So I ranted and raved about the "manana time" yesterday.
Unfortunately, I will probably rant again today. I spent most of my day
at the hospital waiting for Celestine to finish in her meeting so we
could see patients in the ward. Since the patients are usually elderly,
they do not speak English well, so I need Celestine to translate.
Her
meeting was all the health care workers getting together to complain
about the government not paying them on time this month. I don't think
there was any actual purpose to their meeting other than to complain.
She said they didn't come up with any sort of plan at the meeting.
By
the time her meeting was over it was 3 pm. She was ready to go home. I
wanted to at least see the little boy who has burns. By that time he
was out of the hospital with his father so he did not get his therapy
today. It made me a little upset. I should have just gone to see the
boy by myself. However, the therapy is very painful for him, so I like
Celestine there to explain to him what I'm trying to do to help calm
him. I know he already thinks of me as the evil white lady so I didn't
want to make that worse by coming alone.
I did see 3
patients in the gym today. That was good. I think they all found my
treatments helpful. It's so hard for the patients to understand the
importance of continuing exercise. That is a problem in the US too. I
would say most people in the US understand the importance, but just
care to ignore their doctor or therapist's advice. They always ask me
if I'm going to give them a pill to get better.
I did
work with a pastor today. He is 74 and had a mild stroke. His attitude
is very different than many Ghanaians. He believes in hard work. He was
also an entrepreneur when he was a pastor. He didn't believe in getting
rich off his parishioners. He gave me good ideas to help promote health
in Ghana. I do not think I will accompolish it on this trip, but maybe
it can be a good project for future volunteers or on my next trip to
Ghana.
Rev. Mother, the medical director and head
sister of the hospital, had a nice talk with me today. We discussed
having the staff pay to use the equipment in the gym in order to
maintain it properly. I'm glad some of the staff wants to use the
equipment, but they often use it improperly. Throughout Ghana, they do
not really perform maintenance. I think the idea of an oil change
every 4000 miles is a foreign concept. Thus, if the hospital employees
do not take ownership for the equipment it will break down and will not
be available for patients either. I know they were not happy with this,
but nothing in life is free, right?
I'm turning into a
nagging mother. Haha! I hope everyone enjoys this leap day! I'm excited
because it means I got an extra day in Ghana.
Love, Kari
Wednesday, February 29, 2012
Tuesday, February 28, 2012
Sitting Still
The end of my trip is fast approaching so I am trying to really enjoy life here. I think the hardest thing about this trip has been the pace of life. We, in the US, have gotten so use to the hustle and bustle that we do not realize what life would feel like without all of our distractions. Here in Ghana, I've had more than plenty time! Many Ghanaians are very content to just sit and look around. Me, I would have gone stir crazy if I did not have my Kindle and Laptop. Attempting to write my blog every night and reading the over 20 books have been a lifesaver!
I think this trip has been successful. I think I've started the ball rolling for future Physical Therapy volunteers, but I've wasted a lot of time too. However, the average Ghanaian does not think like that. There is no such thing as productivity or deadlines. Things get accomplished sometimes, on their own schedule. People at times seem frustrated with the lack of progress here, but they also seem very content with the amount of time they personally spend at work. I think the average work day here is about 6-8 hours; however, from what I've observed, they probably only spend 3-4 of those hours doing work related tasks. This may be true for most Americans now too, since we spend so much time answering emails or playing on our iphones, so I'm not trying to be critical.
I am a very laid back person so I don't always care for the rudimentary time schedule we have in the US. It's stressful having to be on time. Here, I'm suppose to be at the hospital at 8 am, but I usually get there at 8:20. I don't usually find Celestine until 9 am, so I figure, I might as well sleep an extra 20 minutes. In the US, most of my jobs had productivity standards of at least 80%. That means 80% of my time at work was suppose to be billable time spent with patients. I don't disagree with that idea. I'm a therapist, I want to be working with my patients. However, that never left much time to find the doctors or nurses to discuss a patient, document on each patient, or call a patient or family member if there were concerns. Here, after observing 5 hospitals, I can say that they barely spend 50% of their time treating patients. The government run hospitals are so busy, too. However, they just are very inefficient in how they spend their time. I guess that all stems from the fact that they get things done when they feel it needs to be done. I try not to get frustrated by this attitude, since it's a difference in culture. I don't really think that we can say it is wrong either. Needless to say, it has made my suggestions to the various departments very hard to implement.
I've enjoyed the slowness to an extent, but as an American we are use to seeing results fast! My volunteer packet explained a lot of these cultural differences so I understood I was going to have to deal with them. I guess, I'm just thinking more about it now that I only have 3 weeks left. I'm questioning my time here. I wonder, did I make any impact? Did I really help any of the patients I saw? Luckily, I have documentation. It's a little biased since I wrote it, but this blog will allow me to always reflect on my time here. I definitely did not transform the whole PT profession in Ghana, but I know I planted a few seeds here or there. Also, I know that there are great Ghanaian PTs, named Lewis and Cinderella, which will help those seeds grow. I will cast my insecurities aside. This trip was successful! I am just one puzzle piece, but I know a lot more will fall into place once I leave!
Love, Kari
I think this trip has been successful. I think I've started the ball rolling for future Physical Therapy volunteers, but I've wasted a lot of time too. However, the average Ghanaian does not think like that. There is no such thing as productivity or deadlines. Things get accomplished sometimes, on their own schedule. People at times seem frustrated with the lack of progress here, but they also seem very content with the amount of time they personally spend at work. I think the average work day here is about 6-8 hours; however, from what I've observed, they probably only spend 3-4 of those hours doing work related tasks. This may be true for most Americans now too, since we spend so much time answering emails or playing on our iphones, so I'm not trying to be critical.
I am a very laid back person so I don't always care for the rudimentary time schedule we have in the US. It's stressful having to be on time. Here, I'm suppose to be at the hospital at 8 am, but I usually get there at 8:20. I don't usually find Celestine until 9 am, so I figure, I might as well sleep an extra 20 minutes. In the US, most of my jobs had productivity standards of at least 80%. That means 80% of my time at work was suppose to be billable time spent with patients. I don't disagree with that idea. I'm a therapist, I want to be working with my patients. However, that never left much time to find the doctors or nurses to discuss a patient, document on each patient, or call a patient or family member if there were concerns. Here, after observing 5 hospitals, I can say that they barely spend 50% of their time treating patients. The government run hospitals are so busy, too. However, they just are very inefficient in how they spend their time. I guess that all stems from the fact that they get things done when they feel it needs to be done. I try not to get frustrated by this attitude, since it's a difference in culture. I don't really think that we can say it is wrong either. Needless to say, it has made my suggestions to the various departments very hard to implement.
I've enjoyed the slowness to an extent, but as an American we are use to seeing results fast! My volunteer packet explained a lot of these cultural differences so I understood I was going to have to deal with them. I guess, I'm just thinking more about it now that I only have 3 weeks left. I'm questioning my time here. I wonder, did I make any impact? Did I really help any of the patients I saw? Luckily, I have documentation. It's a little biased since I wrote it, but this blog will allow me to always reflect on my time here. I definitely did not transform the whole PT profession in Ghana, but I know I planted a few seeds here or there. Also, I know that there are great Ghanaian PTs, named Lewis and Cinderella, which will help those seeds grow. I will cast my insecurities aside. This trip was successful! I am just one puzzle piece, but I know a lot more will fall into place once I leave!
Love, Kari
Sunday, February 26, 2012
Tro Tro Adventures
I'm back in Kpando. I had quite the adventure yesterday riding the tro tro to get back to here. I was so sad to leave Patsy and Allan. They are my Ghanaian parents. I felt like I was home from college staying with them for the week. I even brought my laundry! Haha!
I had a delicious breakfast of bacon and eggs before I left their house. I got to the tro tro station around 2 pm. It took an hour for the tro tro to fill up with people before we could leave. They sure know how to pack the tro. They do not leave until every seat is full. There were 18 of us in it. I would say its a little smaller than a 15 passenger van in the US. The seats are so small that even I feel squished. Most people consider me pretty petite so you know it is a tight ride if I'm complaining!! It costs about $5 so you get what you pay for. It's such an easy way to travel though because they are everywhere and they go to every town. I have gotten very use to the pot holes and the crazy driving, but it did not keep my bottom from getting sore. I had no room to shift around. I seriously thought I would have pressure sores after that ride!
Half way through the trip we smelled some smoke. I didn't think anything of it. I just assumed it was a bush fire. The driver stopped though and quickly got out of the van. I looked behind and saw him stopping on something that was on fire. Now, I was freaked out! We all got out of the van while the men messed with stuff underneath the tro tro. The muffler ended up falling off into their hands. They figured this solved the problem of whatever caught on fire so we all piled back into the tro tro. The ride was noisier after that but we didn't smell smoke again. Haha! I guess it's a successful ride if you get from point A to point B in one piece. I have a few more tro tro rides before I leave Africa. I would like to hire a driver, but I'm trying to make the most of this experience.
Patsy and I were talking yesterday about how you don't have to do a volunteer trip they way mine has been structured. There are so many opportunities out there where you can do volunteer work and stay in more modern accommodations. This trip for me was also about submersing myself in another culture. It's been fun and I laugh at all my crazy experiences, but to be honest I don't think I could do it the same way again. A month without running water is not easy! My skin is not a fan of the heat so I feel like a teenager again. Also, the creatures keep me up at night. I picked up the toilet paper roll last night in the bathroom and screamed since there was a lizard on it. Then 2 seconds later when I walk back into my room, I screamed again because there was a huge cockroach in the room! I made Millie kill it! She's home for midterm breaks. I actually slept okay last night except all my mosquito bites were itching like crazy. I was only outside at night for 5 minutes on Friday and managed to get 10 bites on my legs. They are really bad in Accra!! Thank God my malaria medication seems to be working!
