2012 Team

Week 1 Update

Dear Family and Friends,

Thanks for your support of our trip. 

We have had a great first week! What follows is a day-by-day account of our trip so far by Charles Opalak.

June 20th

Wednesday evening, the group met at the Accra airport and travelled to the hotel with Lilimed personnel.  Jan, however, was delayed due to losing her passport in Oslo, but assured us she will be arriving the next day.  Everyone was in good spirits and our hotel was quite pleasant despite the lack of running water in some rooms.  After a dinner of rice and chicken the team retired to prepare for an early start to travel to Ho which will be our operational base for the trip.

June 21st

After a delicious breakfast of beans, omelets and toast in the hotel’s ample courtyard, the team packed up our bus and began the trip to Ho.  This involved an hour long detour at a bank in order to transfer funds.  The ride to Ho was uneventful, save for eating delicious cornmeal out of plantain leaves sold to us through the window of our bus at a pull-off before  crossing the Volta River.  We arrived at our hotel and got our rooms, which are next to each other with balconies, televisions and mini-fridges; the luxury is really quite surprising.  Out of our porch we can look down on the courtyard and the verdant hills that our companions in Lilimed call ‘typical bush.’  That afternoon we went to organize the medications that had been donated by the Irani brothers and meet some of the other individuals we will be working with including the nurse Gertrude who helps us account for and separate the medicine according to clinic day.  That evening we have our first real taste of ‘African time’ when our bus is an hour and a half late to take us from the hotel to the welcoming ceremony.  Despite our late arrival, the welcoming ceremony was a smashing success with grateful speeches, two drum circles with dancing, a dance performance by the children of Lilimed and Share Life members and an abundance of gifts.  The dancing is remarkably similar to what is known in New Orleans as ‘second lining;’ the women shuffle and twirl and spin handkerchiefs over their heads.  We were all enjoined to ‘refresh ourselves with dancing.’

June 22nd

Friday we had our first clinic in Peki Agbateh, a farming village in the flatlands about a half an hour from Ho.  Our bus was again late, and I got the feeling that – as with any operation – there was going to be a lot of ‘hurry up and wait’ during this trip.  Upon our arrival at the site, which is a 5 room school compound situated in a clearing, nearly 120 people were waiting to be seen.  Jan and Dr. Victor still hadn’t arrived at this point, but we begin setting up registration, vitals, history, eye screening, pharmacy, physical therapy and consultation stations to begin seeing the large volume of patients.  Getting translators proved to be somewhat confusing, but after about an hour even the physical therapy and research groups had the necessary personnel.  Physical therapy is an excellent addition to the team this year since many of the complaints involve ‘waist pain’ or ‘general body pain,’ due to the constant stress of farming and other labor.  The researchers meanwhile walked through the villages and surveyed the inhabitants about their hypertension health literacy, since this was a problem that we noted in many of these communities last year.  Finally, around 2 in the afternoon, Dr. Victor and Jan came up the road and were immediately put to work.  The first clinic was long and some difficulties cropped up with moving during the rain and efficiently conducting histories and physical exams, but by the end of the day everyone agreed on a job well done.  Some of the cases were difficult, however, and remind us of how important even simple clinics like ours can be:  we saw a woman who had never been able to walk probably due to vitamin deficiencies and many cases of malaria whose treatment we were able to start.  We managed to see 170 patients in Peki Agbateh.

June 23rd

It is amazing what a difference one day can make.  Our bus was on time, medications were loaded without a long delay, and we arrived at our second site – Adigbo Tornu – around 09:30.  Our clinic was beautifully situated with a lovely view of the Volta River and a crowd of around 60 people.  At every site there is a small welcoming and today the headman, who conducts the daily administration of the village, spoke to us about the work the community and its partners are trying to do to improve their lot, which included building the road that we had driven in on and securing electricity four months previously.  Our clinic ran very smoothly since we had a full complement of personnel and the previous day’s experience.  One striking patient was a girl of around 10 years of age who came in with a kerchief covering her left hand and took it off to reveal badly burned fingers that were clearly infected.  The burn had happened 20 days previously after falling in a fire and she had still not gone to the hospital. I cannot imagine what they would have done for her care if our clinic had not been arriving.  In total we saw around 120 patients in Adigbo Tornu, some of whom had even ridden in boats across the considerable length of the Volta River to come see us.  The blood pressure in this town was markedly lower than any of the others that we visited, which I attribute to the fish that is their livelihood and main dietary staple.  That evening we went into downtown Ho and used the internet, much to everyone’s relief.

