Tea Time

I wake up around 6:30 am on my own. I guess when you go to bed at 10 pm that is plenty of sleep! My throat was a little scratchy from all the smoke and dust the previous day, so I stayed in bed reading my kindle until 8:30 am.

Once I was up, Isaac and Grace insisted I have tea with them. Since I had been up for awhile I decided why not. I enjoy the company over meals so it was a nice way to pass the time.

Ghana was a British Colony prior to their independence in 1957; therefore, they put milk in their tea, similar to the British. I was told not to drink any milk here, but the only milk they drink is evaporated milk out of a can, so I added some to my tea. I made sure to check the expiration date on the can since that is one thing they do not check around here.

While I was drinking my tea, Isaac, Grace, and myself discussed African politics and geography. Isaac was telling me that the government did not pay government workers this month before the holidays. The government in the past would give them their paycheck on Dec 24^th instead of the 30^th of the month when they normally get paid. They still have not received their wages for the month of December. The presidential elections are in January. I was telling Isaac that a politician in the US could ruin their campaign if something like that happened. Isaac said people here are not willing to cross party lines even if the candidate is bad so the majority party will probably still win the election. I told Isaac how it is much the same in the US.

In the afternoon I accompanied Millie and her cousin to the hairdresser. They needed to get their hair done. I figured it would take about 2 hours. It takes about an hour and a half to braid the hair so they can weave the extensions into the hair. The weaving of extensions takes another hour! I lost all patience. I think the hair stylist only actually worked on their hair half the time I was there. They stopped to eat and gossip a lot. I guess its not much different than the neighborhood salon in the US, but I only get my haircut a couple times of year. It is too hard for me to sit in one place for that long!! Finally, around 5:30, I had enough and had to walk home alone.

I’m hoping Millie will want to show off her new hair tonight to celebrate new years. However, she does not like to go out in her hometown all that much. I’m not sure if Isaac and Grace stay up for new years or not. If I’m asleep by 10pm it won’t be my first new years eve in bed. Since I’m in healthcare, I’ve definitely worked a couple of new years’ days and have needed a goodnight sleep! I would like to see the festivities though!

Happy New Year!!! Feel free to call me when you our celebrating tonight! Its right around 6 am when I wake up! J

Love, Kari

Bush Meat

I went with Kenneth and his wife to the village of Ho, today. Kenneth wanted to talk to the physical therapist at the regional hospital there to inform him of the Step FaR organization. Kenneth’s vision is to come to Ghana every 6 months or so and do continuing education courses and in-services with the physical therapists at various hospitals in Ghana. Unfortunately, the head therapist was in meetings so we did not get to meet him. We gave them our information. Hopefully, we will hear from them so I can go there for a couple of days to help them out. The intern we spoke with says they need a lot of help!

After visiting the hospital we had lunch in Ho. I’m trying really hard to eat traditional foods. I’m getting use to the texture of the dough balls. The soups are usually quite tasty. However, the meat is just so difficult to eat. I have an aversion to fat and gristle on my meat!

I was pretty adventurous though and tried a bite of bush meat. It tasted very wild. Bush meat comes from the little varmints running around the bush. I guess they look like giant guinea pigs. The hunters set fires to the bush and then shoot the animals as they are running away from the fires. I guess you use to be able to get Bush Meat in NYC, but then they found cocaine in their stomachs. Obviously, the US government put a stop to that!

In the jungle surrounding Ho, we could see the hills burning from the hunters setting the fires to caputre the bush animals. It was rainy ash today! Also, it is so dry here right now that there was a terrible haze over the whole village! Many times the bush fires get out of control and end up burning down whole villages. They are illegal, but there is just no way the government can enforce many of the laws. Also, if you have enough money you can usually bribe someone. It’s sad, but that’s life in a developing nation.

The ride to and from Ho is very beautiful. We were on a mostly paved road winding through the bush and mountains. Spots along the road are very jungle like. We could see Lake Volta when we were higher up in the mountain; however, the haze from the dust and smoke kept me from really being able to see it.

Next month, I plan on going on a boat ride on Lake Volta! Until then I will enjoy my view while driving. Lake Volta is fresh water so I will not be able to swim in it. There are too many parasites to worry about.

I hope everyone has a safe and fun New Years!! Don’t drink and drive. I’m going to try and avoid cars tomorrow since there are no drunk driving laws here!

Love, Kari

Ghanaian "Moonshine"

Moonshine

Kenneth from Step FaR accompanied me on the home visit to “Aunti” today. I was very happy to have insight from another therapist on how to help her. It’s funny because last week I attempted the slide board transfer with her and it did not go well. Her bed is very low to the ground so the slide board was a poor bridge from the bed to wheelchair for her to scoot across. There was about a 5-inch height difference. I was racking my brain trying to think of inexpensive ways to even out the height. All it took was Kenneth looking at the cement blocks outside and we decided we could put those under the bed frame to raise it up. “Aunti” was then able to perform the slide board transfer with min assist from Kenneth. I think with a few more therapy sessions “Aunti” will be independent with the slide board transfers! That is excellent! It will give her a little more freedom in her room.

I saw a few more patients at the hospital and then Kenneth took me to his parents’ house for lunch. He made me eat an authentic Ghanaian meal. He said he was not going to let me get away with the way I’m eating anymore. Haha! I had bamku. I’m learning to swallow it whole. I’m acquiring a taste for it. I was only using my index finger and thumb to eat the food. I was informed that I must use my whole hand. I don’t like my hands to get sticky and so it was hard but I forced myself!!! I ended up spending the whole afternoon and some of the evening with Kenneth and his wife. We drank Star beer. It is brewed in Ghana. Also, he made me try the local “moonshine.” It is made from palm tree. My throat is still burning from it and that was 2 hours ago! It’s worse than the bourbon moonshine I had on the bourbon tour in KY during my friend Xouhoa’s wedding!!! I think I will stick to beer!

Tomorrow, Kenneth and I will travel to the village of Ho to do some education at the local hospital. We are not leaving until Monday to travel around the country. We are on African time so there are always delays. Regardless, I am really excited to help Kenneth and his organization. His goal is to come every 6 months or so and hold training sessions at hospitals here to help train Ghanaians in physical therapy. Again, it's the idea of sustainability or paying it forward! I really love the concept!

I am so stuffed from eating 2 huge traditional Ghanaian meals today! I really can’t believe how worried I was about losing weight here. The food is so so filling! I can’t quite stomach the beef and goat, but the chicken and fish is quite tasty. The various dough balls that are the main portion of the meal fill you up very quickly! I still have to get use to eating with my hand, but I definitely will not starve in this country! Haha!

Love, Kari

Barefoot Gait Training!