We will see how this week will be. It's really my last full week at the hospital before I leave. The week after, I have to go back to Accra to pick up Tiffanie, the OT volunteer who is coming to Ghana. The week after that we are hopefully going to Cape Coast, and then the week after that I leave! Crazy, crazy that the end is in sight. While I will be so glad to be back in the US with all the modern amenities, I will miss Ghana so much! It really has been home for me the past 3 months!
Love, Kari
I had a delicious breakfast of bacon and eggs before I left their house. I got to the tro tro station around 2 pm. It took an hour for the tro tro to fill up with people before we could leave. They sure know how to pack the tro. They do not leave until every seat is full. There were 18 of us in it. I would say its a little smaller than a 15 passenger van in the US. The seats are so small that even I feel squished. Most people consider me pretty petite so you know it is a tight ride if I'm complaining!! It costs about $5 so you get what you pay for. It's such an easy way to travel though because they are everywhere and they go to every town. I have gotten very use to the pot holes and the crazy driving, but it did not keep my bottom from getting sore. I had no room to shift around. I seriously thought I would have pressure sores after that ride!
Half way through the trip we smelled some smoke. I didn't think anything of it. I just assumed it was a bush fire. The driver stopped though and quickly got out of the van. I looked behind and saw him stopping on something that was on fire. Now, I was freaked out! We all got out of the van while the men messed with stuff underneath the tro tro. The muffler ended up falling off into their hands. They figured this solved the problem of whatever caught on fire so we all piled back into the tro tro. The ride was noisier after that but we didn't smell smoke again. Haha! I guess it's a successful ride if you get from point A to point B in one piece. I have a few more tro tro rides before I leave Africa. I would like to hire a driver, but I'm trying to make the most of this experience.
Patsy and I were talking yesterday about how you don't have to do a volunteer trip they way mine has been structured. There are so many opportunities out there where you can do volunteer work and stay in more modern accommodations. This trip for me was also about submersing myself in another culture. It's been fun and I laugh at all my crazy experiences, but to be honest I don't think I could do it the same way again. A month without running water is not easy! My skin is not a fan of the heat so I feel like a teenager again. Also, the creatures keep me up at night. I picked up the toilet paper roll last night in the bathroom and screamed since there was a lizard on it. Then 2 seconds later when I walk back into my room, I screamed again because there was a huge cockroach in the room! I made Millie kill it! She's home for midterm breaks. I actually slept okay last night except all my mosquito bites were itching like crazy. I was only outside at night for 5 minutes on Friday and managed to get 10 bites on my legs. They are really bad in Accra!! Thank God my malaria medication seems to be working!
We will see how this week will be. It's really my last full week at the hospital before I leave. The week after, I have to go back to Accra to pick up Tiffanie, the OT volunteer who is coming to Ghana. The week after that we are hopefully going to Cape Coast, and then the week after that I leave! Crazy, crazy that the end is in sight. While I will be so glad to be back in the US with all the modern amenities, I will miss Ghana so much! It really has been home for me the past 3 months!
Love, Kari
Friday, February 24, 2012
GAP Scientific Congress Day 2
So I need to make a correction. This is GAP's first scientific congress. I think they have been hosting annual meetings for awhile.
Today was more interesting than yesterday! Thank God! We still managed to arrive an hour late. But that is normal here. We missed most of the first talk, but what I heard was interesting. They are trying to create a masters program in physiotherapy. The more education they can get, the better, but I hope they realize the importance of practical knowledge. I wrote that all over my conference evaluation form!!
They had 4 more research/evidence presentations. Cinderella presented on the community exercise programs her and Nancy, the other PT in Hohoe, have started. The two of them exemplify what a PT should be and act like. I hope I can continue to work with Cindy. She gets what it means to be a PT!
The next presentation was a case study. A PT decided to try out thermoplastic splinting after reading the research about it. She had success with it on a patient with a hand contracture. She wrote up a case study to show how successful it was and the cost effectiveness of it. I hate speaking in public, but I made sure to comment after her talk. I wanted everyone in the room to know that what she did was an example of evidence based practice. They all think they must be doing research in order to be an evidence based clinician. I hoped they understood what I was trying to say. It's not about doing research (not that it's bad), but it's about applying the research you read about into your everyday clinical practice.
The afternoon was 2 more interesting topics. One was on how to integrate physiotherapy technicians/assistants into the practice. The other topic was bridging the gap between Ghanaian therapists and therapists in other countries.
After the conference was over there was a dinner ceremony. I'm glad I went because at first I was going to leave to spend the evening with Patsy and Allan. It was fun seeing how the PTs and PT students interact. The students of course have their little inside jokes and showed up like they were going to a black tie dinner. The guys were all wearing bow ties. It's so funny how formal they dress in Accra. When I hangout with this group of people I forget I'm in a developing country. They played a few games. One of them was someone mimicked the faculty and everyone had to guess who they were trying to be. It reminded me of our faculty roast in our last year of school. The also had an Azunto dance off! I love the Azunto, but I'm always behind the beat so I will never be able to dance it. There was no alcohol so I didn't even try. Haha!
Tomorrow I go back to Kpando. I'm sad to leave Patsy and Allan. I feel like some of the goodbyes are a little more permanent now that I have only 4 weeks left. I really do plan to come back to Ghana, but financially it is something I have to plan for. My goal is to come and do an outreach program with Patsy and Allan and a CEU course with Step FaR every other year. I think that's realistic! I've fallen in love with the people of this country. Yes, some of the culture drives me crazy, but overall they are so friendly that you can't help loving them!!
Love, Kari
Today was more interesting than yesterday! Thank God! We still managed to arrive an hour late. But that is normal here. We missed most of the first talk, but what I heard was interesting. They are trying to create a masters program in physiotherapy. The more education they can get, the better, but I hope they realize the importance of practical knowledge. I wrote that all over my conference evaluation form!!
They had 4 more research/evidence presentations. Cinderella presented on the community exercise programs her and Nancy, the other PT in Hohoe, have started. The two of them exemplify what a PT should be and act like. I hope I can continue to work with Cindy. She gets what it means to be a PT!
The next presentation was a case study. A PT decided to try out thermoplastic splinting after reading the research about it. She had success with it on a patient with a hand contracture. She wrote up a case study to show how successful it was and the cost effectiveness of it. I hate speaking in public, but I made sure to comment after her talk. I wanted everyone in the room to know that what she did was an example of evidence based practice. They all think they must be doing research in order to be an evidence based clinician. I hoped they understood what I was trying to say. It's not about doing research (not that it's bad), but it's about applying the research you read about into your everyday clinical practice.
The afternoon was 2 more interesting topics. One was on how to integrate physiotherapy technicians/assistants into the practice. The other topic was bridging the gap between Ghanaian therapists and therapists in other countries.
After the conference was over there was a dinner ceremony. I'm glad I went because at first I was going to leave to spend the evening with Patsy and Allan. It was fun seeing how the PTs and PT students interact. The students of course have their little inside jokes and showed up like they were going to a black tie dinner. The guys were all wearing bow ties. It's so funny how formal they dress in Accra. When I hangout with this group of people I forget I'm in a developing country. They played a few games. One of them was someone mimicked the faculty and everyone had to guess who they were trying to be. It reminded me of our faculty roast in our last year of school. The also had an Azunto dance off! I love the Azunto, but I'm always behind the beat so I will never be able to dance it. There was no alcohol so I didn't even try. Haha!
Tomorrow I go back to Kpando. I'm sad to leave Patsy and Allan. I feel like some of the goodbyes are a little more permanent now that I have only 4 weeks left. I really do plan to come back to Ghana, but financially it is something I have to plan for. My goal is to come and do an outreach program with Patsy and Allan and a CEU course with Step FaR every other year. I think that's realistic! I've fallen in love with the people of this country. Yes, some of the culture drives me crazy, but overall they are so friendly that you can't help loving them!!
Love, Kari
Thursday, February 23, 2012
First Annual Ghana Association of Physiotherapy (GAP) Conference
Today, I went to the first GAP annual conference. It was interesting, but also really boring for me. I shouldn't say that. I just have such a hard time sitting still in a lecture hall. It was nice seeing so many familiar faces from the Step FaR CEU course and all the other PTs I've met since I've been here.
We got there a little late since the PTs from Tema Hospital, who I rode with, had to run an errand before we got there. We also left a little early. I should have stayed for the whole thing, but the student's research presentations were long! I'm excited that they are teaching them to perform evidence based practice. However, the PTs here do not know how to apply research and book knowledge so I'm not sure if you could call anything they do evidence based. They really are trying hard though to be good healthcare providers. I do not want to be critical. It's just given me lots of ideas on projects/courses/presentations that they would benefit from.
This has been such a nice week with Patsy and Allan. I will be so sad to leave on Saturday. They are such wonderful people. I've love eating American food too!! They have so many great projects planned for the people of Ghana, especially people who are suffering from disabilities. I can't wait to come back and visit them on future trips to Ghana!! Any therapists who are interested in joining me, let me know!! Also, check out www.thwb.org and www.villagevolunteers.org for more volunteer opportunities.
Tomorrow, I return to the conference. I'm hoping they do a little more talking on how to actually treat the patients. I will try and give some insight. I can't decide if I will go to the dinner. 9am-8pm is a long day. Also, it would be nice to have one last night with Allan and Patsy before I return to Kpando. I miss my African family, but it was nice to come to greater Accra for a week for a change in scenery.
It's so funny because I was so overwhelmed by Accra the first day I was in Ghana. Now, Accra seems like a modern city since I've gotten so use to village life. Haha! I think I will definitely have some reverse culture shock when I return to the US.
Love, Kari
Tuesday, February 21, 2012
What!! Only 1 month left. :(
This trip has gone by too fast! I still remember saying that prayer on my first night in Kpando. I was so overwhelmed wondering what I had gotten myself into. My prayers were definitely answered!! This trip has been amazing. I'd be lying if I said it was easy. I went 1 month without running water. The culture is so different than American culture. I miss American food a lot! People drive so crazy here. But despite all the difficulties, I've loved experiencing another culture and way of life. I think I've helped a few people along the way, too! Also, I think I helped teach some Ghanaian PTs some new exercises and techniques.
