Dr. Jennifer Wilson

We might be a little knackered — another fantastic word I’ve added to my vocabulary thanks to our UK friends. It has been a busy three days, and today the team worked and worked and worked from dawn until dark. Over the past three days, our Ghana Health Team has cared for 2,795 patients (1,298 medical, 444 eye, 70 laser, 105 surgery, 160 dental, and 718 pain clinic). We feel honoured and privileged to be visiting the sick and working alongside NEA and our Ghanaian health care colleagues. This very full day contained so many special moments. I’ll share a few of them….

Happy Moments: This year we have two portable ultrasound machines which have, as Dr. Carlye said tonight, been a game changer for our ability to provide a higher level of care at the bedside. Today, Dr. John was able to tell a patient that she was expecting twins. In Ghana, you are considered a woman of honour if you give birth to twins so this was a moment of celebration indeed.

Creative Moments: When a child with glaucoma needed a particular eye drop that we didn’t have and a post op patient needed a suspension we didn’t have, Sherry was able to compound them by using the oral version of the required ingredient. She was in her glory putting these more specialized skills into action.

Funny Moments: Charlie and Sandra, whose room is right next to Neil’s, had to put a sign on their door to prevent Neil from continuing to stumble inadvertently into their room day or night.

Interesting Moments: Today we witnessed yaws, onchocerciasis, leprosy and hydatid disease. Before you look these up, make sure you really want to know about the lifecycle of a worm. Dr. Helen, who has a tropical medicine diploma was really in her element.

Life-Changing Moments: A 17-year old patient, blind in one eye, was identified by our eye team as having vision threatening pressures in her good eye. Across the field, she went to our laser clinic where Marion prepped her and Dr. Josh performed the first of two laser procedures. When her family said they could not bring her back for the second procedure tomorrow, the NEA pastors kicked into gear and made arrangements for her to stay . They were determined that she would not miss this opportunity to restore and preserve her sight.

Alarming Moments: When an emergency occurs on the compound, three whistles sound. This triggers our doctor of the day, and Jessica, our ER nurse to jump into action with a backpack stocked and ready with emergency medications and supplies. The whistle blew twice this morning, with seizing patients. When a whistle sounded for a third time this afternoon, Dr. John and Jessica arrived to find something very unexpected indeed — a child with a whistle.

Selfess Moments: At 8:00 pm, while we are all eating dinner, hearing team reports, and enjoying comments from home, Becky and Le-Anne slip out to make their ward rounds. At midnight, our Ghanaian colleague Collins is on duty.

Delicious Moments: Today at lunch, we enjoyed NEA’s famous donuts that are fondly known as “Sweet Bad”.

Milestone Moments: Emmanuel, our Ghanaian pharmacy colleague, was proudly in charge of Uber Hour today. I still need to explain Uber Hour but I’m too tired.

Miraculous Moments: We continue to dispense medication to thousands and thousands and thousands, and yet our supply that Sherry spent all year procuring just seems to never end. #loavesandfishes

I’m sure I could carry on with another one hundred adjectives to describe the moments that made up this day of service, but I’ll send along some pictures so you can see for yourselves.

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

We hear many lovely comments from our patients on a daily basis, but I think Dr. Josh received the best one. After his laser procedure, one man looked at Dr. Josh and Johnathan and said, “I can see your face. You look really good”.

Sight was improved, restored or preserved for 24 glaucoma patients in their tiny clinic that is normally used to incubate ostrich eggs. At least the laser team has air conditioning. Their colleagues in the eye clinic are in a dark, damp peanut storage facility and when I walked in to pay a visit today, it felt like I was walking into a sauna. Dr. Pete’s shirt was so wet he needed to change it at 10:00 am. I grabbed some pictures and after about five minutes, I had to get out of there.

In this dark room, patients process through Dan and Barb’s station to check eye pressure and acuity, then they see the eye doctors who do a full eye exam and generate a prescription. Jane searches a massive data base for the exact prescription required and sends a volunteer to storage bins. Marion and Jane spend all year collecting, washing and measuring the strength of every pair of those glasses and entering them into the database. Finally, they stop at the eye pharmacy. A clinic just for reading glasses is also run in parallel to the full clinic.

Today all teams remained on the NEA compound and let me tell you, this place was humming. Patients started to camp out Sunday night to ensure their spot in the line. Taxis, busses, motorcycles were arriving all day long from places as far away as Accra. People were cooking and selling food, and the atmosphere was one of excitement. Huge tents and waiting rooms became jam-packed, and the NEA staff ran a master class in crowd management. We use up to eight different wrist bands to identify where patients are flowing to and from and the system ran smoothly in all areas. Except for the one moment. Someone in the waiting tent had the bright idea to pick up their chairs to attempt to form a big circle closer to triage after which hundreds thought they would do the same. Leslie’s voice boomed out over the radios “ Anarchy, Anarchy!”. NEA came to the rescue and peace was restored. And some ropes were put up.

