children who were waiting for the doctor. I took temperatures and weights of the children and logged the information in their patient folders. Those it was simple and repetitive, it was so rewarding because I was able to help out the extremely busy department and relieve a nurse to go about other important duties for the day. All in all, an awesome morning.
This afternoon we went back to Wli Waterfall, and like the monkeys, it was just as amazing as the first time.

Tomorrow I am back in the Diabetics Clinic, and I am thrilled to see what the day will bring me. Until then!

Akpe kakaka! (Thank you so much!),

~Sarah

Diabetic Ward

This morning I went and visited the Diabetic Ward for the first time. It was an interesting set up because the ward was just a room with chairs for patients to sit in and then a table up front where the nurses sat with the only hospital nutritionist, Carl. I have met Carl several times now, once in the HIV testing unit, once at the Out Patient Department and then again this morning. Throughout the whole hospital, there is usually only specialist in each area of health, so it is quite normal to see the same people overlapping in different wards.

I had absolutely no idea what to expect with my volunteering today, but it has ended up being my favorite morning thus far. Here's how it went: I was introduced to the staff and told that I would be observing how the ward is run. I pulled up a chair next to the head of the department (her name is escaping me, it was pretty hard to understand) and watched as she took pinpricks of the patients' thumbs and tested their blood glucose levels. After she had done this to a few patients, she turned to me and said, "So you know how to do this?", implying that I might be taking over for her. I was caught somewhat off guard and awkwardly answered, "Um, well, I never have done it before...". For some reason this answer was pretty funny to both the staff and the patients, so the room filled with chuckles. I could tell though that they were laughing with me and not at me. I've noticed that it is the norm for people here to just constantly be laughing at things, and while we back in the states might interpret their laughter as rude, here is it genuine and perfectly friendly.

I watched a few more patients go through the pinpricking processes. Next on the agenda was for Carl to give a diabetes health education talk. It was quite long and all in Ewe so I had little to no understanding of what he was saying. Once he finished, he walked over to me and asked if I too would like to give a talk. Again, I was caught off guard and a little intimidated because I had absolutely nothing prepared. But then again, this is Ghana and here you just go with flow! Plus this was the perfect opportunity for me to get some hands on work to test my knowledge and interact with the locals. I expressed that I was nervous about potentially repeating information that he had already explained to them, but his reply was comforting, "Honestly, they would just love to hear your voice and hear what a person from the USA would have to share with them". This was very nice to hear, so I walked to the front of the room with Carl at my side as my translator. I was able to greet them and fully introduce myself all in Ewe, which I think won them over immediately. I proceeded to explain what diabetes is, the difference between Types 1 and 2, why it is important for a diabetic to understand their condition, the need to maintain carbohydrate intake, etc. I also explained that it was a life-long disease that they would need to educate themselves on. I've been all nervous that my undergraduate studies would not yet be sufficient enough to provide adequate healthcare information, but this diabetes talk made me realize that these people don't have basic knowledge of diseases like the average American might. For example, when I was giving my talk, the nurse made me stress the point that you cannot magically get rid of diabetes and that the insulin injections were not like drugs would cure it all together. I also held a small Q&A session afterwards where I had to explain that it was not a contagious disease and it seemed as if almost the entire room was unaware of this fact. I was asked plenty of questions, some basic and some a bit more in-depth, and I was fairly proud of myself for how well I was able to answer each question accurately, yet with basic terminology that these patients would understand. I don't mean to make it sound like Ghanians are ignorant or helpless people, but it is just becoming more and more clear to me that certain educational topics are not as widely understood in their society as they are in American society.

Overall the morning was incredible. Giving that talk, interacting with the locals and seeing smiles on the faces of everyone that I was able to converse with and clarify questions was the biggest rush for me. It felt great knowing that I was able to help these people understand a disease they will live with for the rest of their lives. It really seemed like they were taking everything I said to heart and were very enthusiastic about learning as much as they could in order to live a healthy lifestyle and educate their families as well. The overall atmosphere of the Diabetes Ward was so different from the other ones - the patients seemed more laid back, much friendlier, and the staff was cracking jokes with those that were waiting to be tested. There was even a time where they took a short break and led a small exercise and stretching session that got all the staff and patients off their feet and laughing. Definitely my best volunteering day to date.

I can't wait to see what surprises tomorrow will have for me.

