4/17 – Dream Big 2.0

The alarm clock rang at 5:45am, and I staggered to pack the last of my things up before Dan graciously took me to the STC bus station in his car. The house was silent as I got dressed and ready to head out, but as soon as I brought my luggage into the adjoining verandah and entered the main house, I saw Dan emerge from his room. He was ready to offer me breakfast of tea and that amaaaazing bread. Yes.

Becca arose from her slumber, and as we three sat there and chatted quietly over the breakfast table, I gave them my little notes of goodbye. It was getting late, so we quickly packed up their nice land cruiser, and hoped we would be able to meet Big Man at the station in time. That’s the way it goes, goodbyes are always too fast.

As we were approaching the walled lot where all the buses were parked, I saw a tall, bespectacled, familiar frame pass in front of the car. I was so happy to see Big Man again! The sight of him gives me comfort. He’s like my African dad. I gave him a big hug when I got out of the car to greet him. We weren’t late after all, but he was in a big hurry to go–Dan helped me get luggage tags and put my bags in the undercarriage, and I bid both him and Becca a sad goodbye. That was the end of my time in Tamale with those wonderful people. It would be a long time till I would come back.

On the other hand, I was so happy to be back with Big Man again. We talked and talked on the way down to Kumasi; I barely saw the country flash by, and there we were in Kintampo, at that same little egg sandwich stand that I had my first taste of Ghanaian food at. It was even the same man and woman who were making the tea and egg sandwiches. I wonder if they remembered Big Man and me from 10 weeks ago! This time, I scarfed down my sandwich and my tea. I had learned to eat like a Ghanaian, fast, and everything scalding hot! Big Man just laughed at me as I bragged about this. We picked up to bags of mangoes, and I was dashed one!

As we moved South, I saw the landscape change from dry savannah dotted with sporadic green trees to lush jungles dense with underbrush. I counted twelve different types of trees that I knew, and wondered at sprawling cities–all made of the same little wooden shacks with the aluminum roofs as far as the eye could see. There was a Pee Cola sign. Yes, that’s the brand name, but Pee is actually a surname, so don’t worry about the taste.

A little while before we expected, our bus arrived in Kumasi. Kumasi is a choked city! There is just so much traffic, so many people, so many cars and tro-tros and taxis. We stood still in the same spot for almost 10 minutes, waiting for some light to change or someone to move out of our way, I don’t know which. A far cry from little Saboba village, where there is not one taxi to be found, and most people come in by climbing on top of all the goods and hitching a ride on the once-every-six-days market lorry!

Big Man and I stepped off the STC bus at the station to be greeted by his son, Joseph, who is just as big as he is! Joseph drove us home, speaking in Dagbani to his dad and discussing matters of which I knew not. Thankfully, once we got to Big Man’s house, I was able to get to know Joseph a little more! After lunch, we talked about his dreams for the future. He wants to start an NGO that would be basically a network of professional that barter their skills to help each other in whatever needs are present. Even now, he is working on it with his friends and they have started and begun some small projects of this nature. In addition to that, he wants to plant a hospital in a strategic location in the North that would run on a system of rotating volunteers. Yes, these are very big dreams! I heard him speaking about all these things next to me on the couch there, and I immediately began to doubt the feasibility of his plans, but then he reminded me of my other friend Joseph Jidoh who also had great ambitions of starting a clinic, an orphanage, and becoming a doctor after his nurse’s training. And then I remembered what Joseph Jidoh taught me that day–to dream big, and to not doubt what God’s power can do. I remembered how terrible I felt when I realized how all my doubt was discrediting all the amazing work God has done in the past. I didn’t say anything to my new friend except encouraging words after that.

Joseph continued on to tell me about a project that he and his dad are working on now–a preschool in Kumasi that would provide young children with a very strong foundation for future education. They are motivated by the need of young children who are set up for failure in Junior and Senior Secondary Schools because of a lack of a firm foundation. He also spoke about roofing the Kumasi church, building the church in Sang, and going to get his Master’s degree in developmental studies. Big dreams. But these Ghanaian men of faith like Joe and Joe exhibit complete trust in God to accomplish even the greatest tasks. They don’t hesitate to put themselves out there and see what the Lord can do. I want to be like that, not fearful or dependent on my strengths. God help my unbelief.

Big Man and Joseph went off to rest, I retired to my room for the afternoon to work out the rest of my travel budget. Money was running scarce, I barely had enough to make it, so I would only be seeing the Cultural Center in Kumasi and not be able to buy anything. It would normally worry me to run out of money when traveling alone in Africa, but I thought if worse comes to worst, I may just be hungry for a couple days. It wouldn’t hurt me, and I might gain a better perspective on some things about Africa. Even though it probably won’t come down to that, it wouldn’t be the most terrible thing in the world by far.

I wrote journals till suppertime, when Pastor Abel (another visitor to the Alhassan household) and I were called for dinner from the guesthouse. It was TZ and ayoyo soup, made by Owabu, Big Man’s wife whom I’d never met! I was so pleased to see her, after hearing so much about her from Bob and Jean! I was sad that she wouldn’t eat with us, but I thanked her for the food immensely. We were getting some Northern Ghanaian fare tonight! Although, the TZ was not the same, and more like corn starchy lump because the corn had its outer skin removed before it was ground for flour. I already missed Aggie’s TZ, but I still enjoyed this meal.

We all enjoyed black currant tea together, which reminded me of Tabi, who loves all things black currant! We were all joking around about Pastor Big Man liking very strong tea. Pastor Abel said that he couldn’t leave his bag in there long at all, and I told him that sometimes I see Big Man put two tea bags in one cup! He then asked me how I liked my tea, and I took one look at Big Man and said, “The water must be jumpin’,” which is what I heard him say when we first arrived at Bob and Jean’s in Saboba together. Big Man loved that–he just cracked up and continued bellowing until finally he calmed down and said, “There is one lady in Cape Coast that calls me Jumping Water whenever she sees me!! She puts th ekettle on right away because she knows that is what I want as soon as I come from traveling!” He just had the best time with that one, and I was very satisfied to know I had pleased him. J It’s true, though! I copied Big Man’s tea as soon as I got to Saboba–one cup, two bags, just boiling water, lots of sugar, blip of Ideal.

After we talked for a while Big Man sent me back to my room with lovely treats–a box of Lipton Yellow Label, an electric kettle, a jar of sugar, a can of Ideal, and an entire loaf of soft wheat bread. Does he not know that this is a dangerous combination? I will have finished it all even before breakfast tomorrow morning, that is how much I love Ghanaian tea. I think he really wants me to get a fufu belly! It took me some serious restraint to not consume inordinate amounts of bread as I was writing my journals.

The night had some wonderful comforts like this tea and bread, and my first warm bath in the entirety of my stay in Ghana–supplied by the electric kettle. Buuuut, the night also had some very unsettling horrors as well. A cockroach. I saw it crawl under my bed, and my eyes grew wide. What was that? a minute or two later, the large dark form came back out again, and I grabbed my sandal and smacked it down right on top of it. Lift, view smooshed cockroach, almost have a heart attack. It was absolutely disgusting–long antennae and big jointed legs and everything. I had a cow. I had just killed my very own African cockroach. I am almost too legit to quit. Almost, because I didn’t know what to do with the body after that. I just left it sitting there on the floor, and created a virtual wall around it with my imagination, fearing to step within a wide radius of its remains. Can’t believe it took my more than 10 weeks to meet my first African cockroach and kill it, but I did. I feel baller.

4/16 – Hike to Tamale

Today was Michelle’s day off from working in the market, and so we all decided to take a walk all the way into town, just to go to the bank. But of course, from 11-3 was just too hot to even step outside, so we were all doing our subsequent work on our computers until then. In between bursts of writing, I got to see pictures of Becca’s huge, 11-child family on Facebook! Coming from a household with just one mom, and one older sister, that life seems so foreign and wonderful to me! Their family photo was replete with happy faces that loved and supported each other. It was great to also show the girls pictures of Austin and his own trip to Ghana (the photos are still on the little netbook he let me borrow), and connect lives like that.

