Today is our first day of working in the clinic or the hospital. We walk the mile walk up to the Kpando health clinic because we are supposed to meet with the medical director before we start our day. We are told he was at the bank and then he was on his way to Accra. There is so much protocol involved before we can enter a clinic. We separate into 2 groups. Five students plus Maura go to the Margret Marquart Hospital. The other five students go with me to the Kpando Health Clinic. We are divided into 5 different areas. Two students are with the midwives in maternity clinic, one student is doing vital signs, another student is with the intake nurse, one student is with our friend, Maria who is a medical student from Puerto Rico. I am spending some time with Psychiatric nurse. She gives a daily HIV/AIDS talk in the waiting area. It is all done in Ewe dialect so I cannot understand what she is saying but I can tell that the patients are engaged in the lecture and are asking questions. The HIV rate is very high in this region and that is why we are doing HIV education programs as part of our community project. I then spend some time with this nurse, Margaret. She is doing an initial evaluation of a new patient with a history of some type of seizure disorder related to multiple beatings. He is also describing other symptoms which ( in his broken English) sounds like a Schizophrenic presentation. He has been on Haldol at a prior clinic and needs a refill. He is ok today but he is worried that he will get worse. It is interesting to watch her do her assessment. She does not ask the questions that I think are necessary and she makes no eye contact with the patient. One of the most interesting observations with the nursing care here in Ghana is the way that the nurses interact with the patients. They are very brusque and appear to be uncompassionate with their patients. There is very little touching and patients are treated more like a nuisance at times. It is vastly different than the way our American nurses are educated. We are taught the value the human interaction and that we , as nurses, have so much to give to our patients. We are told that there are many women who go into nursing for purely economical reasons. It is one of the highest paying jobs, about $5,600 per year. They seem to work at a slower speed than the American nurses. I quickly analyze the patient flow and can think of recommendations but I am not sure I am in a position to suggest changes. There are many other behaviors that are witnessed by our nurses and I will try to comment on those as I write other entries. The nurses are friendly enough to the UML nurses but not overly so. A few of them want to ‘further their studies’ in America but I do not know if they have the means to do that . I have some admission information which I share with them. I think some of them are surprised that I cannot sponsor them and pay for their education.

So now to the slow part of my day. The internet. The curse of my existence here in Ghana. I had such grand hopes of really staying connected to family and friends via my BLOG entries. The internet caf’ is run by a lovely young man called Eyram who was there last year. He does the best he can but the service is limited by dial up speed and very slow computers. I was in the caf’ for over 2 hours and left frustrated because I could not connect to the UML blog site but also had a hard time reaching friends and family. IF you are reading this I would love an email at”mailto:valkingnp@gmail.com” valkingnp@gmail.com

I have now been here for about 9 days. I have 14 more days. This trip is much more organized than last year. We are getting so much done and our schedule if jammed packed. Stay tuned for more stories.