"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