Happy Birthday Avery!

Saturday was my little buddy Avery's first birthday. Avery, you are so handsome! I miss you very much, and I am so sad that I wasn't there as you ate your first piece of cake. I can picture the huge grin on your face as you opened your presents. You are my favorite little man ever, and as soon as I get home I am coming to give you big hugs and kisses. I love you!

Anne and I have been experiencing more of the preventative aspects of nursing here as we've joined the community health nurses on some of their outreach programs. One day, we went to rural villages on a vaccination outreach program, where they try to "mop-up" and catch the adults up on their tetanus and yellow fever inoculations. The two of us vaccinated at least one hundred adults in one hour, and I think we suprised the nurses at how quickly we worked our way through all those people, but that's how we white people do it. When there's no handwashing facilities available, things move a little faster. We felt like we actually did a measurable task this day, because we made a visible difference that we could quantify. We needed this, and it probably helped us more than we helped the people, because we needed to feel productive.
Last week, we visited a couple of other villages for well-baby checkups. Finally, some healthy babies! We went really far out one day, to a village where many people have probably never seen a white person, so our presence was appreciated among the mothers. I think just seeing us there shows them that we care, especially when we tell them how beautiful their babies are. Anne and I teamed up and weighed the babies, ages 6 weeks to 2 years. It's so cute, because we put the naked baby in a sling and hang them from a hook on the scale. Some of the babies hate it and kick around, especially if they are afraid of the white girls, but most babies just go with the flow and hang in the air without complaint. It's a really nice program that these communitly health nurses provide - the babies are weighed, vaccinated, and checked up as needed. The mothers are educated on breastfeeding and nutrition, and they are starting mothers' support groups in each of the villages. We love visiting the clinics, as we are able to learn from the nurses as well as support the things they are trying to do. Last week was actually fun!
Last week we also spent some time in the operating theatre with Dr. Opare, the medical director, and we were able to discuss post-op pain control with him. He took our suggestions, and starting today he will medicate his patients for pain immediately after surgery. Small step, but a huge improvement on patient care. Now we have two surgeons medicating earlier, which means that patients may actually wake up from surgery without experiencing high levels of pain, ultimately resulting in a faster recovery.
This past weekend, Anne and I made an escape to a very nice hotel a few towns over. We were able to enjoy hot running water and CNN! We even had an air conditioner in our room, and a microwave (only the third microwave I've seen in Ghana so far). We slept a lot and really enjoyed the clean, almost bug-free environment. What a vacation, a great chance to relax and enjoy the quiet. We were not once called "obruni," so it was almost like we weren't in Ghana at all. We are also planning a trip to Cape Coast, to see the slave castles there before we finish our time here.
We were told, by another non-Ghanaian, that we can only realistically expect a 10% return on our efforts here, meaning that the amount of change we're able to make in three months will be minimal. For a country that is so far behind with so few resources, the opportunity for advancement is limited. It has taken us two months to accept this, but we have finally come to the realization that we will not be able to revolutionize the place in just a few months time. We are really trying to adapt to the Ghanaian pace, and as we experience more environments outside of the hospital, I think we will broaden our knowledge of healthcare in Ghana.
We still miss home, probably more than ever, and we are really looking forward to seeing everyone again. So we just ask for your continued prayers and support - we really need it!