I enjoyed working with the therapists at Ridge hospital today. However, I had a hard time dealing with some of the cultural differences today. There is a lot wrong with American culture, so I'm not trying to say everything we do in the US is better than Ghana. However, their lack of professionalism at times and lack of dedication to their job really frustrated me today. I guess I am not as laid back as I thought I was. I am so use to time schedules so its hard for me to see people come and go as they please when they are in the middle of treating a patient. Also, the doctor/nurse/therapist, patient relationship is so authoritarian. A patient could never question a doctor here. A student could never question their teacher. I value PT students. They are in school learning the newest and best research. They need a mentor in order to understand how to apply that new technique or treatment. Here a student may know a better way to perform a certain exercise or treatment, but a superior will just tell you you are wrong because I'm more experienced than you. I feel like that must stifle the learning process very quickly.
Okay enough of that. I am all about embracing differences. I will focus on the positive! I helped patients today! I showed the therapists a few new exercises. I showed them how I interact with the patient so they understand it doesn't always have to be an authoritative paternalistic relationship. I'm a PT because I love what I do. Hopefully, they will see that being a therapist is fun even if you have to work the whole 8 hours you are at work. Haha!
I haven't quite embraced Ghana Maybe Time!
I think its the prayer/saying used at 12 step meetings, but I think it applies to everyone:
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Love, Kari
I enjoyed working with the therapists at Ridge hospital today. However, I had a hard time dealing with some of the cultural differences today. There is a lot wrong with American culture, so I'm not trying to say everything we do in the US is better than Ghana. However, their lack of professionalism at times and lack of dedication to their job really frustrated me today. I guess I am not as laid back as I thought I was. I am so use to time schedules so its hard for me to see people come and go as they please when they are in the middle of treating a patient. Also, the doctor/nurse/therapist, patient relationship is so authoritarian. A patient could never question a doctor here. A student could never question their teacher. I value PT students. They are in school learning the newest and best research. They need a mentor in order to understand how to apply that new technique or treatment. Here a student may know a better way to perform a certain exercise or treatment, but a superior will just tell you you are wrong because I'm more experienced than you. I feel like that must stifle the learning process very quickly.
Okay enough of that. I am all about embracing differences. I will focus on the positive! I helped patients today! I showed the therapists a few new exercises. I showed them how I interact with the patient so they understand it doesn't always have to be an authoritative paternalistic relationship. I'm a PT because I love what I do. Hopefully, they will see that being a therapist is fun even if you have to work the whole 8 hours you are at work. Haha!
I haven't quite embraced Ghana Maybe Time!
This is what I had to keep telling myself today.
:)
I think its the prayer/saying used at 12 step meetings, but I think it applies to everyone:
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Love, Kari
Monday, February 20, 2012
Ridge Hospital Follow Up Visit
Yesterday, I had my first big shopping excursion since I've been in Ghana. I was walking along the street trying to find an ATM that would accept my debit card. Of course this street was covered in little souvenir stands, so every person was yelling at my "Abrunni Abrunni look for free, no charge for looking." I am in Accra right now so they say "Abrunni" for white person where in the Volta Region "Yahvo" means white person. I was so impatient with these people bugging me since I just wanted to get money from the ATM that I finally agreed to look at one guys paintings. I really like one of them so I figured I buy it from him. I had no idea what the going price would be so I thought I bargained down to a good price. I found out that I should have paid about $7 for it. I bought it for $20. Oops! I guess he had a good dinner last night.
After the street shopping, we went to Accra mall. It is a real shopping mall. When you are inside it you feel like you are in a US mall. It felt so comfortable, but you were also expected to pay Us prices. I did buy some pretty fabric for my mom who likes to quilt. It's not as cheap as I can get in the village, but I found the patterns very pretty and I knew it was good quality so I figured it was worth a little extra money. It still was inexpensive by US standards.
Today, Pastor Allan and Patsy's next door neighbor drove me to Ridge Hospital in Accra so I could do a follow up visit. I went to Ridge with Samuel about a month ago. Ridge is one of the main hospitals in Accra. It was good working along side the therapists there today. However, the therapist there have a little more of a true Ghanaian mindset so they were not as open to some of my suggestions. I don't want to be critical of what they do, but I have a hard time with the way patients are treating in Ghana. The patients are not suppose to ever question the doctors, nurses and therapists. If they do question they will be thrown out of the clinic or office. The "Patient First" mentality does not always exist in Ghana.
I spent most of my time working along side two of the PT interns. Since they haven't graduated yet, I find they are much more open to suggestions and they still want to learn. I tried telling them how US PT clinics are structured because they exercise treatment area is very chaotic at times. There are 4 staff members with 4-6 patients, but no patient is assigned to a staff member so often times the staff will just be sitting around talking as the patients are off on their own completing exercises without any guidance. The interns seemed much more willing to try and embrace my suggestions for one on one therapy.
I was very excited though to see the patient I met a month ago with Lymphedema. I wrote about her in my blog. Last time at Ridge, I showed the intern named Samuel how to perform manual lymph drainage and apply compression wraps. He has been treating her for the past month. She has had a dramatic decrease in her swelling. The patient was so happy. I was really excited to see that the treatment had been working and that they had been continuing it as instructed. Ridge therapists now know how to correctly treat Lymphedema! Success!! :)
There was one patient to day that was really hard to see. She was a 19 year old girl presenting with major neurological symptoms. The doctor that referred to therapy wrote mild stroke on the referral sheet. I was flabbergasted and furious at that diagnosis. The girl was unable to move her extremities. The only active movements she could perform were shoulder shrugs and slight turning of the head. She had severe spasticity, increased muscle tone, and clonus. Her sensation was not intact. She was fairly oriented though. She was not able to assist at all with a stand pivot transfer from wheelchair to bed. I had to hold her in a sitting position on the bed and she was completely dependent for sit to supine. I found out after questioning the girl, her symptoms came on gradually. It started with mild weakness in her hands and progressively over a 3 month period of time got to the point that she could not walk. Since that time she has been bed bound. Her family did not take her to the doctor until today. An herbalist has been seeing her and that's it. An Auntie finally forced the family to take her to the doctor. The doctor she saw did not make a very good diagnosis though!!
I can only make an educated guess on what is going on with the girl, but I highly doubt she had a stroke. Usually, a stroke only affects one side of the body. She has bilateral involvement. A stroke is usually sudden onset, she has been getting progressively weaker. My hypothesis is that she has some sort of spinal cord or brain damage/disease. I sent her to the Korlebu teaching hospital immediately. Physiotherapy is not the most important thing. They need to know what is causing her paralysis. It could be anything from demylinating disease, spinal cord tumor, brain tumor, guillan-barre syndrome to name a few. The teaching hospital has an MRI and CT scan. They need to know what she has to get her on the right medications/treatments/surgeries so she does not end up dying. I do not think her prognosis is very good.
It just makes me so sad that families often just think some herbal medicine or tribal doctor can solve the problem and so they do not take them to a real doctor. The herbal doctors often are scams just to get money! The promise the world and do not deliver. That's life in a 3rd world country though. I couldn't do much for this girl, but at least hopefully she will finally get the medical care she needs!
I stayed at Ridge until 5 pm. The afternoon was so slow and mornings were so busy. It's like they don't want to actually work a full day so they have all the patients come in the morning at one time to allow them to just sit around and talk the last 3 hours of the day. I used the time to talk to the interns and help talk them through any patient questions they had. I did get a little bored though and was glad I had my Kindle.
Becky, Pastor Allan and Patsy's neighbor, drove me home from Accra to Tema. It was such a long drive! A 30 minute commute was an hour and half commute since traffic is always so bad! It's nice to be in a big city. I think I can only take village life for 1 month increments and then need a break; however, the traffic is horrible!! Patsy had chili waiting for me! Yummy!!! I also needed to come visit them for American food. Haha! :)
I feel so fortunate to have met Patsy and Allan. They are 2 of the nicest people I've ever met. They have done so much to help the people of Ghana. I hope I can make 1/100th of the impact that they made in this country. They have helped distribute thousands of wheelchairs/walkers/canes/crutches over the past 17 years. They also help perform many other humanitarian projects across Ghana. I don't care what religious beliefs you have, they are amazing!
Tomorrow, I will brave the hour and half one way commute to return to Ridge hospital. Until then....
Love, Kari
After the street shopping, we went to Accra mall. It is a real shopping mall. When you are inside it you feel like you are in a US mall. It felt so comfortable, but you were also expected to pay Us prices. I did buy some pretty fabric for my mom who likes to quilt. It's not as cheap as I can get in the village, but I found the patterns very pretty and I knew it was good quality so I figured it was worth a little extra money. It still was inexpensive by US standards.
Today, Pastor Allan and Patsy's next door neighbor drove me to Ridge Hospital in Accra so I could do a follow up visit. I went to Ridge with Samuel about a month ago. Ridge is one of the main hospitals in Accra. It was good working along side the therapists there today. However, the therapist there have a little more of a true Ghanaian mindset so they were not as open to some of my suggestions. I don't want to be critical of what they do, but I have a hard time with the way patients are treating in Ghana. The patients are not suppose to ever question the doctors, nurses and therapists. If they do question they will be thrown out of the clinic or office. The "Patient First" mentality does not always exist in Ghana.
I spent most of my time working along side two of the PT interns. Since they haven't graduated yet, I find they are much more open to suggestions and they still want to learn. I tried telling them how US PT clinics are structured because they exercise treatment area is very chaotic at times. There are 4 staff members with 4-6 patients, but no patient is assigned to a staff member so often times the staff will just be sitting around talking as the patients are off on their own completing exercises without any guidance. The interns seemed much more willing to try and embrace my suggestions for one on one therapy.