It was a rather uneventful day at the hospital. Ghanaians are still celebrating the holidays so I guess they stayed home. One of the patients who I was seeing in the ward, but now has returned home has gone from hardly being able to sit by herself to walking 20 feet with hand held assist. She is a very proud lady and was dancing as she walked today! I love her spirit! I think she had sort of given up hope of walking again after her stroke since they tell her she is an old lady. I helped explain to her family and her that even if she is old she still has potential to walk and be independent in her home! If I have more patients like her I will feel like this is a successful trip!

Another interesting thing here is that everyone wears flip-flops or walks barefoot. I would never allow one of my patients in the US to wear flip-flops during our treatment session. While I love flip-flops, they are not safe shoes for gait training or anyone with balance problems. However, I don’t really have a choice here so I am embracing barefoot gait training! Haha! I just hope there is no broken glass around when we are walking on the dirt outside their homes. There is something to be said about being barefoot in that I’ve noticed very few foot deformities. The foot deformities I have seen have not been due to shoes. Most of my middle age female patients in the US have some sort of hallux valgus, bunions, or corns due to improper fitting shoes.

One way I keep myself from getting bored after work is sitting around with Millie, Grace, and Patience watching them cook dinner. They have gas for the stove so they are cooking some of the food inside again; however, they still use the little charcoal stove for the more traditional foods. I described them a little but I will try and go into more detail now. They eat a dough made out of various things and dip it into a soup with their right hand. You do not chew the dough. You just swallow it whole. I have now tried the following doughs: fufu, bamku, ackbale, kanke (I know none of those are spelled correctly). Fufu is made by boiling cassava plant (a type of root vegetable) and plantains then pounded until they turn into a raw dough. Bamku is made from some sort of yam flour (I think) that is boiled with water and then stirred into a dough. Ackbale and Kanke are made from corn flour and again are boiled and stirred into a dough. I do not have a discerning palate yet and so they all sort of taste the same to me. Also, since you swallow the dough to me it seems like a lot of calories that you do not even enjoy tasting. Kenneth told me that I should be embracing all the African foods so I’m trying! He doesn’t know yet how picky of an eater I can be. Haha! Luckily, nothing tastes bad. It’s just that none of the more traditional foods are anything that I would crave. Maybe, by the end of this trip I will love them as much as the Ghanaians!!

I’m starting to miss American food. I have been slowly eating a few of my snacks I brought along. I’m only 3 weeks into this so that is probably a bad thing! Oh well! They feed me very well so I know I will not starve. I can’t help but feel guilty that I will probably gain weight here, and there are Africans that are starving.

Love, Kari 

I missed a post! Sorry!

I missed a post! Sorry! Yesterday was a very busy day. Also, I did not stay in Kpando last night so I was not near my computer to type. I will write an extra long post to make up for it! J

I met Kenneth yesterday morning. Kenneth grew up in Kpando, but now lives in Arizona. He is a US trained P.T. He started an organization called Step FaR. I will be travelling with him to various villages giving presentations on P.T. and performing P.T. services. Kenneth, his wife, and his 5 month old son travelled here this Christmas! I’m amazed that someone is willing to make a trip like this with their baby. I guess start them young, right? I briefly chatted with Kenneth’s wife, who is an American. It was nice to compare notes on the things that are so different than the US. We were supposed to leave for the trip today, but Kenneth’s partner is delayed so we will leave on Friday or Saturday. It will be nice to have 2 more days at the hospital this week.

After meeting Kenneth I walked with Grace and Isaac to one of their friend’s houses. The friend had guests, a nice young German couple around my age. They are on quite the adventure! They took a cargo ship from Brussels to the Ivory Coast and then travelled in car through Africa to Ghana. They stopped to visit Isaac’s friend since the lady stayed with him 4 years ago. They made it to his house 2 weeks ago and she came down with malaria. She has been recovering for the past 2 weeks! Once she is feeling better they then will be travelling through Ghana, into Toga and then to Northern Nigeria. She is studying the language of that region. Then the man is studying Swahili so then they will go to Kenya! I admire people who are willing to travel like that. I think this trip is as adventurous as I will get! Haha! J I have no desire to make Africa any harder than it already is.

Once we said goodbye to the friend and the Germans we went to the market. Oh before I forget, Isaac’s friend graciously offered for me to be his 2^nd wife. I nicely declined. Haha!! I told him I don’t know how to pound fufu (one of the local foods) and so I would make a poor wife here.

Anyways, at the market we went to the butcher. It was a little traumatizing!!! When I was standing in the room as they were hacking away at cow and goat, I swore to myself I’d give of meet. First of all, the room is room temperature. I don’t think the FDA would approve of that. Next, all the butchers shared the same scale to weigh the meat. Thus, goat and cow were mixing. The butchers did not wear gloves or hair nets. Blood and guts were splattering everywhere. I stood in the very middle hoping I nothing would fly on me. The smell in there wasn’t quite rancid, but it was not appealing. The meat was unrecognizable to me. I don’t think they serve filet mignon in Africa!! I think their cuts are totally different then ours. Honestly, I felt they were just hacking away haphazardly with their machete knifes. I fear they would have been quickly eliminated on “Top Chef” butchery quick fire.

Isaac quickly became impatient with Grace in the market. I guess now matter the culture men do not like shopping with women. Haha! Isaac suggested we go to his favorite bar. I had a fanta instead of a beer since it was 11 am. Isaac ordered street food that was basically beef kabobs. I thought for sure in the butcher I would not eat any beef here, but ate the kabobs and they were quite tasty. Haha!

The next part of my day was going with Isaac to his village to deliver Boxing day parcels. I met many of his relatives. I drank some palm wine that was fermented in a motor oil container. I’m not sick today so I guess the alcohol killed everything. Haha! Palm wine was sort of sweet and then had a weird salty bitter aftertaste so I will stick to grape wine. Ghanaians respect the volunteers that come to their country greatly, so Isaac wanted me to meet the head Tobi, or chief of the village. It was funny because it was about 15 men sitting around talking. They had a secret bow and handshake to honor the Tobi. I felt like it was a meeting of the Dons like in the Godfather minus the violence and illegal activity!!

My day was not over yet! Once I returned back to Kpando, I left shortly after to go to Hohoe, a neighboring town to go out for the evening with Millie, her cousin and friends. We went to 2 bars.

The first bar was called Obama Gardens. It made me laugh. I’m not sure how the president would feel about having a bar named after him. Africans are very proud that a Black man could be elected president of the country they still aspire to be like. Despite your political affiliations, I think as Americans we can be proud that people around the world still admire us.

The bar scene in Ghana is not much different than in the US. Its young people having a few drinks and dancing! They probably dance better than most Americans! Haha! It was great people watching!

My ride to the Guest House was on a motorcycle! It was only the second time I’ve been on one! It is very liberating but extra scary on Ghana’s roads!! It probably is not the smartest thing to do here, but you only live once so I’m going to make the most of it. In case you’re wondering, I did not wear a helmet. I figure wearing a helmet is just so they can harvest your organs when you get into a crash. I don’t think they do much organ donation in Africa.

