Monthly Archives: December 2009

‘Who has the right of way?’ – December 31, 2009

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By Valerie King

Today we have our first full day in Kpando. After a breakfast of peanut butter and crackers and water I prepare to meet the students for a walk to the District Commissioner’s Office for a formal meeting. This is the first day that the students will get the ‘walk the walk’ that I did so many times last year. Our guest house was chosen specifically because of its central location. I spent many hours last year at the internet caf’ and the small adjourning park that is across the street from our guest house.

This morning we are walking to the Kpando Health District offices which are about a mile away through the busy roads of Kpando. The roads are very busy and it can be treacherous to walk down the street with the many taxis, private cars and other vehicles on the road and every one of them think they have the right of way.

The students are seeing Kpando in the light of day and will learn to call this community home for the next few weeks. They will learn where to find the best pineapples and water and where to get a cold drink or where the children will rush up to meet you. There is much activity and not much has changed since last year. I am a bit dismayed to find the house where the little girl Hannah lived appears to no longer be occupied. She and her mother and (?) auntie were the first people of Kpando that I met last year and I have come prepared with gifts for them and they are not there. I have asked around and no one seems to know where they are. Their home was an unsafe shack before and I can only hope that maybe they have moved into more suitable living quarters.

We arrive at the District offices and have an official meeting with the Director. There is so much protocol that must be followed. We present our plan for clinics and interventions and anxiously await his approval. It seems strange that we could travel all the way here and then to have someone turn down our offer of help. Fortunately that is not the case. He is a lovely man and is appreciative of our efforts and also longs for a continuing relationship with the people of UMass Lowell.

After our meeting I walk to the next building to reunite with Shine. She was my host last year and I am her ‘mommy’. She shrieks and runs to me and we hug. She is such a wonderful person and I realize how much I had missed her and she missed me. I also am reunited with some of the other nurses from last year and it is comforting to see some familiar faces. We meet a medical student (3rd year) who is living with Shine for a while and working at the clinic. Her name is Maria and she is from Puerto Rico. She is excited to have some nurses working with her next week. She said she sees over 100 patients a day.

We gather the students and some supplies and we cram into a pickup truck and drive 4-5 miles to Torkor. This is the impoverished fishing village that we visited last year. Today is market day and the community’s population here has tripled. So as we ‘go where the patients are.’

A quick impromptu clinic is set up. Two tables, 6 chairs and some benches. I give out assignments. Five students for BP readings, 2 recorders, 2 medication sorters, and a roving photographer. My plan is to circulate throughout the stations and the students have been instructed which patients to refer to me for further assessment and medication administration. I was concerned that the experience was going to be too intense but I was very pleasantly surprised and proud of their adaptation to the circumstances. They were being asked to assess patients who did not speak English and to practice some of their assessment skills and critical thinking to determine which patients needed further intervention.

It was a crazy 2 hours. I have not counted the actual number of patients that we saw today but I would not be surprised if we saw over 100 in 2 hours. The incidence of hypertension is mind boggling. I know that my supply of BP meds is not going to last during this trip so I have to adjust my dispensing. I am only giving them 10 tabs and then instructing them to return to a local clinic. Many of them have no insurance and I am not sure that they will go but I cannot in good conscience let them leave the clinic without medications. I have also adjusted my threshold of what patients receive meds. I am only giving meds if the diastolic pressure goes over 100. We have so many people in Stage 1 hypertension but I cannot afford to give them meds. I am saving my meds for the more extreme cases and trying to supplement our intervention with lots of patient teaching. It is a difficult compromise for me to do but I am trying to make the best of the situation.

These people are the poorest of poor. They live off fishing and sales of goods. The clothing is tattered and worn. It breaks my heart to think of all the clothes I have at home in my closet and if I could get them here I would. One woman who was so appreciative tries to give me one cedis (this is equivalent to one dollar). I know that is a fortune for her. I cannot take her money and politely refuse but I realize that I may have offended her. One woman hands us a bag of oranges. Another man, whom I discussed his high BP and urged him to cut out salt, told one of our escorts that I must have heavenly powers because I told him the exact same thing a MD specialist told him. It is interesting to hear that and you wonder if hearing from a nurse from America helped to make a health behavior change for him. We return home to our hotel to get ready for our New Years Eve Feast. We have ordered some Ghanaian food from our friend Patience and she will bring it to our hotel along with some beer and Smirnoff Ice.

