Location: Ogden, Utah, United States

Monday, June 12, 2006

Let's try this again.....

This is Kathy, Lisa's mom, and I am doing an update for Lisa on her Blog.

Lisa has a few more days of journaling to add for the days not covered and will do so later.

Thursday, June 1st

Today, we would travel west to Cape Coast Castle and Kakum tropical rain forest. But before doing so, we have an appointment to meet with Dr. O.A. Duah at Martin Luther King Medical Center (MLKMC). This is the doctor who will work with us in Kumase to do our free patient clinic and screenings. When we got to MLKMC I think we were all a bit surprised to see the condition of this clinic, although it was consistent with most of the buildings in the area. It was a two-story building made of concrete walls painted white. Atop the building was the sign “Martin Luther King Medical Center”. To the left of the building was an addition that looked to be still under construction, lacking windows and doors. All of the buildings here are strictly made of cinder blocks and concrete. None are framed with wood as we see in the states.

As we entered this gated compound, we could see medical staff walking in and out of the clinic. They are always in pressed, bright white uniforms, the women always in a dress. I am amazed at how they keep their clothes so clean considering most of the roads throughout these areas are dark red dirt, and, because of so much rain, muddy. We waited in the lobby of the clinic for Dr. O.A. Duah. He is a very well educated man and has not only worked as a general physician, but has specialized in Oncology. He greeted us with open arms and excitement in his voice for our visit. He was anxious to show us his clinic and to introduce us to his very helpful and dedicated staff. We asked for permission to video tape and take pictures in his clinic and he was more than happy to allow it. We met with him briefly so he could introduce himself and what he is working on. Two of the main projects are the nursing school that will be in the unfinished area of the building and a project he is working on to develop telemedicine. This will allow him to have computers at more remote locations and via the internet, he will be able to see the patient, talk to the nurse assessing the patient and assist with diagnosis. This will be a great project because the need for medical aid in remote locations is vast. He spoke with enthusiasm and conviction about what he is doing. He obviously loves his work and the people in his community. He expressed difficulty in obtaining equipment such as computers to help this telemedicine to progress.

We look forward to meeting with him in Kumasi to do offer service to those in need.

After leaving the clinic, we started our long drive to Kakum National Park and Cape Coast Castle. The road to these places was unlike anything I had ever seen before. A great majority of our trip was on a dirt road, and not just any dirt road. The potholes in this road and the ruts were unbelievable!! We zigzagged back and forth across both sides of the road, avoiding holes that were a foot or more deep and some as wide as 3 feet. This slowed our travel greatly. I think it an additional 1 ½ hours to get to our location because of the road conditions. I can see why people loose the wheels off their cars when driving around this area. We saw cars with the hub of the axle on the ground and the wheel sitting off to the side. You would have to have a pretty tough car. Another thing we noticed, if your car breaks down – no matter what the problem is, you just set up shop and fix it in the middle of the road where it broke down. You can see several people working on one car, lying under it, working on it right where it stopped. I don’t think toe trucks exist.

On our drive to Kakum, we passed many villages with the poorest of the poor. They live in mud huts with elephant grass roofs. No plumbing, no running water, no electricity. Never the less, there always is a smile on the faces of those we meet. Money doesn’t buy happiness!!! This trip has certainly proven this to me. We are so blessed in the states. Even our poorest areas would be considered high society compared to the conditions we have experienced.

We arrived at Kakum and purchased our ticket. The tour guide led us through the rain forest up a steep path. The forest was thick with vegetation around us, the red mud was wet under our feet and the humidity was thicker than we have experienced thus far. After hiking up the path for 15 minutes or so, we reached the canopy where we will traverse through the treetops. We can only go one at a time. There is a rope bridge that spans from treetop to treetop. There are about 12” wide planks to walk on surrounded by rope netting. We are between 80 and 120 feet above the forest floor. The view is amazing and I am sure that pictures and even video will not do it justice. We are able to hear birds of all kinds around us. It is like the sounds of relaxation music we pay good money for. We each took a turn walking across each span. There were 6 in all. As we walked across the planks, the ropes swayed with each step. I loved it!!! What an experience.