The Guest House was clean, but the bed was hard as a rock. Millie and her cousin wanted to make sure I stayed somewhere with a real toilet. They are always looking out for me!

This morning before we left Hohoe, we went to the Cocoa Company. I got to see how Cocoa pods grow from the tree. They split one open for me so I could try it. I was expecting chocolate inside the pod so I was a little surprise what it was like. The pods are oval shaped about the size of a small melon. Inside the pod are large seeds covered with a fruity membrane. You can suck on the seed and it has a sweet taste similar to cantaloupe with a slight hint of chocolate. Weird, huh? To make cocoa powder, they dry the seeds and ferment them. Then they grind them. I also saw a coffee plant/tree. Coffee comes from the berries. The coffee seeds are inside them. Those are dried and then ground into coffee.

I know this was long, but I wanted to tell you about everything I did the past day and half! I hope everyone had a Merry Christmas!!!

Love, Kari

All I want for Christmas is a Hot Bucket Shower!!

Merry Christmas!!!

It’s sort of surreal to think I am in African on Christmas! They do decorate some and they celebrate a little, but it definitely does not have the same feel as Christmas in the US. They did prepare chicken for Christmas lunch, but they do not eat around the table like we do, so it did not have the same feel to me. They do not really exchange gifts either. American commercialism hasn’t quite reached Ghana on Christmas. I have a feeling though its slowly creeping here.

I gave everyone a little gift for Christmas so they have an idea how Christmas feels in the US. I had my camera out and snapped a picture of everyone opening their gifts and then posing with the gift after they opened it! No matter where you live, people’s faces are priceless when they open a gift!

My Christmas gift was a hot bucket shower this morning! I actually woke up a little chilled this morning (it was probably 70 degrees outside), so I was more than willing to take Millie up on her offer to warm water!

In the town, little boys are running around setting off fireworks! USA mom’s would have a heart attack I fear. I have yet to see an obese child yet since all they do after school is run around until the sun comes down. Wise, Isaac’s son is so exhausted in the evenings that he passes out on the couch around 7 pm every night like an old man! There are no video games here to taint their imaginations!

I hope everyone is having a wonderful Christmas in the US. Also, I hope everyone remembers what Christmas is truly about: family, friends, and helping others!!!

Love, Kari

Orphanage

This morning, I delivered presents to the Ryvanz- Mia Orphanage. My Grandma, Suzanne Somos, and her sister, Daisy gave me money before I left the US to give Christmas presents to the orphanage. “Mama” as they refer to the lady who runs the orphanage was very thankful! There were lots of little kids running around. While it was an orphanage, the children all looked so happy! I’m excited to go there in the afternoons and help out in whatever way I can, in a few weeks once I’m back from travelling around Ghana.

The orphanage and Isaac’s special inclusive school (special needs school) are very neat in the way they function. They are providing children with either a home or education, but also, they are teaching the children to one day be self-sufficient. The orphanage teaches the children how to make the beautiful African fabrics and sew them into bags, dresses, etc. The special inclusive school partners with local tradesmen, who teach the children how to perform a task in order to work someday. This way when the children leave the orphanage or graduate from school, they will be able to support themselves.

The organizations I am here with, Village Volunteers and Therapists Without Borders, partner with both the orphanage and special inclusive school, in order to help them achieve their mission. Since it is Christmas Eve, and Christmas is about giving to others, if any one wants to make a donation please go on the Village Volunteers website! You can ask for your donation to go to one of these programs!! It will go there too! That’s the nice thing about small organizations! They do not have as much overhead so most of your money actually goes to the cause!!!

Also, look at Therapists Without Borders facebook page. Linda, the CEO, has post some very interesting articles about the effectiveness of NGOs (non governmental organizations) in developing programs in developing nations. Some examples of successful NGO projects are the hospital I am working at in the village and Isaacs’s school. They were both started/funded by German NGOs.

Merry Christmas everyone! I’m excited to post tomorrow about Ghanaian Christmas festivities!!!

Love, Kari

Finished my 2nd Week

I finished my 2^nd week at the hospital! These 2 weeks sure have gone by fast. I’ve really enjoyed seeing all of the patients. They are all so friendly and thankful! They have brought me lots of bananas! Good thing I like bananas. I swear I got a new bunch everyday this week.

Today was just a typical day of therapy. The interesting ward patients were discharged home. It actually is pretty crazy to think a man who cannot walk was just sent home. There are no social workers or nurse case managers here to ensure you have all the necessary equipment for discharge. The man will be bed bound until the wheelchair and brace specialists come to Kpando in February.

I will have 4 days off for the Christmas holiday and then I will be leaving Kpando and travelling Ghana with Step Far Organization until about January 20^th. Then I will return to Kpando and spend 2 more months at the hospital.

I am excited to spend Christmas here and experience another culture’s celebration. They do not have Christmas trees and they don’t really exchange gifts with one another, so it’s going to be interesting!

I hope everyone has a wonderful Christmas back in the US!! I will be thinking about all of you! I still plan on posting this weekend so check my blog!

Love, Kari

Market Day

I had too much excitement last night to write about the hospital so I will try and write about it, now. I still never figured out what was going on with the man who could not move his legs but seemed to have normal sensation. I found out it’s because the doctor, who sees the male patients, is Cuban. Her documentation is very brief due to her limited English. I introduced myself to her and she said hi, and then proceeded to talk to me in Spanish. I had absolutely no idea what she was saying! I’m sure she is knowledgeable but it does not give me a chance to know their medical background. The Ghanaian doctor told me he sometimes looks at her patients, too, so he can explain what’s going on to the nurses, but he does not want to step on any one’s toes. I told him I appreciated any information. He is a very thorough physician. I know he makes do with the resources he has available; however, I can tell he is often only making an educated guess. He refers when appropriate!

The stroke patient who is 32 is making excellent improvement! The brain is remarkable. Yesterday, the doctors told him he’d be blind in his left eye so he was very depressed when we worked with him. Today, he was able to see out of the eye and was so happy!! His balance was much improved. We no longer had to help steady him while walking. He still looks like a tree branch blowing in the wind, but he is now able to right himself on his own when he is thrown off balance. I feel this will improve to almost normal levels in a few weeks! My one area of concern, which I feel may be his main issue for years to come, is his foot drop. I educated Celestine on the importance of addressing this early to avoid plantar flexion contracture. He has some volitional control of dorsiflexion so I think it should improve. I hope he continues to come to therapy as an outpatient since he was discharged today.