Akpe kakaka! (Thank you so much),

~ Sarah

Living the High-Life

What an incredible morning.

Instead of going to our volunteer placement, we took the morning off to go on a hike up the Likpe mountain, just a 20 minute drive from our house. Our program driver, Makafawe, describe the mountain hike as "somewhat physically challenging, but very do-able and only an hour walk up and then an hour back down". I'm going to go ahead and say that that definition was completely misleading. It was easily the hardest, most physically demanding thing I have ever done, yet so rewarding overall. We got to the base of the mountain and waited to be introduced to our tour guide. All of a sudden, this seemingly 12-year old boy wearing shorts, a t-shirt, flip flops and carrying just a flashlight showed up in front of us and proceeded to introduce himself as our guide. We just went with it. Come to find out later, he was actually 20 years old and hikes this mountain roughly three times a day. At the time though, it was pretty funny thinking that this small child-like person was our safety net for this hike. 

We started walking up this wide dirt road and within minutes I was already sweating. The entire walk up the mountain was unreal; so hot, sweaty and exhausting because of how terribly steep it continued to become. Once we were off the dirt road we ended up hiking up these rocky paths through the African brush. I was honestly dripping from head to toe and could feel my heart beating in my ear drums. Over an hour later, we emerged from the brush and into this beautiful green meadow area that reminded me so much of the hills from the Sound of Music. This meadow could not have come at a more perfect time. There was a rope swing that we were able to swing on and we just relaxed for a bit, overlooking the beautiful country scenery. Being at the top of a mountain like that and gazing for miles was such an incredible sight and reassurance that this adventure was well worth the sweat and heat. 

Once we were well rested, our guide explained that the next step was to kind of walk around the top of the mountain and traverse through 6 different caves in the process. This part was absolute insanity. We were free-hand scaling the walls of these caves, crouching low to crawl our way into them and using shoddy ropes as our support to ascend and descend the caves and dense forest grounds. I've never done anything like this though and it was so extreme and exciting! The final cave was the best - we climbed this extremely steep wall into the darkness of the cave and had to blindly feel our way to the top of it. We literally had to follow the light to make it out. The entire series of caves were such a blast. 

After the cave portion, we walked down the mountain to a waterfall where we were able to cool down and relax. We all just ran in at once, in our clothes and all. Easily the most refreshing waters I've ever felt, and so necessary at the moment. 4 hours later from the start of the hike we were finally finished, and each of us was so proud of what he had accomplished together :)

This evening we learned a style of dancing called High-Life, that has been a traditional style of dance and music in Ghana since the 19th century. We set up speakers out in the front lawn and learned the different steps and body movements of High-Life dancing. Once we learned about that, we moved onto something called Hip-Life, which takes the traditional musical tones of High-Life and adds a sort of hip-hop style to it. This part was a blast. Neighboring kids came and danced with us and we had a mini dance party in the lawn :) Such a great way to end the day.

Tomorrow I'll be back at the hospital! Until then.

Dedi te nu nye nuto, (I'm exhausted), 

~ Sarah 

Witch Doctor

This afternoon we visited a local Witch Doctor, just a few minutes walk from our home base. While we were there, it was stressed that the term "Witch Doctor" does not have a bad connotation in Ghana like it might in the USA. These people consider themselves as healers and use spirits, chants, and energies to cure the many people who come for their aid. We learned of how people will visit him for different ailments, such as infertility, epilepsy, strokes, and if they feel there is a demon or bad omen possessing them. It was also explained that if a person is not able to be healed through the Witch Doctor, then they are sent to the hospital and vice versa. Sometimes patients will visit the hospital many times for issues such as epilepsy and if they cannot be cured, they will make their way to the Witch Doctor and see what can be done. 

One by one we were all given the option to have our "fortunes read" by him. Most of us, including myself, decided to do it while a few others opted out. I usually don't believe in this kind of spiritual practice, but today I was pretty nervous about what kind of fate would be revealed to me. The reason my nerves were heightened is due to a story that Makafawe, our country program leader, told us about his brother: Apparently two years ago, his brother visited a Witch Doctor who unveiled that someone in his family was going to pass away very soon. He notified all of his family members of this news, and visited the Witch Doctor again a few weeks later to see how his fate had progressed. This time, the Doctor said that it was he who was going to die very soon. One hour later, as the brother was driving back home in a 14 person van, there was an accident on the road, the van tumbled, and he was the only passenger to pass away. Regardless of my belief in this stuff, that story scared the poop out of me. 