Speaking of NEA, they truly have been the foundation of the success of this mission. During this fortnight (I’ve officially decided I am never saying “2 weeks” again!), most of NEAs development activities “go to sleep” as every staff member becomes a health team member. The kitchen team not only cooks for us, but they are also preparing food for the hundreds of volunteers and translators and surgical patients all week. There is a laundry team, cleaning team, driving team, security team and clinic set up team. The entire pastoral team is involved too and they help wherever help is needed. Every evening after a long hard day, I see them sitting together and praying — I mean really praying— for us, our families and our patients that were seen that day. This NEA staff just love us so much and take such amazing care of each and every one of us. We are so grateful!

Our physicians had a really fun day today because we were all in one room together with pharmacy and..wait for it…with air conditioning. Strategies were put in place to minimize noise and it was a very efficiently run clinic. One by one, we worked together to visit the sick, many of whom arrived Sunday night and camped out in line. One of the great things about all of us being on the compound is that it allows us to visit one another’s areas and to consult with one another. Consultation requests were constantly flowing between doctors, surgeons, eye doctors and dentists. Dental had its busiest day in the history of the team, caring for 60 patients. Our surgical theatres were full-on all day completing 37 surgeries. Dr. Hicks had a special honour of his daughter Elsa observing her first ever surgery — a very proud dad moment!

By 7:00 pm, we’re all back together in the dining hall to enjoy a meal together, hear the blog comments from home (we love them — especially Charlotte) and listen to team reports. One of the sweetest stories from today was shared by Graham. A very elderly woman over 90 came to triage. She didn’t have any major complaints, but she told Val, our triage nurse, that she waited for two days at last year’s clinic and was never seen. She wasn’t upset as she was happy we cared so many of her people and was happy to wait the year to see us. Usually, our triage nurses will deal with minor illnesses and will send well people on their way, but Val felt compassion for this sweet elderly woman and decided to make her a VIP. She spent the day in the clinic being seen by the physician, dental and eye clinic. At the very end of the day, Graham was on the driveway and the team bus started approaching. There was one lone patient sitting halfway back on the bus. This tiny lady was waving at him out the window. NEA was chauffeuring her home.

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

There is so much I could tell you about what happened in the life of the Ghana Health Team today. Instead, I feel compelled to tell you about one little boy. His name is Bernard.

Bernard is seven years old and he has a massive umbilical hernia. The protrusion coming off his abdomen was so large he could not even run. He could not go to school because the other kids bullied and beat up on him due to his deformity. His father died, and his mother needed to work all day on the farm, leaving him to fend for himself during the day.

Ernestina, our dear health care colleague, was visiting the Eastern Region of Ghana when she saw this boy roaming the streets. She was concerned about his protruding abdomen and asked the women in the community about him, “He is a bad boy. He runs with the bad boys”, she was told. Ernestina brought the boy to see her, realized this deformity was a massive hernia and sent for the mother. She had taken Bernard to three hospitals, but the surgery to repair the child’s hernia would cost her over a year’s worth of wages. She would never have these funds. Ernestina and her husband decided to pay for transportation so that they could make the eight-hour journey from Eastern Region to Carpenter. Bernard was seen by our surgical team and had his hernia successfully repaired on Thursday.

On Sunday at church, there is always a time for people to share testimonies about what they want to thank God for. Bernard’s mom walked to the front with him trailing at her side. He was stooped over and walking slowly from the pain from the incision stretching across his abdomen. With Ernestina translating, Bernard’s mother gave a special testimony thanking God and NEA, and the team for intervening in the life of her boy. She had lost hope that she could give her son a meaningful life and now his life is changed forever.

Bernard continues to recover on the compound. Every night, Ernestina moves a mattress onto the floor of her tiny room where he and his mom sleep. Ernestina will accompany the child back to Eastern Region after our mission is over and has decided to care for him during the day for the next two months so that his mom can continue farming to feed the family. When I thanked Ernestina for all she did and will do to help Bernard, she just shook her head and said, “He will be a meaningful person”.

Bernard’s story and Ernestina’s role in it, speak to me in so many ways. It is a reminder of the great health disparity that exists in our world that we can so easily forget about. No seven-year-old child would be in this predicament in any of our home countries. It is a reminder that every life matters, is of great value, and deserves an opportunity to live a meaningful life. It is a reminder of the incredible care and compassion that Ghanaian health professionals like Ernestina show towards their patients and their willingness to make personal sacrifices for their well-being.