June 24th

On Sunday in Ghana nothing much happens because everyone goes to church.  It is a highly religious society and even the less religiously inclined among us got swept along into various services.  That afternoon we rested, napped, read and in the evening the team went to see the England versus Italy football match and eat delicious local food.  The chicken in Ghana is among the best I have ever tasted, a testament to free range!

June 25th

Off to our third clinic in Goviefe Todzi.  Todzi means on a hill, and upon arriving the team climbed to the top of a water tower to take in an incredible panorama of the Volta River valley.  That day we set up our clinic in a church and it had an excellent flow with an abundance of benches to serve as waiting areas.  One of the cases we saw was a young lady who had been in a car accident five years ago and had broken her left ankle.  It had never been put in a cast or reduced and now she is constrained to walk on the outside of her foot and a large ulcer has developed over the medial malleolus that she has been living with for years.  A simple procedure after the initial injury would have saved so much suffering.  That day we saw nearly 150 patients and even had time to play with the children who gathered to watch us.  The Ghanaian children are fascinated with us and are constantly seen watching from a distance. 

June 26th

Our fourth clinic was in Logba Horglikofe, a farming community situated in swampy lowland.    Our team leader, Zack McDowell, saw a little girl around one year of age playing with some of the other children with a large poultice on the back of her head and peeled it back to discover a large abscess about the size of a baseball.  The patches of clumped dirt and dried herbs around the wound from the herbal dressings, together with not washing out the wound, were likely the source of the infection. Although we cleaned it, there was little else we could do except exhort them to take her to the regional hospital for more extensive treatment.  It is so hard to see cases like this that we can do so little for, but they do speak to the urgent need of these communities for a more established and well supplied primary care system.  On the other hand, we got to find out about the success of one of our patient education sessions from the previous year: a local alcoholic had been counseled to stop drinking in order to lower his blood pressure and improve his health and had successfully abstained for eleven months.  Towards the end of the clinic, a storm started gathering, and our bus driver, the ever-resilient Bala, suggested that it might be difficult to drive the bus out if the dirt road turned to mud, so we were forced to pack up the clinic without finishing with the last 20 patients.  Luckily, we are returning on July 2nd, so we told them to hang on to their paperwork and meet us next week.  Once all of the gear had been packed up a small crisis ensued because the rain had started and our research team hadn’t returned, so Alexander, the Lilimed eye specialist, borrowed a local motorcycle and sped off.  Five minutes later the group was together and we started back to Ho.

June 27th

Today we headed off to our last clinic at Akpafu Todzi, a two hour drive.  Since it is so far away, we decided to stay overnight in the village, which has several advantages.  It will allow us to get to know the local community more closely, to not have to worry about finishing the clinic too soon and to conduct our educational session first thing in the morning before the community set off to work.  The town was beautiful, built on the two hillsides and converging on a road leading to the town well where we set up our clinic.  Unfortunately, Akpafu Todzi has a high prevalence of hypertension, which we will be seeking to aggressively educate them about in the future.  Late in the day, a man presented with a massive boil which was cleaned, lanced, and bandaged.  This man also had lost his right leg in an accident and we were able to provide him with new crutches, thanks to medical supply donations from supporters in Richmond.  The town provided us with an abundant dinner of chicken, fried plantains and rice and we spent the night under mosquito nets on camping pads.  It was the first time most of us got to hear a real town crier in operation; banging a pot and telling everyone to gather the next morning for our educational session. 

June 28th

At 7am the team gathered in the town square to meet the chief, who is an impressively educated man who has obviously been trying to get more resources for his town, especially better schools.  After the ceremony, the men and women of the town were divided for an educational session that involved sexual health, cancer self-checks and healthy relationship counseling.  Later, the team went up to the local school to talk with children about hygiene, germs and malaria.  Then we loaded back on the bus and rode home to our hotel in Ho, which seems opulent with mattresses and showers.  It has been a great first week. 