To start off my reading, I had to whisper into a 5 Cedi bill (the currency they use) what I wished to learn from the Witch Doctor. I mouthed "I want to know everything about my life, good and bad". I set the bill on the mat that he was sitting on in front of me. He proceeded to chant all sorts of incantations, shake beads around and move all these stones and shells around in an intricate sort of manner.Once he was finished, these were the things that were said to me:

He told me that the first thing that I needed to do once I got back to the home base was pray. I needed to lock myself in my room and pray on my knees for 7 straight minutes. "Well, that'll be the first time I've ever really prayed", I sarcastically said to myself. I just needed to pray for anything and everything to be sure that I ward off evil vibes and have success in all that I do. He then told me that when it is time for me to get married, that I should go ahead and do it, but I need to always be respectful to my husband. This point he stressed. He then said that people tend to be extremely envious of me because I can often do things that others cannot, so people tend to dislike me for this. Apparently I also have a strong personality and need to careful. He then said that overall I have good luck, am rich, and will live a long and prosperous life. The final point he stressed what that whatever faith I have, I need to hold onto it dearly and pray as often as possible. Nothing detrimental or even very coincidental was said, so I'm really not taking it all too much to heart. Phew, no predicted deaths over here. 

So that was that! Tonight we are just relaxing and taking it easy because we are going on a 1 1/2 hour hike up the mountains and through a cave tomorrow morning. I'm so excited! 

Ndo! (Good afternoon),

~ Sarah 

Lab Coats and Pinpricks

Ndi! Good Morning!

I was back in the HIV testing ward this morning for volunteering. I spent part of the morning assisting with taking weight of patients for their check-ups with the nurses. It was terribly hot and cramped in the little room that I was in, and I was feeling a bit like I was just in the way of the nurses instead of actually being a helpful set of hands. Like I mentioned earlier, my lack of medical certification of any type is pretty hindering in terms of what I can actually help with at the hospital. Don't get me wrong, I am absolutely loving everything that I have been learning, but there are times that I feel stuck between actually being helpful and being just another body in the room. 

Just as I was feeling pretty down about my situation in the HIV clinic, one of the lab technicians, Emmanuel, popped in the room and immediately motioned for me to follow him. He was wearing a very clean, crisp lab coat and seemed to be of high importance. I've learned since being in the hospital that you don't really question what any of the doctors, nurses, etc. ask of you...you just respond immediately to their request. I followed him into a nearby room that I found out was one of two laboratories on the hospital grounds. Luckly for me, the room was air conditioned and my mood was lifted almost as soon as sitting down in nice cool chair :) Emmanuel started chatting with me about the hospital, my time in Ghana as was asking me all about the United States in comparison to Ghana. Out of all the people I've met and the conversations that I have had, this one with Emmanuel was easily the most laid back, comfortable, and fluid conversation I've had in Ghana. His English was excellent and I had little to no trouble understanding him, even with his Ghanian accent. He had been to the US before so we were able to chat about that for awhile. 

After we chatted for a good 30 minutes, he started to explain his work in the hospital, specifically within the HIV ward. He is the head of the laboratory testing unit and works within all sectors of the hospital. The main job that he does in this ward is taking blood samples of infants who were born from HIV positive mothers. He then uses these samples to determine if the child contracted HIV from the mother or if it was fortunate enough to be born HIV negative. I've learned that if the doctors and nurses are able to catch a woman's HIV positive status early on in her life, and in pregnancy, then they are able to start her on medications that do not affect the development of the fetus and most often result in an HIV negative birth. I helped Emmanuel outline the notebook that he uses to log all of his patients and their HIV results. I then observed while he took the blood sample from the heel of a infant boy. I felt so sad for the child as he squirmed uncomfortably in his mothers arms, but Emmanuel was very good at handling the pinprick and obtaining the samples. I had to leave shortly after observing him at work, but Emmanuel seemed extremely eager to have me work with him again and I would love the opportunity to learn more about what he does and hopefully be of assistance to him!

This afternoon we will be visiting a Witch Doctor and and Herbalist to learn about alternative forms of medicine and health care that many people in Ghana still partake in. I'm extremely interested to see how it goes. :)

Mia dogo kpuie! (See you soon),

~ Sarah 

The Crafty Side of the Ghanian Lifestyle

This is going to be a relatively short post tonight.