I was very excited though to see the patient I met a month ago with Lymphedema. I wrote about her in my blog. Last time at Ridge, I showed the intern named Samuel how to perform manual lymph drainage and apply compression wraps. He has been treating her for the past month. She has had a dramatic decrease in her swelling. The patient was so happy. I was really excited to see that the treatment had been working and that they had been continuing it as instructed. Ridge therapists now know how to correctly treat Lymphedema! Success!! :)
There was one patient to day that was really hard to see. She was a 19 year old girl presenting with major neurological symptoms. The doctor that referred to therapy wrote mild stroke on the referral sheet. I was flabbergasted and furious at that diagnosis. The girl was unable to move her extremities. The only active movements she could perform were shoulder shrugs and slight turning of the head. She had severe spasticity, increased muscle tone, and clonus. Her sensation was not intact. She was fairly oriented though. She was not able to assist at all with a stand pivot transfer from wheelchair to bed. I had to hold her in a sitting position on the bed and she was completely dependent for sit to supine. I found out after questioning the girl, her symptoms came on gradually. It started with mild weakness in her hands and progressively over a 3 month period of time got to the point that she could not walk. Since that time she has been bed bound. Her family did not take her to the doctor until today. An herbalist has been seeing her and that's it. An Auntie finally forced the family to take her to the doctor. The doctor she saw did not make a very good diagnosis though!!
I can only make an educated guess on what is going on with the girl, but I highly doubt she had a stroke. Usually, a stroke only affects one side of the body. She has bilateral involvement. A stroke is usually sudden onset, she has been getting progressively weaker. My hypothesis is that she has some sort of spinal cord or brain damage/disease. I sent her to the Korlebu teaching hospital immediately. Physiotherapy is not the most important thing. They need to know what is causing her paralysis. It could be anything from demylinating disease, spinal cord tumor, brain tumor, guillan-barre syndrome to name a few. The teaching hospital has an MRI and CT scan. They need to know what she has to get her on the right medications/treatments/surgeries so she does not end up dying. I do not think her prognosis is very good.
It just makes me so sad that families often just think some herbal medicine or tribal doctor can solve the problem and so they do not take them to a real doctor. The herbal doctors often are scams just to get money! The promise the world and do not deliver. That's life in a 3rd world country though. I couldn't do much for this girl, but at least hopefully she will finally get the medical care she needs!
I stayed at Ridge until 5 pm. The afternoon was so slow and mornings were so busy. It's like they don't want to actually work a full day so they have all the patients come in the morning at one time to allow them to just sit around and talk the last 3 hours of the day. I used the time to talk to the interns and help talk them through any patient questions they had. I did get a little bored though and was glad I had my Kindle.
Becky, Pastor Allan and Patsy's neighbor, drove me home from Accra to Tema. It was such a long drive! A 30 minute commute was an hour and half commute since traffic is always so bad! It's nice to be in a big city. I think I can only take village life for 1 month increments and then need a break; however, the traffic is horrible!! Patsy had chili waiting for me! Yummy!!! I also needed to come visit them for American food. Haha! :)
I feel so fortunate to have met Patsy and Allan. They are 2 of the nicest people I've ever met. They have done so much to help the people of Ghana. I hope I can make 1/100th of the impact that they made in this country. They have helped distribute thousands of wheelchairs/walkers/canes/crutches over the past 17 years. They also help perform many other humanitarian projects across Ghana. I don't care what religious beliefs you have, they are amazing!
Tomorrow, I will brave the hour and half one way commute to return to Ridge hospital. Until then....
Love, Kari
Saturday, February 18, 2012
Autism Conference
It's been a few days! I wanted to blog last night, but we had our first rain in Kpando so I did not venture to the internet cafe. I couldn't get on the internet with my modem at the house.
It was so nice having rain! 2.5 months is a long time to go without rain. If the sky was always blue here I think I'd enjoy it more, but there is always this yellowish haze from the dust. The rain came down pretty heavily for about an hour. While it rained, I sat outside reading my kindle on the covered porch. It cooled off a bit which was nice. However, once it stopped rainy it was so so muggy!!!
The 3 days at the Marquat hosipital were so so slow this week. Celestine still came to work, but was often in one of the other rooms resting or getting IV medication. I only had a few outpatients come to the clinic. The mother returned with her child who has Cerebral Palsy. She brought a toy so we were able to work on rolling and turning her head a little more. I really just reinforced what I told the mother on Wednesday and made sure she could demonstrate everything to me. I told her this is going to be a life long disability and so the mother cannot neglect doctor appointments and therapy sessions. I think she understood! She seems very active in her daughter's care.
I am so happy to say the small boy who sustained burns on his legs has made so much progress in the past week. I was really nervous when we saw him last week that I found out about him too late. Just in 1 weeks time of exercises and ROM to his legs, he can get the left leg fully extended. The right leg is only lacking about 10 degrees from full extension. I was so impressed with his progress that I didn't feel the need to perform PROM on him on Friday. I showed him a hamstring stretch and had him perform quad sets. I'm not use to working with such little legs! :) The boy is such a cutie!
I feel redeemed to some extent. I felt useless with a few patients recently even though I know it wasn't my fault. I feel I have positively impacted this boys life. Now he will return to walking and running once his burns heal!! Also, Celestine and the nurses now understand the importance of PT with burn patients. Celestine will not be a therapist when I leave, but at least she now knows the importance of some therapy techniques!!
Today, I woke up at 3 am to take a trotro at 4 am to Tema for a conference on Autism. The course was at Pastor Allan and Patsy's disability center. About a 100 people came for the conference! It was a great turn out. There were 5 speakers with different health care backgrounds explaining about Autism and various treatments for Autism. Intellectual disabilities are not quite yet acknowledged in Ghana. Often times people with these disabilities are labelled as crazy, wicked, or possessed. The mother is told she sinned and that's why her child has these problems. This conference helped bring awareness to the problem and help professionals and caregivers know how to treat these children better so they can live productive lives!
I learned some new things myself. I don't work with a lot of people who have Autism in the US, so it was neat hearing the information. This trip has been a lot of fun for me because I've had a chance to use my education to the fullest extent! In the US, most therapists now specialize to some degree. I've been a gypsy in my career (and maybe my personal life too, haha!) and so I've worked in many settings. I haven't quite settled into my therapy niche. This trip has allowed me to experience even more as a therapist.
I was excited to network with some of the people at the event. I hopefully created some new friendships/partnerships with Ghanaian organizations and NGOs. Also, I met some new therapists and providers who could maybe help out with some of the programs that Step FaR and Therapists Without Borders would like to continue in Ghana.
It's funny because I'm a very reserved person, but I think I've done a pretty good job at least attempting to work with people or establish connections. I guess Ghana is helping me get over my shyness. I stick out a lot here so its pretty hard to be a wallflower. Haha! :)
I'm staying with Allan and Patsy this week. They are going to help me go around to meetings with people and the various hospitals. I had a wonderful dinner of fried chicken, potatoes, green beans, and baked beans!!!! Oh how I missed American food!!! I'm about ready to take a hot running shower! It's been a month so you don't know how wonderful that will be!
Have a great weekend!
Love, Kari
It was so nice having rain! 2.5 months is a long time to go without rain. If the sky was always blue here I think I'd enjoy it more, but there is always this yellowish haze from the dust. The rain came down pretty heavily for about an hour. While it rained, I sat outside reading my kindle on the covered porch. It cooled off a bit which was nice. However, once it stopped rainy it was so so muggy!!!
The 3 days at the Marquat hosipital were so so slow this week. Celestine still came to work, but was often in one of the other rooms resting or getting IV medication. I only had a few outpatients come to the clinic. The mother returned with her child who has Cerebral Palsy. She brought a toy so we were able to work on rolling and turning her head a little more. I really just reinforced what I told the mother on Wednesday and made sure she could demonstrate everything to me. I told her this is going to be a life long disability and so the mother cannot neglect doctor appointments and therapy sessions. I think she understood! She seems very active in her daughter's care.
I am so happy to say the small boy who sustained burns on his legs has made so much progress in the past week. I was really nervous when we saw him last week that I found out about him too late. Just in 1 weeks time of exercises and ROM to his legs, he can get the left leg fully extended. The right leg is only lacking about 10 degrees from full extension. I was so impressed with his progress that I didn't feel the need to perform PROM on him on Friday. I showed him a hamstring stretch and had him perform quad sets. I'm not use to working with such little legs! :) The boy is such a cutie!
I feel redeemed to some extent. I felt useless with a few patients recently even though I know it wasn't my fault. I feel I have positively impacted this boys life. Now he will return to walking and running once his burns heal!! Also, Celestine and the nurses now understand the importance of PT with burn patients. Celestine will not be a therapist when I leave, but at least she now knows the importance of some therapy techniques!!
Today, I woke up at 3 am to take a trotro at 4 am to Tema for a conference on Autism. The course was at Pastor Allan and Patsy's disability center. About a 100 people came for the conference! It was a great turn out. There were 5 speakers with different health care backgrounds explaining about Autism and various treatments for Autism. Intellectual disabilities are not quite yet acknowledged in Ghana. Often times people with these disabilities are labelled as crazy, wicked, or possessed. The mother is told she sinned and that's why her child has these problems. This conference helped bring awareness to the problem and help professionals and caregivers know how to treat these children better so they can live productive lives!
I learned some new things myself. I don't work with a lot of people who have Autism in the US, so it was neat hearing the information. This trip has been a lot of fun for me because I've had a chance to use my education to the fullest extent! In the US, most therapists now specialize to some degree. I've been a gypsy in my career (and maybe my personal life too, haha!) and so I've worked in many settings. I haven't quite settled into my therapy niche. This trip has allowed me to experience even more as a therapist.
I was excited to network with some of the people at the event. I hopefully created some new friendships/partnerships with Ghanaian organizations and NGOs. Also, I met some new therapists and providers who could maybe help out with some of the programs that Step FaR and Therapists Without Borders would like to continue in Ghana.
