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