Since today was a holiday, National African Union Day, we did not go to our volunteer placements since everything was closed down. Instead, we spent the morning doing our laundry by hand and the afternoon was spent learning the art of Batiking. Batik is the name given to the style of art that stamps different patterns onto fabrics that are dyed and can then be made into clothes, tapestries, cushion covers etc. We went to this large house and in the garage area was a classic Batik station - complete with a table, giant bowl filled with hot wax and different large stamps scattered about. Each of us was given a small white sheet of cloth and told to pick out a stamp or two that we liked best. Some of the stamps had meanings, others were just beautiful designs. I selected a stamp that was called "Kuntenkanten" and represented humility and modesty. We swirled the stamp in the hot wax and then pressed it onto the white fabric to leave a mark.

After everyone was done, we then watched as our Batik teacher combined different powered chemicals with a blue powder and water to make a giant bowl of blue dye. The fabrics were soaked in the blue dye, hung to dry for a few minutes, then stirred in a pot of boiling water to melt off the wax. We then rinsed our fabrics in cold water and voila! A beautiful blue-dyed cloth with a white stamp of the pattern we had selected. These types of fabrics are strewn all about town so it was wonderful to actually learn the technique behind such beautiful works of art.

Tomorrow we are back to our volunteer placements and I'll be back in the HIV counseling and testing ward. I'm hoping to be able to help deliver information to patients about maintaining a healthy lifestyle while living with HIV.

Fie! (Good Evening),

~ Sarah

The Curious Case of the Fire Face

It all started with a squeak in the room. 

My roommate, Sarah woke up myself and my other roommate, Kate, because she was convinced that she could hear a mouse in our room. It was 3 o'clock in the morning, and the three of us were listening intently to a periodic squeaking noise coming from somewhere in the room. Sarah was freaking out, looking under the beds trying to find it. We were searching everywhere for this mouse, at least 20 minutes. Kate suddenly spoke, quietly and thoughtfully, "you know guys... I think that noise is the fan??" We unplugged all the fans and sure enough the squeaking stopped all together. After some laughter, we settled back into our beds under our mosquito netting. Just as I was about to drift back to sleep, Kate spoke and asked, "Is anyone else's face on FIRE?!" We had no idea what she was talking about. "I've got the fire face, oh my god it burns so bad!" Sarah and myself didn't feel anything so we laughed as Kate ran to bathroom to check her face, which had no rash or redness of any type. We decided maybe she was just hot so we thought nothing of it, but Kate was throwing out all types of possibilities, until she landed on this one: "It's gotta be windburn from the giant fan we put in our room". Our room was so hot that earlier that night before we went to bed, we grabbed the giant industrial sized fan from the kitchen and squeezed it into our tiny room. In our tired stupor, we reasoned that this was the most logical conclusion, so we turned off the giant fan to save our faces from the windburn and went to bed.

At 6 am, I woke up realizing that my face too was on fire! It burned so bad and I had no idea why. I tossed and turned for awhile to find a comfortable spot to fall back asleep but no such luck. At this point Sarah and Kate were also awake and rubbing their fire-faces in agony. We couldn't fall back asleep and so we tried to figure out what it could be. The change in humidity from the beach this weekend to back home?  Salt water irritation, maybe the sunscreen, a sunburn? We had no idea, but all this morning we've been in so much pain from the burning on our face and in our eyes. Christine, one of our Ghanian program supervisors knew exactly what was going on as soon as we told her about it. She said that it was from the mosquito netting in our rooms! They air out newly unpackaged, mosquito netting for 24 hours each time they put it up, but we think that because we had that industrial fan along with literally 4 other fans in our room, we were just blowing around the mosquito netting chemicals all up in our eyes and face. Lovely, right?? Either way, our faces are less inflamed now and we can rest easy - mystery solved :) 

Anyway, all of this was hilarious when it was happening so I figured it was blogosphere worthy. This afternoon will be learning how to Batik, which is the way that people here make all the beautiful cloths and fabrics that are then made in to clothing. I'll be sure to let you know how it goes! 