Cultural Differences

We spent the day yesterday in the operating theatre, where we helped with a cesarean delivery of a big, healthy baby boy. He had lots of curly dark hair and huge lips! So handsome, and of course I got pictures. I had to restrain myself from tucking him under my arm and running - I don't think his mother would have appreciated that very much.
In our time here, we have learned a few things about the Ghanian culture that have suprised us. For example, it is a very male-dominated culture. A man can take as many wives as he wants, even though polygamy is not as common as it used to be. But often a man will have two or more familes living in the same house. And if he decides to take another wife, his current wives just have to accept it. It is also very common for a man to commit to a woman, have a family with her, and then leave them all behind. Elizabeth, Anne's host mother, has been with three men, all of whom have left. Actually, most of the time, couples are not even married. They may call each other husband or wife, but there is no official marriage, leaving the women even more vulnerable.
And here's an interesting situation. We live in the nurses' quarters, a group of small apartments located about a 10-minute walk from the hospital. There is no running water here, and the closest source is a small faucet on the hospital grounds. Pipes were installed in these apartments almost two years ago, with the intention of providing running water for the nurses. Interestingly, since then nobody has connected the pipes to a water source, leaving the families with unusable shower spouts, sinks, and unflushable toilets. But, across the street, between the nurses' quarters and the hospital, are the doctors' homes. They have running water. Why, then is it impossible to connect the nurses' pipes to the same water source that the doctors enjoy? When we ask the nurses why they haven't complained about this, their answer is, "We have complained, but nobody will do anything to fix it". Why aren't they complaining louder? I can't figure out if they don't think they have the right to really speak out, or if they don't feel that they deserve the convenience of running water. Or is it that they have lived for so long without it, that it would be almost a break of tradition to change?
But perhaps the most shocking information that we have learned pertains to HIV/AIDS awareness and prevention. We have a friend, Aaron, who is volunteering in the Planned Parenthood organization in the neighboring town. He has learned that condom use is not common here, because often the first sexual encounter is forced, so that leaves little time to put on a condom. Women are being forced to have sex and likely contracting HIV at the same time. Birth control is cheap here - it costs less to purchase a month's worth of birth control pills that it costs to buy one small apple. They have many available options of inexpensive birth control here, yet women are not using them because it is not socially acceptable. But, some days in the OR we see up to ten young women coming in for abortions. And the most shocking thing I've heard yet: "AIDS is a myth, an American created myth to stop us from having so much sex." If AIDS is a myth, why are we seeing so many young men and women wasting away, dying of that very disease on these hospital wards every day?
In the newspaper today, we read an article saying that homosexuals are "sub-animals". It even went so far as to say that Hurricane Katrina was God's punishment on New Orleans for immoral acts. The article also blames the HIV epidemic on homosexuals, with outrageous and unbelievable statistics. To publish these things as fact, I can't help but wonder what other choice people have but to accept it as truth. Upstanding, educated individuals support these opinions, believing that God's wrath will disturb the peacefulness of the nation if homosexuality is allowed. Pastors of the church are saying these things - what happened to a loving God who has created us in his image? I choose to believe that we can love the person without condoning the act, that calling our fellow human beings "sub-animals" would be displeasing to God.
My first reaction to all of these situations is shock and anger. Anne and I were raised, thank you parents, to be strong and independent women. We have been given the right to express our ideas and to be respected as women. I can't imagine living in a society in which I am expected to be submissive to men - it's uncomfortable at times for us to just walk down the street and be the object of their stares. Of course, not all men are this way and not all people believe these things, but it is so prevalent here and we encounter it every day, so it is extremely difficult to ignore. As we do each day, I once again thank God that we have been blessed with the privileges we enjoy in the United States, even though by no means is our country perfect. I also pray for tolerance and understanding as we interact with these people, that I can be nonjudgemental and loving toward each of them.

Safari

An update on our premature baby boy... We returned to the hospital that afternoon to find the nurse by his incubator giving him oxygen. She said, "My baby isn't doing well." His heart rate had slowed down quite a bit, his breating was more erratic, and he looked much less pink than he had earlier in the day. We knew this was to be expected, as there was nothing that we could have done to prevent it, so we took him from the incubator to his mother. Initially, the nurse resisted, but per our request she explained the situation to the mother. We wanted her to see him, to hold him, but instead she asked that we take him away. So Anne and I held him, cried, prayed, until he died about an hour later. His name would be Kofi, meaning Friday born, and he lived almost eight hours that day until he died in our arms. We could only take comfort in knowing that this beautiful boy is now with God, where he knows no pain or struggle. He has to be in a better place now, I'm sure of it.
On Wednesday we went to Mole National Park in the more northern part of the country, a trip that took about 12 hours each way. We all packed into a small passenger van and drove the bumpy roads to the park. At one point, it takes over 3 hours to travel 40 miles because the roads are so bad, but we survived both getting there and back. We spent two days at the park, went on a walking safari one morning where we saw antelope, warthogs, monkeys, and elephants all in their natural habitat. It was pretty awesome - we stood about 100 feet from two huge African elephants as they went for their morning stroll. They are beautiful! At our hotel, which is in the park, the baboons jump right up onto the breakfast table looking for food. It's funny how people-like they are! The mothers carry their babies on their backs, just like the African women do, so cute. We even were lucky enough to come across the path of five elephants one evening when we were driving the road back from town. We got a really up-close look as they crossed the street in front of our van, moving so slowly and gracefully.
The people of Laribanga, the neighboring town, invited us one evening to see some native dancing. They brought benches and chairs for us and we sat in a circle around a lantern while they danced and sang. Anne and I even joined in a few times and I think we impressed them with our ability to keep up! It was a lot of fun to spend time in their village and I think they enjoyed our visit just as much as we did.
Our time at Mole gave us some quiet time spent with some other volunteers. Anne and I had a chance to reflect on the work we've done so far and sort out our goals for the rest of our stay here. It was nice to take a short vacation, to see the part of Africa that we always hear about. We enjoyed just sitting on the observation deck, looking out across the endless span of green. It was time well spent.
We came home to the mountain Sunday afternoon, after passing through Kumasi, the second largest city in Ghana, where we had pancakes for breakfast at a hotel. They were like Chinese pancakes, and they had to make syrup for us, but they were so delicious!
We returned to work on Monday, very tired after doing laundry that morning. It took Anne and I two hours to scrub our clothes and hang them to dry - does it take that long to do a load start to finish with a washer and dryer? We definitely miss that luxury! But I'm getting better at it, my clothes seem to dry faster with each week of practice. This Friday we have planned to join a group of nurses on a trip to immunize children. According to Dr. Opare, I think we'll be going into towns just looking for children under age 5 who'd like a shot in the butt. Sounds like fun, a chance to see some of their preventative health care in action. We're looking forward to becoming involved in more trips like this, so we're excited, even though we are leaving at 6am!
As always, Anne and I appreciate all of the emails, thoughts, prayers that we have been receiving. Prayers are being answered here, I'm positive of that.