‘Hail to the Chief and Heathens’

We had a nice dinner. I am not a huge fan of Ghanaian food but Patience’s cooking was good and the girls loved the meal. We sat around our tables in the courtyard of the guest house. Our 5 small cocktail tables are illuminated by my Barnes and Nobles book lights (thank you Santa). After we finish we have a wonderful discussion with one of our organizers, Maule. He is from Peko which is a village we will be visiting in a week or so. He explained to us the chiefdom system that is the custom here in Ghana. He is the first born son of the Chief of Peko and someday he will be assuming this very important role. He is a personable and educated young man who has love of learning but also love of his village and a desire to return to Peki to make a difference in the lives of his people when he graduates this May from the University of Ghana. He has been incredibly helpful to us and is knowledgeable about local customs, dialect, and history.

We learn that New Year’s Eve is a religious holiday here. After dinner we cross the street to go to the Friendly Spot, local bar/shack that serves beverages and has an MTV type program on a portable TV on the grass outside the establishment. There are large speakers which at this moment are pounding with bass and music. As we sit there we notice many of the people of the town are passing us on the road and are dressed well and going to church for a 9 pm service. We are told that they stay until midnight to welcome in the New Year and then return to their homes and local bars to celebrate until the wee hours of the morning. I suspect that the Friendly Spot will be booming for hours to come. I think I may need to sleep with headphones tonight.

We are the heathens who instead of going to church are drinking and waiting for the New Year to arrive. I have left the UML students to enjoy some relaxation without the presence of the ‘Mama.’ I am enjoying the solitude but am sad that I am missing NYE with my husband and children. I want to call home but we do not have any minutes on our phone and the internet caf’ is closed. I wish all my dear friends, colleagues and family a very happy New Year and I will see you all in 2010.

“All Around Town” Part 2 – December 30, 2009

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After our meeting with the minister’s chief director we board our bus again and we began driving to our next destination of the Kwame Nkrumah Mausoleum. The traffic is stopped ahead and our driver who is following the lead of our truck in front of us, decides to go over the curb into the oncoming 2 lanes of opposing traffic. The passenger in the truck is frantically waving to the oncoming cars to get out of ‘our way’ so we can drive ahead to our destination. I was too busy watching my life pass in front of my eyes to take out my camera and get a video of this adventure.

Well, I am writing to you now so you must know that we arrived safe and sound at our next destination. We toured the Mausoleum which is a lovely tribute to the first President of Ghana when the country became a republic in 1961. Our tour guide tells us that he was removed from office around 1966 in a coup d’etat that was secretly supported by our own USA CIA. I don’t know if that is true but the fact that I see only one photo of President Nkrumah with JFK and multiple pictures of him with Fidel Castro then I suspect there could be some truth in this fact.

It is an impressive site that also contains the headless and handless statue of this president that was partially destroyed during the coup d’etat. It has some eerie resemblance in my mind of the statue of Saddam Hussein that was destroyed by soldiers during the invasion of Iraq. This Ghanaian president was obviously loved and respected and when he died his remains where brought to this park (that used to be a British polo field where no Blacks were ever allowed to walk on). We also saw his car, a bulletproof American Cadillac that sits out in the hot African sun. The display in the museum and the car are interesting but seem to be in dire need of some good museum conservation to keep the exhibit viable. There are signs of aging of the photos and not much appears to be done in terms of archival preservation. We also do a drive by of the Parliament and the massive conference center and parade grounds.

Kwadwo has rejoined our group and he has taken our personal funds and exchanged them for Ghanaian cedis. The exchange rate is not bad 1 USD to1.4 cedis. We finally have some money to buy some water and food. My task was to divide the over $3000 in Ghanaian money (mostly 1’s and 5’s) into even piles of $280 each. The one mistake I did was to count this money in the rear seat of a moving bus. For those who know me you know I am extremely sensitive to motion sickness, especially in the back of vehicles.

We arrived at our restaurant which was a bountiful buffet of all the Ghanaian foods that the students wanted to try. Some of the students love the food others are less than enthused but it is an opportunity to experience some of the culture. After a quick trip (thru the endless traffic of Accra) we go to the Mall to purchase a cell phone so the students can call home and some water for our day tomorrow. We will be journeying to Kpando and the students will leave the bustling city of Accra and see the rural area of the Volta Region. We are scheduled to work at 2 different blood pressure clinics tomorrow.

