Wow. A lot has happened since I’ve blogged last. The main events that I’m going to try to hit on in this post are my experiences in the operating theatre, my first experience sitting down and talking with Liberian refugees, and my trip this past weekend to Boti Falls and Shai Hills Resource Reserve. And how badly I’m craving a Turkey Tom from Jimmy Johns…

It ended up being a little on the long side. It’s hard to limit what I want to tell everyone to a bearable length, but maybe you can grab a Turkey Tom and have a little lunchtime reading. Or you could forgo the awkward inspirational book on the back of the toilet this time and take my blog for a nice bathroom read. At least I’ve given you options!

The Operating Theatre

At my hospital, I have finally figured out that, outside of emergencies, they perform operations on Tuesday, Thursday, and Saturday. When I was in the surgical ward (pre-op surgical patients), we had a diabetic woman who needed her foot amputated. At the risk of sounding sadistic, I had been waiting to see the amputation for two weeks. It turns out they did it this past Saturday while I was out of town.

I am really glad I’ve had the opportunity to watch various surgeries in the States, because it has allowed me to make comparisons in surgical procedure here. I can’t decide whether it’s more similar or more different but I don’t think that distinction is really necessary. When I am in the OR, it is such a familiar feeling. Whether the surgeon is using decade old equipment and having to do invasive surgeries, or the surgeon is using the latest technology and doing a minimally invasive procedure, there is a commonality among it all. My favorite part about the whole experience is that we all look alike on the inside. Whether your skin is black or white, we all have the same pink organs.

The first procedure I saw here was an emergency ectopic pregnancy. This where the egg is fertilized and starts to grow in the fallopian tube rather than making it all the way to the uterus. You might imagine how this could be problematic. When the fallopian tube bursts, the woman starts bleeding into her abdomen along with other complications. In this surgery the tube had already burst, so they opened her abdomen and repaired the tear.

There are tons of significant differences between operating room here and back home in the States. To list them all would take a while, but it is very interesting so if you would like to hear more about it, I can send you a separate email. Notably, all the drapes and gowns used are cloth and they are reused. Whereas we use several disposable paper drapes per procedure at home, here they use a single cloth drape with a hole to expose the operation site. The doors hang off the hinges leaving me thinking about all the germs floating in and out throughout the operation. Overall, it just seems like they are operating a decade or so behind the times. Certain staple tools used at home are absent from the theatres here. However, what impacted me most about my first time watching a procedure here is not all the technology or procedural differences. When they drape a patient at home, there is a large drape that clips to two poles by the patients head so that their face is hidden from view to essentially all but the anesthesia personnel. Here there is just one drape, so you can stand back and is one glance see the face of the woman and the incision revealing her organs all at once. This really made an impression on me because it is so easy to view the case as a body part and not an actual person with a life story. This image brought the humanity back to surgery.

Liberian Refugee Camp

First, a little background on the camp and why there are Liberian refugees in Ghana:
There were two civil wars in Liberia, the first from 1989-1996 and the second from 1999-2003. When the war in Liberia broke out many fled to Guinea and the neighboring Ivory Coast. Ivory Coast had its own war around 1995 (I have not verified the date here, but this is what I’m assuming based on my conversations with refugees) causing the refugees there to flee to Ghana, the next country to the east. The camp is 19 years old and they are currently trying to close it down.

At the beginning of the year, the UN was offering a repatriation package of $5 per person and they were allowed to take 20 kg (or 44 lbs) of their personal belongings. Obviously, even in Africa, $5 is not going to suffice even for a week. Rent is averaging $25/month in Liberia right now. Many of the women’s groups in the camp gathered to protest and demand more money. While asking for $1,000/person, the UN conceded to give $100/adult and $50/child, but still only 20 kg of belongings.

In Ghana, you are supposed to ask permission from the government to protest. The groups in the camp did not do this, so the government looked at the acts and decided the Liberians weren’t appreciative anymore and wanted them to leave Ghana. Also, Ghana has presidential elections coming up in December and they don’t want the refugees causing any problems.