After we had all made it across the bridges, we headed back down to the bus. On our way, we saw a millipede (red and you can touch it) and a centipede (tan and you can’t touch it). They were both about 5 inches long. Probably the biggest bugs I have seen in the wild. When we got back to the entrance, Eric asked if it had rained when we were in the forest because we were all soaked with sweat from the humidity and the water that condenses on the leaves and drops to the forest floor. Just as we were leaving, we saw the cutest monkey in the trees above our heads. We were all excited to get a picture of him and felt our wildlife experience in this location was complete.

We boarded the bus and headed toward Cape Coast. It is about 3:30 in the afternoon and the sun goes down by 6:00 so we needed to hurry. When we arrived, it was after 4:00 and they were closing. We were fortunate that one of the guides agreed to stay and take us for the tour. I was so grateful he agreed to do this for us. The history of this place is amazing. They estimate that about 20 million Africans were brought here and sold as slaves. Most were shipped to countries around the world and many died before even boarding a boat to be shipped. We were able to visit the dungeons where all of these people were kept while waiting to board a ship. They were held underground in dungeons. They kept nearly 1000 men and 500 women at any given time in these dungeons. They would have approx 250 men in a room about the size of the main floor of my house. In this room, there were only 3 small slits in the walls to let in light. They had gutters in the floor to drain the sewage out of the dungeon, but at the time these were completely full, the excrement would measure up to about 18” deep. People died every day in these dungeons. We also visited living quarters for the Governor and workers at the castle. There was a tunnel that led from the dungeons, under the castle and out to the harbor where the slaves that had survived living in the dungeons would be loaded on boats and shipped away. There was a church directly above the dungeons. This very much reminded me of my trip to Germany and the Concentration Camps that Jews were kept in. It was a place rich with history and I have certainly gained a greater appreciation for what the people of this country went through as they became slaves and were sold as property. I have learned a great deal today.

Our ride home was very long and in the dark. We left the castle quite late and had to travel the same road we had come. Once we made it home, we were all very exhausted and worn out. We had not had lunch because of trying to fit everything in today. Only the snacks we had on the bus. After eating, we presented George (our driver) with a gift and a tip. We prepared a bag with a few postcards from Utah along with some Candy for his children, some earrings and perfume samples for his wife and a picture of our group. We also included a tip for him as well. I hope it was generous enough. Later, we headed to bed to prepare for Friday. We will be traveling to Jamestown (a shantytown), one of the poorest areas of Accra. I had met a woman in the African market on Wednesday from England who is working in the village with a pastor. He has a school and is developing an orphanage and a clinic. I am excited to see the work they are doing.

Friday, June 2nd

Today we had planned to sleep in a little longer than usual. But just like clockwork, I was up at 6:00am, just as I have been every morning this trip. I spent some time journaling and getting cleaned up before everyone else was going. I headed downstairs to buy some more water. We can only drink bottled water and with the amount we sweat out each day, we are drinking several liters/day. When I reached the bottom of the stairs, I noticed that George (from the radio station) was sitting at the table on the patio. He was excited to see me and thought I was still asleep because of our late night. He had driven all the way out to our guesthouse (approx 45 minutes drive from the radio station) to bring me a cell phone that I can use in Ghana. It has prepaid minutes on it and he wanted me to be available for radio interviews. We spoke for some time about our experience thus far. He asked if I would please be available at 12:00 noon and 3:00pm for a telephone interview live on the radio. I agreed.

After our visit, we prepared for our drive to Jamestown. It is near the ocean and will take us about an hour to get there. To our surprise, George (our driver) is back to take us to town. We thought last night was our last night with him. It is great to know he will be taking us around. He knows this place like the back of his hand. It is amazing the roads he can zigzag through to get us where we need to go. The driving here is nothing like the states. I don’t know that I would like driving here and I am a pretty confident driver. George took a moment before we left for Jamestown to tell us that he appreciated our gifts, as did his wife. He was very grateful.