Everyone is weary so we head back to our hotel for a nice cold drink and a suitcase supper. A suitcase supper is made up of snacks that were brought by us to Ghana. Our land package does not include meals so we are trying to economize and eat some of our snacks as meals. Many of us are still full from the food we had earlier today. Back at the hotel we experience a blackout for an hour or so and we are told that this is a regular occurrence. All the students are prepared with flashlights. We now have running water and the air conditioner is working so life is pretty good here tonight. Jet lag has really caught up to us so we are going to bed a bit earlier today. Tomorrow will be a busy day!

‘All around the town’ Part 1 – December 30, 2009

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Today started with a loud tapping on my door at 6 am. Kwadwo’s wife Sylvia was waking me up about an hour earlier than I had expected. Oh well, guess I will function on 3 hours of sleep today. I was unsure about our breakfast arrangements so I finished my ‘ leftover turkey sandwich I had bought 2 days ago at Panera. I was hoping I would not get salmonella but if I did I rationalized that it was probably ‘American’ salmonella.

We all met at the hotel restaurant and I had a glass of OJ and the girls were very pleased that coffee and tea where available. The owners of this hotel called the Samartine Hotel are very friendly and accommodating. They have just finished years of work on this hotel and opened last week. I think we are one of the first guests. The sheets on my bed are brand new and the place is immaculate. It is a nice change from some of the previous hotels/guest houses we have stayed in and I would very highly recommend that you check out this hotel if you are in need of affordable, yet clean hotel rooms. Ok, enough of my commercial but the proprietors, Sam and Martine, are such lovely people I had to give them a shout out.

After breakfast we loaded onto our 25 seat bus (also a huge improvement in the Tro Tros that we used last year). Off we go for a day of sightseeing and a meeting with the Minister of Education. We had hoped to meet up with the University of Ghana students today but they are all on Christmas break so we will try to connect at the end of our trip. We drove through the campus. It is quite large and covers many acres of prime land overlooking the city of Accra. There are many academic departments and it is a frequent choice amongst students from neighboring countries.

The campus is impressive but we hear stories about the living conditions for the students and the UML students realize how good they have it at UML. Often there are 6-8 students sharing one dorm room with many bunk beds. We ask our friend Mawuli who is attending there in his last year of a BS in Social Work, how much the tuition is a year. He reports $500 per year. Ummmm’ I could save a lot of money and send Jimmy here.

After our drive through the campus we drive to the site where the Minister of Education works. He is a very important man and he has written an official letter of support for our group and that is not very often done. I believe he has interest in our trip and has agreed to meet with us. He was unable to meet with us so we meet with his Chief Director, Mr. Dannyo.

After brief introductions by all the students and myself we review our itinerary with the him. He appears impressed by the type of experiences we have planned. The students ask him some very relevant questions and we present him with one of our blue NSWB polo shirts and a copy of the UML Magazine article that was written by Karen Angelo last Spring about our trip in 2009. We also have given him some medicine that have brought with us as a sample of some of the supplies that we have carried into Ghana to deliver to the underserved people in our clinics. He is also impressed by this little ‘freebie’ gift of multivitamins, ranitidine, loratadine and Advil. He reports it is the first time he has ever gotten free medicine.

‘Is it night or day’ and hey.. where is my running water?’ Part 2 – December 29, 2009

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We drive a bit through Accra but the hour is getting late and we are hungry, hot and tired. We are taken to Frankie’s which was the local restaurant I went to last year on my last day in Accra. It has wonderful American type food and I am thrilled because I know this will probably be my last Diet Coke for a while.

We are brought to a newly renovated hotel in Accra. We drive down a rutted dirt road and I am questioning the locale as safe destination but soon we drive into a courtyard with brick pavers and a hotel that has obviously undergone some recent renovations. We are surprised to be treated by private rooms for each student. The rooms are clean and new sheets, bathrooms and best of all, air conditioning. After carrying in our 44+ boxes and suitcases we retire to our rooms for a long awaited shower and rest. I guess the water fairy is not on my side again this year because I have a lovely bathroom with new tile and sink but no running water. I sneak down to a student room and after trying 3 different rooms I finally find one room with a trickle of cold water. At this point it feels like a luxury and I quickly shower. I hope this is a minor plumbing glitch that can be resolved in the morning.

Prior to my shower I start to give out some of my gifts to Kwadwo and his wife (who has joined us tonight). I have given him a used laptop for which he is very grateful for. It will help him with his work with AFRICED. I am feeling bad because it is a few years old and not too fast. If anyone has the inclination to donate a newer or new laptop to AFRICED I would be happy to arrange for shipment to Kwadwo. I will tell you more about AFRICED in another entry.