Soon after, we geared up to walk into town! It was about an hour’s trek in the sweltering heat, cutting through racing cars and motos, maneuvering around a freshly dead goat in the path and dodging animal excrement and various piles of rotting rubbish. We got to see all the sights and smell all the smells of Tamale on our way to the Barclay’s bank, but thankfully we missed the corner where they sell chopped-off full heads of cows, right next to their hooves and other random body parts, all open o the air and flies, and in various states of decay. We even cut our way through the market–yes, they have market every day, with permanent stalls! The stalls are so close together, and actually roofed, so the market is literally a maze. It’s so different than little small-town Saboba with its once every 6-days market, with relatively wide open spaces.

For a quick stop at the bank, two-hours round trip on foot  seemed a little excessive, but we were getting in the exercise we had been talking of doing all week, and so it was worth it… Especially before our dinner of hot dogs and French fries! We all ate plenty, and had hot chocolate for dessert after. I enjoyed our after-dinner conversation as usual–those girls are just so easy to talk and get along with. Then we waited for Michelle to be done with her mandatory weekly discussion with Di to fulfill her practicum requirement, and popped in Becca’s DVD pick–Radio, a movie I’ve always wanted to see. It really was an endearing movie, and we all fell in love with Cuba Gooding Jr. as Radio, just as Becca predicted we would.

Before the night was over, I said goodbye to Michelle and Dzifa. Becca volunteered to get up early with me to head to the STC bus station at 6:30 and send me off to Kumasi! I was so touched. We all said a sweetly sad goodnight, and I spent the rest of the evening writing Dan and Di, and Michelle and Becca their letters of thanks and appreciation. I had such a wonderful and relaxing time with them in Tamale after all the stress, disease, and death at the hospital. It was truly a blessing to be with all of them there at the Dzokotoe household. In the trajectory of their lives, I could clearly see that God had something special in store for them for the future, which was pretty amazing to behold. They are all three very special girls that I will miss and continue to remember in my prayers. I definitely want to keep in touch with how their ministry at the school is doing! God is working great things there, too, and I could see it just from that one day of teaching with them.

4/15 – Expectations Exceeded

Sunday dawned again with a nice big breakfast. The Dzokotoe’s have the best bread ever. Dan and Bob were at the prison in Tamale ministering to the inmates, and would be joining us for church with Reverend Asari’s congregation. I had no idea who that was, but Dan and Di go sometimes, so we were all tagging along!

I would say that church in a big city like Tamale is a lot different than church in Saboba. There are fancier clothes, and people are much more restrained when it comes to worshipping with singing and dancing. I really missed Pastor Jonah’s church, and the pure joy I found in the members of the Body there. What made it worse was that the speaker system in the little upstairs room of a building was giving me a ringing headache. I really don’t know why they have to turn it up so loud, or even have a speaker system in the first place! The congregation was no bigger than 30 people. My head was throbbing we walked out of the building.

Lunch was surprisingly tasty for macaroni noodles in a sauce made out of tomato soup mix! After we all ate together, the three other girls and I spent the afternoon playing cards together again. Even with such a simple game, we have so much fun together. This time I learned Dutch Blitz, and also that I suck at it majorly!

By the time it was getting to the evening, I had to call Pastor Jonah and Solo to see how their churches were doing. I missed them a lot. Pastor Jonah had visited his church in Lifuul! I remember that I wanted to go back to Lifuul to visit them again, but now it was too late. There was just never enough time, all the time, it seemed.

The “adults” went out for dinner again, so us girls made rice with tomato sauce again, but this time we each had a tiny scoop of ice cream for dessert afterward! It was the best thing ever. Salad and ice cream are the two foods I miss the most from the U.S. And maybe a nice fat cheeseburger. And fruit. But I have to stop there, because I could go on forever! In just 10 days, I will be home anyway, and I can eat all of these things to my heart’s content.

I kind of love evenings with Michelle, Becca, and Dzifa. We just cook together, eat together, wash dishes together, and relax and talk for the rest of the night. It’s a calm and peaceful life. Tonight we talked about everything from Dzifa’s school, to extreme feats of athleticism (marathons and iron mans, both of which Becca wants to compete in, DANG!), to disabilities, to weird things to do with your nerves. Michelle and Dzifa were tired and went to bed for the night, so Becca and I stayed up finishing our hot chocolate, and had a good conversation about missions in Ghana and future careers, and serving Christ with those skills.

I love Becca, she is such a sweet girl, very mature for her age, and just a huge joy and blessing, even in the short time that we’ve known each other. Michelle, too. And Dzifa of course is just like a hilarious younger sister. I am going to be very sad to leave them on Tuesday. Another goodbye that I will have to endure, but at the same time, I am just so thankful that I even got to meet all three of them in the first place. God has been so good to me, introducing so many wonderful people into my life here. This period has been so wonderful for showing me the Body of Christ in a larger scope, and it has been so educational and encouraging for me. I knew I was going to have a life-changing experience coming here, but the Lord has exceeded my expectations in so many ways. That is just like my God! What a wonderful Father we have.

4/14 – I’m a Lobster

Morning dawned with a feast of a breakfast, as is customary at the Dzokotoe’s house, at least when they have guests. It was like my dream come true. Michelle, Becca, and I ate to our hearts content together, until Michelle had to leave to continue her work at the market–she is shadowing a woman for the entirety of her work day selling kitchen utensils, to see what it’s like to have her profession. There is a lot of documenting and reflection going on after hours on this process, and Michelle is doing awesomely.

Becca and I decided to head for the pool! As a swimmer coming from a swimming family, she is really reminding me of my “youth,” when I worked out for 5 hours a day in the pool. Bringin’ back the memories!

We packed a lunch in a small little cooler, grabbed a taxi at the nearby station, and headed on our way to the VRA swimming pool for a day of relaxation. It was good to be on break, although I kept thinking of Tabi working her butt off at the hospital all by herself! We sunbathed for a bit, tried to avoid the creepy dudes trying to get our numbers, read, jumped in the (nasty) pool and enjoyed the cool water for a while, and jumped back out to dry off on our mats. We watched the pool get more and more crowded, and were super entertained by adults trying to swim who didn’t really know how to swim. It was a little mean, but both being from swim teams, we couldn’t help chuckling.

Lying by the side of the pool in the grass, I was engrossed in a John Piper book and the Bradt Ghana Guide, and didn’t notice that the sun was baking me a nice lobster red. It had been probably a full two hours I had been lying there in the sun! And I hate being sunburnt, mostly because it’s so unhealthy! Skin cancer risk factor x10! I felt like such a hypocrite for always getting on Austin for not wearing sunscreen. Bleargh. It stings like all heck.

It was around 3:30 by the time we got back to the Dzokotoe’s compound, and it was about time that I bought my STC bus ticket for Kumasi! Luckily, I had called Big Man about my stay at his house, and it turns out that he will be in Tamale also, and is heading down on Monday as well! We would travel together on the STC bus and I won’t be a lone, frightened obruni in Kumasi, trying to find my way haphazardly to his house.

Becca came with me to the STC station in town in Tamale–we took a taxi to the middle of town and then walked the rest of the way, almost getting run over several times by the crazy Tamale drivers. A random dude noticed we looked a little lost, and showed us the way to the station, and even spoke Dagbani for us at the ticket window! People in the North are just wonderful like that.