We made the drive to Jamestown and it took a couple of times asking for directions to locate the school that we wanted to visit. It is called New Life Academy. We finally found the location and parked outside. Eric (our guard) jumped from the car to locate the person we had spoken to on Wednesday. Her name is Jo and she is one of a group of people who travel to this area once or twice a year to assist the Pastor of the church with his work and his school. Jo came to greet us and mentioned that the students were still working on their lessons, which would give us time to tour the living areas in this community. She called for 2 other workers from the school, male residents of Jamestown, to follow along with us. It was apparent that she would be uncomfortable walking through without additional protection along for the walk. We also took Eric with us. As we began our walk through, many of the areas looked like those we had seen before. We walked deeper into the living areas and the smell slowly changed to that of open sewer and rotting garbage. While we walked, we were greeted, every few moments by children. They would run up to us, stopping a few steps away, then some would stare, some would say “How are you today?”, some would simply say hello, some would just smile and run away from us.

It was humbling to see such impoverished conditions! But, this area was not without laughter, smiles and welcoming greetings. We walked down narrow alleyways, ducking under clotheslines, dodging piles of trash and buckets of waste. Throughout this area, there were little gutter type things that ran throughout the community, they are most often down the center of the walkways. They make up what appears to be a drainage system. This is where they can dump their waste. I asked where it goes and the response is that it goes out to the sea.
This area is heavily populated, a person in every doorway and every alleyway. Most of the homes are made of cinder block or mud. Some of the homes are merely 2 walls with a roof and one support beam on the 4th corner. As we walked through, I felt as though we were on parade. I wonder if the people of Jamestown felt the same way.

I think everyone should, once in their life time, have the opportunity to visit a location such as this. Although at home in the US, we often see areas such as these on the television, please believe me when I say that the television in no way gives it justice! As I watched my boys walk through this area and be approached by children, I could see that their hearts went out to them. I look forward to seeing what they write in their journals about this experience.

We stopped and talked to many of the people and occasionally asked if we could take their picture. Before this tour, we were informed that we should have our cameras and video equipment put away. Only if permission was granted, should we take pictures or video. We were lucky to be granted this chance a few times during our trip through. Many of the children were in tattered clothing, some obviously too small. Some of them had no clothing at all. As I mentioned before, despite the extreme poverty, the people always returned our smiles and welcomed our greetings.

After we finished the tour of the community, we returned to the school. The children had finished their lessons and were preparing for an afternoon party. Before we entered the building, we were briefed on the goals of the Pastor and what to expect from the children. In this schoolhouse, which consists of one large gymnasium type room and 2 smaller ones, they had over 300 students. This included 90 nursery children of the age of 2-4 years old with only 2-3 teachers to work with them. Also, we learned that many of these children are orphans and the Pastor would often take 10 children home with him and allow them to sleep in his parlor, the rest of the homeless children sleep at the school. It is their home until an orphanage is built. In order for these children to receive medical care, they need to be registered under a parent’s name. The Pastor of this church took it upon himself to register every one of the over 300 students as his own children for the purpose of getting them health care. Unfortunately, we weren’t able to meet him.

As we walked into the schoolhouse, we were greeted with looks of wonder, surprise, and excitement. We walked through the first classroom into a much larger one where most of the children were. Slowly, we divided ourselves and wandered around this room, swarming with children. We towered over them not only because of their age, but their size for the age they were. Malnutrition has taken it’s toll on their growth. Many of the children that were the same as my boys (12 and 14) appeared to be much younger, maybe 8 years old. They were all in blue and white uniforms, the girls in dresses and the boys in pants. As we started taking pictures of the shear number of children in this room, they became very excited. Every child wanted their picture taken, repeatedly. They would crowd around at your legs and look straight up to you and say “picture… picture… picture”. Many of us had digital cameras and would take the picture, then turn the camera around and show them the picture of themselves. This must have seemed like magic to them. They were so anxious to have their pictures taken, it was difficult to have them stand back far enough so you could fit them all in. I noticed a bulletin board covered with brightly colored fish that they must have made during a craft activity. I asked if they could show me which fish was theirs. They ran to the wall and feverishly searched for their fish to point out. I took pictures of them proudly pointing out their work. But, as soon as I had snapped the picture, they would run up to me, wanting to see the picture on the screen of the camera. It was thrilling to interact with these children. After seeing the conditions they live in, some with parents, some without, this school was a safe haven for them. I can see why the people from England are so dedicated to working with this population of children. Although they have done great work and have been able to mark their progress, the work is slow and resources are difficult to find. I plan to bring some of our school supplies back to this school once the container arrives.