I reflect upon the day’s events that we have experienced. Some of the sights, sounds and smells are the same. A few of the roads appear better but then very quickly they deteriorate into a rutted dirt road. Ghana is making progress but it is sporadic in some areas. We are stopped by the local police at least 5 times as we travel to our hotel. It is a bit unnerving to be stopped at a roadblock with police in combat fatigues and large rifles on their shoulders. It is the Ghanaian form of police oversight but it feels a bit weird to be stopped and have the flashlights shinned into the vehicle.

I have had a conversation tonight with our new friend, Nicholas, from the Education Ministry( I think he is some sort of protocol officer). He is trying to educate me about the relative safety of Ghana but also some of the traps that are present for the obviously white tourists. I am encouraged again by the attention that NSWB has garnered from upper levels of government here in Ghana. There will be more to report on that later.

We also met a Ghanaian woman in the airport in London who is a nurse at Johns Hopkins hospital. She is home for a holiday and has invited us to come to her home. I am reminded of the friendliness of the Ghanaian people. This woman, who is a stranger to us has just invited 11 of us to her home. I also am reminded of the poverty as the people swarm our bus as we disembark and try to ask us to purchase little trinkets or just to give them some money. It is a bit of a shock for the students to have this so visible on their first few hours in Ghana. The students will have many more eye opening experiences and I can see them trying to acclimate to this type of human suffering that is not so apparent in their comfortable suburban life.

The halls are quiet. It is about 3 am and I need to wake up by 7 am for a 8 am departure. I am sure my body will crash sometime tomorrow. All the students are in bed and I am now going to sleep myself. Tomorrow will be a busy day and I will have a second entry later on tomorrow as long as I can stay awake to write it later tonight.

‘Is it night or day’ and hey.. where is my running water?’ Part 1 – December 29, 2009

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Technically it is 12/29/09 but just barely. It is about 2 am but my body thinks it is about 8 pm. I am sitting in my hotel room at Accra. We landed a few hours ago after a fairly uneventful flight where I really did not get much sleep but managed to watch a few movies. The back of the plane (the economy seats) was packed with mostly Ghanaians returning home and a smattering of UML students and ironically a UML faculty on her way to spend her sabbatical teaching Biology at the University of Ghana. There were plenty of open first class seats and I tried to negotiate my services as ‘the on flight nurse’ in exchange for one of those nice seats but unfortunately the cabin crew could not grant my wish.

The heat of Ghana is overwhelming as we descend down the stairs of the giant British Airways plane. The sights and sounds are rushing back to me. As I enter into the customs area I see my friend Kwadwo waving at me from beyond the check in kiosk. And to my great relief there was an American Lieutenant Colonial from the US Army assigned to the US Embassy who is assisting us through customs and immigration. He obviously has some pull and we were whisked thru immigration and one of the students who was without her visa was easily able to acquire one onsite at the airport. Gathering of our 22 boxes, 11 large suitcases and at least 22 carry-on items is a huge but somewhat painless process. The hardest part was navigating our carts through the line of Ghanaians who were also toting large carts with suitcases.

Instead of leaving out the customary door to the chaos of the parking lot we were whisked to an alternate door leading to a private lot with a large air conditioned bus awaiting our arrival. I am amazed at the ease of this process as my recall of last year was one of chaos and frustration and essentially being on our own. It has helped tremendously to work with Kwadwo and AFRICED volunteers who are our escorts and coordinators for this trip.

We have caught the attention of the Minister of Education whom we will meet with tomorrow and later on in the trip we will meet with the Minister of Health. They are appreciative of our efforts and have helped us overcome some of the barriers from last year. Of course it is with the intent of creating a lasting relationship with UML and future benevolent trips to Ghana. I am VERY grateful for any help that can be provided to us at this stage.

“Journey to Africa” December 28, 2009

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Our plane was due to leave Logan at 8:00 pm on Sunday night. We had a 4 hour delay which worked great for me because I still was unpacked a few hours prior to departure.

Our check in process was uneventful. We learned from last year and we bought sturdy Sterlite plastic bins to transport our supplies. We have 11 extra bins over and above our allowed luggage limits. We are restricted by the 50 pound weight limit. You would be amazed at how many supplies the students were able to collect either via donations or purchased with donated funds. In all we are carrying 22 boxes filled with baby formula, adult and child multivitamins, prescription and non-prescription meds, first aid supplies, kids toys, shoes and books, just to name a few. The hard part is distributing when we arrive. They are all so needy that we need to distribute in a fair and equitable manner.