On the way back, we stopped by Colwod, the batik and tie and die seamstress shop that rescues abandoned women. We got some lovely gifts for our people back at home, and then headed back toward the taxi stop. Going there, we tried to flag down a tractor (they just drive down the street here) for Becca to hijack and ride. It’s her goal to one day ride a tractor down a road in Tamale, we’ve just got to find an unsuspecting driver one of these days!

Back at the walled compound, Bob, Jean, Dan, and Di were going out for an anniversary celebration dinner, and us girls got to cook and eat hot dogs and grilled cheese together. So American and so good! Y’all know I can eat those things till there’s no tomorrow! Dzifa made us laugh the whole way through dinner with her antics, but in between, Michelle got to tell us a tiny bit of the story of she and her boyfriend. They had known each other since they were kids, from sitting on the same church pew together. They have recently been teaching Bible studies together. Can you saw, AWWWwww? This night, they were celebrating their one year dating anniversary with a nice long skype conversation. So sweet. It really made me miss Austin even more, as though that were possible. It’s been rough being away from him for so long. I haven’t even seen his face on skype–only talked on the phone.

While Michelle went off to her skype date, Becca, Dzifa, and I played cards together–something I hadn’t done in a very long time! I learned Skipbo, and saw some of Becca’s magic tricks; it was all around good fun to be with both of them, laughing and joking.

After the “adults,” I.e. those over 50, got home from dinner, Dzifa was sent to bathe and go to bed, so Becca and I also retired for the night. The sun at the VRA pool had wiped us out! I just lay in bed talking with Austin on the phone, which was so encouraging. I got to talk to him about everything that had been going on at the hospital recently–all the medical complications and tragedies that occurred. It really gave me a lot of peace to talk it out with him and hear what he had to say. I can’t wait till I’m back with him.

Slowly but surely I’m making my way there! The next stop is Kumasi, where I’ll stay at Big Man’s house for two nights to see his church and his school, and to see the Cultural Center. Then I’ll be heading down to Cape Coast via Metro Mass bus (the worst transit experience in Ghana, I’m told), and spending four nights there, soaking up the beach, Cape Coast Castle, and Elmina Castle. The next stop on the itinerary is Accra, at the Baptist Guest House, from which I will be going to the Accra airport, to fly on my way home!

That’s the update for now. Thanks for following along again,

-ATP

4/13 – Our Lady of…

It was a very early morning wake up call. I felt like I hardly slept at all, and it was true, probably only a three or four hours. It was a little strange to clear out all the cabinets I had been using for almost three months. It was almost like going home after your first semester at college.

Pastor Jonah came over soon after I woke up and we shared a cup of sweet, creamy, Ghanaian tea on the couch. I almost didn’t know what to say, I was so sad to be leaving him. I finally got to present him with the gifts for him and his family, and the letter and Bible verse I wrote out for him. I was pretty surprised that I wasn’t crying yet. Maybe Africa is making me a little tougher!

We all got into the car, my dear friend sitting next to me in the cab of the lorry. The tiny thatched mud huts flew by as the sun climbed slowly into the sky. There were rain puddles everywhere, and gullies where the torrents of water had washed out the red dirt road. We saw many aluminum roofs blown off the top of schools, and several fallen trees due to the strong winds last night. These storms can be so damaging. It’s really hard for a community like Saboba to maintain all these buildings when funds are already so scarce.

The familiar road West led us to that same blue bridge that I saw when I first drove in to Saboba with Big Man and Barbara. I remember feeling absolutely elated–I was arriving at my home for the next 3 months! Now crossing the opposite way felt exactly that–opposite. I was leaving behind a home. I didn’t know when I would be able to see it again. A little while later, we passed the sign that designated Saboba District. It was happening too fast. We drove through Sang, the village where Big Man’s heart lies. Another memory from only my third day in Ghana.

And sure enough, there we were in Yendi. Pastor Jonah had to be dropped off near the bank, and he hopped out of the lorry like it was no big deal that we were leaving each other. I leapt out as well and embraced him, my brother in Christ and example in faith. The lorry was still running, waiting. It was happening too fast, and I didn’t know what to do. I had to get back in, but I rolled down the window to shake his hand, choking back tears. Bob and Jean saved me from bawling by chatting away, thankfully. I watched his orange and white striped polo get smaller and smaller, and that was it.

All of Saboba was behind us. I probably wouldn’t see another Konkomba until the next time I come back to Ghana. I stayed awake the whole way to Tamale for the first time, feeling sorry for myself. We pulled into Tamale pretty early, and were feeling pretty hungry, when Bob asked, “Should we go to our lady?” I immediately thought Catholic church for some reason, and asked Bob and Jean about it. They cracked up at me! They were really talking about their egg sandwich lady at the Goil station! Now we’re going to call her Our Lady of the Egg Sandwich. J

We ate, exchanged money, and pulled into Dan and Di Dzokotoe’s compound once again. It was beautiful as ever, but very quiet without all the kids from the school running around, as they were on vacation. Becca and Michelle, my two friends were inside! We stepped in, and there was Becca, going over curriculum for the next term with Di. I was so glad to see her! I previously didn’t know if we would ever meet again, but here we were together again! Michelle was at work in the market, and would be coming home before dinner.

I had asked Becca if she wanted to travel in the South with me (Michelle had to finish her practicum work and couldn‘t), so we spent the rest of the afternoon figuring out the cost of the trip, and where we would be for each night. After lunch of rice and tomato sauce, she called her parents (she’s still 18) to get permission to go, but it didn’t look likely. It looked like I would be traveling by myself down to Kumasi to meet Big Man, and again by myself to Cape Coast to meet some Peace Corps volunteers that Brendan (Unibonmo) hooked me up with! I would miss Becca while I was gone though. She is such an awesome 18-year-old!

We both went to the cultural center with JK and shopped for some gifts, then came back home to help dinner get started–it was spaghetti with tomato sauce and bread! Carbs galore, and delicious. I loved catching up with Michelle, Dzifa, and Becca over tea after our dinner. We just sat there and talked like girls do together, until it got late. We picked a movie to watch to relax for the rest of the evening, and then wished each other good night. It was great to be back with such awesome girls. I really spending time with them, even Dzifa, who is only 13. I feel like it would be awesome to have three sisters like this all the time.

I got to check in with Tabi before I went to bed–everything is going alright at the hospital–she’s doing great handling everything while Bob and Jean are in Tamale for their 30^th wedding anniversary, and while I am making my way down south. I already miss my friend and her hilarious remarks. There’s so much to be sad about leaving, but at the same time I feel very excited to go home. Ten weeks of hospital/orphanage work was a lot for me, and my homesickness was reaching a high point.

Right before Brendan left for his Peace Corps conference, he told me that getting over the three-month hump in Ghana is the worst, and after that it gets easier and easier. I definitely felt like the three-month hill was a steep one to climb. The beginning of my trip was full of encouragement, uplifting experiences, and novelty. I was so happy and affirmed in being where I was, even though it was difficult to be there at the same time.

Then, nearing the end of my trip, living got easier, but I was beginning to be broken down a little by all the frustrations in the health and education systems. I wish it weren’t true because it demonstrates how weak I am, but I think it was definitely time for me to make my way back home and start my travels through the South. I wish I could say I could hack it out in Saboba for 20 years like Bob and Jean, but even 10 weeks was reaching a limit. I know for sure that I want to return to my little village, though. I still love them dearly, think about them constantly, and long to be with them. Maybe I’ll be able to increase my endurance and stay even longer the next time I come. I don’t know. I just know that even though it was really hard for me to say goodbye today, I feel it was the right time.

Only 12 more days until I am flying home to my family and friends. I miss all of you guys immensely as well. Can’t wait to see everyone again!

Love,

ATP

4/12 – Never Really Say Goodbye

It was 5am and Tabi and I were awoken by Dr. Jean because there was a retained placenta case at the hospital. This was my last full day in Saboba, and I wanted to spend it saying goodbye to people, but I was so glad that I got myself up out of bed to go with her to the hospital.