As I looked around the room, it was a sea of these beautiful black children with the tall, very white members of our group. Even with the destitute conditions of these children, at that moment, I couldn’t have imagined a happier place or one that was filled with as much love. It was truly moving.

When it neared 3:00 I slipped out the front door with Eric our guard. I needed to be on the bus when I received a phone call from the radio station for an interview. I had a few minutes and thought I should use the restroom before the interview started. I asked Eric to see if there was one close. He stepped next door and asked a young lady if there was a restroom I could use. She hesitated and looked at me, I am sure wondering if I knew what I was asking for. She then took both of us down an alley lined with clothes hanging out to dry. We came to an area that opened up slightly where there was an older woman sitting on her chair. The young lady spoke to her in Twi and asked if I could use their bathroom. She gave me the same look as the young lady had. Eric explained that what ever they had was fine. The young lady walked past me, a few steps further down the alley. She moved a wooden door that looked as if it were a 100 year old piece of fencing. She disappeared behind a short wall with no roof. After a moment, she reappeared and motioned for me. This was where I would use the bathroom. I stepped into what was similar to the size of a small changing room. It was an addition outside of a building that had 3 walls, allowing for a narrow entrance. I stepped inside and Eric helped move the door into place. It was just propped up, no hinges. I turned around and noticed a bench of concrete with a blue bowl sitting atop it. This was to be my toilet. I then understood what it means not to have indoor plumbing. I was humbled to think that these kind women had offered all they had, just to help me. After I finished, I kindly thanked them for their generosity and gave the older woman 10,000 cedi (approx $1.00 US money). What an experience. We are so blessed!!! I will never forget my visit to Jamestown, Accra.

I returned to the bus and located the radio station so I could be ready when they called. My head was not clear and I didn’t know how I could do this interview following how I spent the last 2 hours. I settled down and waited for the call. Promptly at 3:00pm, the radio station called and placed me on hold. Shortly, a woman came on. She was the news broadcaster. She prefaced my interview and had introduced our group. She then asked about our experiences thus far this trip. I spoke of the beauty of the land and the kindness of the people. I told her of our tour of Korle Bu Newborn Intensive Care Unit and my admiration for the medical staff there. I also mentioned our visit to Martin Luther King Medical Center and the great work Dr. Duah is doing there. She then asked me about my thoughts regarding the physicians that are presently on strike in Ghana. I answered, stating that I didn’t feel I had enough information to speak to that topic. But I knew that this country is in great need of trained medical professionals and that we were here for the purpose of not only learning from the medical workers here, but to provide training in hospitals and clinics that may allow them to educate future staff and provide improved patient care.

Overall, I felt it went very well. I was surprised my tongue wasn’t tied in knots. After the interview, everyone else had boarded the bus and we traveled to the internet café to catch up on our e-mails, etc. It seems as though 1 hour just isn’t enough, but we have so much to do that time is precious. At home, I have wireless internet. It is amazing how much I have learned that I, and we as a society, take for granted.

We finished up at the internet café and made our way to exchange money. Tonight we have to pay for the bus rental and the guesthouse bill, so we all exchanged a bit more than we would have normally done. We made a stop by the grocery store to pick up some snacks for the long ride to Kumasi tomorrow. It will take about 3-4 hours, which will mostly likely mean 5-6 hours. I have come to expect that things are not done on a tight schedule here and for many of us, that is difficult to swallow. We are used to such a rush, rush society. Even though I was told that things are simpler here and more relaxed, I couldn’t have imagined it would be like this.

Before dinner, I received a telephone call from George (from the radio station). He was so excited about the interview from 3:00pm today. He said it was like a tornado after the interview finished. People were calling and asking questions, wondering where Weber State University was, and most of all wanting to say thank you for speaking so highly of their nursing staff. He said that there were 5 calls alone from nurses from Korle Bu that were listening and happy to hear my comments. He then said he had a nurse with him that wanted to talk to me. He put her on and we briefly spoke. She said thank you for recognizing all that they do in the NICU at their hospital and for the comments of support and admiration. It was such a pleasure to speak to her. Although I was the one interviewed, I know in my heart I spoke for the group of us regarding our impressions. We are supposed to do more interviews such as this once we reach Kumasi.