Akpe! (Thank you),

~ Sarah 

Cape Coast

This weekend was our first free weekend for us to travel and see parts outside of Hohoe! Our group of 8 decided to travel to Cape Coast for the weekend to go to the beach, visit Kakum National Rainforest and check out the third oldest slave trade castle in Ghana, Cape Coast Castle. Turns out it was only a 7-hour car ride instead of the 9-hour ride we had anticipated and we were able to pass the time with games and story telling. We arrived to our hotel (that looked straight out of a horror movie) late Friday night and went right to bed in order to be ready for the canopy rainforest walk! 

The canopy walk at Kakum National Forest was incredible. We hiked a bit up into the rainforest and then proceeded to cross 7 rope bridges that were suspended up in the canopy treetops! It was so exciting and thrilling, knowing that we were so high up above the ground. We were dripping sweat by the end of it, but it was easily one of the most exciting and hilarious things I have ever done. 

After the canopy excursion, we made our way to Cape Coast Castle for a guided tour of the third oldest slave trade castle in Africa. The castle was absolutely stunning: completely white stone with blue-ish, grey-ish stones intermingled in the architecture. It faced the ocean and had the most wonderful beach breeze flowing around every corner. Though the castle was stunning, it's history was extremely unsettling. Our tour guide informed us of how it passed hands between the Portuguese and the Dutch when it was just a colonization and trade site. He then explained in great detail of how it came to be a site for slave storage just before the slaves set off in ships to join the American slave trade. We visited the different cells where slaves who misbehaved were sent to die, the male and female dungeons where slaves were kept until shipment, and also the cell for female slaves who misbehaved and refused the advances of the Europeans. This part of the tour broke my heart most of all. We learned how the female slaves would be locked up in this terribly small, dark cell as punishment if they fought back against European men who would try to take them up to their rooms and take advantage of them. Our guide also explained how if women unwillingly became impregnated while on the slaves ships, the European crew would just throw them overboard, like unnecessary cargo. The cherry on top of the entire tour was when our guide showed us the dark, terrible male dungeon and then the church where the Europeans would rejoice in worship, which was located right above it. The slaves could hear all of the singing and music through a tiny opening in the floor that led to their cramped and filthy cells. Irony in it's finest. We've all learned of slavery in school, but being in an actual slave castle and seeing first hand the terrible conditions that humans forced other humans to live in was so incredibly emotional, but also something that I feel everyone should experience at least once in their lives. 

After the tour, we collected our thoughts and decided to the beach for lunch and swimming. It felt amazing to be swimming in the ocean, and the water was honestly like bath water. The waves were ridiculous through, in such a great way. They were HUGE and were breaking right at the shore so it was such a struggle to even remain standing before they swept you off your feet, rolled you around in the sand and washed you up on shore. There was a pretty big undertow that we had to be careful of, but we still spent so much time jumping and cascading around in the waves. While this was happening, there were several groups of pigs that would just casually be walking past us on the beach. When in Africa... 

All day today we just drove back home, had dinner, and have been resting up for the week ahead of us. One week down, and it went by way too fast. Until tomorrow!

Xede nyuie! (Good bye), 

~ Sarah

Health Education 101

This morning I gave my first Health Education talk at the hospital! I was told yesterday that each morning, the Out Patient Department (OPD) gives health education talks to their patients while they sit in the waiting room to be consulted. The staff in this unit said that I could do the honors of providing the health education talk this morning, and I was so happy to hear this! I've been struggling a bit with figuring out where my skills could be most useful in the hospital, since the staff really are in need of certified nurses, doctors, and physician's assistants. Being an undergraduate with no type of certification leaves me a little lost in terms of how make sure that the skills I do have are being used in the best manner possible. So last night I took the time to create some very basic pictures of ways to live a healthy day to day life. I was not sure how much these people already know or how difficult it would be to work through the language barrier so I kept it simple: 1) brushing your teeth for dental hygiene and overall body health, 2) eating healthy - having a colorful plate with plenty of fruits and veggies to outweigh the amount of white carbs that are so abundant in Ghanaian cuisine, 3) getting plenty of sleep to help keep your body and immune system strong, and 4) washing your hands constantly, especially here where they are handling goats, chickens, babies and any number of unsanitary things. I will say that I was definitely a bit nervous to present my talk. Though these people are incredibly hospitable (the most hospitable people I have ever met in my life), it is still intimidating to the only, and I mean only, white person in the entire hospital and then make a presentation to people who can barely make out my American accent. Courage, both internally and the name of the doctor who works in the OPD, helped me out immensely. He was my translator and was able to convert my words into Ewe so that it was certain that the patients understood what I was conveying. I saw plenty of nods, laughs, and smiles from the crowd, so I believe I can say that it went quite well. I'm hoping to have the opportunity to make these talks a regular activity, which will allow me to better plan for what I want to say and give much more educational talks as time goes on. 