Last week when I visited the camp, I just sat and talked to a number of refugees. In the short time that I was there, I uncovered some interesting trends. Most of the people who were older or had arrived more recently wanted to return to Liberia. The exception was a little boy named Michelle who came up to me when I first got there that day. He was wearing a Camp Wesley Woods T-shirt; I asked him if he knew where it was (fully knowing that he didn’t) and told him it was in Tennessee, where I’m from. I went to that camp in 5th grade! He told me that he and his mom were going back to Liberia soon. I asked him if he wanted to leave, and he said yes. He was 7 years old, had been born in the camp, and even speaks the local Ghanaian language Twi. I thought this was interesting that he wanted to go “home” to Liberia, a place he had never been and knew nothing about. I concluded that this must be largely his mother’s influence. It’s interesting how much you can tell about an adult from their young child’s opinions.
In another area of the camp, I sat with some people who were less willing to leave. Most of them either had been in the camp since the early 90s or were very young when they left Liberia. A few of them who were around my age were talking about how they don’t know anything about Liberia. They know Ghana’s history, not Liberia’s. They have friends here; they’ll know no one in Liberia.

Another common theme was the importance of education and a proper job. One of the women who wanted to go back to Liberia said, aside from going to Liberia, the one thing she would like the most is a loan so that she could start a business. She said she didn’t think she would have any problem paying it back. Another woman was 23 years old in business school when she had to leave. Nine years later, she is still determined to return to Liberia and finish her education. Her life has essentially been on hold for the past 9 years. All of the people I talked to are very capable people. They were living normal lives until they had to start over in Ghana with nothing. They knew another life and then had to flee that comfort and come to a foreign land with no one and nothing and completely start over.

Although my emphasis is health care, that seemed like mute point here. There is an equipped clinic on the grounds. Anyone who needs treatment can go there—providing they have the money. They aren’t treated until they pay. It seemed obvious what the obstacle to health care here is: poverty.

As I familiarize myself with situations like these all over Africa, poverty is the common theme. It’s a vicious circle, and one single aspect such as health care cannot be isolated. We have to work together to build the infrastructure at once. If you lift a table from one corner at a time, everything is going to fall off. If you work together to lift all four corners at once, everything will stay in its place. You can’t fix the problem of poor health until you fix poverty.

Boti Falls and Shai Hills

This past weekend 11 others and I went to explore the amazing nature that Ghana boasts. The trip was interesting from the start since we had 12 people. We thought we’d never find one trotro with space for us all. It turns out 12 is the perfect number—we fill an entire tro! When drivers noticed this, they would allow us to essentially charter their tro to take us where we wanted to go. The only problem is that they saw the cedi signs in their eyes and paid no attention to the fact that they had no clue where exactly it was that we were going. However, Ghanaian men aren’t too proud to ask directions, unlike their American counterparts.

On Saturday, we went to Boti Falls. First, we hiked to Umbrella Rock. For most hikes in Ghana, you have to have a guide. The only problem is that these guides, in my experiences, have their speed set at turbo, so you’re rushing to keep up with them and not being able to enjoy the scenery. I enjoyed the hikes here more than back in the Smokies because they’re not as worn down from so many hikers. My favorite parts are climbing over roots and rocks. It did, surprisingly, remind me a lot of the Smokies though. All it was missing was a picnic by the river with my family and a turkey sandwich, Lays, and double stuffed Oreos.

Once we got to the rock, I noticed there was a scanty little ladder leaning up to the top of the rock. Our guide said for 20 pesawa ($0.20) we could go onto of the rock. Seeing a way to be adventurous and put my life in danger at the same time, of course I had to go up. You could see 360 degrees of the mountains—the first amazing view of the weekend. After Umbrella Rock, we went down to the falls. They are twin falls, and pretty big. When we were in the clearing by the pool of water, mist from the force of the falls hitting the water cooled us off nicely after our hike.

Saturday night we took another it-should-have-taken-one-hour-but-took-three-instead tro rides to Shai Hills Resort to ready ourselves for our early 5:30am rise to see monkeys. Sam, one of the other volunteers, is amazing at bargaining and was able to persuade the driver of a facility truck to drive us around the reserve for 35 cedi. We did two hikes in the reserve: one to a point 290 meters above the ground and another to the bat cave. (I ran into Alfred there. He said Bruce was out of town, but he let me take a spin in the Bat Mobile.) The first view, from the high point, was incredible! It is, hands down, the most beautiful view I have ever seen in my life. The land was so flat you could see for miles. I know at least 300 km because we could see the town of Tema in the distance. You could see small mountains come up out of the ground and then still see past them. It reminded me of looking out onto the ocean, how the horizon gently curves as it passes out of view.

The bat cave was interesting because a tribe used to live there and you could see where they fortified the area and put up traps to stop enemies. Other than that, I ended up way too close for comfort to a room full of bats I could only hear and not see.

On another note, my roommate, a couple friends, and I are making American pancakes for dinner tonight. I am extremely excited. Even more than a hot shower, I miss certain foods…What does that say about me?