When we got to the maternity ward, Tabi slapped on some gloves and put her hand all the way up into the uterus. She was probably in up to her forearm! Tabi needed to start creating a plane between the placenta and the uterine tissue in order to separate them from each other. Meanwhile, she was using her other hand on the lower abdomen to push down on the fundus of the uterus to create some leverage. It took several minutes of very careful digging around, going centimeter by centimeter.

Tabi said it was stuck there like cement, and she needed to be extra careful that this woman didn’t bleed to death. Finally the strange circularish mass came out, with the umbilical cord rising from its middle. It was checked to make sure no pieces were missing, and that all of it was out of the uterus. Indeed, all the edges matched up and everything looked great. That was the first time Tabi had ever removed a retained placenta! I thought she did an amazing job! Our patient was asked to be monitored for bleeding.

Tabi thought it might be beneficial to round the female ward while we were at the hospital for the morning. All I wanted to do was go back home and eat and sleep until 9, but I sucked it up and went along with her. Luckily, rounds flew by and by 7 we were on our way back to the bungalow for breakfast. Ti doon Uwumbor!

After this, Tabi went back to round with Dr. Jean, but I stayed at home to write letters to my friends in the hospital. I wanted to give them to each ward and department so they’d have something to remember me by, and so that those nurses and staff who weren’t present today would be able to read it later and know that I didn’t leave without “goodbye-ing” them.

It was a painstaking process. I hate goodbyes more than anything. Whether it’s a loved one that has passed away, or a mere semester-long absence from a friend, goodbyes are always hard for me. I had to fight back tears, but I eventually got through all of them and headed on my way to make their deliveries.

At each place… the lab, the male, female, maternity, and childrens’ wards, I stopped and bid farewell to my friends that I had known and grown to love over the past 10 weeks. It was so hard to think about them continuing their way of life here in Saboba, while I am all the way in San Diego. I wanted them to know above all that they mean so much to me, and I will never forget them or stop praying for them. We took pictures together, ones that I will cherish forever.

Dr. Jean and Dr. Tabi were in the theater with the fellas, performing a laparotomy on a patient with severe abdominal pain. I walked in, and there was bile-green fluid everywhere. It was a humongous pyloric ulcer the width of your index finger. Solo was back from his family’s funeral (I was so glad to see him!), and was dumping a total of 4 liters of fluid into his veins to replace what he had lost. I had come in for the end of the operation, and Jean was on her way out, flushing everything with normal saline and sewing things up.

Things at the hospital were moving at breakneck speed today–Tabi and I still had to do childrens’ ward rounds after the laparotomy, so we headed there while Dr. Jean and Alex were performing more hernias, and we checked on all the patients–they were all improving and doing well, except that the family of the baby with the broken femur was requesting that he be transferred to Tamale. All of us really doubted that he would get better treatment at that hospital, but even so, the parents insisted, so we had to take apart the device that Bob, Ishmael, and Tabi constructed with such care and effort, and sent the baby off to back West.

The childrens’ ward was not about to let us move on quite yet, though! While Dr. Tabi was finishing up writing orders at the nurse’s station and we were about to move on to the post-rounds tasks of the day, a small boy came into the wards with a head that looked like a balloon. The poor thing’s face was so swollen that his eyes were closed shut! He had been bitten on the head by a snake. How on the head, you ask? Well, he was sleeping on the floor of his compound, which is so common here. His family even opened up a polythene (plastic bag) and showed us the tiny dead snake that had bitten him. I knew that baby snakes often can’t control the amount of venom they release, therefore bites from baby snakes can be most dangerous. We ordered clotting times and got some ASV for the little kid pronto. He would be alright.

I got to witness Pullsheet David pull another pick-up line on Dr. Tabi, and it was hilarious. She just told him flat-out that she doesn’t like men with “Fufu bellies,” and the entire nurse’s station cracked up, including Pullsheet David. Poor guy!

It was a brief comic relief, however, because Tabi and I had to rush back to the male ward to see what to do about our alcoholic patient with his infected leg wounds. The fellas and I brought him in, and put him on the operating table between his moans of pain. It wasn’t looking good–the bottom part of his leg near his ankle was peeling black skin and leaving raw, red parts underneath–it was necrotizing fasciitis. What made it worse was that there was a part of his upper thigh near his groin that he never showed to us, and always kept covered under a cloth. That, too, was infected with gas gangrene–the bacteria that was in his leg were producing gas as a product of their reproduction, and it wasn’t pretty at all.

Jean inserted a needle to test the area, and he began oozing bright red blood that wouldn’t clot. She decided that we couldn’t flay his leg in the theater like we wanted to, in order to get rid of the infection. It was impossible because he would bleed to death. Our cautery was broken, and we just didn’t have the resources to cut. Instead, we put him on high-dose wide-range antibiotics and hoped for the best. His family was all gathered around, and Jean had the unpleasant task of breaking the news to them that there was a possibility they could lose him. I was shocked and immediately believed the worst, but Jean in her wise manner, declared, “Where there is life, there is hope.” That is the attitude a doctor should have, and I was immediately shamed. I put away my pessimistic perspective and resolved to pray hard and trust in God’s will for this man and his family. He was put into a private room in the back of the male ward, with his relatives all gathered around him.

It was already late afternoon, but we were still busy–there were three maternity ward patients that Tabi was going to perform some ultrasounds on. Two of them turned out to be normal, but the last one had a set of twins, one of which was almost at full term, and the other was at 36 weeks, meaning it had died. It was going to be a difficult and tragic delivery. I wasn’t going to be around for it, but I am going to keep the family, Dr. Jean, Dr. Tabi, and the midwives in my prayers.

It was dark by then, and we were all very hungry and tired, but there was still one more hernia to do! It would be my last surgery with Dr. Jean, so I scrubbed in and savored every moment of that theater. I hated to think that soon I would be gone, and it would be a very long time before I saw the place again. The little scenes of the past surgeries I observed and assisted in ran through my mind–Dr. Jean’s surgery play list that I basically knew by heart, Alex dancing to the grooves, Ishmael giving “therapeutic touches,” to the patients, the first baby I saw sectioned, my little typhoid perforation girl Tikala, the surgeries with no electricity…

This one was a left inguinal hernia. Over the past weeks, I learned to anticipate what instrument Jean needed next, how to slap them firmly in her hand, how to cut sutures, how to think about keeping everything sterile during every second of surgery. I got a tiny introduction to key-hole anatomy and what it’s like to find the all parts, even if the patient’s anatomy varies from the textbook. Jean even said, “You are ready for med school and one step ahead of the game!“ I don’t know if she meant it, because I still think I don’t know enough, but it really encouraged me to hear it from her. It had been an amazing hands-on experience to scrub in with the team, and such an honor to learn from these guys who were so welcoming and willing to help me. I am already missing it.

After that last surgery, the team was itching to go home. I don’t think we’ve ever spent that long in the theater during the entire 10 weeks that I had been there, and we were all exhausted! But I wouldn’t let them leave without a photo together. I gave each of them a big hug, presented my letter, and let them know again how much I would be missing them and praying for them back at home. They are all so special to me. From the first day that I met them, they immediately endeared themselves to me, and I would not forget how kind they had been, and how enjoyable it was to spend time with them working and relaxing, too. It was a sad goodbye, but a hopeful one. Hopeful for a return to this place.

Back at the bungie, I briefly forgot my impending departure, and happily inhaled a bowl of redred and plaintains. Favorite Ghanaian meal, right up there tied with TZ and groundnut soup. Perfect farewell dinner, especially with the leftover cake and ice cream from Raymond’s visit yesterday.

