First Week: A New Continent, A New World

Photo from BuzzGhana.com

Dream Turned Into Reality "Akwaaba! (Welcome!)" yelled the airport workers as I stepped inside the Kotoka International Airport in Accra, Ghana. After thirteen hours of flying, five hours of layovers, and 3 hours of sleep, I made it to Ghana. It felt unreal as I stepped on the plane leaving for Ghana. During the

next four weeks, I will be shadowing and observing public health outreach in Cape Coast, Ghana through Child Family Health International (CHFI). Never in my life did I imagine studying abroad. The last time I flew internationally was in 2010 when my parents and I went to Haiti. This time, my flight was to an entirely different continent and I was alone. However, I was at peace. At sight of the houses, schools, open fields, stadiums, and local people, my anxiety vanished. What started as a dream became a reality.

Accra, Ghana

Upon exiting the airport, I found Augustine Bimpong, the program coordinator for Child Family Health International (CFHI) and was driven to the CFHI house in Accra. After a few hours of rest, I an invite by some of the other participants in the program for dinner at a Thai restaurant. As a taxi drove us to the place, I was amazed by the night-life of Ghana. It was 8:00pm and the streets were teeming with pedestrians and were filled with parties and the sound of music. After a fulfilling dinner, we went to an ice cream parlor then went home. My first day in Ghana was hectic and overwhelming but it was quite an experience. On Sunday, I toured Accra and prepared for my trip to Cape Coast where I am located for my program.

On Monday, I along with Zoey, another participant for the Cape Coast program and Albrain and Ronald (two other CHFI coordinators) left for Cape Coast, Ghana. There is stark contrast been Cape Coast and Accra. Accra is characterized by busyness and a large population, while Cape Coast is relaxed and less populated. Along the streets of Cape Coast, you will find lively marketplaces bustling with vendors selling food, fabric, and merchandise. On the edge of the city, you will find the historic district of the town where the British built castles and apartments during colonial times. By the beach, children are usually at play in the water. The people are very friendly and have mistaken me multiple times for being a native. I'm not surprised. I am in love with the richness of the culture. The food is also amazing. In my first week, I ate some traditional Ghanaian foods such as Red Red (Bean Stew), Jollof Rice, and Banku (made from maize).

The Program Begins

On Tuesday, I started my program at Ekon Community Health and Planning Service (CHPS) compound. I learned that the Ministry of Health has CHPS compounds located in various communities. All CHPS compounds offer the following services for the community at no charge: consultations, child wellness checks, school health, family planning, immunizations and home visits. Tuesday was child wellness check day. When we arrived at the compound the waiting area was packed with mothers who came with

their children for immunizations and checkups. There were noticeable differences in the way the nurses worked in Ghana compared to the US. A number of children wore a harness and were weighed on a scale similar to one that is found in a grocery store. The harness was attached to a hook on the scale and the child was suspended until the scale evened out. I felt severely uncomfortable with the method used to weigh the children. Did the harness cause any pain or scarring on the infants? Was the harness sanitized after each use? Did it cause any rashes? These questions ran through my mind as I heard the cries of some of the infants that were weighed. After weighing, most of the infants were given immunizations.

Effective medicine is one that connects people together on a personal level.

Home Visits

On Wednesday, we returned back to the Ekon CHPS compound for our second day of rotations. Wednesdays are reserved for home visits in the local community. Home visits are separated into two categories; routine checkup (for anyone needing treatment) and special clinics (specific people in the community who require weekly visits). It was interesting viewing healthcare on such a personal level. As the nurses visited the homes, I observed that each visit involved health education and was characterized by intimate relationships between the nurses and the people. The nurses would ask questions ranging from health to lifestyle. The bond wasn’t formal at all. One thing that I learned from the home visits is that effective medicine is one that connects people together on a personal level.

Interactions with the Community

Here are some of the cases I encountered:

1) An adult with high blood pressure who was recovering from a stroke

The nurses educated her on the importance of having a healthy diet

2) A mother with a severely underweight infant who refused to go to the hospital with the child from a routine checkup.

The nurses implored her to visit a hospital because malnutrition can lead to death.

Grace, one of the nurses, revealed to me that there is a people refuse to go to the hospital because of fear, the reliance on traditional medicine, and expenses. However, a large number of people in the Ekon community accept the advice and aid of the local clinic.

Overall, my experience at the CHPS compound was amazing and though-provoking.

Better Community, Better Health

On Thursday and Friday, I had the opportunity to visit Cape Coast's Department of

Social Welfare and Community Development. I learned that the Social Welfare and Community Development Department is in charge of child rights and protection, disability and welfare for certain populations. Though my program is primarily public health based, I found it interesting that the visit to the social welfare center was included. I’ve come to understand that health is interconnected with the community.

The Ekon CHSP compound and department of social welfare and community developed have opened my eyes to the community aspect of public health.

Lessons Learned

There are two takeaways that I have from this week in regard to the clinical aspect of the program.

Locally led community health programs are 1. Sustainable 2. Effective at tackling short term problems.

I am left with these following questions, From the CHPS home visits, would the community have a different response if westerners came instead of the local nurses?

Are there possibilities for true relationships to form between provider and patient in short-term clinical trips? Hopefully, within the weeks to come, I will have an answer. I will be placed in the Cape Coast Teaching Hospital next week for my clinical rotations and go on excursions. Stay tuned for my upcoming posts.

Unless otherwise noted, all photographs are my own.