I was trying to imagine Kim and I pulling a mattress into our room every night on this busy mission for a mother and child to sleep on. It is a reminder that poverty is complex and that many interconnected challenges impact health.

I found myself thinking about this boy and Ernestina all day today. Will their story change how we see the world? Will their suffering change how we live our lives? Will it change how we practice medicine? Will the solidarity that continues to grow in our hearts toward the people of Ghana fade when we return to our busy lives at home?

A John Wesley quotation delivered to each team member settled my troubled heart, and these words often prevent me from feeling paralyzed by the overwhelming wrongs in this world:

Do all the good you can. By all the means you can. In all the ways you can. In all the places you can. At all the times you can. To all the people you can. As long as ever you can.

This little boy has given us a lot to think about.

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

Bernard’s story and photos are being shared with permission from Bernard’s mom.

After breakfast on Saturday, we were given a presentation by NEA’s Leyaata Ane Project team. The Leyaata Ane Project is funded by Global Affairs Canada to reduce maternal and newborn mortality and provide reproductive health education to the 16,000 adolescents registered in the program. Our student, Elsa Hicks, presented the project team with hockey bags full of personal hygiene packs for adolescent girls that her friends and classmates had made and donated. It was a very emotional presentation and there were not many dry eyes in the room.

We had some activities planned for the rest of Saturday, but the Chiefs of the Mo Land had something else in mind. Dr. Mensah very excitedly explained to us that a Durbar had been planned in our honour. He asked us to go and get into our best clothes and be ready to gather under the tents when the talking drums began to beat.

A Durbar is an infrequently held event to honour someone of prominence such as the President. When the drums started, we gathered as instructed and over the next 3.5 hours — yes 3.5 hours — our team was honoured for our “good work and good will” in supporting and augmenting the health care system over the pass 11 years. Chiefs, Queens and Traditional Councils from all the villages in this region arrived in a huge processional to the beat of many drums. There were speeches, cultural dances and the presentation of gifts. Our team and NEA received over 400 tubers of yams, 2 cows, 2 sheep, 5 goats and a citation. My son, Joshua, was honoured with 150 yams, a goat and a smock. We’ve never seen anything like it. Josh had a funny look on his face when goat curry was on the menu for dinner.

Dr. Hicks and I were asked to give a speech with a few minutes of warning after which we watched the Chiefs interpret and dance to the talking drums. This was most interesting and very mysterious. The event concluded with an address from Dr. Mensah who was in his full chieftaincy regalia.

He told a parable about a wolf who came across a rabbit and thought it was an easy kill. The rabbit noticed a set of deer antlers lying on the ground so he put them on. The wolf came upon this rabbit with horns and was confused so he asked him, “What kind of animal are you?”. The rabbit answered, I am “Jombalabinijombalkehgaw”. At this, the crowd went wild with laughter. There was no such thing as a jombalabinijombalkehgaw but it confused the wolf enough that he couldn’t make the kill. David explained that when he first came to the Mo land after finishing his PHD, he thought poverty would be an easy kill. But it turned out to be a jombalabinijombalkehgaw — a much more complex creature with complex problems, and he realized that he needed to find more sophisticated hunters to take its horns off. He thanked us for being those hunters who have helped remove the antlers of illness, disease and hernia off the rabbit of poverty over the past 11 years.

The Durbar was a once in a lifetime opportunity for us, and we were completely overwhelmed by the generosity of words and actions expressed. It was an incredible celebration of all that we have accomplished together over the last 11 years. I want to pass on this unforgettable story as the gratitude extends to all of the past team members, our friends and family, and of course, all of our donors.

Our day concluded with a fabulous and hilarious annual Ghana’s Got Talent show with emcee Graham, and let’s just say that it was such a fun filled, creative and fun evening together with lots of time to visit afterward. I’m hoping the pictures will tell the tale as this update is becoming a novel.

Sunday, we attended a wonderful and inspirational church service, a sold-out yoga with Bex, a baseball demonstration (Thanks to Dr. Cressey), a football match, a tour of the NEA compound, book clubs, naps and lots of good ‘ol fashion fellowship.

We are refreshed and ready for the final stretch of this mission and wait in anticipation for any jombalabinijombalkehgaw that comes our way!

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

At the end of the day today, I asked one of our Ghanaian colleagues how his day went and he replied, “It was so wonderful”. I agree with him.