Week 2 Update

June 30

Woke up early to tour the lovely countryside north of Ho, which started with a stop at a monkey conservation area that had been established with the help of a Canadian to create a sustainable source of income for the local village and to preserve the monkey population. We all took turn feeding the monkeys bananas and hearing about the local history from the guide. Next, we stopped at War Plant Mountain, which is the tallest mountain in West Africa. Every member of the team made it up the 2905 foot peak, despite the steepness of the hill and how crowded it was. Afterward, we went to a beautiful waterfall, Wli Falls, that was another short hike. It was the most pristine waterfall that I have seen and we were told it was also a “highest in West Africa”. Making it back to Ho, we were all exhausted and happy with the day of exploration.

July 1
Church in the morning was even better this week. At the Catholic Cathedral there was a four hour mass welcoming a new priest with all the exuberance of a wedding and at Share Life, Jeremy had the honor of being invited to preach. Later, we went to play volleyball at a local girls’ boarding school and I had the pleasure of talking with one of the students who told me about the positive view that young Ghanaians have of the United States. The American Dream is alive and well. As it was Republic Day, the rest of the day was spent relaxing.

July 2
Went back to Horglikope to finish up the clinic that had been interrupted the week before. Unfortunately, we were not able to teach due to the holiday weekend and we were inundated with new patients that we were not able to treat. We had great translators here, even getting the opportunity to work with the chief’s son who was very interested in research himself. On our way out, a local pharmacist got on the bus and presented us with a letter of thanks and encouraged us to return next year with more resources.

July 3
Wrapped up education with a double-header. We started at Peki Agbateh and then proceeded to Adigbokofe where the rain forced us to conduct our education jointly in a small church. Afterwards, the children sang several songs for us and we taught them the Father Abraham song, which they greatly enjoyed. In Peki Agbateh the village presented us with an enormous amount of food: sugar cane, mangoes and coconuts.

July 4

On Independence Day, the team went down to Accra to observe cataract surgery. I spent the day in Ho entering the data from our surveys and getting some much needed R&R, which included a nice long walk through the town to the market.

July 5

We started the day by teaching at the local McCollins Orphanage Center and Preparatory school. I got the opportunity to teach with Zack McDowell and we talked about sanitation, malaria, microbes and nutrition. Afterward, we played soccer against some of the students and teachers. In my opinion, we won the game 3-2, but the referee refused to end the game until the local team scored another goal, which was amusing. Also, our excellent bus driver, Bala, played an excellent goalkeeper for us. Later, we had the closing ceremony with the Reverend Bankas, Lilimed and several local physicians. They presented us with certificates, gave excellent speeches about practicing medicine in different places and generally thanked us for our service. Additionally, they ended the ceremony with coca-colas all around, which they called ‘item 13’ for its place on the agenda.

July 6

We left at 4:30am in the morning and headed down to the Cape Coast, where we spent time on a canopy walk at a local rain forest, which was beautiful and thrilling. Then we went down to the famous Cape Coast Castle, which had been built by the English as a trading post and had served as one of the more massive centers of the slave trade. It was fascinating and terrifying to see that aspect of our shared history. That evening we stayed at what was essentially a luxury hotel with air conditioning, internet and delicious food.

July 7

Last day in Ghana started with an all out drive for the airport in order to ensure that we got Jan to the airport on time. Then we went to the cultural market, which is essentially a large bazaar where shop owners and passersby will unapologetically try to sell you anything and everything they think a tourist might be interested in. It was right near the beach, so out of curiosity several of us wandered down and walked along what should normally have been an incredible beach but instead was being used as a large scale trash fire (Ghana has many other nice beaches, but unfortunately this one was not well maintained). After the market we made it to the airport for a second time, said our goodbyes and were on our way.

We are incredibly grateful for your help and support in launching us forth to Ghana to help the villagers of the Volta Region. In the process, we had the time of our lives and learned a great deal about ourselves and how we can continue to live our lives to help others. We hope you’ve enjoyed these updates and found them inspiring in your own lives. Many of us are staying on board with the REACH 4 Ghana organization and we’re excited to start the team building and training process for next year’s trip…we hope you stay in touch!

All the best,

2012 REACH 4 Ghana Team

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