It's funny because I'm a very reserved person, but I think I've done a pretty good job at least attempting to work with people or establish connections. I guess Ghana is helping me get over my shyness. I stick out a lot here so its pretty hard to be a wallflower. Haha! :)
I'm staying with Allan and Patsy this week. They are going to help me go around to meetings with people and the various hospitals. I had a wonderful dinner of fried chicken, potatoes, green beans, and baked beans!!!! Oh how I missed American food!!! I'm about ready to take a hot running shower! It's been a month so you don't know how wonderful that will be!
Have a great weekend!
Love, Kari
Wednesday, February 15, 2012
Typhoid
Today was a very slow day! I went to the hospital in Kpando this morning. Celestine is always at the hospital before I get there; however, she usually does not make it to the PT gym until after I've been there for 20 minutes. She usually is around saying hi to people, I think. However, today she was really late. I sat around for over an hour waiting for her to come. She finally showed telling me she wasn't feeling well so she was waiting to see the doctor. I told her I understood and that I would wait for her.
Around 10:30 a patient showed up. Finally, I had something to do. The patient was an eleven month old baby. She had been diagnosed with a weak neck. In actuality, the child has cerebral palsy. I really needed Celestine around because the mother did not speak/understand English well enough for me to explain what was wrong with her child. I tried to assess the child as best I could without any toys. Obviously, from the diagnosis of weak neck, the child has poor head control. Also, the child exhibited abnormal tone and reflexes. The mother was very caring to the baby, but probably does too much for the child. I talked to the mother about trying to help the baby sit, but with not too much support, to have the child on her belly throughout the day when she is awake to force her to life her head and look around. Also, if the child does not like the position or wants to be on her back, it may force her to learn to roll over. The mother told me the child sits throughout the day. I asked the mother to show me how she helped the child to sit. She pointed to a cardboard box. I guess it would be the African version of a playpen or I think we call them play and packs because playpen is too offense in the US, right. Haha.
Again, I am not a pediatric therapist. In the US, therapists have the opportunity to specialize so I've never worked with babies before. I know what I'm suppose to do, it's just hard for me to get a child to do things. Adults are nice because they can usually follow commands. If an adult doesn't listen to your advice then I can always say that's not my problem.
I finally told the mother she would need to come back on Friday and bring toys with her so we could work with the baby more. Celestine still wasn't around after playing with the baby for 30 minutes, so I had no idea on how to file the paperwork. Finally, Celestine came an hour later. She told me she has typhoid. I have to say I was pretty shocked. Typhoid is really serious. I figured you were on your deathbed when you get it. I guess Celestine must have gone to the doctor early enough. I just hope she made sure to get the medicine today. I told her it was really important to start treating it today. Typhoid is transmitted through feces. People are not great about washing their hands here after using the bathroom. I very happy I got the typhoid vaccination before coming here since I've ate at a lot of restaurants while traveling. Even if the place looks clean, you really have no idea if the person practices hand hygiene.
I walked home to eat lunch and then walked back to the hospital to see the little boy with burns. However, the nurses would not let us work with him today since he was sleeping. He cries during the ROM so I couldn't really argue. Sleep is very important for recovery! Celestine said she ranged him the previous days when I was in Hohoe, so I didn't press the issue. I think I need to make sure the mother starts performing ROM on him too that way he gets it done even on days when we are not there. If we cannot get his leg straight, walking will be very difficult for him for the rest of his life.
I forgot to write about something Cinderella and I were discussing in Hohoe yesterday. We were helping a patient perform a squat exercise correctly to strengthen his legs. The patient was performing a deep squat. I told Cinderella that I usually have patients only squat to 90 degrees since its less pressure on the knee caps. Cinderella told me that she tries to make sure her patients can perform deep squats because how else do the go to the bathroom. I never thought of this. Obviously, in the US, unless someone is fond of camping, there is never really a need to squat to go to the bathroom. Here, most public toilets are only urinals, a drain in the floor. Women must squat a lot to go to the bathroom, and if someone only has an outhouse or has to go in the bush like myself last week, then you must squat. Life is so different here in so many very simple ways. I've definitely learned a lot that a book will never tell me on this trip!!
Love, Kari
Around 10:30 a patient showed up. Finally, I had something to do. The patient was an eleven month old baby. She had been diagnosed with a weak neck. In actuality, the child has cerebral palsy. I really needed Celestine around because the mother did not speak/understand English well enough for me to explain what was wrong with her child. I tried to assess the child as best I could without any toys. Obviously, from the diagnosis of weak neck, the child has poor head control. Also, the child exhibited abnormal tone and reflexes. The mother was very caring to the baby, but probably does too much for the child. I talked to the mother about trying to help the baby sit, but with not too much support, to have the child on her belly throughout the day when she is awake to force her to life her head and look around. Also, if the child does not like the position or wants to be on her back, it may force her to learn to roll over. The mother told me the child sits throughout the day. I asked the mother to show me how she helped the child to sit. She pointed to a cardboard box. I guess it would be the African version of a playpen or I think we call them play and packs because playpen is too offense in the US, right. Haha.
Again, I am not a pediatric therapist. In the US, therapists have the opportunity to specialize so I've never worked with babies before. I know what I'm suppose to do, it's just hard for me to get a child to do things. Adults are nice because they can usually follow commands. If an adult doesn't listen to your advice then I can always say that's not my problem.
I finally told the mother she would need to come back on Friday and bring toys with her so we could work with the baby more. Celestine still wasn't around after playing with the baby for 30 minutes, so I had no idea on how to file the paperwork. Finally, Celestine came an hour later. She told me she has typhoid. I have to say I was pretty shocked. Typhoid is really serious. I figured you were on your deathbed when you get it. I guess Celestine must have gone to the doctor early enough. I just hope she made sure to get the medicine today. I told her it was really important to start treating it today. Typhoid is transmitted through feces. People are not great about washing their hands here after using the bathroom. I very happy I got the typhoid vaccination before coming here since I've ate at a lot of restaurants while traveling. Even if the place looks clean, you really have no idea if the person practices hand hygiene.
I walked home to eat lunch and then walked back to the hospital to see the little boy with burns. However, the nurses would not let us work with him today since he was sleeping. He cries during the ROM so I couldn't really argue. Sleep is very important for recovery! Celestine said she ranged him the previous days when I was in Hohoe, so I didn't press the issue. I think I need to make sure the mother starts performing ROM on him too that way he gets it done even on days when we are not there. If we cannot get his leg straight, walking will be very difficult for him for the rest of his life.
I forgot to write about something Cinderella and I were discussing in Hohoe yesterday. We were helping a patient perform a squat exercise correctly to strengthen his legs. The patient was performing a deep squat. I told Cinderella that I usually have patients only squat to 90 degrees since its less pressure on the knee caps. Cinderella told me that she tries to make sure her patients can perform deep squats because how else do the go to the bathroom. I never thought of this. Obviously, in the US, unless someone is fond of camping, there is never really a need to squat to go to the bathroom. Here, most public toilets are only urinals, a drain in the floor. Women must squat a lot to go to the bathroom, and if someone only has an outhouse or has to go in the bush like myself last week, then you must squat. Life is so different here in so many very simple ways. I've definitely learned a lot that a book will never tell me on this trip!!
Love, Kari
Tuesday, February 14, 2012
Happy Valentine's Day
I don’t miss the commercialism of holidays at all! It’s so
nice not to have hallmark or flower commercials in my face today! Ghanaians
seem to celebrate Valentine’s Day by telling their loved one’s they love them.
They do not have enough money to give gifts so they acknowledge each other
instead. I like that much better!
I went back to Hohoe to visit Cinderella again today. It was
such a good day. We saw some really interesting patients. I was excited to work
with a couple of patients who recently had strokes. They are still in the
timeframe where they can make really good progress. Cinderella and I discussed
good treatment options, and then we implemented them on the patients. The
patients seemed to respond so positively. It was nice to help Cinderella. She
really just needed some reassurance from me that she was choosing the right
treatments for her patients. I showed her a few new exercises. I think I just
really gave her confidence in her treatment techniques. She always wants to
learn new things. I was glad to help her in that process some.
Once I returned to Kpando, Isaac and I took a taxi to get
water. He decided to drive to one of the neighboring towns to check on one of
his students. The student’s family has a little drinking spot. They gave us
some pork. It was my first time eating pork in Africa. I’m not sure it was the
best idea. Haha! I don’t have a stomach ache, but I keeping thinking about all
the illnesses you can get from undercooked pork. Luckily, they overcook all the
meat here, to the point that I can’t chew it. Ghanaians like their meat touch
and chewy. It is completely opposite to how I like my meat. It’s funny to think
Ghanaians would prefer a chewy cut of meat to a filet mignon. They’d be a cheap
date in the US. J
I hope everyone enjoys their chocolates and flowers in the
US. Happy Valentine’s Day.
Love, Kari
Monday, February 13, 2012
Hohoe Hospital
In case anyone is wondering, Zambia won the African Cup in an
overtime shoot out. No one scored a goal during the game or during
overtime, but it was a really good defensive game. I enjoyed watching
it.
Today, I went to visit Cinderella, the physical therapist at Hohoe Hospital. I met her during the CEU course in Kofurida. Her clinic was not very busy today, but it was nice sitting and discussing patients with her. Despite the limitations, she does a really good job treating her patients. She is very dedicated to her job. I think her and I would be great friends if we lived in the same city. She is about my age and not yet married so we relate well to each other. I think in Ghana there is even more pressure to be married by 28 then in the USA. Obviously, we haven't met the right person yet so that's why we are single! We've waited this long so we are not going to settle either!!! Haha!