I only worked until noon today. They had a meeting this afternoon so there was no point in me sticking around. Millie and I went to the market so I could buy Christmas gifts for everyone! Gift giving has become such a huge part of an American Christmas that I want to give a little bit of our culture to them, too! They are getting compensated for me to stay with them; however, they have been so hospitable that I want to give them gifts!

The market was even more crowded today then the first time I went! It was the last market day before Christmas so everyone was out and about getting their supplies. The market is a cross between the grocery store, a flea market, farmer’s market, and shopping mall. Again, it is extremely rustic by American standards. There is no walmart or target here, so this is where you go. The market occurs every 4^th day.

Along with keeping the blog, I am also trying to journal. Since I am not so overwhelmed by the town anymore, I figured I post my journal entry from the first market day excursion. That way you can get a true feel of my reaction.

Market:

So it seems like this house is very close to the center of town. As I walk around I realize that it is a much larger town than I have seen so far. The market was a short 10 minute walk or so. We took a shortcut that had us walking through what I would call the alleyways. The very main roads are poorly paved, the side streets are pressed dirt, and the alleyways or small roads are dirt and larger rocks. How cars drive on them I do not know. I’d be afraid of a flat tire and its not like you can call triple A here. The main roads have large open drainage ditches on the side about 1 ½ feet wide and 3 feet deep. Right now they are dry but during the rainy season they overflow and flood the streets. There are cement ramps across them so you can drive onto driveways. Driving off the road here could have horrible consequences since you really will end up in a ditch.

Garbage is strewn everywhere. I remember watching a Mad Men episode a year or two ago where Don Draper went on a picnic with his family and they left their garbage everywhere in the park. I didn’t really believe that people do that. People who know me know that I’m not an environmentalist by any means and I can be very lazy about recycling, but I always try and throw my trash away. I guess being here I know maybe understand that it’s a taught thing. If someone doesn’t teach you to throw your trash away then you just throw it where ever. Despite all the garbage I haven’t really been bombarded with too many smells yet.

The closer you get to the market the more crowded it becomes. Little kids are endlessly staring at me. Some turn their heads away in embarrasment, some follow me and yell at me hoping all acknowledge them, some wave at me. I try and smile, wave, or say hello back. I’m not offended by their curiosity and they are so darn cute.

Once you are in the market, it sort of reminds me of a flea market. Stalls are everywhere along every small street or alleyway. The shacks are almost like a very large lemonade stand. They sell anything you can imagine. I have yet to see a real store in this town like we have in the US, so this is where you come to do all your shopping.

Women have their infants tied to their back while they try and shop or try and sell items. Also, once they are finished they carry the loads on their heads, along with baby on their back. It’s a pretty amazing site. These women are hard working tough ladies. Life is not easy here, but so far I’m getting the feel that most people are pretty happy. Obviously, I’ve only been here 5 days so that may be an observation that changes.

Some of the streets in the market have an open sewer running through it. They are strewn with garbage. I saw people dumping their garbage in there, peeing in there, etc. Again, I was so shocked by how little it smelled.

The Muslim vendors roll out their prayer clothes in order to observed midday prayer. However, they were willing to make a transaction with us first before starting.

My only true excitement tonight was the bat flying around inside the house! It made me second guess not getting the rabies vaccine series! At least if a bat or mammal bites me I have 24 hours to seek medical attention. If a snake bites me, I’m dead in 20 minutes!

Life in Africa! My heart may race a little faster, but I’m enjoying it! J

Love, Kari

My life flashed before my eyes for the 2nd time in 4 days!!!!

I should write about the hospital tonight since it was an interesting day there! However, I had an interesting night so instead I will write about that!

Isaac was taking his son to his home village about 30 minutes away from Kpando tonight! Wise, Isaac's son likes to spend Christmas there with all his cousins. Isaac wanted to show me his village so I went with him. He decided to have his school bus driver, drive us to the village. Isaac's school bus for the special needs school is actually only a Honda minivan circa 1985! It is on its 2nd engine, and it will soon be on its 3rd! We were not even out of the town of Kpando yet when the thing started rumbling and smoking! It was so much smoke that I could not see my hand in front of my face! I jumped out of the car as fast as I possibly could because I thought it was going to explode like in the movies!!! Isaac said it wasn't the first time something like this happened. I'm a little worried for the school children who they transport everyday in that van!! I guess this is life in Africa!! They managed to get the hose reconnected. Luckily, Isaac was smart enough to suggest us taking a taxi to the village.

The taxi to and from the village was uneventful by African standards. It was the typical darting across the road to avoid potholes and "chicken" playing with the cars coming down the road! Haha!

We only had about 10 minutes of sunlight at the village since we got there later than expected. The village was actually very pretty. It was in the hillside of the jungle. The houses were built into the hill. It was more rustic than Kpando, but since it was not so crowded it seemed cleaner! They do not have consistent trash service and the idea of a trash can is foreign here! Ghana has much potential for tourism, but they first need more work on basic infrasturcture before the country as a whole would appeal to Americans.

Once we returned to the village, Isaac took me to his favorite "corner bar." I told him that's what we call it in the US, or at least Wisconsin! Haha! I was still a little shocked by the car incident that I was willing to drink 2 Guiness with him! Haha! 

So, I'm quickly learning everything here is an adventure! A simple car ride is not simple here; however, everything is guaranteed to be exciting! :)

Tomorrow, I will try and write about the hospital!

Love, Kari

My African Sister

We were busy again in the ward today. The 2 stroke patients I saw yesterday and today will make good recoveries. I still cannot get over someone at 32, in really good shape having a stroke!

I’m still trying to figure out what is going on with my man who has no volitional control of his legs but normal sensation. Someone with an incomplete spinal cord injury could have sensation and loss of motor control, but usually both motor and sensory nerve fibers are affected to some degree. In his case it seems like only the motor neurons are affected. He had much less tone today. The doctors in his chart have not acknowledged his leg issues other than writing that they are weak. Also, they made a referral for PT. I appreciate the referral, but if the legs are not innervated, there is not much I can do to make them work again. I guess the motor tract of the spinal cord could be injured, but again it usually does not present bilaterally. PTs reading my blog, please correct me or give me insight!!! I was not able to pack my neuro rehab book in my suitcase since it was already overweight!

The patients I have been seeing in the clinic seem to be making some progress. I’m pleased since, I feel like I am off my game. They do not do any documenting here so I have a hard time remembering what I did with the patient the previous session. I try and write myself notes to remember, but sometimes they just look like chicken scratch. That is the nice thing about computer documentation; you can read it! I educated Celestine on the importance of documentation, but there is only so much I can successfully implement while I am here. I do not think documentation will happen this trip.

After work, I “chilled” with Millie. Its funny to me that Millie and her friends enjoy using that word. There is no chill whatsoever here!! I like warm weather, so I’m not complaining. However, it does get very hot here, to the point that I look forward to my cold nightly bucket shower.

