5/21-5/24 - Elubo Outreaches

Casey, Lindsay, Matt, Jamison and I have had a great week in the Western region around the city of Elubo, where we have been doing some huge outreaches. We got to the Super Gardens Hotel late Sunday night. We had fun figuring out how to shut a bathroom door that doesn’t stay shut, but does lock from the outside.

On Monday we went to Tarkwa and saw about 325 patients in one day. Ernest, the optometrist with us, has discovered my love of Microsoft Excel and relatively fast typing speed and has me covering data entry at every outreach while we’re in the Elubo area. Although I love giving visual acuity exams, I still get to see some patients while entering data and also really do love Excel, so I can’t complain too much. When the volunteers introduced ourselves to the crowd of community members at the beginning of the day, I got a great laugh out of my “ma chay” (“Good morning”). The Ghanaians really love to hear obronis (white people) speaking Twi. I generally get a light chuckle from anyone who I tell “thank you” in Twi.
On Tuesday, our outreach was in Ichaban, only a 25 minute drive from the hotel. It was definitely my shortest drive to an outreach yet. It was also extremely hot and humid! The weather has been a little more manageable with the help of rain coming more often, but today was an exception. I took a break from data entry to do some visual acuity exams outside in the sun for about 30 minutes and my shirt was drenched in sweat. We did, however, see over 300 patients again, so all the sweating was definitely worth it. On the way back from the outreach, we stopped at a chop bar that has great fufu and Matt, Lindsay, and I got our first tastes. Fufu is very similar to banku – a very doughy, starchy ball that is eaten with stew. We got an extra bonus because we ordered ours with goat meat. Fufu is not my favorite, but I did really enjoy the goat!

Wednesday we had another short outreach to Kwesi. The church where the outreach took place was enclosed in a large gate, which helped everything stay better organized, but also really eliminated any hint of a breeze. The people in this area were extremely nice, except when the line to see the doctors got too long. At that point, a fairly loud and aggressive argument broke out every time a new patient went to the doctor, as everyone shifted chairs to the next available seat. Ghanaians generally have little sense of queues, but when one does form, as happens during our screenings, they take it very seriously. A highlight of my day was sending my first “small girl” on an errand. Ghanaian adults often have children who are within shouting vicinity run errands for them, like getting change for larger bills or buying them a bag of water. These errands usually begin by the adult beckoning “small girl!” or “small boy!” During a short break after doing visual acuity screenings, I saw a girl who looked about 13 years old sitting nearby and called her over to go out to the street to buy Fan Choco’s (very delicious frozen chocolate milk) for the volunteers. It was very satisfying to not only send my first small child on an errand, but also to enjoy a cold Fan Choco on a hot afternoon!

Thursday, our screening took place in Agona. The church where the outreach took place was very small, so visual acuity screenings took place with the eye charts attached to the Crystal Eye Clinic van. There also was no space for me to do data entry near the medication/eyeglasses dispersion table, so I found a little landing on the stairs up to the church’s balcony and set up data entry camp there for the day. Toward the end of the day, a couple of 10-year old named Obed and Buesba started hanging around my chair. I talked to them for a while and they decided they wanted to help me, so they would go outside to pick up patient’s slips from medication dispersion and bring them to me to enter into the computer – so helpful!

We ended up seeing about 1200 patients in 4 days in the Elubo region with 80 referrals for surgery. The week was not the most glamorous, but it was really rewarding!

5/18-5/20 - Extended Weekend

I was very fortunate to have both Friday and Saturday off from Unite For Sight. On Friday, the Crystal Eye Clinic, the staff of which has been leading our outreaches, had a meeting with local community volunteers and then I was not scheduled for a Saturday outreach.