The three theatres ran extremely smoothly and Dr. Karen reported that all of the children who had surgeries yesterday, including the boy who had the anaphylactic reaction, returned to their villages. She gave a big shout out to our Recovery Room team of Becky and Lee-Anne whose small recovery room contains one stretcher, one mattress on the floor and one reclining chair.

One of today’s patients has been a peanut farmer all his life but had never tasted peanut butter as he could not afford to use his income-generating peanuts for this delicacy. It just so happened that peanut butter sandwiches were on the surgical team’s lunch menu, so of course, they offered one to him.

This week, 148 surgeries have been performed by this amazing team. The crowd in Asantekwa was massive, but our approach did not change — give your best to one patient at a time. Everyone had a “let’s do this” attitude and in the end, we didn’t have to turn away anyone who needed care. At one point this afternoon, I simply needed to clear my head and get a breath of air. I walked out to the porch and must have been away from my desk for no more than two minutes when an NEA staff member named Collins tapped me on the shoulder, “Dr. Jennifer, it is now time for you to go back to your desk.” Yes, Collins!

At about 4:30 pm, I heard Dr. Carlye across the room say, “My brain is starting to shut down”. I think we all could have echoed that sentiment due to the intensity of our task today. In the midst of the hard work from all stations, there was much laughter and camaraderie, especially during Uber Hour, which I will explain another time.

As usual, the compound kids were cheering for us as we arrived back and Patience and the hospitality team, who start their day at 4:00 am, had prepared a feast. Tomato soup with homemade croutons, beef stew over rice, salad, yam balls and fresh pineapple was thoroughly enjoyed by all. Everything we eat is grown or raised right here on the compound and is absolutely delicious.

Kim advised me this evening that our medical, dental, eye, laser and surgical teams have provided cared for 3,387 patients so far. Our leadership team all had high expectations for this mission, but honestly, this team is blowing our expectations out of the water on so many levels. It has not been easy and there have been many challenges, but we have fought through them and grown from them. We didn’t know how we would do it without our colleagues Ashley, Sue, Joan and Tracey, but they prepared and equipped us so very well.

Now it is time to rest. We will take the weekend off, and NEA and our team social convenor Leslie have some activities planned so that we can refuel and recharge our batteries for what will be a big second week for sure.

Until Monday….

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

Three years ago, our team cared for a little girl named Dorcas who swallowed a caustic substance. Due to the damage in her esophagus, she could not eat and was slowly dying. With funds raised from our donors back home, NEA was able to send her to Accra where she received a feeding tube and ultimately the surgery she required. She and her mom stopped in to see us today to thank us for working with NEA to save her life. Our paediatrician Dr. Anne and I were remarking how the entire mission three years ago would have been worth it just to save this one little girl.

The village clinic started with a bang when our doctors and nurses simultaneously cared for a man with a poisonous snake bite, a young child near death due to dehydration from diabetes, and a critically ill young mother. All three of these patients were stabilized and transferred to hospital for ongoing care. Talk about unbelievable teamwork under stressful conditions!

Back on the compound, many children received their operations today. One little boy had an anaphylactic reaction to his antibiotic, but thankfully the team was well prepared and acted fast. This evening he was so happy to find two new football jerseys and a pair of new football cleats on his bed. How thoughtful of the team to bring these items to make such a scary experience a memorable one. Lee-Anne, Becky, Laura and Dr. Karen have a schedule for checking on the kids throughout the night.

The funniest story from today came from Dr. Simon. He had a difficult case that was being done under local anaesthetic which means the patient remains awake during their surgery. When he finished this technically difficult procedure, he simply said to himself “Hallelujah”, to which his patient surprised him by responding with a resounding “AMEN”, to which the translator translated a second resounding “AMEN!”. Apparently, this isn’t something that happens every day in the UK, and Simon is now wondering if he should be referred to as Pastor Simon.

The main health issue on the team today is fondly known as “cankles”. This is a condition where your ankles are so swollen that there is no distinction between them and your calves. There seems to be an epidemic of this today due to the heat and long hours on our feet. Not very attractive, but we will take cankles over diarrhea any day.

We celebrated a birthday tonight and Bex really seemed to love her gifts including the tube of toothpaste she received from the dental team. We were privileged to hear from Dr. Mensah tonight. Today is the 29th anniversary of their arrival back in Ghana as a family. He shared stories like only he can do, and wanted us to know that because of our work, his tribe feels that God cares for them.

At 3:00pm each day, our two students Josh and Elsa hand deliver an inspiration quotation and treat to every team member. I will end with today’s quotation from Florence Nightingale which seems so fitting considering the work of this remarkable organization called NEA began 29 years ago to this day.

So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself.