For dinner tonight, we were brought Fufu, a traditional meal that people here may eat nearly every day. We had tried it before and were excited to have it for dinner. After dinner it was time to collect the money for the bus and the room and food. The totals were as follows:

Bus rental: 5,300,000 cedi
Room rental: 5,800,000 cedi
Food/drinks: 1,085,000 cedi

After calculating, I collected 1,120,000 cedi from each person. With most of the bills being 10,000, you can imagine what the stacks of money looked like. We had over 12,000,000 once it was all collected. We laid it all out on the bed and took pictures of it, then a couple of us took turns holding all of it. Although 1,085,000 sounds like a lot per person, it translated to about $113.00 in US dollars.

Please keep in mind this was from Sunday night until Saturday morning (6 nights, a bus that drove us from dawn till dusk and breakfast each morning). It is easy to spend this amount on just one night’s stay at a hotel back home. I think it was a great deal.

Saturday, June 3rd

Today we will travel to Kumasi
Visit from George from Top Radio
Travel on Government bus – public transportation
Problem with the bus, - but George ends up taking us to Kumasi himself.
Flat tire on the way, stop for some food
Arrive in Kumasi and Aninwah Medical Center
Room assignments,
Getting settled – obviously, they have purchased new items for our use. We finally have an air-conditioned room.
Church in the a.m.

Sunday, June 4th

Church at the LDS ward
Everyone is in church of some sort or another
Shopping for groceries
Cooking spaghetti, beans and bread
Laura made crepes – amazing
Most everyone took a nap except Laura and myself
Meeting with Hospital Administrator
Dinner – crepes
Plans for the week – education schedule

Monday, June 5th

Meet Koffe for a tour
Call from Dr. Tuffour – Ohio
Begin tour of hospital
Lunch at the cafeteria – spaghetti with spicy meat sauce
Drive to St. Patrick’s Hospital
It seems like we are always told the drive will take about 45 min, I think this translates into 2 ½ hours in Twi.

Presented our profession – CPR

The drive back to kumasi, stopping for a roadblock, buying ice water from the gas station
Call from Koffe for dinner –
Yams and something else to dipping