On Friday, the Nicoles & I went to the Accra Mall. It is an extremely nice mall and it really felt like I was temporarily transported back to the U.S. We didn’t buy too much except a few groceries, but we did eat at the food court. The pizza and ice cream were both extremely satisfying. We also saw a movie (The Lorax) at the mall’s movie theater. The theater was equally as plush as the rest of the mall. On our way out, I got one of my biggest surprises in Ghana so far – running into someone I know! I saw Clementine, a friend from the University of Michigan, who is in Accra for the summer, working on her MPH internship with the University of Ghana Medical School. I knew Clementine was in Accra and had actually made tentative plans to meet up with her on Saturday, but it was still extremely coincidental to see her at the mall! Friday night was the last night with our original core group of volunteers, so we went out to an Italian restaurant. Nicole, Matt and I tried ordering on of the “specials”, gnocchi, which turned out to just be small shell-shaped pasta in a boring marinara sauce…what a waste of 20 cedi!

On Saturday, Matt & Laura were departing for Kumasi for outreaches and the rest of the volunteers were scheduled to go on an outreach with the Northwestern Eye Clinic, but I had the day off, so I planned to meet with a couple friends who are also in Ghana for the summer. Clementine, who I had run into the day before, brought 4 other volunteers with her program and Jen, a friend from Yale School of Public Health, also brought another volunteer from her internship program in Kasoa (about 45 minutes outside of Accra). We met at the Labadi Beach Hotel, which was a really fancy hotel, even by U.S. standards. I devoured the bacon cheeseburger and fries (below) that I ordered, knowing full well that I may never see another one while I am in Ghana. It was great meeting many other volunteers and hearing about their summer projects. After lunch Clementine, Jen, and Jen’s friend, Amanda (I think her name was Amanda?) and I trekked to the National Museum, excited to see their exhibit on malaria. Unfortunately, the museum closed right as we arrived, so we just headed toward the Circle and walked around. The Circle is a stop for tro-tros (vans that drives around/between cities and has routes similar to a city bus), but it was pretty hard to get around the area because heavy rain and wind earlier that day had knocked over many trees, signs, and billboards. After walking for about an hour, we parted ways. I went back to the Telecentre, met a few Unite For Sight volunteers who had arrived back in Accra from a couple weeks in Kumasi and our group went to a chop bar to watch soccer projected on a huge screen. I have never seen the chop bar so crowded! Bayern was playing Chelsea for the World Club Championship (I think…?).  Casey, one of the volunteers who had come from Kumasi that day, is an avid Chelsea fan and helped clue in the rest of us on how the season had gone so far. Regular game time ended with 1-1, so extra time was played and eventually the game came down to penalty kicks. Chelsea ended up winning and the whole street went insane. People were running around, singing, dancing, tearing off their shirts, jumping on cars, taking pictures with us, waving flags…just a ridiculous scene! It was really fun to experience the night!

Sunday morning I got up bright and early to go to church. I went with a couple that lives next door to the Telecentre. The husband is a teacher and the wife works at a bank. They were both extremely nice and we drove to church at 6:30 AM (with their 11-month old son). Mass was surprisingly similar to the U.S. The church was extremely beautiful with many stained glass windows. Mass was all in English and I felt very comfortable participating in nearly all aspects. A few things were slightly different. Offertory took place by each member walking up to the altar and placing money in a collection bin…and there were also two offertories, one at the time I expected and another at the end of mass. Mass also “ends” with a lecture-type presentation by the priest. This Sunday, the priest talked for about an hour on the different kinds of prayer and had time for questions from parishioners at the end. All in all, the service took about 2.5 hours, but we were done at 9 AM because it started so early!

Later on Sunday, we met two new volunteers, Lindsay and Matt. Jamison and I took them around Achimota to the ATM and to get phone cards. It’s incredible to think that 10 days ago, someone had to show me around! Later that afternoon, Lindsay, Matt, Jamison, Casey and I packed our bags and headed to the Takoradi in the Western Region, where we’ll be spending 5 days doing outreaches in this area.