We saw an 11 year old girl today who is having left side hemiplegia (partial paralysis of her left arm and leg). The girl had meningitis in the fall. Her brain was injured from it. She presents very similar to a stroke patient. The girl's family does not understand her condition and so they have not been very active in bringing her to therapy. The girl is doing well and will live a pretty functional life; however, her left hand may never regain movement. It is hard to know if she would have had better results if she had consistent therapy. Also, despite the little girl being able to walk on her own, the family was carrying her everywhere until a month ago. Families often think that an illness like a stroke means a person can never do anything on their own again. However, that is not true. Yes, most people will have some lingering physical impairment, but with activity modifications people can become functional individuals again. The girl has not returned to school. I really hope she gets a chance to start going. Cinderella said she would talk to the mother. They are Muslim and so there are some cultural differences that Cinderella may not be aware of that may be keeping her from school, too. It is hard for me to hear about children stopping school at such a young age. Education is an equalizer here. If she does not receive an education she is much more likely to live a life of poverty. Also, her physical deficits will stigmatize her even more! I hope I am helping breakdown these barriers a little even though one trip is not enough!
Tomorrow, I will visit Hohoe again. Tuesdays are much busier so there should be more patients to write about.
Love, Kari
Today, I went to visit Cinderella, the physical therapist at Hohoe Hospital. I met her during the CEU course in Kofurida. Her clinic was not very busy today, but it was nice sitting and discussing patients with her. Despite the limitations, she does a really good job treating her patients. She is very dedicated to her job. I think her and I would be great friends if we lived in the same city. She is about my age and not yet married so we relate well to each other. I think in Ghana there is even more pressure to be married by 28 then in the USA. Obviously, we haven't met the right person yet so that's why we are single! We've waited this long so we are not going to settle either!!! Haha!
We saw an 11 year old girl today who is having left side hemiplegia (partial paralysis of her left arm and leg). The girl had meningitis in the fall. Her brain was injured from it. She presents very similar to a stroke patient. The girl's family does not understand her condition and so they have not been very active in bringing her to therapy. The girl is doing well and will live a pretty functional life; however, her left hand may never regain movement. It is hard to know if she would have had better results if she had consistent therapy. Also, despite the little girl being able to walk on her own, the family was carrying her everywhere until a month ago. Families often think that an illness like a stroke means a person can never do anything on their own again. However, that is not true. Yes, most people will have some lingering physical impairment, but with activity modifications people can become functional individuals again. The girl has not returned to school. I really hope she gets a chance to start going. Cinderella said she would talk to the mother. They are Muslim and so there are some cultural differences that Cinderella may not be aware of that may be keeping her from school, too. It is hard for me to hear about children stopping school at such a young age. Education is an equalizer here. If she does not receive an education she is much more likely to live a life of poverty. Also, her physical deficits will stigmatize her even more! I hope I am helping breakdown these barriers a little even though one trip is not enough!
Tomorrow, I will visit Hohoe again. Tuesdays are much busier so there should be more patients to write about.
Love, Kari
Friday, February 10, 2012
TGIF
TGIF
My body is glad this week is over! I haven’t been sleeping
well. I’m not really sure why. The weather is cool again in the mornings. I
keep waking up to all the noises. I think Bats live in the ceiling of the
house. Also, there are really loud crickets or some bug that chirps all night.
And, I’m still waking to the Mosque at 4 am. So all that has caused me to get a
sore throat again. Hopefully, sleeping in tomorrow will alleviate it!
Today was a much better day at the hospital. I saw the
patient that I was so worried about. He seems to have recovered from the
collapse the previous day. He must have only had a TIA (transient ischemic
attack), very mild stroke without long-term deficits. He said he was feeling
weak today, but his left side that was affected by the original stroke was not
any weaker. I didn’t force him to work with me today. I figure he needed
another day to medically stabilize before beginning therapy. I am becoming very
cautious here since there is not constant monitoring.
Thank you for the comments after yesterday’s post! I am
helping many people even though some people I cannot help. I am keeping it all
in perspective.
I spent sometime comparing stories with the premed students
from the US. They were telling me a little about surgery here. It sounded
interesting. The procedures are what were done in the US probably 50 years ago!
They only do open procedures. There is no equipment for scopes.
Also, they informed me there is a little boy in the
children’s ward with burns. I didn’t know about this boy. I’m glad I found out.
He was burned about a month ago. He is starting to develop knee flexion
contractures. I did ROM on him to get the legs straight. It was so painful for
the poor little guy. I felt so badly. However, if we do not get his legs
straight he will not be able to walk upright again. He was walking with the
mother when we entered the room. He had about a 90-degree bend in both knees.
It is definitely not easy to walk like that! His left leg could get almost all
the way straight with stretching. His right leg was lacking about 30 degrees
from full extension. I’m going to start seeing him 2x/day to get that right leg
straight. If we can get it straight he will make a great recovery.
I don’t really have much planned for this weekend. I just
want to feel better!!! Monday, I will head to Hohoe for a follow-up visit with
Cinderella. She was the other therapist that really impressed me at the course,
so I’m excited to work with her!
Love, Kari
Thursday, February 9, 2012
It wasn't the best day...
Today was an emotional day. A patient that I have been
seeing was admitted shortly after I talked to him. He was coming for therapy,
but said he was going to stop at the pharmacy first to pick up his medication. I
guess he collapsed at the pharmacy. I saw him lying in a hospital bed when I
went to see another ward patient. This man looked like he was having a stroke
or seizure and there was nothing I could do to help him other than ask the
nurse if he was going to start to receive treatments.
The man had a CVA about a year ago. He is noncompliant with
his medications to control his diabetes and hypertension. His family said he
also has been drinking a lot recently. Regardless, it was really hard to see
someone suffer like that especially when 2 hours earlier he looked like he was
fine.
In the US, when you are admitted to the hospital, you are
hooked up to monitors and IV medication right away. Here you just have to wait
until the doctor makes it to you. There are 3 or 4 doctors total for the hospital.
They have to see all the inpatients and all the outpatients. I think around 200
patients come everyday. Obviously, only the most basic medical care is given
due to time constraints and lack of resources.
My training as a therapist just does not allow me to offer
help in these situations. It saddens me and makes me feel helpless. I just have
to remember that I am helping people, but there is no way I can help everyone!
Another Stroke patient I have been seeing since Christmas is doing really well. Every time I see him, his balance improves greatly. He is compliant with his home exercise program. He is only 32 so its nice to see that he will not have many major long term issues as long as he stays compliant with his diet, medication, and exercise! He could hardly even sit at the edge of the hospital bed on his own before Christmas. Today, he walked 2 miles to get to the hospital. We had to wait a good 20 minutes before we could start the session since he was so tired, but I'm so glad he his trying!!!
I have to focus on successes because I can only empower someone so much. Therapy is not a passive treatment. If a person does not want to follow my advice then there is nothing I can do for them.
Love, Kari
Wednesday, February 8, 2012
Tough Loss!
The Black Stars lost in the semifinals tonight! It will be another year before they can attempt to win the African Cup again. Too bad! I was adopting this country's football team.
So last night was very interesting for me. Cynthia's landlord decided to lock them out of the outhouse. We had to go to the bathroom in the bush. Africans call the woods or fields the bush. Let's just say camping will be very easy for me once I'm back in the US. Little kids were laughing at me as I walked to the bush. They thought it was the funniest thing ever that a yevo (white person) was going to the bathroom outside. I was a little nervous they were going to run up on me since they are always so curious about white people. Talk about a nervous bladder. Haha! :) I know TMI!
Anyways....
Today was another good day at Ho Regional Hospital. I saw a couple of pediatric patients and a stroke patient. The patient had his stroke 5 years ago so unfortunately he will not make a ton of progress with therapy. It was hard for me to see him since I know if he would have had good therapy 5 years ago he'd probably be walking independently with a cane. He has been bed bound for the past 5 years. Also, he had some herbal/spiritual treatment where they amputated his toes, if I understood that correctly. Losing your big toes will really hurt your balance. It definitely is never a good treatment for a stroke patient! Obviously, if one has severe wounds it may be the only option, but not in this man's case.
The first kiddo I saw was a 2 year old with developmental delays. The child looked like a 12 month old to me. She has missed many normal developmental milestones: crawling, standing, walking. Lewis said they were making some progress with the child last year. When she first started therapy she couldn't sit unassisted and had horrible head control. In December, she was standing some on her own and could take steps with assist. However, the family says the child was ill and so she was not seen for 2 months. She has regressed, unfortunately. The family is not very active in her care. They often neglect her and if she cries they will hit her to stop. It is sad. The culture is different here and they do not understand that while this child may never be "normal" she is still a human being and deserves some chance!
The next little kiddo was a 5 year old with Cerebral Palsy. His mother is very involved and was right beside me trying to assist in the treatment session. The have made knee braces for him to try and help with standing. I think they have been very helpful. My suggestion was to try an ankle brace rather than knee braces. When his knees are in extension (straight) it cause his feet to point into plantarflexion; thus, he was unable to stand with his feet flat. I think if we can get him weightbearing with his feet flat on the ground then he may be able to stand and take steps with the assistance of a walker. The boy had good trunk control in tall kneeling so I feel with a little more therapy, bracing, and a walker he will walk someday soon! The mom was very excited for my suggestions and is going to a carpenter this afternoon. I hope my ideas will work! I do not normally work with children so it is a lot of trial error for me to know what will be effective.
It was so nice working with Lewis and the other staff at Ho. Lewis really seems to love his job and wants to continue to learn new things. I really admire his desire for continued learning. I only hope I can continue to help him and the other therapists of Ghana! I hope my suggestions were helpful. I realize that things cannot always be done like they are in the US. The way I do things probably isn't always right even though I feel they may be. I am trying so hard to not judge or be critical of things. I hope I am giving constructive feedback because that is always what I want when I am trying to continue my learning process!!!
I survived my solo tro tro ride back to Kpando. It's nice to be back in my African home! I had a Guinness with Isaac tonight! It's become one of my favorite evening activities. Haha! I promise its not every night and its just one at a time. :)
Love, Kari
So last night was very interesting for me. Cynthia's landlord decided to lock them out of the outhouse. We had to go to the bathroom in the bush. Africans call the woods or fields the bush. Let's just say camping will be very easy for me once I'm back in the US. Little kids were laughing at me as I walked to the bush. They thought it was the funniest thing ever that a yevo (white person) was going to the bathroom outside. I was a little nervous they were going to run up on me since they are always so curious about white people. Talk about a nervous bladder. Haha! :) I know TMI!