Tuesday, June 6th
This morning I am sending some of the students along with AMC’s (Aninwah Medical Center’s) outreach program and a couple of them to a outlying clinic called Magazine (different accent in pernouncing this word than at home). Kira and Lou will go to the outreach and Kallie and Rosey will go to the Magazine clinic. I feel pretty comfortable sending them because they will be with nursing staff from AMC. I do, however, always have some sort of concern, knowing they are not close by. I am sure they will be fine. They have packed their packs with water and snacks and are ready to go. The remaining 3 students will stay at AMC and shadow staff for the morning (Laura, Susan and Melanie). After getting the ones sent to remote locations, I took the other three in to find the Matron (head or charge nurse). She will get them situated. As we walked in, the Matron said there was a c-section being performed in the theater (operating room) and asked if we wanted to attend. What a great opportunity! Laura, Melanie and I decided to attend and Susan reported to the Out Patient Clinic within the hospital.
The three of us entered the theater scrub room and were instructed to change our clothes into other scrubs. We then placed on other shoes, hairnets and masks, then we scrubbed-in. As we entered the operating room, there was the surgeon, a nurse to assist the surgeon, an anesthesiologist, a tech and the patient. We timidly approached them and asked where we should stand. Since I have experience with resuscitating infants, I asked that when the baby comes, could I please watch the resuscitation. They said that would be fine. The woman on the OR table was still awake and only slightly covered with a sheet. Right away, they removed her sheet and began to prep her abdomen. The anesthesiologist said they would wait until right before they would cut to give her medication to put her to sleep. They would use a general anesthetic instead of the epidural we are accustomed to. This would prevent too much of the medication from passing the placental barrier and affecting the infant.
She was prepped and the anesthesiologist gave the patient sedation and a paralytic. He then placed a mask over her face to give her oxygen. Once she was asleep, she intubated the patient. The steps he followed were similar to those I teach my students, but it was not a sterile procedure. There was an anesthesia ventilator next to the head of the patient that would be used once he had secured an airway for her. As I glanced down, I could see in the bottom drawer many endotracheal tubes, none of which were in packaging. I am sure these are reused here, but even so, I would expect that they would be cleaned and packaged some how to keep them sterile for the next patient. The anesthesiologist used a 6.5 ETT to intubate this patient (small for the size of the woman), I would have recommended an 8.0. His skills were good and the tube went in smoothly. I kind of found myself on autopilot. I guess after assisting with and intubating patients at home, I did the same thing here. I looked for the 10cc syringe and inflated the cuff as soon as the tube was placed, then removed the stylette and placed the bag on the end of the ETT to check tube placement. As I bagged her, the anesthesiologist listened for breath sounds. The tube was in place. I was also amazed that he just dropped the tube once it was placed and attached to the vent circuit, before the tube was secured in place. At home, I don’t let go of the tube until I am sure it is taped and tied into place. He didn’t seem worried.
The surgeon began the c-section and it progressed rather as I have seen before. I continued bagging the patient. I am not sure what they do with the anesthesia ventilator. We only used it for flow and oxygen, bagging the patient manually with the reservoir bag. After a few minutes, the surgeon looked over me and told me to get gloves on. He said the baby was coming. The tech quickly ran me a set of gloves and said I would be the one to catch the baby once it was delivered. This not only shocked but amazed me. At home, there are such regulations on who (outsiders or visitors) is allowed in the hospital to shadow staff, let alone the operating room and to think I would be allowed to participate in the resuscitation was mind-boggling. Suddenly I felt very nervous. I was out of my element and knew that I didn’t know if I would have the same tools available to me as I would at home to perform this resuscitation.
I quickly gloved and looked for some sort of a blanket to catch the baby with. I had to hurry. I grabbed a 3’ x 3’ piece of green cloth from where the surgical instruments were laid and made my way around the bed next to the surgeon. Just as I stepped up to the bed, the baby was out. They cut the cord and passed the baby into my arms. She wasn’t crying and was obviously depressed (possibly from the medications given to mom). I turned quickly and asked where I should lay the infant to work on her. The tech directed me to what looked like a bedside table from a hospital room. You know the kind you can adjust the height and place over the bed for a patient to use? It was long and narrow, too narrow to lay the baby across. I had to place the baby lengthwise to fit her on the table. There was already one blanket there. (these blankets are like the material scrubs are made of, not very absorbent or soft) After positioning the neonate, I began the resuscitation. Warm, dry and stimulate came to mind. At home, I would have placed a baby under an open warmer to work on it. Here, we were directly under an air conditioner. I began vigorously cleaning the infant off. After removing the first blanket, I used the one that was on the table and called for others. The baby had an APGAR of 3. She had a good heart rate and a slight respiratory effort. Other than that, her color was poor, she had no muscle tone and no grimace. I could feel her chest in my hands as I dried her off that she needed to be suctioned out and we needed to get her to take some deep breaths. Because she was a c-section, she didn’t benefit from passing through the birth canal and having the fetal lung fluid squeezed from her lungs. I asked for suction and the tech brought over a delee that was powered by oral suction. The tech put one end of the delee in his mouth and the catheter end in the baby’s nose and mouth, suctioning her with his own breath. There is a trap between the mouthpiece and the catheter where all of the suctioned secretions remain. After suctioning her, I continued to stimulate her. She was very floppy and still had poor respiratory effort. Because of her poor effort, she was not filling her lungs, expanding them as she could. I asked for oxygen and a bag and mask. I was handed oxygen that was coming from a cylinder next to the table. I held the end of the oxygen tubing, cupping my hand to form a reservoir for the baby. She still didn’t improve her color so I gave her a few positive pressure breaths. While bagging her, she had good chest movement but still sounded wet. We suctioned her again, stimulated her further and applied oxygen. Finally she began to wake up a little more. She was pinking up and her tone was from a 0 to a 1. Once she was stabilized with an APGAR of 7, we wrapped her and carried her to another room where we cleaned her up and dressed her.
It was interesting to participate in this because it gave insight into how things are done here. We entered a room where there was an overnight bag. The nurse got into the bag and removed a plastic bag that contained baby oil, baby soap and many other items to care for an infant, even diapers. It was obvious that it was entirely up to the mother to bring all of the supplies to care for her baby once she was born. This is much different from what we are all used to in the states. Everyday, we experience many things that are so unaccustomed to. It is all a great learning experience.
Following my time at the hospital, I left for an interview at a local radio station (Solid FM 103.7). Casey and the boys went with me and Akohene (AMC Administrator) drove us. We met Albert at the radio station which was located in downtown Kumasi. It was a very busy place, more people that I have seen in one location in this city. The streets were bustling with people selling everything. We really stuck out (we are very, very white compared to the dark skin of the people here). The interview went very well. We talked about why we are here, the hospitals we have visited and our impressions of the country and the people.
The interview started much later than what was planned. We arrived at 11:20 and they didn’t want to start the interview until 12:30pm. This posed a problem since we were supposed to leave from AMC to travel to St. Patrick’s hospital by 12:00 noon. It became obvious that this was not possible. I have learned that there is absolutely nothing I can do to alter how time is kept here. We have lovingly titled it “Ghana Time”. It takes hours to get anywhere and nobody seems to mind, much different mentality than back home. I think it has done us all a bit of good to let things slide and not worry so much. I think all of our blood pressures have dropped considerably.
We finished the interview, traveled back to AMC and loaded up in the van for the trip to St. Patrick’s. Once again, we were not going to be on time. It was 2:30 and we were supposed to be there by 2:00, and we still had an hour and a half to drive. The drive to St. Patrick’s is 90% on a dirt road that is full giant pot holes and covered with washboard areas and ruts from the rain runoff. We can’t drive very fast and are usually somewhat carsick once we arrive. But, none-the-less, we make the drive to and from each day. We arrived promptly at about 4:00pm. We all felt horrible for being so late. As we walked in, we apologized for our delay and quickly began teaching.
Today, we reviewed CPR