I was gathering up all my presents for Pastor Jonah and his family, when a storm hit. They come super fast here, and before I knew it, there was wind, lightning, tremendous claps of thunder, and torrents of rain. I was about to head out and run to the Manyan compound with my bag of gifts, but for fear of being hit by a falling tree like our trauma patients the other night, I was not permitted. I was heartbroken that I wouldn’t be able to see the compound one last time and bid a proper goodbye to my best friend here in Saboba. Why, God, why? But I called and Pastor Jonah was not even at the compound. What consoled me slightly was that he would be coming with us in the lorry to Yendi the next day early in the morning. If I didn’t get to see Aggie, Ruben, James, and Gloria, at least I got to say goodbye to Pastor Jonah.

It was the middle of the night when the rain stopped. I still wouldn’t be able to visit Pastor Jonah and his sleeping family, but Tabi and I were able to visit the hospital to check on the laparotomy patient, the leg infection patient, the maternity ward’s small babies, and the mother with the twins. Everything was looking alright. Finally the mothers in the maternity ward were following the directions we gave them, and we thanked the nurses for also working so hard on them.

When we were checking on our mother who was about to give birth to one full-term twin only, Dr. Tabi was able to teach Musah, an adept nurse with experience in delivery, how to do a vaginal exam and measure fetal heart rate. Musah is a good learner–I recounted the story to Tabi and the other nurse there, of how Musah caught a baby all by himself, clipped the cord and cut it, and everything. Jean had walked into the labor ward from the emergency call to the hospital, and found that he had done everything correctly already! I have high hopes for the further instruction that Dr. Tabi gives to Musah. She is doing a great work, teaching them things in such a detailed way, and allowing them to improve their skills. I was very encouraged as we said goodbye to them and came home.

The thunder began to clash again as we returned to the bungalow. Tabi and I were both quite exhausted, and even though I was going to miss my wonderful new friend very much, both of us couldn’t stay awake, and we fell fast asleep almost as soon as our heads hit the pillows. It had been a wonderful week-ish that I had been able to spend with her. I love her sense of humor, her bluntness, her passion for medicine and serving people, and her heart for Ghana. I learned so much from and was greatly encouraged by Dr. Tabi. I am so grateful that the end of my trip was highlighted by her presence; I just wish it could have lasted longer.

There just never seems to be enough time wherever I am with the people I love. No matter where I am–Berkeley, San Diego, San Jose, Los Angeles, France, Ghana, or a multitude of other places… There are always people I live apart from whom I wish were with me all the time. I get mournful, but then I think about the end of our lives when we are all gathered together at home in heaven, where we were truly made to be. It’s going to be wonderful. Marvelous. Indescribable. They will all be there, we’ll all rejoice together. It will be more happiness than we could ever imagine to worship there around the throne. Even across the country, across the globe, Christ unites us. We’re all heading for the same place, and the wait-period to get there will just be a small little blip in time compared to eternity together with God.

Goodbye, Saboba! Goodbye friends! Until we meet again, if not in this life, then the next J

4/11 – Full Range

It was a huge day at the hospital. There was so much to do every single minute that I was just dead tired at the end of it all. I really am so amazed that Jean does this by herself most of the time. Thankfully, Dr. Tabi is here to help now, but she won’t be here forever, unfortunately. There should be at least two doctors working at the hospital at all times. It’s just a good system to keep both of them from wearing out completely. There is definitely work enough for two!

Tabi and I started bright and early in the male ward today, to check on our moto accident patient. We had to watch carefully for stiffness in the neck especially, because that could be a sign of further injury. Since the patient had many open wounds that weren’t healed yet, we couldn’t give him dichlophinac injection to ease the pain; it has a nasty habit of decreasing clotting factors and could cause him to bleed profusely from his wounds. Instead, Margaret one of our most attentive nurses, suggested dichlophinac gel for massage on the neck. Awesome, problem solved. I love it when the staff works as a team to treat the patient. Tabi didn’t even know the gel was stocked at SMC, but Margaret had her back. I want to see more of this!

There were two patients in the male ward waiting for inguinal hernia operations in the afternoon. I was looking forward to assisting in at least one of those!

In the female ward, we had a few cases we haven’t seen too often–a patient with maniere’s  (sp?) disease and symptoms of vertigo, a patient with a 2-year-old anal fistula, and a patient with severe vaginitis. The last one was interesting to me because she had originally come in for some completely unrelated problem that I can’t even remember now. But when she saw Dr. Tabi, a female, she was able to finally disclose one of her biggest health issues. If she hadn’t been admitted, she would have only seen the male Medical Assistant in the consulting room, and would have never had her condition treated–she would have just gone home in pain. There should be a better way to go about these things, even if it’s as simple as having the M.A.’s ask their female patients if there’s something they’d rather speak to a female health professional about.

In the childrens’ ward, Pullsheet David noticed that one baby’s leg was bending in the wrong place. Yes… it was a femur fracture on a poor little 1-year-old. And how did he break his thigh bone, the biggest bone in his body, if he couldn’t even walk yet? The darn motos. He was thrown from a moto and now his leg was broken. We didn’t have any plaster of paris to set up his leg, nor a gutter splint small enough, so Jean looked up a gallows traction rigging in one of her textbooks, and Bob, Ishmael, and Tabi set to work making one for the little guy. They worked hard, and finally he was all tied up, with his leg hanging vertically while he lay on his back. The gravity would help the bone to set back in place, so another problem solved. He wasn’t even crying as much when they left.

In the maternity ward, it was the same thing as it is almost every day, since we’ve had these complicated pregnancies deliver. We scold the moms about wrapping their babies tightly in two dry cloths, and urge them to feed their babies every 2-3 hours whether they are awake or not, and then do cup top-up since the baby could be too weak to suck until it’s full.

One baby is jaundiced and seized right there as we were doing rounds. I don’t understand things like this–the moms have good nurse translators and are fully informed as to what they should do, but they don’t want to do it. It’s that patient compliance thing again. Tabi and I come into the maternity ward whenever we have free time to monitor these moms and ride their backs to take care of their kids. That’s the best we can do, but the rest is up to the moms. I suppose it’s one of those “You can lead a horse to the water, but you can’t make it drink,” things. It sucks majorly, and I hate it, but if I have to lead the horse to the water a hundred times to make it drink, I will. I know Dr. Jean and Dr. Tabi would do the same.

The worst part is when something terrible happens before that one hundredth time, like it did today.

I had just come back from assisting in one of the inguinal hernia cases and one ganglion cyst removal. Dr. Jean and Dr. Tabi were still in the theater working on the second one, and I was assigned to go check on the maternity ward and make sure all the recordings of the feedings and temperatures, etc. were being taken. Everything looked fine, but I couldn’t find the mom with the jaundiced baby. For some reason, they had moved her to the female ward from maternity. I asked the mom to cup-feed her baby because it wouldn’t suck. There wasn’t even any milk, so I got one of her nearby friends who was also nursing to expel some breast milk into the cup. I left the woman with John Manyan and Janet, and went to finish checking on the rest of the babies.

I was gone maybe 15 minutes when John called me back, and said that the baby wasn’t breathing. BAD NEWS. At this point, I can only think “Oh, #$*%.” I ran over, looked for rise in thorax, there was none, more expletives in my head, and I quickly called across the ward for Janet to get the manual respirator, except I only yelled “THE THIS THING!” and did the hand motion. In a flash, Janet had the device in my hand. I gave it to John and commissioned him to do one breath for every five compressions, I quickly checked for brachial pulse like Tabi taught me, and I thought I felt a small one. John was excellent and did as I instructed. When Tabi came, though, she confirmed the little girl dead. I thought the brachial pulse was still there, but I believe was feeling only wishful nothings.