Anyways....
Today was another good day at Ho Regional Hospital. I saw a couple of pediatric patients and a stroke patient. The patient had his stroke 5 years ago so unfortunately he will not make a ton of progress with therapy. It was hard for me to see him since I know if he would have had good therapy 5 years ago he'd probably be walking independently with a cane. He has been bed bound for the past 5 years. Also, he had some herbal/spiritual treatment where they amputated his toes, if I understood that correctly. Losing your big toes will really hurt your balance. It definitely is never a good treatment for a stroke patient! Obviously, if one has severe wounds it may be the only option, but not in this man's case.
The first kiddo I saw was a 2 year old with developmental delays. The child looked like a 12 month old to me. She has missed many normal developmental milestones: crawling, standing, walking. Lewis said they were making some progress with the child last year. When she first started therapy she couldn't sit unassisted and had horrible head control. In December, she was standing some on her own and could take steps with assist. However, the family says the child was ill and so she was not seen for 2 months. She has regressed, unfortunately. The family is not very active in her care. They often neglect her and if she cries they will hit her to stop. It is sad. The culture is different here and they do not understand that while this child may never be "normal" she is still a human being and deserves some chance!
The next little kiddo was a 5 year old with Cerebral Palsy. His mother is very involved and was right beside me trying to assist in the treatment session. The have made knee braces for him to try and help with standing. I think they have been very helpful. My suggestion was to try an ankle brace rather than knee braces. When his knees are in extension (straight) it cause his feet to point into plantarflexion; thus, he was unable to stand with his feet flat. I think if we can get him weightbearing with his feet flat on the ground then he may be able to stand and take steps with the assistance of a walker. The boy had good trunk control in tall kneeling so I feel with a little more therapy, bracing, and a walker he will walk someday soon! The mom was very excited for my suggestions and is going to a carpenter this afternoon. I hope my ideas will work! I do not normally work with children so it is a lot of trial error for me to know what will be effective.
It was so nice working with Lewis and the other staff at Ho. Lewis really seems to love his job and wants to continue to learn new things. I really admire his desire for continued learning. I only hope I can continue to help him and the other therapists of Ghana! I hope my suggestions were helpful. I realize that things cannot always be done like they are in the US. The way I do things probably isn't always right even though I feel they may be. I am trying so hard to not judge or be critical of things. I hope I am giving constructive feedback because that is always what I want when I am trying to continue my learning process!!!
I survived my solo tro tro ride back to Kpando. It's nice to be back in my African home! I had a Guinness with Isaac tonight! It's become one of my favorite evening activities. Haha! I promise its not every night and its just one at a time. :)
Love, Kari
Tuesday, February 7, 2012
2 months!!!
Today marks 2 months that I have been in Ghana! This trip is
really going by fast. I’ve definitely had my moments where I’ve wished I could
be back in the US. I’d be lying if I said this trip was all sunshine and
rainbows. Living in a 3rd world country is not easy! However, the
opportunities I’ve had here to advance the therapy profession, help others, and
experience a different culture have been priceless!!!
I finally made it to Ho Regional Hospital! I spent the day
in the physiotherapy department helping treat patients and instruct the
therapists and students. Lewis, the head PT, attended the Step FaR continuing
education course a couple of weeks ago. I thought he was great at that time and
think even more highly of him after spending the day with him. He said he has
become a more hands on therapist since the course. He feels what Sam, Ken, and
myself taught him was extremely useful for clinical practice! It made me feel
really good. I hope Step FaR continues to be a successful NGO for Ghana.
Hopefully, I can help make that happen on future trips! J
We treated some interesting patients today. One case in
particular was very interesting for me. Lewis has been treating a 4-month-old
baby who has Erb’s Palsy. For those without a medical background, it is a nerve
injury that affects the arm. It usually occurs during a rough childbirth. We do
not see it much in the US anymore since the doctors deliver babies via
C-section anytime they are concerned of complications. Erb’s Palsy has an
interesting presentation where the involved arm is turned around and back. The
way it was described in school is a server sticking his arm behind him with
palm up to try and get a tip. It is how servers accepted tips in old fashion
times.
The baby is starting to show active movement. Lewis has been
applying a kinesiotape technique that Ken showed him in the course. Lewis feels
it is helping! I tried to give Lewis so more suggestions. Everything I
mentioned he already thought of so that’s good! J
I do not treat pediatric patients much in the US so unfortunately I struggle a
little with how to get a baby to perform active motion on command. We talked
about trying constraint induced movement therapy (CIMT). CIMT is where you
restrain the good arm, forcing the person to use the bad arm. They have been
trying it with some success. The baby tries to suck on her good hand when this
is done!
The baby has also developed some torticolis due to the Erb’s
Palsy. The baby’s neck is stiff and always turned to the right side since the
left arm was not working well. We were trying to problem solve ways to get the
baby to look left and force her to keep her head left. We had her practice
laying on her tummy with her head to the left. Also, we used toys to force her
to look left. The techniques worked pretty well.
I made some silly comments. I talked to the mother about
feeding the child by standing at her left side. I forgot that infants do not
start on solids until around 6 months. I’m not really sure how to get the child
to breastfeed with her head turned left or in a neutral position since it isn’t
anything I’ve tried before. Haha! I think I will be able to treat children a
little better once I have a child of my own. I will also probably have better
patience.
I admire Lewis’s eagerness to learn. I hope myself, Step FaR
and Therapists Without Borders can help in the future with his learning! Lewis
and I were discussing how there are such great You Tube videos available that
show many therapy techniques or new exercises. However, the internet is so unpredictable
here that it makes it hard to access them. He likes textbooks too but they also
are not easy to get a hold of and are very expensive. I hope I can be a
resource for the therapists I have met on this trip. I hope I can keep in email
communication with them once I return to the US. If I could answer their
questions or direct them to the right resources I think I can help them even
when I’m not in Ghana!!
Tomorrow, I will visit Ho Regional Hospital again. Then, I
will have an interesting Tro Tro ride back to Kpando. It will prepare me for my
longer one I have in a week and a half when I go back to Accra and Tema.
Love, Kari
Monday, February 6, 2012
The town of Ho
I started my first follow-up trip today. Isaac and I dropped Millie off at her school in Ho. Then I met up with Cynthia, Isaac's other daughter. Cynthia graciously allowed me to stay with her while I visit Ho regional hospital. Unfortunately, by the time we left Kpando, dropped Millie off, and I met up with Cynthia, the PT was finished at the hospital for the day. Tomorrow, I will visit Lewis, the PT at Ho regional hospital.
I hate that I wasn't able to get there to see him. I am on Ghana Maybe Time and so the best intentions often do not pan out as I would like. It's part of being flexible in another country. Luckily, Ghanaians are use to this so they do not consider me terribly rude for not making it there today. If the trip had been up to me, I would have left at 7 am to make it to the hospital by 9 am. However, Isaac is such a good host that he would not allow me to travel without him! But, that means we did not leave until 10 am. Also, I was planning on getting a hotel room, but he made Cynthia host me. I feel bad for inconveniencing her, but that is the Ghanaian way.
It will be a little interesting at Cynthia's studio apartment. The toilet is a hole in the ground. The shower is also outside. She does have running water though. I find that funny. To me I would much prefer a flushable toilet over a running shower. I guess a sewage system is harder than getting running water. There are 4 walls and a door on the toilet and shower, so at least I will have privacy! :)
Yesterday, while everyone else was getting ready for their Superbowl festivities, I was cheering on the Black Stars! They won in overtime with a very lucky goal! The Tunisian goalkeeper, dropped the ball and Dede kicked it in!! Overall, the game was pretty boring. I got annoyed at the players because they would get so dramatic during any foul hoping the referee would give the person a yellow or red card. I mean, I guess basketball players act a little when they are fouled, but no where near as much like these soccer players. Play the game, don't be babies! I guess that's why Americans prefer football! I am so so happy to see the Giant's won! The Patriots are my least favorite team! Brady's looks unfortunately cannot get him a Superbowl ring this year!!! :)
I promise tomorrow's post will be all about therapy! I'm so excited to work with Lewis tomorrow. He really is a great therapist. I think with more Step FaR continuing education courses, he could be an excellent PT. My hope is he can be trained to help teach courses himself once Step FaR and Therapists Without Borders have established themselves a little more in Ghana!! After all, the goal of my trip and future volunteers' trips is to empower Ghanaians to be better health care providers!
Love, Kari
I hate that I wasn't able to get there to see him. I am on Ghana Maybe Time and so the best intentions often do not pan out as I would like. It's part of being flexible in another country. Luckily, Ghanaians are use to this so they do not consider me terribly rude for not making it there today. If the trip had been up to me, I would have left at 7 am to make it to the hospital by 9 am. However, Isaac is such a good host that he would not allow me to travel without him! But, that means we did not leave until 10 am. Also, I was planning on getting a hotel room, but he made Cynthia host me. I feel bad for inconveniencing her, but that is the Ghanaian way.
It will be a little interesting at Cynthia's studio apartment. The toilet is a hole in the ground. The shower is also outside. She does have running water though. I find that funny. To me I would much prefer a flushable toilet over a running shower. I guess a sewage system is harder than getting running water. There are 4 walls and a door on the toilet and shower, so at least I will have privacy! :)
Yesterday, while everyone else was getting ready for their Superbowl festivities, I was cheering on the Black Stars! They won in overtime with a very lucky goal! The Tunisian goalkeeper, dropped the ball and Dede kicked it in!! Overall, the game was pretty boring. I got annoyed at the players because they would get so dramatic during any foul hoping the referee would give the person a yellow or red card. I mean, I guess basketball players act a little when they are fouled, but no where near as much like these soccer players. Play the game, don't be babies! I guess that's why Americans prefer football! I am so so happy to see the Giant's won! The Patriots are my least favorite team! Brady's looks unfortunately cannot get him a Superbowl ring this year!!! :)
I promise tomorrow's post will be all about therapy! I'm so excited to work with Lewis tomorrow. He really is a great therapist. I think with more Step FaR continuing education courses, he could be an excellent PT. My hope is he can be trained to help teach courses himself once Step FaR and Therapists Without Borders have established themselves a little more in Ghana!! After all, the goal of my trip and future volunteers' trips is to empower Ghanaians to be better health care providers!