I promised Millie I would write about her in my blog! Millie has quickly become my African sister while I’m here. She is 19 years old, but despite our 9 year age difference we have become fast friends! She is friends with everyone. Her phone rings as much as any American teenagers phone! She is the equivalent to a high school senior. She is very excited to go to the University next year. She is interested in broadcast journalism. Millie would love to see America so if anyone is interested in an exchange student she’d love to come! She is home from holiday from her boarding school and is becoming very bored. Thus, we both enjoy each other’s company. Without her, I do not think I would have transitioned so well into this experience. While there are many cultural differences between us, she has been exposed to enough American music and TV that we find plenty of common ground. Also, she is always willing to leave her house and go for a walk in town with me. Further, she has helped my ego by always telling me, “Kari, you are a beautiful girl.” I tell her she probably says that to every white girl, but she reassures me that not all white people are beautiful. Haha!

I hope one day Millie and her family can visit me in the US and I can welcome them as much as they have made me feel welcomed in their home and country.

Love, Kari

Busy Morning in the Hospital Ward

Today, we were very busy in the hospital ward. We saw 5 patients in the ward, 3 outpatients, and 2 home health patients. The ward patients were all very interesting. 2 of the men had strokes. 1 was only 32 years old. Another man was in the hospital due to complaining of stomach pains, but could not move his legs.

If I can find the medical chart, the information in it is very brief. Also, the doctor’s do not have access to CT scans or MRIs so there is not much information regarding their brain. I have to figure out the area of infarct (death/injury in the brain) based on how their symptoms present. I guess I know why our neuroanatomy class was so challenging in PT school. It prepared me for this!

The patient who could not move his legs and was presenting with stomach pains was very interesting. He had clonus in his feet when I pushed up on his heel. He seemed to have normal sensation. He reported control of his bowel and bladder. I do not feel he has cauda equina syndrome due to that. Usually, a CVA does not present with symmetrical symptoms. It leads me to believe he has some neurological disease happening, maybe some sort of demyelination of the nerves. He was able to put some weight through his legs when I stood him with maximal assist of 2 people; however, I had to heavily guard him. Hopefully, through forcing him to weightbear through his legs we can get the circuit between the brain and legs working again!

The other thing I am finding troubling is the incidence of heart disease and CVA in the African population. In the US, African Americans are also predisposed to heart disease. I always assumed it had more to do with people’s sedentary lifestyle and eating habits in the US. However, here most of the Africans are very hard working and have very physically demanding lives. Also, the diet may not be the healthiest here, but everything is homemade and they eat very little processed food. It leads me to believe that it is a genetic issue. Thus, there may be little to prevent it other than medications. That is a sad fact because many of the Africans here do not have access to good medical care to prevent it. If you know me, you know I do not advocate pharmaceuticals. However, I think I’ve been convinced of their use in many instances here (malaria, hypertension, vaccinations)!

I’m trying to find ways to fill my evenings and afternoons since I finish work at 3 pm! I went on 2 walks around the town. Millie had me try killywilly (I’m sure that spelling is incorrect!). It was fried plantains with ginger and pepper seasoning! They were delicious. I’m sure eating them a lot increases your risk of heart disease, but I always figured physical work off set the a bad diet. I’m thinking my logic is poor!

Well, the hospital ward is going to be very interesting this week! I hope I can help these patients make a speedy recovery so they can return home to their families and be more functional!

Love, Kari

Snake!!!!

I woke up this morning feeling so rested! I think I am finally use to the time change. It takes me forever. Once I was up and moving, Millie showed me how to do my wash. It wasn’t too terribly difficult to do. Actually, if was really easy. A washer and dryer is much less of a hassle!!! I’m glad Millie showed me because, I know to separate whites from darks, but when you are washing from hand you also has to separate jeans and any fabrics that may bleed (my new African wrap) from other clothes! My pink and red shirts would have ended up brown had I done the separating! It took about 3-4 hours for everything to dry completely. I also cleaned my room. It is so dusty here since it is the dry season! Despite all the dust, I haven’t been having any allergy issues. I guess I’m not allergic to African dirt. J

Once the laundry was finished, Millie and I went on a walk to her friend’s house. On our walk back into town, a green/yellowish snake about 6 feet long crossed our path! We simultaneously jumped and screamed! It’s the largest snake I’ve ever seen in the wild! Also, it was the first poisonous snake I’ve seen in the wild. Millie said it’s only the 2^nd time she’s seen one, the first time she’s seen one in town! If it bit one of us, we would have had about 20 minute until we would have been dead! It took a good 30 minutes for my heart to stop racing! I am not a fan of snakes. That better be the last one I see in Africa!

It’s a pretty lazy Sunday! I’m ready to get back to the hospital tomorrow and work with more patients! Hope everyone is enjoying their weekend back home! I heard there was snow!!! It’s in the upper 80’s here!

Love, Kari

(I tried to upload a photo of us at the waterfall and it takes too long!)

Waterfall

Today we went to the waterfall. It is about an hour journey from Kpando. The closest large village to the falls is called Hohoe. I woke up around 7 am since we were suppose to leave between 8-9 am. Grace had warm water waiting for me so I was able to take a hot bucket shower again!! Heaven! During the dry season the temperature drops to around 70 degrees at night. I think they are worried that I'm terribly cold during the mornings. To me, it is just the right sleeping temperature. I won't refuse a hot shower, though!

I'm quickly learning African time. It means if someone says a certain time, they mean within 2 hours of that time! Haha!! Its just another thing I'm trying to get use to. I am very prompt and so I'm having a hard time with that.

Millie's friend, Isaac, a police officer in the village came to pick us up around 10 am. We then picked up her friend Evelyn and Millie's Dad's friend Killian. Killian invited himself along since I think he worries about me. Maybe since I look 15 years old, he felt like I needed a chaperone. Haha!

The car ride was an adventure. The roads leave a lot to be desired. You alternate between periods of pavement and dirt roads. The pavement is smooth 50% of the time. When that occurs, they drive, I swear, 100mph!! When the pavement is full of pot holes, you get thrown around and feel like you have whiplash, since they dart all over the road trying to avoid holes. When the road is dirt, they drive wherever they feel it will be the flattest. When there are other cars coming, you constantly feel like they are playing chicken. Pedestrians do not have the right of way. The drivers are kind enough to honk at you so you know to jump out of the way! Now, I understand why the taxi cab drivers who are immigrants from Africa drive so crazy in the US.


Once we got to the base of the falls, we had a 45 minute walk to the actual falls. The walk was very pretty. We were in a jungle surrounded by small mountains. Beautiful little butterflies were flying all around your head. There were pretty white ones, black and white ones, aqua blue ones, yellow ones, and black and orange ones! As we were walking we past palm trees, ferns, bamboo, and cocoa trees. I always thought cocoa came from a plant, but they are tall trees here. Ghana is known for their cocoa crops so I'm excited to try some when I'm here.