I love the babies

Anne and I had a small victory today with the nurses. This week we have spent time teaching some of the nurses on the maternity ward how to use an incubator. This incubator had been donated from a hospital in France some time ago, but it had never been unwrapped it or plugged in because the staff was never instructed how to use it. Since the hospital has no capacity to care for critically sick newborns - no appropriate medicine, no ventilator, no monitoring devices - we are using the incubator as a warmer for the babies born by cesarean section until they can go to their mothers. When we came, the nurses would keep the baby in a hard wash basin in the corner of the nurse station, unmonitored, covered with a thin sheet. Now, they have a nice warm place for the baby where they can monitor his temperature and keep an eye on his breathing. Well, when we arrived this morning, the incubator had been turned on to warm up in preparation for a c-section baby, just as we had instructed them to do! This, for us, was very exciting, because we can never tell just how effective our instructions are, so the fact that they listened to us and wanted to use this equipment is encouraging.
We went to the OR for the c-section, for the delivery of a 31-week preterm baby boy. In this hospital, they give the mothers general anesthesia, so I think the babies' respiratory systems are affected, because every baby born by cesarean here must be resuscitated. So we resuscitated him, put him in the incubator with oxygen and watched him for two hours. We noticed some physical birth defects, and we can assume that he has internal abnormalities as well. Anne and I learned today that mothers will often suffocate their babies if they have physical defects, so even if this baby fights and survives, he may not have much of a chance at home. Our education tells us that without the proper medical care, he will not survive, but we wanted to give him everything we could. So we baptized him, prayed for him and his mother, and showed him all the love we could. The doctor came by, and the plan will be to see if the baby can breastfeed. If not, they can place a feeding tube and hope for the best. It is possible to refer the baby to a pediatric hospital, but the mother has to approve and pay for the transfer. Honestly, I don't think this baby has a chance of surviving even if they can feed him, because his lungs are not mature enough at 31 weeks without intensive medical care, which is simply unavailable here. But as we cared for this baby today, many nurses and nursing students came to see him, giving us another chance to teach. If only our efforts here could create miracles! But we have faith that God is with this beautiful baby boy right now and His plan will prevail. And we will continue to fight for miracles here, because we refuse to lose hope.
We had a very special experience yesterday on the maternity ward. Here, it seems that the nurses do not want to give the baby to the mother until he has been bathed, so we jumped at the opportunity to give a tiny, handsome baby boy his first bath. The babies here all have that little head of soft curly hair and some of them have the cutest big lips! It is really difficult for me not to wrap them up and run away with them, something I have contemplated more than once! How is it possible that they are all so cute?
Anne and I are looking forward to a small vacation next week to Mole National Park, a natural game reserve with big African elephants and monkeys. We will spend a long weekend there with some of the other volunteers that are working with the SVG organization here in Ghana. There is some speculation about whether we will be staying in a tent, which I think is crazy when there is wildlife running around, so I'm voting for a hotel or hostel with a shower! We are excited to go make friends with the monkeys.
Although we have seen no monkeys or elephants here on the mountain, we do come into daily contact with families of goats and chickens, as well as the occasional turkey. The baby goats are cutest, and Anne thinks we should bring one home for my brother Adam. So what do you think, Adam, you've always wanted a dog, right? There are also many bugs, spiders, caterpillars, and lizards of all sizes, so my fear of bugs has been dulled over the last month.
The weather here is still nice, cool in the mornings and evenings with a little sunshine during the day. Since it's still the rainy season, we have seen rain many mornings and it is usually fairly humid here. I've been suprised some evenings when I've been outside and I've actually been cold... in Africa. I like it.
The women here are amazing. They carry huge jugs of water on their heads, jugs that I have trouble lifting! Starting at about the age of 7, children will carry water in small buckets with lids, eventually carrying more as they grow. Men and women will carry everything from baskets of food for sale, baskets of cloth, and huge tree trunks! Yes, really long tree trunks on their heads. I'm not sure where they're taking the trees or what they plan to do with them, but wow these people are awesome. I tried to carry a box on my head at the hospital and I couldn't do it without dropping it, so I'm pretty sure I won't be trusted with a bucket of water anytime soon. Anne and I cooked spaghetti last Sunday for her host family, something for which we were able to find the ingredients at the market. They didn't really know how to eat the noodles, so we were in business once we taught them how to twist the noodle around the fork. The family enjoyed it and asked us to cook again for them this weekend.
We are still doing well here, facing challenges daily, and we are learning the value of patience. No matter how difficult our task is here, we know that with patience and persistence we can be successful. God willing, may we be successful.