It was one of the most terrible sights I’ve ever seen. The poor first-time mom was sitting there on the bed, watching us try to resuscitate her child, but we failed. Even though she didn’t speak English, she knew what the verdict was when Tabi removed the stethoscope from the tiny chest and turned away to tell us. She began to cry. I’ve never seen a Ghanaian woman cry, ever. I’ve seen them lose their babies, had their bodies cut open, suffered anxiety attacks, lose their husbands, and many more horrendous things, but I’ve never seen any shed even one tear. Knowing the strength of these women, to see this one cry was absolutely heartbreaking. Tabi tried to touch her shoulder for encouragement, but she tore away and turned her back. We were all devastated there in that room, but none more than her.

Tabi and I walked home in virtual silence yet another time. Those times are the worst, but as soon as we get back to the bungalow and report to Jean, she always says the exact right words to encourage us. But more than that, I think it’s her example of strength and trust in God that lifts the weight off us. Pastor Jonah was there also waiting for an evening chat. Even his presence there is calming to me, because I can feel the Holy Spirit in him. He was reading the Likpakpaln Bible that he himself helped to revise, and just seeing him there reminded me to trust in God above all things, and of Romans 8:18-21, about our future glory.

We ate Bob’s wonderful meal together, and then after our dinner, Raymond Aidoo and his wife Esther came over for cake and ice cream. Esther was leaving back to her Health Assistants Training School, and we wanted to “goodbye” her well. They are very jovial people, which definitely lightened the mood.

After this, I wanted to also “goodbye” Ishmael, since he was going to be leaving the next morning for a funeral, and I would be leaving “tomorrow next” morning and wouldn’t see him again. We went to Back Home Spot, and thanked each other for the past 10 weeks over some Alvaros. Again, Ghanaian generosity and hospitality just overwhelmed me. The way they treat guests or strangers here is beyond kind. I just felt so grateful for his words of encouragement and friendship. We continued to talk more about the hospital, his new goals for it and the emergency unit to be established there, and for his personal goals. As we finally wished each other goodnight, and I walked back to the bungalow, it hit me how much I am really going to miss my friend.

It had been a very full day, overflowing with a full range of emotions, and I was definitely ready for my rainwater bath and a hopefully a good night’s sleep. I am dreading facing the mom again in the wards tomorrow. I don’t know what will happen, or how she will react to our attempts to help her, but I will just pray that God would give me the wisdom to know what to do and the strength to deal with whatever comes.

-ATP

4/10 – Dealing

Today was one of those days that you just feel frustrated.

We are continuing to monitor our tuberculosis patient who is severely malnourished. At least while she is admitted here in the hospital, she is compliant and takes her medicine. However, she did have to be scolded because of her refusing treatment while at home, she may put the public at risk for drug-resistant tuberculosis, which is a very serious matter! Dr. Jean has told her this in the past, but I don’t know why she doesn’t listen.

The moms who have just given birth have been instructed many times on how to feed and wrap heir babies, but even though we make sure they understand during rounds, whenever we check back on them, they have ignored every piece of instruction, their babies are getting worse, and now we had to treat them with antibiotics.

One patient was withdrawing from alcohol–his hands were shaking, had a magnesium deficiency, and was at risk for seizure or coma. This very old man was a regular patient to the hospital, and yet even with all the support his family had been giving, he still hadn’t quit drinking. We tried to tell him that the alcohol is killing him, and asked if he would stop drinking it. He said no.

Later in the night we were called in for a moto accident patient who was not wearing a helmet and had been thrown over his handlebars to land on his face. He was in fact very fortunate that road rash and some deeper lacerations were his only concern; he could have had a serious brain injury or even died, all because he wasn’t wearing a helmet. We sewed up the skin all around his orbital and in his lip, and carefully dressed the rest of his mangled face.

Dr. Jean scolds everyone to wear helmets when they ride their moto because it’s just good public health practice, but there’s a macho culture around here that glorifies the fast-driving, helmet-less moto rider, so we still get bad moto accident cases all the time. While Dr. Jean was stitching his face up, I just looked down at him and all the blood, and all his very worried friends standing around, and knew that most of the injury could have been easily prevented.

But I know all these frustrations are ubiquitous in healthcare. No matter where you are, you will always have to manage noncompliant patients. From what I’ve seen, the best thing to do is to just do your very best to inform and educate concerning the consequences, and then let the patient have their autonomy. Healthcare doesn‘t always have ideal results; I wish it did, and we should be striving to find new ways of improving patient care, but there is a huge amount of humility that I see doctors exhibit when they are forced to accept that they can’t be the ones to fix everything. That’s something I’m learning from Dr. Jean and Dr. Tabi during my time here. It’s been eye-opening to say the least, and I am grateful for all the things I am learning, and I pray that I can make them useful in the future.

Other medical procedures of note today:

– Another counseling session with our panic-attack patient, and an ultrasound on her baby, with the father!

– Lipoma extraction–awesome

– LP on a potential meningitis case, turned out to be negative, thank goodness!

I am so behind on all my journals, I’ll probably still be uploading them when I get back to the states on the 25–apologies!

– ATP

4/9 – Caught a Baby!

Bowl fruit for breakfast. I really had to refrain from eating the whole mass of them. I am seriously going to miss these treats when I am back in the states! But our tasty meal was interrupted by a morning emergency call from the hospital. When we got there, it turned out to be a hypotensive 70-year-old alcoholic in respiratory distress. The nurses were giving him a huge bolus of IV fluid to counteract his low blood pressure, but we had to slow it, because the increase in fluid overloaded his old heart and was giving him pulmonary edema (fluid surrounding the lungs making it hard for him to breathe). We treated him for his symptoms and kept him for monitoring, since Tabi believed this whole situation may have been caused by alcohol withdrawal.

Continuing rounds, our most extreme case was a severely malnourished TB patient in the female ward. This young lady had been a regular patient of Dr. Jean’s, and would be doing just fine on her treatment until she was sent home and refused to take it. Dr. Jean was very frustrated her for being so stubborn, and also for putting the rest of the community at risk for drug-resistant tuberculosis. I really don’t know what this girl’s deal was. I thought maybe a psychological issue was at hand, because she was literally wasting away and refusing to receive any treatment. I have never seen anyone that skinny before–not even in pictures. It was scary. Dr. Jean and Dr. Tabi decided to keep her in the hospital for a long time, since that’s the only place she gets better. Uncooperative patients are only one small part in the seemingly never-ending list of frustrations of Dr. Jean’s.

After rounds were done (we split them again, thank goodness!), Tabi and I had the exciting task of draining an injection abscess. This long-standing infection on the upper and outer quadrant of the buttock had probably been caused by a quack doctor or medicine man going around to the villages giving people injections for this and that, just to take their money. There was a raised abscess of about the size of my entire hand, and as Tabi says, “Where there’s pus, let it out!”

She palpated around for the “tracks,” or where the cavities of pus were, and made an incision on the top edge of the abscess, so that the patient would be able to sit down as it healed. I held the receiver tightly against his buttock to catch the drainage. A lot of squeezing and flushing later, and I had about 300 mL’s of pus and necrotic tissue in the basin. It was really lovely. Tabi felt around in the tracks with her finger to make sure there was nothing else there, and she said that one of the four tracks went almost all the way down to the bone. I think this man should be the one to tell every person in Saboba district not to listen to any village quack doctor!

The morning was concluded with an ultrasound scan on a woman who wasn’t quite sure how far along she was in her pregnancy. It was a pretty cool thing to show her the heartbeat of her little baby, and see her face light up. We found out that it’s almost 3 months old, and that she’s due in late October! Tabi has a really good touch for pregnant moms, and I am really enjoying watching and helping her with them.

After lunch back at the bungie, I called Brendan and we got to meet up for a less rushed goodbye than we had yesterday. I found him at the EP Church Easter Monday picnic, playing cards! I sat down right next to their group and started learning how to play Ghanaian mancala with a very nice and patient lady. It’s worlds more complicated than the mancala I learned, and I would have no idea how to explain it to you if you asked! Every turn I took was basically a guess, but I had fun! In turn, I taught her the mancala I knew, which she picked up in a flash, go figure!