After 45 minutes, we came to a clearing where you can first hear the gushing of water. A fine mist of water starts to sprinkle on your face and then you can see the falls! It was pretty tall and we were only able to see the bottom of it. I got excited because hundreds of small butterflies were congregating in this one spot! I finally was able to snap a picture of them. The fall is so tall that we couldn't take a picture with us in it and get a photo of the entire fall. People swam out to the falls in the pool that the fall flows into. I was told by the doctors in the US to avoid any freshwater here so I didn't venture out into them. The falls come down so hard that people have to lock arms so they do not fall over. I love water, but I'm not a fan of cold water so I figured it was okay that I didn't go in it! We sat around for about an hour enjoying the sight and the wonderful sound of water falling and then walked back down.

On the walk down, I met a Canadian volunteer. It was nice for a few minutes to talk to someone who understands the culture shock I am going through. He seemed a little more adjusted then me! Haha!

We were going to eat in Hohoe on the way home since we were all starving, or at least I thought. After two stops we found a place that had rice since I'm not completely use to the food yet here. I thought we were going to eat together, but it was just going to be me eating and so I told them we could just go home. I'm still not use to eating alone yet here. I guess it is a sign of respect here for someone to eat alone. I, on the other hand, enjoy my meals the most when I'm with company!

Overall, my journey to the falls was nice! The drive is emotionally exhausting, but that's Africa! :) If I go back again, I will take the longer hike up to see the upper part of the falls since we could only see the lower falls today!

Tomorrow my post will be about doing laundry! Haha! Hope everyone is having a happy weekend!


Love, Kari

I finished my first full week!

I can't believe I've completed 1 full week at the hospital! It was a good day. I'm seeing such interesting patients with strokes. I wish I was a better hand therapist. At the hospitals I worked at in the US, the occupational therapists would normally work with the hands. Also, I just do not have the equipment to properly splint them to avoid hand contractures. I guess I will start to get creative very fast. Thank God for duct tape. I have a feeling it will come in handy.

I saw "Aunti" again. I helped her husband 2 man fireman lift her to the wheelchair. Its not easy so the sooner I can get her independent with slideboard transfers the better! Also, it will hopefully give her some freedom. The slideboard isn't ready yet, so I focused on arm strengthening and pressure relief education. I'm really worried about her developing more pressure sores since she already has them on her heel. This education may be one of the most important things I can teach Celestine and Doris when I'm here. Its so hard to heal wounds even in the US with the best medical treatment that I think one here would be catastrophic.

Work was finished at 2 pm today instead of 3 pm since the doctors have meetings on friday afternoons and the families come to pick up their deceased loved ones from the mortuary. I took a little nap because I'm still figuring ways to entertain myself. Then I hung out with Millie some which consisted of keeping her company while she did laundry. I have to wash my clothes on Sunday so she is going to teach me how to wash my clothes by hand!

Today was extra exciting because the plumbing worked. I got to go to the bathroom 2 times and the toilet flushed like a normal toilet. Also, since they had plenty of water, they warmed some up on the stove so we could all take hot showers tonight! It was heavenly. I was so sad when I dumped the last warm cupful over my head. I didn't want it to end. Its amazing how the littlest things can give you so much pleasure! :)

Isaac had to get a haircut so he had me walk with him to town. It was weird to be the only girl sitting in the barbershop. There were African teenagers in there waiting to get their haircuts singing along to the music they had playing. Of course it was hard core rap from the US. It was funny hearing them rap along in their Ghanian English accents. Also, I don't think they understand how derogatory some of the words are even though they speak perfect English here. Of course after the haircut Isaac had to take me to one of the watering holes. He enjoys a beer in the evenings but is sick right now so couldn't have any. He made me order a Guiness and of course forced me to drink it. Haha!! Who would have thought that Guiness would be such a popular beer in Africa.

It is 9 pm and everyone is in bed. I guess since everyone works so hard here, they don't really go out on the weekends like we do in the states. I'm glad my computer seems to be working so I can keep myself entertained until I get tired.

Tomorrow we are going to one of the waterfalls around here! I'm really excited. Hopefully, the internet will work well enough so I can post a photo!!

Have a good weekend everyone!

Love, Kari

Brief Overview of My Day

Today I saw patients in the hospital. I know what I did was helpful, but I just saw typical PT patients so I'm going to walk you through my day.

My alarm wakes me up at 6:45 am. I make it out of bed around 7 am. I take my vitamins since I'm not all that sure how balanced the meals are here. I can't afford to get sick here since medical care is not up to US standards.

I get up and fill a bucket full of water to go to the bathroom. Then I have to fill another bucket full of water to take my shower. Right now, it is getting down to 73 degrees at night so when I wake up I am very comfortable. The first cup of water I pour on myself in the shower is so cold. I have to stifle my scream!! By the end of the bucket it doesn't feel so cold anymore. I'm only washing my hair with shampoo every 2-3 days. It is just too much work to get all the soap out every morning.

After I shower, I apply my bug spray and then get dressed. I wasn't all that disciplined my first few days here since I haven't gotten any mosquitoe bites since my first night. However, I have now met 2 people with Malaria. I really do not want to get it! Even though I am taking malaria medication everyday, its not worth taking my chances.

I don't eat breakfast so I fill my water bottle full of water. In this heat it is so important to stay hydrated throughout the day. I cannot drink the water here without filtering it first. I sometimes just drink bagged water since it is easier than filtering. Instead of water bottles they have bags full of filtered water, that way you know nobody tampered with the seal. It is about the size of a freezer ice pack. If I filter the water, I have 2 ways. I have a steripen that I put in the water for 1 minute and shake the water around and it kills all the germs. The steripen uses UV light. Its pretty easy. The other thing I have is called the Lifesaver 4000. It is a water bottle a little bigger than a nalgene bottle. You poor the water in one end. Next, I pull out a pump handle on the bottom of the bottle and pump ~10 times. The pressure pushes the water through filters built into the bottle. Clean water comes shooting out once I open the top. I have to be careful not to spray it everywhere. Google it. There is a you tube video by the inventor. If you want a really easy way to make a difference in someone's life, you can donate a bottle to someone in an area of the world who does not have access to clean water.

Once I have my water, I leave the house. It takes me about 7 minutes to walk to the hospital. Its just down the road. Today I saw about 5 patients. They were typical low back pain and stroke patients so I won't elaborate. We did not go on any home visits today. Also, we didn't have any patients in the afternoon. I'm using that time to educate Celestine and Doris. I am writing a PT manual for them, so they have an idea on how to treat each part of the body and common injuries once I leave.

I walk home for lunch and then walk back to the hospital in the afternoon. Millie, the daughter of my host has lunch waiting for me when I get there around noon. She is so sweet!! I will write more about her soon so you know how the typical Ghanian teenager acts.