The afternoon was much more laid back then it has been the past few days. We had a few hours of rest time after lunch and then proceeded to go into town to convert some money and do a bit of souvenir shopping. I am constantly amazed by the beautiful handcrafted goods that these people can make! Bags, carvings, knick-knacks, pillowcases, paintings, shirts, dresses, jewelry and anything you could possibly want is always for sale in town, and for cheap! I wish I could walk away with all of it. Again, as soon as pictures are able to be uploaded, I'll be able to give you a taste of just how authentic and stunning all of these goods are. 

Tomorrow we will depart for the weekend on a trip to Cape Coast, a beautiful old castle on the coast that was also the place where most slaves were held before their journey to America. Apparently it is extremely rich in history, so we will be making a 9 hour van ride to the coast, spending Saturday morning taking a hike through the Kakum rainforest and then visiting the castle in the afternoon. I am so excited! I'll be back in a few days to tell about how amazing it will undoubtedly be :)

Mia dogo emegbe! (See you later),

~ Sarah

When it Rains, it Pours

For volunteering today, I spent the better part of the morning in the Antenatal Clinic, interacting with pregnant women and observing the many ways that these women are cared for. Since it is Wednesday, the Antenatal Clinic began the day with a brief "church service". Besides just on Sundays, most Ghanians attend a church service every Wednesday at some point during the day. The service in the ANC this morning was mostly singing in chorus, with a few testimonies. It was all in Ewe, but I was able to clap alongside them and enjoy their beautiful singing voices. 

After the service, I visited different consulting rooms, in which nurses took vitals of their patients and palpated them for any abnormalities with their pregnancy. It is obvious to anyone from more developed countries that these departments are severely lacking in what the doctors call "gadgets", that we in the states posses in our health care system. Women's blood pressures were taken with manual BP devices and their heights were recorded from centimeter scales that were written on the wall with sharpie marker. It was also clear that they have different standards for physical examinations. The nurse just told the woman in my room to undress and lay on the bed, without giving her a gown or leaving the room for privacy. This was completely normal for the the patient and nurse, but it still left me taken aback and had me wondering if I should leave the room for fear of embarrassing the patient. She did not seem to be bothered by it though - just another example of the different social norms that I am experiencing. 

After the ANC, I moved onto the Out Patient Departments where I was of much more assistance. The nurses were extremely friendly and taught me how they take temperature and pulse rate of their patients and recored this info in their Patient Folders. I was able to record patient information and assist with taking their vitals, leaving some other nurses free for other work that was needed. This made me feel much more useful and gave me some skills that I can transfer between wards to make myself as beneficial to the hospital staff as possible.  

In the afternoon, we took the most beautiful 45 minutes hike through the rainforest to the Wli Waterfall. I have never seen a more amazing piece of natural beauty in my life! The waterfall is the highest in all of West Africa and were fortunate enough to spend the afternoon cooling off in its refreshing waters. I'm having trouble uploading pictures, but I will get them up as soon as possible because it was the most incredible sight to see. It was amazing too, because as you get closer and closer to the base of the fall, the wind from the cascading water is enough to knock you right off your feet. We all held hand and walked with our backs to the waterfall until we were able to touch the rock behind the fall. It was an afternoon full of swimming, laughter and fun.




I'm not sure if I've mentioned this already, but we are in Ghana during what they call the "rainy season".  Now this doesn't  just mean that they have scattered showers here and there. It means that when it rains, it pours. Tonight we had the most incredible storm I have ever heard. The electricity went out and it honestly sounded like the roof was going to cave in right where we were sitting. Normally I am not a fan of thunderstorms, but being out in the wild like this made the storm seem all the more powerful and incredible. The rain also helped cool things off immensely, so I believe that it will be extremely easy for me to sleep tonight and dream about all the wonderful things that this country has already done for me. 

That's all that I can say right now! Until tomorrow! 

Akpe kakakaka! (Thank you so much!)