After pulling a tie in mancala with my new friend, I followed Brendan to one of Pastor Baaka’s relatives, whom he was asking for a ride to Yendi/Tamale for the Peace Corps conference. He followed me to Lucy’s seamstress shop to pick up some needle and thread so I could sew up my shirt. Then I followed him to return a book to a friend, wherein I found Ephemera (sp?) from the female ward! I am still getting used to the small town feel of Saboba, especially seeing people you know literally wherever you go in town. It’s definitely new for a city girl, but I really have been liking it for the past two months!

Finally after all our errands were over, Brendan and I got to sit down at Back Home Spot and just shoot the breeze over some Alvaro and Fanta. I always enjoy our conversations, especially since Brendan is very relatable. It helps both being the same age, both from the US, both schooled in California, both serving in the same rural village in Northern Ghana! I will miss him when he goes, but thankfully we got to say a proper goodbye.

As I was walking back to the bungalow from my break, Tabi was leaving for the hospital again! I turned right back around and joined her. The tasks on the list today were just to visit David, one of our nurses admitted with pretty bad typhoid, but we got stuck with two labor cases! That’s what happens at the hospital–you go planning to check back on one or two things, and you end up staying the entire night.

We scanned both the pregnancies. One case was a very high-stress situations, so Tabi and I were slightly frantic. She sent me back to the bungalow to fetch things for her twice, and I was working up a sweat! The second time I went for her computer (drug information database on it), the first baby was delivered. Tabi caught it, and it’s apgar’s score was very good, although when the umbilical cord was clipped and cut, it sprayed poor Tabi in the eye with cord blood! That’s another one to add to her list of crazy experiences with body fluids. Prophylaxis and lab tests were duly fulfilled, and we can confirm that our doctor does not have AIDS, Hep C, or Hep B! It was a scare, but she is safe. J

We were just about to tend to the second woman in labor, when Dr. Jean came in and announced that there was a man with a right inguinal hernia that was strangulated. We didn’t want his gut to rot outside the peritoneal cavity, so Tabi went to assist in the operating room and left me with Stella the midwife to catch the baby. I was SO EXCITED! Tabi said that it was a normal delivery case on a “multip,” (multiparous, a woman who has given birth more than once), and was easy to start with, so she would let me catch it!

I was really thrilled but simultaneously terrified and nervous. I kept repeating all the steps that Tabi told me to perform when helping the baby to come out so that there would be less of a chance of doing anything wrong. Stella broke the tension when our plump mama announced that she really felt the urge to push.

“She will deliver the first twin now,” Stella announced.

“First twin? There’s only one…” I answered, confused. Then I looked, and our mama was pooping during her push. I had to laugh out loud! The poop was the “first twin,” haha!

The baby moved steadily down the canal until its head was crowning. I thought it might be at least a minute until the head was delivered, so I went to go throw away some of the “first twin” so it wouldn’t be around to infect things. When I came back, the head was already out! Later, I heard Tabi say to never leave a multip alone! The baby will be out before you know it!

I did get to deliver the rest of the baby, though–help it to turn, guide down for the top shoulder, up for the bottom shoulder, grab the arms and legs and put the baby on the mama’s stomach! I clipped the cord and cut it, and the baby was free! She was crying within a matter of seconds, and weighed 3 kg exactly. What a good girl! I wrapped her up tightly and totally forgot about delivering the placenta because I was so absorbed in the little girl. Stella handled that while I presented her to her mama, beaming the whole time. I was so happy that both the mom and the baby were fine, and that I had played a little role in the delivery.

Soon, after everything was clean and the mom was feeling ready, I walked her back to the lying-in ward, where she was able to start nursing her baby. I was so happy that I caught my first baby that I had to ask her to snap a photo with me. The photo is pretty funny. I look elated, mama looks tired, and the baby looks possessed because of the flash. I asked the mama what her name would be, and she answered that the dad would name it. I turned to him and asked again, and he said that her name would be Soraya. What a gorgeous name. J

I went home with Dr. Tabi and Dr. Jean afterward, late at night. The inguinal hernia had been repared just dandy, and we had a healthy baby. It was a successful night that we were very happy about, considering the suffering and death we endured over the weekend.

We even got to have some bowl fruit when we got home! Tabi and I sat there dipping them into sugar as an extra treat, as if fried dough wasn‘t bad enough for you! I felt complete. Thanks be to God for everything that was accomplished today. J

-ATP

4/8 – A Storm Trauma

Yesterday was probably the hardest day at the hospital yet. Before we both drifted off into our own thoughts and finally sleep, Tabi and I had been up late, talking in the dark. She has a heart that really feels for people. She’s compassionate in an extremely tough manner, which is good for her as a doctor. It was as reassuring as it could be to listen to her work through the things we saw yesterday, but we didn’t get much sleep.

Yet it was the best thing in the world to be woken up at 5am, as the sun was just barely beginning to show, by the sounds of an Easter parade in the streets. A heavy drumbeat was sounding, brass bells were clanging, and Konkombas were chanting as the group slowly marched down the town’s main street. I gained consciousness, immediately thought, “Easter,” and to my surprise, instead of feeling groggy and annoyed, the image of the two Mary’s popped into my mind. They were rushing back to tell the disciples that the tomb was empty. Jesus is risen. That was their joy that dawn, and this parade was celebrating that exact same elation. The sounds gradually faded as the parade moved on, and I finally felt the peace that I had been searching for last night. He is risen indeed.

The morning was a little brighter, a little cheerier, especially with one of my Bob Young favorites–mango oatmeal. Tabi and I hit the female ward, in the middle of which Jean finished her half of rounds and fetched me to go to Pastor Jonah’s church for Easter service. Again, I felt really guilty about leaving Tabi, but I felt like I really needed to go to church. Jean went back to the bungie to change, so I continued on to the little school building where the English Church meets.

Of course they asked me to sit in front (gahhhh) next to Pastor Jonah (well, alright!), and we celebrated the risen King with joyful singing and Konkomba dance moves. Later, Pastor Jonah said I “danced perfectly.” Best compliment ever. I recorded all of Aggie’s song that she presented, and after that sucked my battery dry, snapped photos of Jean singing as well! Worshipping like this with members of the Body all the way across the globe is probably one of the best things I can describe. I say it again and again, but it’s so true. Even though I can’t understand the words to their songs sometimes, I close my eyes and sense the way they are glorifying God, and there’s just no better feeling. By this I know we were made to worship.

I was so glad I got to hear Pastor Jonah preach today. His theme was “He was not there in the tomb, and He is not there today,” meaning that Jesus is risen, and as a result we are given new life. Therefore, there is no place for continuing guilt for past sins in our lives if we accept His sacrifice for us. Furthermore, we cannot go on sinning as if we were still in our old lives. It was a simple but direct Easter message, the type that Pastor Jonah is so good at. I prayed for the church at the end of the service, and after clearing away the chairs and putting the huge speaker onto the back of a moto, I was able to take a photo with the entire church, one I know I will cherish for the rest of my life.

Pastor Jonah, Aggie, Ruben, James, Gloria, and I walked OK, Gloria was carried) back in the direction of home. We saw a HUGE rat run across our path. It was the size of a large rabbit, and I am not kidding you. I said goodbye to the Manyan clan, and walked into a bungalow filled with the smells or seasoned garlic pork roast with roasted carrots, potatoes, and onions, and a cucumber salad. It was an amazing Sunday lunch compliments of Chef Bob. We even got to have chocolate ice cream for dessert. It was like Jesus knew exactly what I had been craving for the past nine weeks. It was absolutely wonderful.