After work, I keep trying to find ways to occupy my time. I read my kindle. I am so so glad I bought it! Its a lifesaver! I sometimes watch the women cook. Yesterday, I watched them make bamko, one of the traditional dishes. They do not have gas for the stove right now so they cook outside. It is a dough ball that you dip into a fish okra soup. The dough sort of tastes like a dumpling. You use your right hand to dip it into the soup. I am left handed, so it was weird. So I just asked Millie the reason why you use your right hand only. I guess they think they do their business with their left. Haha! I'm just going to use lots of hand sanitizer no matter what!! :) After I eat, I try and blog or chat more with Millie. It is much slower here. There is not constant technology. People are content to just sit and wave to their neighbors or listen to the radio. They only get 1 station on their TV.

Once I'm ready for bed. I take another bucket shower or I bough camping shower wipes that come in very handy if I don't want to waste water. Right now, the pumps are not working for running water. There has not been running water in over a week. They have had to fetch it from the well. This consists of women carrying buckets on their head. I have figured out I use about 5 buckets of water a day. That is 5 trips that Millie has to take to the well. I tried to help her but she wouldn't let me carry any water. Also, I do not have the strength to carry anything on my head. When I helped her put it on her head, I split some water so I was useless. I was lifting weights in the US before I came here but I never had to be concerned with water spilling while I was lifting. Your technique gets so much better when you have to worry about that. Haha!

So then I go to bed. I try and fall asleep but I'm still getting use to all the noises! I hear goats, chickens, shee, people shouting, and the mosque at dawn calling people for prayer.

Okay, I guess this wasn't brief, but this is how my day is right now!

Love, Kari

3rd of Work

Today was a busier than yesterday. I’m having a hard time getting use to the slow pace of life here. I don’t need constant stimulation from technology but I did not realize how reliant upon it I have become. The evenings are really hard for me still because I’m so use to surfing the internet, while watching TV, while playing words with friends on my iphone. Okay, maybe I lied! I loved my technology! Haha!

Work today was very interesting. I’m seeing a lot of patients who had strokes. All of these patients had their strokes months ago though so unfortunately it is too late for me to make a huge difference. However, I can still work with them for awhile to allow them to get a little stronger.

I went on an extremely interesting home visit. Two relatives of a lady who was in a horrible car accident 3 months ago came to the hospital today asking if I could walk to their house with them to help their ‘Auntie’ walk again. We walked to the outskirts of town. We were far enough out of town that I do not believe these people had electricity. They did not have running water either. The lady was sitting up in a wheelchair. After talking to her, I quickly learned that she is a paraplegic. I’m guessing about L1 or L2 level since she did not have much sensation from the waist down, but had good sitting balance in bed indicating that the abdominal muscles are still working. The family has been doing a 2 person fireman lift to get her in and out of bed. They did not realize that you can wheel her in her wheelchair over the threshold outside the 1 room house. I showed them how to clear the threshold with her still in the wheelchair. Then I showed her how to wheel her wheelchair around the 10x10 foot area outside that was level dirt. She was very happy to get outside. However, I had to tell her that walking was not a realistic goal. I plan on seeing her 3-5x/week with Celestine and Doris to instruct her in bed to wheelchair transfers. I instructed the family on making a slide board for her out of wood so she can slide on it from the bed to the wheelchair. Hopefully, they understood my dimensions. Last thing I did, I instructed them on positioning and pressure relief. She has already developed large areas of eschar on her heels (eschar is black dead tissue). If those areas open up she is prone to infections. Wound infections can be deadly. Christopher Reeves (who had the best medical care in the world) died of infection from pressure sores. I told her the importance of leaning side to side in her chair and performing wheelchair push ups every hour in order to prevent pressure sores on her bottom. Tomorrow, I plan on giving her some theraband so she can start performing arm strengthening exercises. Once the slide board is made, we will use it for transfers.

I can’t believe the variety of patients I’ve already seen in 3 days. I think they are slowly crawling out of the woodwork. I’m glad because its what I want to do here! I will continue to post about ‘Auntie’ and her progress.

Love, Kari

2nd Day of Work

SO I JUST WANT TO APOLOGIZE FOR ALL MY GRAMMATICAL AND SPELLING ERRORS! IT TOOK ME 10 MINUTES TO GET THE PAGE PULLED UP ON MY COMPUTER SO I DO NOT HAVE TIME TO PROOFREAD IF I EVER ACTUALLY WANT TO GET THEM POSTED!!!

So today was very slow. We only saw 4 patients. According to Celestine and Doris, the hospital is not getting reimbursed well enough from the Ghana health insurance and so they are charging a ward fee to stay in the hospital and for basic equipment such as exam gloves. Therefore, a lot of patients have not been coming because they cannot afford the extra cost. It is pretty crazy because health insurance costs a person in Ghana 14 cedis, which is probably the equivalent to 10 US dollars. You can tell have impoverished of a nation this is when many cannot even afford that. So the hospital adding on extra charges really makes it hard for people to come.

Yesterday, when I was questioning Celestine about how she treats the patients in the ward, I did not realize that she does not get them up out of bed for therapy. I guess she only does bed exercises with them. So today, we got our 1 ward patient out of bed. She stood and took a few steps into a chair with hand held assist of 2 people. It took 2 attempts to get her back into bed since the bed heights are so high and the beds do not raise and lower like in the US. It was not the pretty attempt from sitting to supine, but she did not fall on the floor. As long as she is in the bed we can do rolling and boosting to get her into the correct position. I’m very glad I brought my gait belt.

The other thing that I feel I can offer them here is the importance of positioning in bed and early intervention to avoid plantarflexion contractures at the feet (its when the foot is stuck in a pointed position). Some of the littlest things that I now consider common sense as a therapist really are not. Many times I wonder what I’ve learned as a therapist because there is still so much information out there that I do not know, that I forget how much I do know.

I am trying to put together a pseudo-manual for Celestine, so she knows how to treat certain parts of the body. I am trying very hard not to overwhelm her with information. Once medical terminology became part of my daily vernacular, it is hard to remember that the lay people do not understand what I am saying a lot of the times. Hopefully, I can help her understand if a patient is truly having leg or arm pain or if it is coming from the spine. Then, once she knows where the patient is having pain, hopefully, I can give her ideas of what exercises will be helpful to that body part.

So this is how day 2 went and more of what is going through my brain right now, in order for me to make this a successful adventure to Africa!!

Love, Kari

My First Day at Hospital!!!

I finally got to work at the hospital! It was a busy day but I think I can offer a lot to the sick and injured in Kpando. I saw about 7 patients today, 3 in their home and 4 in the hospital. All of the patients came before lunch. After lunch, nobody was around, so I sat and talked with my therapists in training. I'm trying to come up with a game plan to make them good therapists in 3 months! I will have my work cut out for me!