First week of outreaches

This week has been pretty busy with an outreach each day! My "outreach team" for the week has been both Nicoles, and Alex and we had a really great time traveling to four communities in the Eastern and Volta regions of Ghana.

On Monday we went to Asubone Rails, where the outreach took place in a church. The trip was pretty long (about 3 hours each way) and it rained on the way back - which was great because there was way less dust! Ernest, an optometrist with Unite For Sight, kept us pretty entertained on the way back with lots of singing. We got a little taste of Ghanaian pop music.

Tuesday, Wednesday, and Thursday were pretty similar - though not quite as much rain. Pretty long drives to Bleamazado, Krobo Odumase, and Dagbamate, and all really great times. I've become pretty great at sleeping in a car that continuously goes over speed bumps. I also finished Michael Pollan's In Defense of Food. I think I'll be getting a ton of reading done here!

Tuesday was especially great because I got to start interviewing participants for my research project. Only 4 participants from last year showed up to the screening, so I didn't do too many, but the 4 I did conduct went pretty well, I think!

5/12-5/13 - Weekend off!

We were very fortunate to have this whole weekend off – our outreach got canceled on Saturday and no one leaves Accra for longer-distance outreaches this week, so Sunday was free too! Saturday morning involved our first taxi ride. We decided to go to the central market in Accra to explore the city a little more. We had a group of 6. I was hoping we could go “Cameroon style” (fit as many people in the cab as possible)…but the cab driver in our first cab was not playing that game, so we split into 2 cabs. My cab was me, Matt, and Laura and we made it to the central market after a long, hot, traffic-filled 45 minute cab ride. We looked around for the others for a short while, but gave up after about 10 minutes and just walked around on our own.

The central market was two things: hot and crowded – crowded not just with many people, but with many things. There was stuff everywhere – mostly cheaply made shoes, trinkets, clothes, and kitchen utensils, but also local “fresh” foods (“Fresh” in quotations because most of it was effectively cooking under the blazing equatorial sun). The fish stench was especially pungent. After a couple hours in the market, we headed back to the guest house to get break from the heat in some air conditioning. Upon arriving, we discovered that the rest of our group never made it to the market, but were stuck in cabs for 2 hours trying to just get to the market, before giving up and heading home.

Sunday was much more eventful. We all took a 3 hour van ride to Cape Coast. Our first stop was Kakum National Park, which is referred to as a rainforest, although it technically is somewhere between a moist evergreen forest and a semi-deciduous forest. We took a short hike through the forest and then went walking through the canopy on rope bridges! It was absolutely beautiful and full of tons of greenery all around.

We stopped for lunch at a hotel that had a restaurant on an island in the center of a pond and the pond was full of…crocodiles. Some of us took turns touching the crocodiles…their skin is much softer than I was expecting. We finished the day at the Cape Coast slave castle. Cape Coast was one of the largest pick-up points during the slave trade and the castle is where slave traders stayed (while the slaves stayed in the dungeons below the castle). It’s crazy to think that the castle is about as old as our entire country and was also really devastating to hear about the horrible lives the men and women who lived in the dungeons – and life didn’t get much better once they left. Cape Coast was a really friendly, vibrant beach town so the castle was really juxtaposed in its place there.

Arrival + First Unite For Sight Outreach

After a long, but uneventful flight to Accra, I arrived in Kotoka airport just before noon on Thursday, June 10th. Getting through customs was really easy and I quickly found the driver with Unite For Sight waiting for me at the airport. I expected the arrival to be similar to my arrival in Cameroon a few years back – extremely hot, crowded, overwhelming, and, honestly, pretty scary. On the contrary, the arrival in Accra was actually pretty pleasant, albeit still very hot. Several other Unite For Sight volunteers ended up being on my flight, including two undergraduates and an ophthalmologist traveling with her son.