After lunch, we just relaxed. Tabi suggested going to swim in the Oti! Ishmael, Shepherd, and Brendan (Unibonmo) were coming along too! We rode there together and stopped at the place where the big lorries load sand. It was a sunny little riverside beach with some cow patties littered around. I definitely got a little squeamish about swimming near the feces, but just sucked it up and told myself not to let one drop of water enter my mouth. Hopefully my immune system’s first defense mechanism (my skin and mucous membranes) would keep me safe!

Like I said before, I am definitely a city girl. Some parts of living in Ghana have been really easy to adapt to, and some parts I’ve struggled more with–for example, swimming in this river! I do not like the feel of slippery algae-covered rocks beneath my feet, especially when the water is completely opaque and I can’t even see what I am stepping on! It makes me shudder! But Tabi and Ishmael were having a great time, and even Brendan got in. So as soon as I made myself get over it and moved into the deeper water where I could just take my feet off the bottom and swim without really touching anything, I felt better. The current was surprisingly strong, and even while swimming, I was staying in the same exact spot perpendicular to the bank!

We just splashed, joked, proposed races and trash-talked, and floated along, enjoying the relatively cool water. It was great to be with friends. Brendan and I sat on the beach for a while, talking about our Ghanaian experiences, the Peace Corps, Berkeley, and a host of other things. I could list a bunch of friends that Brendan reminds me of back home, so I feel like he is my friend automatically. Talking with him always makes me miss home a ton initially, but when he starts imparting little bits of wisdom from his 9 months here in Ghana, I feel encouraged instead.

Shepherd had gone to meet one of his school friends who was visiting Saboba, so when it was about time to head back, we started walking toward the hospital, Ishmael taunting us on his moto, riding along the side, that rascal! Danba, a nurse from the childrens’ ward, met us part way down the road and picked us all back to the hospital, thankfully! It was a breezy ride in the late afternoon air, and the perfect ending to our little outing on the Oti. The sun was shaded by some voluminous clouds rolling in, and it looked like it might rain soon.

At home, a nice shower to wash off all the disgusting river water was definitely in order–felt so good! Brendan also stopped by after he finished his lesson with Trinity! We were just chatting and listening to Tabi narrate her photos when thunder started to clap, and rain began to pour down. Looks like Brendan was stuck in our bungalow for supper! I was getting ready to wish Brendan goodbye; he would be leaving in two days for the Ghana Peace Corps conference, during which I would also be leaving Saboba, and so I wouldn’t get to see him again in Saboba.

We were enjoying our jollof rice and side of ice-cold pineapple and I was enjoying some last moments with my friend Brendan, when someone from the hospital called. Four trauma patients had arrived–all sisters, all struck by a falling tree in the storm. There was no time to spare–I tried to wish Brendan a semi-proper farewell and best wishes, all while pulling on my socks and shoes and mentally preparing for what might await us at the hospital. Tabi, Jean, and I jumped in the lorry and sped down the little path.

When we got there, Jean took the female ward where the two senior sisters lay, and Tabi and I rushed into the childrens’ ward, where the two junior sisters were admitted. We burst into the light of the ward. Passing the nurse’s station, I noticed a big splatter of fresh red blood on the floor. Holy Crap. Other parents were watching wide-eyed as Tabi and I ran past, looking for the patients. They all knew what had happened and pointed to the far end of the ward where the girls were laying. To me, that indicated the accident had been very big that practically the whole ward was aware. Not good.

All these things rushed through my mind within the few seconds it took us to reach the two girls’ beds. It was a pretty horrific sight. One girl had blood everywhere, especially on the head, every sort of family member around, panicking and holding her, moaning and struggling against them. Tabi sprung into action, and I realized I had to check on the other sister.

There was very little blood, only some abrasions, but she was lying very still and to me almost looked dead. In the moment, I hardly knew what to do except to check if she was conscious, check for fractures, and examine her pupils for dilation and sign of possible severe brain injury. I called out the examination findings to Tabi who was busy with the more serious case at the other bed–the girl woke to my call and could talk to me coherently, but her pupils weren’t constricting very well to my torch. She seemed to only have contusions. I took her vital signs, and since she was stable by the grace of God, I went to help Tabi.

I’ve seen some critical cases during my time here at SMC, but this was the scariest. Firstly, she was about 10 years old. Secondly, there was blood and vomit everywhere. We had to constantly make sure to keep her neck very still when we had to move her. Just the thought of damaging her spinal cord was distressing me. Tabi said that she had a closed-skull head injury and possible herniation (Brain trauma and swelling so large that it pops out of the foramen magnum at the bottom of your skull, where the brainstem and spinal cord should be). We got her the best steroid drug to reduce the swelling, propped her head up, stabilized her neck with a soft cervical collar, cleared her airway, inserted a Foley catheter, kept her warm with a couple blankets, and cleaned her up.

Tabi taught the nurses how to classify a patient on the Glasgow Coma Scale, a system of measuring how progressed a patient’s state of unconsciousness is (our little girl was a 6–quite bad). She also taught the family members to keep watch over her through the night, constantly keeping the head in the proper position for breathing. That meant two hands pushing the jaw forward throughout the night so she wouldn’t choke on her own tongue.

It was a long, hard, night, full of adrenaline and cortisol (stress hormone) coursing through my blood. In many instances, I was rushing around, running for this and that, asking the nurses for help, delivering messages, phoning the staff on-call, and silently begging God to let her be alright. But finally our patient was stabilized and we had done everything we could for her at that time.

We checked in with Dr. Jean. Of the two sisters in the female ward, one had died upon arrival, and the very eldest had a chest injury. With no X-ray at our disposal, Jean referred her to Yendi hospital. It was a tragic night, to say the least. This poor bereaved family had lost one of their dear girls, the youngest one was injured, and the other two were in critical condition. There must have been a dozen family members huddled together in constant anguish over their children in the wards. They all loved these little girls and each other very much, and it was absolutely heart-rending to witness.

After you’ve done all that you can do, sometimes it’s best to leave the family by themselves to be with their loved ones, and this was one of those times. I felt like staying around to monitor, but really what could I do after everything? Jean loaded us girls in the lorry and we headed back to the bungalow.

It was time for a cup of late-night tea. Something about it is so comforting, especially when after a tragedy like this one, and especially when you’re sitting around a table of God-fearing women who encourage and strengthen you. We talked into the night about family tragedies, during which I realized unspeakable things like this happen every day in hospitals all over the world. The suffering is enormous, and the only way to not go insane is to trust God completely and know that even though it looks like the end of the world to us humans here on earth, our ways are not His ways, and our thoughts are not His thoughts. He has something bigger, better, more perfect in mind, and we’re going to see it come true. We may have to wait a while, but trusting Him will bring it about. These things about God I had already known and even experienced during some really hard times, but now He is giving the same lessons to me in an even more difficult setting. I am praying that after I am tested and tried by these things, my trust in the Lord will not be broken, I will continue to see how God is glorified in these situations, and that as a result my faith with be proven correct and “come forth as gold.”

It had been a joyful Easter beginning, only to be struck with another tragedy… and I am a little confused about being jerked up and down like this, but I think about the disciples experiencing the biggest rollercoaster ride of all. The man they believed was the Son of God had been killed brutally on the cross and everything they thought to be true was dashed to the floor. For two days they were in anguish, at the very lowest point, until those ladies rushed back from the tomb to tell them the good news. Then they realized what Jesus had been telling them all along, and that He indeed conquered death and rose again on the third day as He promised. The ultimate proof of God’s faithfulness to us.

In my own roller coaster days, I have to know that whatever happens, Jesus died and rose again for our sin. He was dead, ultimate low. He was risen, ultimate high. Everything else I experience whether it be sorrows or joys should pale in comparison–not that our suffering here on earth matters little, but that our hope in Jesus is so great that we know we can survive these things and still always rejoice.

Thankful for Easter,

-ATP