Packing for myself was also a huge task. I have learned what I needed and now my task is to try and fit it in my suitcases. My large suitcase is over the weight limit but I gladly pay the extra fee because that suitcase contains my peanut butter and other food stuffs for the trip. I have some books I am bringing to donate and also have an assortment of gifts to give out when I arrive. I know when I come home the luggage will weigh much less.

I have also brought along a netbook. My goal is to journal my experiences in a WORD file and then upload at the internet caf’. I also have some small reference texts that I may need during the clinics.

Our plane is getting ready to board. We are told that the security coming home to the USA will be much stricter due to the recent terrorist incident in Detroit.

Akwaaba.JPG

More to come from Africa.

Leaving on a Jet Plane: Part Deux

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I sit here and make this entry in the London Heathrow airport. I am sitting at a Starbucks caf’ overlooking the huge airplane that awaits our boarding. The trip has begun. I must at this point give some information about this trip to any readers of this BLOG who are not familiar with NURSING STUDENTS WITHOUT BORDERS (hereafter called NSWB). This is the second trip for NSWB which is a student club at U-Mass Lowell founded by senior nursing students in 2008 so that they may have an international service learning experience where they could experience nursing in a different environment while at the same time giving back to society in a global way.

I am a visiting professor in nursing at UMass and I traveled last year with 11 nursing students and one alumna, Maura Sullivan Norton. I am traveling with 10 students this year and Maura will join us in a few days in Ghana. We will be in Ghana from Dec 28- January 18. Let me tell you my story. The students are writing entries to their own BLOG and I urge you to click on the tab on the right side of the page to read some of their entries. Comments are welcome.

Valerie’s Story

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So the journey begins again for me. I am again traveling to Ghana Africa. Many of my close friends and family wonder at my decision to return. I made the journey last year and it was an incredible experience but not without some challenges. The assumption last year for my friends, family and yes even for me was that I would probably not return. For me it was’ been there, done that.’

As time elapsed after my trip I had a chance to reflect upon my experience there was a seed that was planted and it grew very slowly. That seed was ‘are you going to go again?” I will be honest with you and tell you that I did not nurture that seed. I hoped that someone else would take that seed from me but like a dandelion weed, even when deprived of water and nourishment seems to grow.

So after some soul searching and I decided to return to Africa. I feel that we (UMass Lowell) made a commitment to the people of Kpando and surrounding villages that we would return. If I returned with the new group of students we would be fulfilling our commitment to them.

Last year I vividly recall a ceremony with some of the village elders (the Chiefs) of Nkonya. It was a very symbolic moment marked by speeches by the chiefs and a UML student and the ritualistic consumption of Schnapps. Their comments to us were that many groups have come to their village but not too many return. I saw that ceremony with us as their effort to solidify the relationship and encourage a long term relationship.

This has stayed with me and this is one of the big reasons that I return. I will have new stories and insight this year. Part of me is dreading some of the living conditions because it is not the nice comfortable life I live in at home. The other part of me is looking forward to seeing how this trip can be even better than last year. It was life changing for me and the students last year and I don’t expect this year to be any different.

I sent email reports back to family and friends about my experiences. This helped me sort thru my emotions that I was going thru and was a great way for me to document my trip. The recipients of the email stories told me that they read each entry with interest and requested that I do the same thing this year. I have decided that a more efficient way to do this is the have a BLOG (which you are reading now).

This will be like my personal journal and I am sure throughout this journey you may see me in a different light depending on my words and recollections. Comments are welcome but please note that they will be read by anyone who reads the BLOG. I also hope to be able to download some photos to go along with my stories. The internet accessibility and speed is not very good here. Lastly, I try to give a title or theme to each of my entries. Last year I had ‘Toto I don’t think we are in Kansas anymore’ or ‘Mr Toad’s Wild Ride’. It helps me to keep my creative juices going and I had a blast trying to think up the themes or titles.

I
wanted to thank all my friends and family for their support during the planning
process and now while we are away. I
hope to say a bit more in a later entry about some of our generous donors and
their stories. Thanks for being
interested in the BLOG. Feel free to
forward the link to anyone whom you think might have interest The link to the site is http:// www.blog.uml.edu/nswb