Go to radio station
Interview with Albert (Mr. Oklahoma)
Late for trip to St. Patrick’s
We arrive at St. Patrick’s
They don’t mind waiting – no complaining
CPR had been practiced
Brief review of CPR
Introduction of Infection Control and Prevention
Demonstration of hand washing
Use of antiseptic alcohol rub
Difficulty scheduling time with both hospitals
I think we should send a vent to St. Patrick’s
Need money – Casey, Albert and Little Casey go for money while we go to St. Patrick’s
Stop at the supermarket – much less than a market
We come home to make dinner with whatever we have in the kitchen – Rice, sautéed onions in cream of chicken and creamy onion soup – Mango and banana fruit salad – bread
Work on Mech Vent presentation
Need to confirm that St. Patrick’s gets a vent
Looking forward to internet tomorrow after our visit to St. Patrick’s

Wednesday, June 7th

Thursday, June 8th

Friday, June 9th

Saturday, June 10th

This morning we got up around 6:00am to prepare for our safari. We loaded our backpacks with water and got the cameras ready. We all gathered at the building where the tours leave from. There were about 25 other people already waiting when we showed up. I thought we were going to go with this large group and wondered how we would be quite in such a large group. After a few moments our tour guide from yesterday came out. He took our group aside with two others who had been with us yesterday. We began our tour in the area around the motel and saw many different animals. We see wild boars frequently and they don’t seem the slightest bit afraid of us. As we walked further we came to an area that looked like a dump. There were several baboons and more boars. It was near a place that looked like single level apartments, most likely one-room apartments. There were many women outside doing laundry in buckets, as we see everyday. I have learned that about 90% of all people in Ghana do their laundry by hand in a bucket. This is amazing to me, but their clothes remain white and the colors bright.

We walked past the apartments and came around a corner to see an elephant standing near an SUV. We were all so amazed. We were within about 20 feet of this giant wild creature. It was beautiful. The elephant didn’t seem in the least bit irritated by our presence. He stood calmly and ate grass and shrubs that were around it. We took many pictures and all stood there with our mouths wide open. It was amazing to see an elephant in the wild – not in a cage, not in a circus, and not one that has been raised in captivity. It was breathtaking!