~ Sarah 

Hohoe Municipal Hospital

Today was my second day of volunteering! Yesterday was our first day, but for me it consisted mostly of learning about the Ghana Health Services (GHS) and the hierarchy of the medical system. Hohoe is considered a municipal village, meaning it is of "middle population size". A district is the smallest and a metropolitan is the biggest, based on population. The Hohoe Municipal Hospital is the only major hospital in the area that can provided "specialized" (the term is loosely defined) medical attention to its patients. They have many different wards/units, each with their own head person in charge.

This morning's volunteering was three parts: 
Part 1 consisted of further orientation and learning the hospital's recently developed 5-year plan to enact their vision of providing excellent healthcare service while ensuring that their patients live the healthiest life possible. As I was being informed of this 5-year plan, I was awe-struck at how patient-oriented the hospital was trying to become. The doctor who was orienting me, named Courage, explained that two years ago, the hospital directors came together to revamp their program, with a vision of treating the patients with empathy, care, and compassion - ideas that were not enforced in years past. 

Part 2 involved a tour of the different wards/units in the hospital: dental, antenatal, labor, eye, physiotherapy (which I came to find out is the same idea as physical therapy), HIV testing/counseling and several more, including separate wards for males, females, and children. It was wonderful touring these wards because so much of getting around in the hospital involved going outside, walking down a path and then entering a separate small building. To me, half of the construction of the building was outside, with walkways and small roofs overhead. It did not come off as dumpy or unfinished constriction, but rather felt as if the constructors were both embracing the natural beauty within the hospital grounds as well as accommodating for the intense heat, which would no doubt be worse indoors. 

Part 3 involved observing/learning about the HIV counseling and testing ward, which was my favorite part of the morning. Every Tuesday, different members of the wards come to this unit to pool together their specialties and help test patients for HIV and counsel those who are positive. They also counsel those who are negative on how to continue to avoid contracting HIV and to help them lead healthy lives. Different areas that are addressed by each staff member include sexual safety, taking vitals, nutrition counseling/monitoring and helping women in the many stages of pregnancy with regards to passing HIV on to their child during both labor and birth. I have always known about HIV but today I was given the opportunity to ask upwards of a million questions about the stages of HIV, ways of contracting, the effect it has on the Ghanaian community members, etc. I felt like a sponge, absorbing every bit of information that I could. I was also given the opportunity to sit with Carl, a specialist in nutrition while he took vitals of patients and counseled ones about adequate nutrition when necessary. According to Carl, a telltale sign of a PLHIV (person living with HIV) who is going "down-hill" is their nutrition. As a specialist in malnutrition, he observes individuals who are suffering from malnutrition and counsels them appropriately. One girl came and sat down to have her vitals taken, and I was sure she was no older then 12 or 13 for how small she was. As he took her vitals, I came to find out that she was a PLHIV, 35 kg (77 lbs), and about 5’4. She was so incredibly thin, I felt such pain in my heart for her. It was a very sad sight to see, but one that also triggered a little light bulb to go off in my head: “Would I be interested in working with the link between HIV/AIDS and malnutrition in my Dietetics career?” Anything is possible at this point.

This afternoon was so incredible that I don’t believe I’ll be able to adequately put it into words. For starters, we went to the Tafi-Atome Monkey Sanctuary. Ledged has it that many, many years ago, a tribe of people worshiped an “idol” that they had stationed in the middle of their village. As these people began to slowly die out, different groups of monkeys were drawn by the power of this idol and began living together in the mass acres of forest that the tribe had resided in. To this day, the monkeys still inhabit the forest and are representative of the ancestors who originally possessed the idol that the monkeys were drawn to. The visit to this Monkey Sanctuary was beyond amazing. Absolutely no part of it was fenced in and the monkeys intermingled with us as they sat on our shoulders and ate bananas from our hands. One got tangled up in my hair at one point :)


After our visit to the monkeys, we walked across the street to have an authentic Drumming and Dancing lesson, given by a local church group that practices traditional African drumming. I had chills listening to the beat of the drums and seeing the passion of the dancers in their steps and body movements. We were able to join in at one point during the last dance! It was incredible. The dancers were so talented and we would each pair up with a dancer and do different dances and theatrics on the spot. The laughter and joy was the most wonderful feeling. 

I cannot wait to see the adventures that tomorrow has in store for me.

Fie! (Good Evening)

~Sarah