We enjoyed a short drive to the Telecentre Guest House, where we got our rooms. I’m rooming with another volunteer, Matt, who just finished his junior year at Duke. The Telecentre works pretty well for accommodations – each room has a bathroom and shower and our room has a great balcony/porch. The Telecentre should also have Internet, but it has been down and/or spotty pretty much since we’ve arrived.
After settling in, all the volunteers (Matt, Nicole, Linda, Alex and I) walked around the city, exchanged currency, and bought credits for our cell phones here. The city is pretty nice, and better developed than I was imagining. Later, we went to a bar (which is apparently called a “spot” here) and got dinner and drinks while watching some football on a large projector screen. It was akin to going to Buffalo Wild Wings to watch football on Saturdays in New Haven. After returning to the Telecentre and enjoying the (amazing!) air conditioning, we met the rest of the volunteers who arrived that day – Laura, another Nicole, and Jamison. We went to bed shortly after because we had our first outreach the next day!

Our outreach was in a community called Ashanti, which I think was in the Eastern region of Ghana. The outreach was great. It took place in a church and (I would guess) about 100 community members had assembled by the time we arrived. Ernest, an optometrist with Unite For Sight, gave a brief introduction about eye health and then each of the volunteers introduced ourselves. We then broke off into stations for the vision screenings. Jamison, Nicole, Matt and I gave visual acuity tests, with the help of our amazing driver, Bismarck. Then, community members visited Ernest or Dennis, an ophthalmic nurse, for a more thorough examination. The other volunteers helped dispense medication and eyeglasses that were prescribed by the clinicians. After working for about 5 hours, we were offered a delicious Ghanaian lunch (our first real Ghanaian meal) – banku and tilapia in a pepe sauce. Banku is a dough-y/starch-y mix that is fermented in plastic. It’s very similar to fufu in Cameroon (which is odd, because Ghanaians also have a dish called fufu, but it is not the same).

I have really enjoyed my first two days here! The other Unite For Sight volunteers are outstanding, as are the Unite For Sight staff, and the people in Ghana. I’m looking forward to the next few weeks working with the program.

A few other things I’ve noticed…
1. Maybe I’ve just forgotten what Cameroon/Nicaragua heat is like…but man, it’s HOT.
2. I am much more comfortable just getting around here…I’ll chalk it up to experience.
3. I feel extremely well-supported and safe.
4. The language “barrier” is odd. Although English is the official language and Twi is also commonly spoken, Ghanaians speak many languages/dialects…yet they all seem to understand each other. I have no idea what people are saying when they are having conversations with each other, but most understand English fairly well when I speak with them.


Much love to family & friends!

Pre-Departure

This blog is meant to provide updates about my time in Ghana this summer for my family, friends, and any others who are interested in reading.

I leave for Ghana tomorrow evening and will arrive the following day around noon.

Brief run-down of my trip
May 10 - June 10: Unite For Sight
I will spend the first month of my trip in Accra with Unite For Sight, an outstanding global health organization with the mission of eliminating preventable blindness throughout the world. One of the major ways they improve the health of the communities in which they work is by partnering with local leaders to provide vision screenings in rural areas. From these vision screenings, community members are assessed for various vision issues, including refractive error, for which Unite For Sight offers eyeglasses, and cataract, for which Unite For Sight helps eliminate barriers to corrective surgery by subsidizing costs and assisting with lodging and travel for the surgeries.
In addition to performing general volunteering duties with Unite For Sight, I will be continuing a project of a recent graduate of Yale School of Public Health. This project focuses on evaluating how Unite For Sight's services for cataract surgeries impact individuals' poverty levels.

June 11-August 9: National AIDS Control Program
The remainder of my summer will be spent in Kumasi, working on my internship as part of my Master of Public Health degree. I have been working very diligently on this project since October 2011. The main project of my internship is developing a decision analytic model to compare therapy programs for HIV-positive pregnant women. Decision analytic models are really cool - I'm specifically using a decision tree for my model.


That's it for now! More updates to come post-arrival.