The home visits were very eye opening to say the least. I really have lived a sheltered life. It really makes you appreciate everything we have in the US. I know realize even how nice my lodging is here, and I have been in shock with that. The way I'm living here is still a 100 times better than the 3 women live that I visited today. They all lived in 1 or 2 room homes. Other people live with them. They sleep on mattresses on the floor or a small bed near the ground. Since it is so dusty here and they do not have running water, the rooms are very dusty. They are stuck in their homes since they cannot go up/down stairs. Even if they could leave their homes the porches and patio areas are so uneven, I'd be worried about them falling. Home health in the US will be a breeze after these 3 months!

The hospital's layout consists of various wards. There is the medical ward, surgical ward, children's ward, maternity ward, outpatient area, and office area. The physical therapy office is about at 20 x 20 foot room with a decent amount of equipment. The wards, where the patients stay are large rooms with about 10 beds. There are no curtains for privacy. Families are responsible for bringing linens. Also, they must bathe you and help you use the bathroom. The nurses just administer medicine and treatment.

Many of the people I will be seeing in medical ward will be stroke patients. 2 of the home patients I saw today were stroke patients. Treating the stroke patients will be challenging, but I feel it will be rewarding too! They do not have access to early intervention drugs like we have in the USA to limit the severity of the strokes, so many I vary severe. Also, there are no drugs like baclofen or botox available to help combat spasticity or increased muscle tone. In the homes, the barrier is that many of them are only 1 small room with a mattress on the floor. Sit to stand transfers are going to be a challenge! I'm glad I brought a gait belt along.

There are 2 health workers who have been running the PT department since the last worker left for PT school. They have limited training but are very eager to learn. They soaked everything up I told them today like sponges. While I want to help make patients better here, my real goal is to make Celestine and Doris good therapists, that way once I leave, the people in this village still have access to physical therapy. People almost need therapy here more than we need it in the US, since any physical impairment can cause severe disability. Nothing is handicap accessible here so even a mild injury can force someone to be homebound. Hopefully, through training Celestine and Doris, people here will still be able to live productive lives after experiencing an illness or injury.

When I have interesting patients, I will try and elaborate more on them. Today, I just want to give you a brief overview of how my day went.

Love, Kari

Life in Kpando

I do not start work until tomorrow and so I want to write about daily life as I’ve experienced so far in Kpando. It has been quite a shock to my system. We take for granted all the luxuries we have in the US. I can think back to this summer when I stayed at a hotel in Chicago and was so mad at hotwire for claiming it was 3 stars when I truly felt it was a 2 star hotel. Little did I know, I be wishing for accommodations as nice as that!

The house I am staying at, I believe from looking around the village, is one of the nicer houses. They have a good sized front and backyard. Grace, Isaac’s wife keeps an immaculate house. Their living room is very tidy and neatly organized. Next to the living room is a dining area separated by a curtain. I guess they haven’t been exposed to the open concept look yet. Then there is a hallway that takes you to a kitchen, a backdoor, 4 bedrooms and a bathroom. Size wise it is probably similar to the basic American ranch home. The walls are stucco and the floors are cement. It is very dry here, being the dry season, but there is minimal dust in the home. In my room they layed down linoleum flooring in order to make it more inviting for volunteers. They have a TV that gets 1 station. It had not worked for 8 months, so they are very pleased to have it again. There is electricity, but all of the lights are bare bulbs so the lights seem very harsh to me at night. They make me somewhat blue, and so I really do not care for night time here yet. I will be thankful once I have more stuff to do to make the evenings go by faster.

The kitchen consists of an electric stove, some shelving containing nonperishable foods and cooking utensils and equipment. Also, they have little fire stoves they cook with on the floor. All of my meals are prepared for me and they haven’t let me help clean my dishes yet, so I have yet to really see how the food is prepared. I haven’t disliked anything yet, but everything is unfamiliar and so if all tastes similar. They usually give me some sort of stew like dish that I eat with yams, rice, or spaghetti. The stew has fish, meat, and/or beans in it usually. I brought black pepper and Lawry’s season salt with me and so I can make the food taste a little more like I’m use to by adding that. I would describe the food as having almost a paprika taste or curry taste. The pineapple, oranges, and bananas all taste amazing though! I’m still getting my appetite back so I haven’t needed to eat any of my food from home yet. I will continue to go in more detail about the food as I continue to try more things!

My bedroom consists of 2 beds, a small sofa, and all of my stuff I brought from home. There are no closests or dressers so I tried to lay my stuff out as neatly as possible. I sleep on or in my little sleep sack. It is basically a sheet like material in the form of a sleeping bag with a pocket for my pillow. I have a need to be covered and so it suffices since it is hot here. They have screens on the windows that are always open in order to keep the bugs out but allow air inside the house. I’m getting use to all the things go bump in the night. Also, the Isalmic Mosque is nearby so I am awoken by the calling for prayer at dawn. Hopefully soon, I will be able to drown it out and stay asleep until I have to wake around 7 am. The women here sleep in a wrap that acts like an night gown, robe, and blanket. I bought one for myself at the market yesterday. I just need Millie, Isaac’s daughter, to show me how to wear it so it won’t fall off of me. Haha!

The hardest part of living here for me is the bathroom experience!!! The plumbing only works a couple of times a week right now since the town rations water during the dry season. When the pipes are open, they fill the 2 huge water barrels with water. The pipes have yet to be open so Millie had to fetch 9 buckets of water from the well yesterday! She carries them on her head! In order to flush the toilet, you must fill the bucket full of water. There is a small can that I use to take water from the barrel and put it in the bucket. I have figured out it takes 7 cans full in order to flush the toilet. I am trying to get myself on a water schedule to avoid going to the bathroom at night. Hopefully, I will succeed as not to wake everyone every night. Also, to shower you use a bucket and can. The water is room temperature, but to me it feels freezing when I poor it on myself. I have to stifle screams! I’m resorting to shampooing my hair every other day in order to make the shower easier. I am so glad I chopped my hair short. It would have been horrible to dry and shampoo my long hair!! Also, I am not using any conditioner. The worst thing is I’ve realized I probably will not be able to shave my legs! I’m just going to embrace it. However, I will not be able to embrace it for my underarms and will dry shave there. Men, I’m sure this is TMI, but I want everyone to get a good grasp of life here, so deal with it! J

I have yet to do laundry yet, so I will elaborate more on that at a later date. This post is already very longs, so I will also tell you more about walking through the market and town in a later post! I hope this was insightful. While, this new life is definitely culture shock, since my one night where I sort of had a freakout laying in bed, I am adjusting pretty well, I think! I’m very excited to start work tomorrow, after all that is the reason why I came here!

Love and miss everyone!

Love, Kari