Day 7

Today is our first day working in the clinic and the hospital in Kpando. It is also the first chance the students have to see Kpando in the light of day. I see some trepidation and concern in their eyes because this is a busy, dusty, noisy town with buildings that are ramshackle and lots of clusters of homes that appear very poor.

Our first week has spoiled us with nicer hotels. The UMass Lowellnursing students are excited to see some health care facilities. We begin our long dusty walk to the clinic where are supposed to meet with the District Chief.

This is the road that can be treacherous and I tell the students to walk single file to avoid getting hit by the many cars and trucks. We stop to buy some minutes for our cell phones and meet Grace the tailor regarding making some dresses and I point out Maxy’s Spot which is a run down derelict bar but it is the ‘in’ place to go.

The students don’t seem to impressed and if they decide not to go there then I will be happy. They seem totally happy with playing rummy and Phase 10 which Amanda and I have introduced them to. I am amazed at the different group dynamics every year with the students. We have a good group this year and so far no personality conflicts. We settle into life in Kpando.

The students quickly figure out where to buy water, where to buy carved wood, where the internet caf’ is and how all my warnings about crazy drivers were true. The are many very small businesses by the side of the road but mostly are small provision shops, casket makers and bars. There is also some tailors and beauty shops. So I tell Maura, we are all set; we can get beautiful, drink and have our body buried all in the same town.

I go to the outpatient clinic withfive students and Maura goes to the hospital. We have both found our comfort zone. Unfortunately many of the people I met last year at the clinic are not there so I must begin anew in establishing the relationship. It really is more of an observational experience than a working experience. I take whatever opportunity to ask questions and interpret (medically) to the students what is happening but it is hard for me to be infive places at once because I have distributed the students to five different areas.

They find the consulting area the most interesting because that is also my comfort zone and before long I am assisting the medical assistant (like a physician assistant) in his diagnosis and prescribing of meds for various problems. We see 83 patients that day and I would say at least 60 of them were malaria. The disease is so rampant here. Everyone always assumes that HIV is the prevalent disease but malaria is a more common disease with such death rates that are very high especially for the young children under 5. Seeing the prevalence has made our malaria project in Peki seem that much more valuable.

Time is short today so I will not write much. More to come tomorrow.

Day 5: ‘The Gifts: Education, Land and Experience (and lack of modesty)’

Today was our full day in Peki. Our plan is to implement the community projects that the students have been planning.

Last evening I had to make a public announcement to the attendees at the Durfur about our programs. We had hoped to have no more than 50 children for the Nutrition Program and about 20-25 mothers of young children for the malaria program.

Due to the exact time of both programs in different locations I have to rely on Maura to evaluate one of the programs. I evaluated the Nutrition program. This was a program targeted school age children and to teach them about healthy foods and the benefits of exercise.

Obesity is not a problem in Ghana but rather malnourishment is a problem. The children (and some of the parents) do not have an understanding of the various types of food. Although in this environment the children often eat whatever is made available to them we wanted to empower them a bit with some knowledge to help guide any decision making that they may be involved with regarding food choices.

The program was attended by at least 80 children along with a few mothers. The students need to use an interpreter to convey their message. Although English is spoken in the schools here in Peki, many of the children communicate primarily in their native dialect. The UMass Lowellstudents had prepared a craft project to coincide with their lesson but we had only enough material for 50 children.

Remarkably these children happily share the project with their friends. They did not know what a glue stick was but by the end of the program they had a paper plate with pictures of health food glued on them. We wanted the children to take the plates with them but the plates were collected by the clinic nurse (who was our interpreter) who felt that they would be good teaching tools for the mothers. I guess this logic makes sense because the mothers are the ones preparing the food. Each child left with a silly band bracelet and a smile on their faces.

The other project was a Malaria education program where the mothers received information about the signs and symptoms of malaria and how to take a temperature. The Nursing Students Without Borders club was able to purchase some thermometers and insecticide treated mosquito nets due to the generosity of the Lutheran church in Woburn.

We had hoped to give 30+ mothers a net when they left but we did not purchase enough. We have some additional church money left over to put toward our projects so we hope to purchase more before we leave. It was a great feeling at the end of the day when the students realized that their actions today have improved the health of so many in the village. It may even save the life of a young child who often die from malaria at young ages. It was a fitting way to repay the hospitality of this wonderful village.

After our programs we were treated to some cold water (actually they call them sachets of water which are the bagged purified water). The Chief of Peki asks to speak privately to Maura, myself and Jason. Jason is chosen because he is our only male student and the chief wants to recognize that and calls him a chief. We are offered some sweet red wine from South Africa and then followed by a small amount of a chocolate liquor called Takai. Both are quite good. And so begins the official discussion.

Land in Ghana is mostly privately owned and can be quite expensive and difficult to purchase especially for an outsider. Large amounts of land are controlled by the Chief. He is very pleased with the relationship between his village and the students from UMass Lowell and wishes to make a donation of land for our use. He would like to establish some type of building or structure(s) that would have lasting impact for the people of the region but also will bear the name of UMass Lowell. He encourages us to think about how this may take form.

He does not make this gift without much thought and I am proud yet concerned about being able to meet these expectations. This venture should not be entered into lightly because if done successfully could have lasting impact on both the people of Peki and future visitors from the USA. Maura, Jason and I leave this meeting with some trepidation but also with a sense of an important relationship that could transcend our national borders. This is an opportunity that will take some careful thought and planning but we do not make any commitments but express our appreciation of his trust and friendship.

Upon our return to our hotel we have a few hours to relax. This is the first time we have had some time to relax and it has not been after afive hour bus ride or after a 12 hour day. It is great to catch up on some rest because we will be working very hard for the nextsix days.

Our plan is to leave for Kpando tomorrow after we go a hypertension screening clinic in Peki. Tomorrow is Sunday so we must wait until after church and lunch are over before we can arrive in the village. Some of the student may go to church while others have decided to sleep late and enjoy the last few hours at this hotel.

I have told them that the accommodations at the next hotel are not as nice and we should expect more power outages and water problems. They are actually a bit excited about living a bit more rustic but I am sure that will wear off when they see a few bugs in their room or no internet because of power outages.

Every night we have a debriefing and talk about the day’s events. Tonight I could hear a difference in the students’ comments. I think they are finally coming to realize the enormity of what they are doing. I told Maura that I thought it was so brave of these students to take on this trip but she thought it was very brave for us (the Mamas) to take on this trip. I am not sure who is more brave but we all recognize that it is a truly remarkable experience that most of our friends and family will never experience and will only get a small glimpse of our adventures by looking at our pictures.

It is my hope as a nursing educator that this trip will make an impact in a way that traditional nursing practicums or lectures cannot even begin to compare. I believe that the students will develop an awareness of the blessings of their own lives at home in USA but also to become more acutely aware of the health and social disparities that are so prevalent beyond our borders and that they may now be empowered to address these issues at some point in their careers.

And to leave you all with a funny image rather than my soapbox comments. Two nights ago we made a presentation of new mattresses and some clinic supplies in the village of Ada. After enjoying some Fanta and Coke (no Diet Coke!) some of us needed to relieve ourselves before the long bus ride home. We were directed to the bathroom which was behind the clinic. Off we trot with our one little flashlight. We find the bathroom and Jason uses it first but reports back to us that is it quite disgusting, more like a small hole in the concrete. We take our chances outside rather than use the ‘hole’. I giggle when I think of my students merely 10 feet away in the utter darkness as their Professor King acts quite ‘unprofessor-like.’ Our daily struggles for the usual comforts of food, water and sanitation create a strange bond that many will never experience!