Love, Kari
Saturday, February 4, 2012
Somber Day
It was a long day. We left the house at 7:30 am to go to Grace's village for her nephew's funeral. It was neat seeing her village, but funerals are never a fun thing. Grace's village is built into the mountainside. I found it very pretty, but definitely rustic. There are no streets to most of the houses so everything must be carried. Most of the houses do not have running water. I needed to use the bathroom, this consisted of a 3 sided wood fence, no door that you squat in! It seemed some what isolated, but it wasn't the easiest time since anyone could have come up upon me!!! I sure this is TMI, but I think it helps for people to know what its really like!
Anyways, we started out by walking to various family memebers' homes to pay our respect. This consisted of the usual cultural greetings and then taking a drink of the local spirits. I passed since I tried them once and they were disgusting and because it was 9 am in the morning. Also, we walked to the tent that had the open caskets of the deceased. I guess they combine funerals so it was for 4 people. I realized I haven't been to a funeral since my Grandma's 9 years ago so it wasn't the most pleasant thing. Around 10 am, the funeral started. It was some singing, prayer, sermons, and eulogies. I couldn't understand most of it so it was a very boring 2.5 hours! We then ate lunch after hiking back up to Grace's childhood home! The hill is really steep. The littlest physical impairment could really disable you in this village!! After lunch, we walked to more houses to pay our respects. Finally, at 4 pm we headed back to Kpando. I was very hot at that point and glad to head back home!
I like experiencing parts of other cultures, but I can't say I was entertained today. I find it interesting to know what a funeral is like here, but overall it was boring and sad. Two of the people were only 40 years old so it was not a happy funeral like they are for older people. I'm not really sure how they died. I think both had been sick for awhile.
I hope everyone is having a good weekend. I'm looking forward to sleeping in tomorrow morning after waking up early today!
Love, Kari
Anyways, we started out by walking to various family memebers' homes to pay our respect. This consisted of the usual cultural greetings and then taking a drink of the local spirits. I passed since I tried them once and they were disgusting and because it was 9 am in the morning. Also, we walked to the tent that had the open caskets of the deceased. I guess they combine funerals so it was for 4 people. I realized I haven't been to a funeral since my Grandma's 9 years ago so it wasn't the most pleasant thing. Around 10 am, the funeral started. It was some singing, prayer, sermons, and eulogies. I couldn't understand most of it so it was a very boring 2.5 hours! We then ate lunch after hiking back up to Grace's childhood home! The hill is really steep. The littlest physical impairment could really disable you in this village!! After lunch, we walked to more houses to pay our respects. Finally, at 4 pm we headed back to Kpando. I was very hot at that point and glad to head back home!
I like experiencing parts of other cultures, but I can't say I was entertained today. I find it interesting to know what a funeral is like here, but overall it was boring and sad. Two of the people were only 40 years old so it was not a happy funeral like they are for older people. I'm not really sure how they died. I think both had been sick for awhile.
I hope everyone is having a good weekend. I'm looking forward to sleeping in tomorrow morning after waking up early today!
Love, Kari
Friday, February 3, 2012
Friday!
I am in a much better mood today! We've had 24 hours of nonstop power!! Yippie. :)
I would say TGIF, but work/volunteering isn't really stressful so it don't really care when the weekend comes. I spent my day at the hospital. It was nice to be there after visiting the school again yesterday. I thought the school would keep me a little more entertained, but they instruct the kids in the local language for the most part so I can't follow well or assist.
There are a few pre-med students at the hospital now. I've spoken to one of them a couple of times now. It was nice just having an American to talk to for a few minutes. She was telling me how they were helping in the AIDS/HIV clinic, yesterday. She said there were a ton of patients and only one staff to help. The staff was one of the sisters (nuns). AIDS is very stigmatized here. I guess many healthcare workers will just refuse to treat the AIDS patients. Its really sad. Africa is making improvements with AIDS treatment and prevention, but it has a long way to go. I guess we can only hope that a vaccine gets discovered soon!!
I went to Mama's home today. She is a stroke patient that I have been seeing since my first day here. Unfortunately, she is not feeling well again. She is having a lot of pain. I think she has severe gout. Also, her diabetes is poorly managed. Hopefully, the new medications she got from the doctors will help keep her pain under control so we can increase you strength and independence with functional mobility. I'm beginning to think she is a lot sicker that we realized.
Its hard here. I'm always making educated guesses on patients' conditions. The chart is not very usefull since the doctors are unable to diagnosis much better than myself. They just do not have access to daily blood draws and diagnostic tests like in the US to get a clear picture of someone's health. I'm sure a medical doctor here is use to it and can still make accurate diagnosises. For myself though, I do not find it as easy since my training as a Physical Therapist focuses on one's physical impairments. I am interested in the diseases/conditions one has; however, it is how they physically present that dictates my treatment plan. I can still treat their physical impairments, but I find I have a hard time knowing their prognosis without having a clear idea of the diagnosis.
So tomorrow I will go to Grace's village for a funeral. I was confused on my weekends. It shall be interesting. I passed a funeral procession on my way to the internet cafe tonight. There was a drumline in front of the hearst. It reminded me of the drum processions that they have in New Orleans. I'm realizing how many African American traditions are still very African!
Have a good weekend everyone!
Love, Kari
I would say TGIF, but work/volunteering isn't really stressful so it don't really care when the weekend comes. I spent my day at the hospital. It was nice to be there after visiting the school again yesterday. I thought the school would keep me a little more entertained, but they instruct the kids in the local language for the most part so I can't follow well or assist.
There are a few pre-med students at the hospital now. I've spoken to one of them a couple of times now. It was nice just having an American to talk to for a few minutes. She was telling me how they were helping in the AIDS/HIV clinic, yesterday. She said there were a ton of patients and only one staff to help. The staff was one of the sisters (nuns). AIDS is very stigmatized here. I guess many healthcare workers will just refuse to treat the AIDS patients. Its really sad. Africa is making improvements with AIDS treatment and prevention, but it has a long way to go. I guess we can only hope that a vaccine gets discovered soon!!
I went to Mama's home today. She is a stroke patient that I have been seeing since my first day here. Unfortunately, she is not feeling well again. She is having a lot of pain. I think she has severe gout. Also, her diabetes is poorly managed. Hopefully, the new medications she got from the doctors will help keep her pain under control so we can increase you strength and independence with functional mobility. I'm beginning to think she is a lot sicker that we realized.
Its hard here. I'm always making educated guesses on patients' conditions. The chart is not very usefull since the doctors are unable to diagnosis much better than myself. They just do not have access to daily blood draws and diagnostic tests like in the US to get a clear picture of someone's health. I'm sure a medical doctor here is use to it and can still make accurate diagnosises. For myself though, I do not find it as easy since my training as a Physical Therapist focuses on one's physical impairments. I am interested in the diseases/conditions one has; however, it is how they physically present that dictates my treatment plan. I can still treat their physical impairments, but I find I have a hard time knowing their prognosis without having a clear idea of the diagnosis.
So tomorrow I will go to Grace's village for a funeral. I was confused on my weekends. It shall be interesting. I passed a funeral procession on my way to the internet cafe tonight. There was a drumline in front of the hearst. It reminded me of the drum processions that they have in New Orleans. I'm realizing how many African American traditions are still very African!
Have a good weekend everyone!
Love, Kari
Thursday, February 2, 2012
No running water and no electricity!!!
I’m not going to take electricity for granted once I’m back
in the US!! The power has gone out everyday the past 5 days in a row. It didn’t
bug me too much until yesterday. It was just going out for about 1-2 hours in
the evening. However, yesterday it was out most of the day. The power returned
5 minutes before the Black Stars game started. There would have been a lot of
pissed off Ghanaians if they missed their game. The game was a draw, 1-1, but
Ghana qualified for the quarterfinals of the African Cup so it didn’t really
matter!
Tonight when the power went out I got really annoyed. I was
sick of being in darkness at night. Yesterday was so so hot at the hospital
without fans that I really was grumpy with another power failure. I know
Africans are use to the heat, but when most of the patients I see are stroke
patients, it makes me very nervous to have them exercise in the heat! First of
all, many of them have to walk 20-30 minutes to even reach the hospital. Then,
the room is so hot that even the simplest exercise of having a patient perform
sit to stand 10 times causes them to sweat profusely. I want to get them
stronger and moving better, but it’s not worth taxing their heart or lungs in
the process!!
I really shouldn’t be complaining. This is life in a 3rd
world country after all. I think the heat has gotten to me this week. The
weather has changed. The mornings are no longer cool. We haven't had running water in 2 weeks. Also, I’m really starting
to miss American food at the 8-week mark. I've started to tap into my food
supplies a lot this week!!! I will not have any gushers, tuna fish, crackers,
or slim jims left by next week if I keep this up! I realize how hard it must
have been for Sam and Kenneth in the US. There is no way to eat Ghanaian food
in North Dakota, unless you visit an African market. I’m sure the closest one
is Minneapolis. At least for me, I can live off peanut butter, jelly, and bread
if I need to. Also, they serve me a lot of rice that is easy to stomach. I just
miss salad and steamed vegetables and cheese!!! I’ve always loved cheese, but
after living in Wisconsin for 8+ years, I really really love cheese!!!!
Enjoy your American Dinners tonight! I really should have
written more about the actual hospital or school children, but I’m allowed to be
annoyed 1 night, right?
Love, Kari
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