We continued our safari to find more elephants. We walked down a path toward the lowlands of this area. This is a place where the water holes are. We hoped to find elephants there. Along the way, we were able to see more of the animals we saw yesterday, antelope, water bucks, boars, and occasionally monkeys. We came to the first water hole where there was a large structure built as a lookout. We climbed up and sat for a while watching the waterhole. After about 10 minutes of not seeing anything, our guide took us to another waterhole. As we approached the waterhole through the trees, we could see what appeared from a distance, to be large black rocks in the middle of the water. As we got closer, it was apparent that they were not rocks, but a herd of elephants. We moved closer, struggling to walk through the muddy area that was their path to the waterhole. It was lined with huge holes, footprints from the elephants. Each of the footprints was filled with murky water. As we approached, the elephants circled themselves with their back ends together, looking out in a circle. They raised their trunks, blowing water over their backs. Again, we were very close to them. It was like being in a National Geographic Documentary. I don’t think I can even explain the feelings we all had, being so close to such grand animals.

After a short time, they began to move and made their way past us and out of the water. The moved slowly, keeping their eyes on us as they passed. The guide told us to keep our distance, because when elephants leave the water, it is difficult to determine where they will head. He said we didn’t want to cross their paths because they may want to scare us. With as close as we were, it wouldn’t be hard. They walked out of the water and into the trees. After cooling off in the water, they brushed themselves up against trees and shrubs and threw dirt on their backs. A couple of them laid down on their bellies and rolled around on the ground to scratch. WOW! All I can say is WOW!!! This is worth the trip. I would drive twice as far in a smaller van and pay 10 times as much to see this again.

While we watched them in the trees, we tried to position ourselves where we could see them for video and pictures. Everyone wanted to get themselves in a picture with the elephants in the background. For a moment, our excitement took over and we found ourselves closer and closer to the elephants. The guide got a little nervous and stood out in front with his gun, directing us to back up. We did and noticed that the elephants had stopped their scratching and they were staring at us, not even moving. It was a little disturbing. We were within about 20 feet of them and the look they were giving us and their paralyzed stance clearly stated that we needed to back up and leave them alone. We retreated and gave them what they wanted. We were, however, in their back yard. They deserved our respect!

We made our way back through the trees toward the path that would lead us out of the lowland. As we approached, we could see in the distance, coming down the hill, a large elephant. He was on the path we needed to use to reach our motel. We walked closer, paused, he came down further, we walked closer and paused once again, he also made his way further down the hill. Finally, he took a different route, leaving the trail open for us. Yet another experience I will never forget.

Everyone is going swimming now and I am sitting at the outdoor restaurant. From this area, you can see the waterhole with elephants playing in it. The scenery is beautiful. I can’t believe we are deep in the jungle of Africa, searching out wild animals and soaking in all of the beauty around us. Never in my dreams did I think I would do something like this and here I am!!! I hope my kids remember this to tell their children. I am so happy I could bring them with me, along with my husband. I can’t imagine trying to share all of this with them, had they not been able to travel here with me.
This afternoon, we made a trip into the village just outside of Mole National Park. A young man had been hitting Casey up to allow him to give us a tour of a mosque from his village. He sounded quite knowledgeable and we decided to take the tour. We traveled in the bus with 3 other people we met here. We stopped at a place called the Mystic Stone. It was a historical place for this village, dating back to the early 1400’s. After we saw the stone, we went to the mosque. The chief of the village sat out by the road, reading what to appeared to be an ancient Muslim book. We stopped and shook his hand before walking back to the mosque. It was a very strange shape. (It reminded me of something out of the Land of Point by Nilsson.) The doors were nearly 4 feet tall, requiring you to bow as you enter, showing respect to Allah. We were surrounded by village children, most of which were only in what appeared to be underwear. We made a donation to the community (a dollar or so each) and paid for our tour (also a dollar). On our way out, I stopped and gave the chief 20,000 cedi (about 2 dollars) so I could take his picture. I asked how old he was and the guide said he was 110 years old. He looked that old, very frail and thin.
When we got back to the motel, it was time to swim. Everyone hopped in the pool, since none of us had a swimming suit, we wore whatever we had, some in their clothes, some in less. It felt so good. The water was kind of warm because of the heat from the day. We spent about 2 hours in the pool. We even got Richard, our driver, in the pool. We didn’t know that he had never learned to swim. It was fun to see all of the girls trying to teach him to swim. Eventually, we found a life jacket and then he could swim all over and not be worried. I think he had a great time. One of the other groups of people we met here said their driver slept in their van. We got Richard a room, bought his meals and tried to include him in our activities. He is a very nice guy and we have had a great time getting to know him.


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