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

Tonight at dinner, Brenda Mensah shared the story of her first trip to Yaara village to meet her in-laws. It was one of the hardest days of her life. The trip from Carpenter to Yaara took their young family six hours on treacherous paths and across rivers with no bridges. It was there that she met a very, very sick man who was burning up with fever. She knew there was no way he could survive the journey out of this remote village to receive medical care. The helplessness the Mensahs felt prompted them to begin to dream and pray that perhaps someday, one doctor or one nurse might partner with them to bring health care to places like Yaara.

Over the past two days, our mobile team brought health care to over 1,000 patients in the very village of Yaara. Today’s clinic began with a triage nurse shouting for a doctor to help a sick child who had been bitten by a cobra. Dr. Helen was available and she and our nursing team spent a number of hours caring for this child. It turns out, she was sick from pneumonia, not the cobra, but our pharmacy was prepared with anti snake venom in their battery operated cooler just in case.

Speaking of pharmacy, our pharmacy program is truly a wonder. Don’t get me wrong, we all work extremely hard, but our pharmacists carry the heaviest load. They spend an entire year organizing every medication we might need for the medical, dental and eye team. They also help procure for our surgical and anaesthetic colleagues. Medications for chronic conditions like diabetes and hypertension are strategically chosen to match what is available in Ghana so that patients can renew their medicines locally. Dosages and length of treatment are all decided based on WHO standards. They receive every prescription the physicians write into their automated system, put up with our handwriting, dispense it, double check it and then counsel the patients on how to properly take it. Then, when the day is done and we are all playing euchre and games in the residence, they are preparing medications for the next day. I don’t know how Linda, Sherry, Martha, Lisa, Karen and Kirlis, together with NEA’s pharmacy graduate Emmanuel do it, but our pharmacy program is instrumental to the care we provide and to the success of our mission. They are super-heroes.

Speaking of medications, we have started a new club on the compound called the “Cipro Club”. This is the medicine you take for travellers diarrhea and, yes indeed, it seems to be “running” through our ranks. Thankfully, it is short lived and we all get great care from Dr. John, our team doctor.

Back on the compound, 34 operations took place and we are thankful that there were no complications, adverse events, fires or floods. Dr. David Cressey remarked at what a tightly knit group they are after only working together for three days. It was interesting to note that we saw very few large hernias in Yaara over these two days, as over the past 10 years, our surgical program has come close to eradicating them. Our emergency patient from yesterday underwent a successful surgery today and will be heading back to his village tomorrow.

Dr. Josh and Marion had the laser up and running today with Dr. Martin supervising and it seems that word has spread even to Accra that NEA is providing this service to treat glaucoma. Despite Ghana having one of the highest rates of glaucoma in the world, NEA is the only organization with this laser. What an exciting service that the Leyaata Hospital will be able to provide for the entire country in the near future and discussions and planning are underway.

All in all it was another rich and rewarding day and just so special for us to hear that we are part of a dream coming true and a prayer being answered for the Mensahs, NEA and this land.

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH

A small scandal broke out on the compound this morning when someone let it slip that the surgical team had air conditioners in their residence. I thought the rest of us staying at the beautiful Nim House took the news quite well, until one of the surgeons complained he was a little chilly when he woke up this morning.

The mobile team set off for our first village clinic at 7:00 am. This journey along the narrow dirt road was such a stark reminder of how difficult life must be for rural Ghanaians. We passed women carrying large buckets of water and batches of firewood on their heads, farmers toiling by hand in the hot sun, and children carrying swaddled babies on their backs. We also saw many signs of hope and development along this road as we passed new bridges, school yards full of children, community wells, community latrines and more and more tin roofs as opposed to thatched roofs. NEA’s handprint is everywhere.

A delegation of first time team members joined me to greet the Chief, Queen Mother and elders of the village, but we collectively decided to keep the ceremony brief as the crowd was so large. The NEA team left the compound at 4:00 am this morning and had the entire clinic set up and ready to go so that we could begin work immediately.

A clinic of this magnitude is only possible due to the amazing team of translators and operations volunteers. Our translators wear blue shirts and they are with us during every moment of the day. Our operations volunteers wear yellow shirts and they manage the crowds and stand at every door of every classroom and circulate throughout all areas of the clinic to help control and direct the flow of patients. Our sea of yellow, blue and white shirts worked side by side all day long as we cared for each patient, one at a time, even as the thermometer peaked at over 40 degrees.

One of our sickest patients today was a precious little three year old with severe malaria. Nurse Karen brought her directly to our nursing station from diagnostics where Jessica, Lauretta, and Val attended to her all afternoon. She made a miraculous recovery, munching on a snack as she left the clinic. The dentists were busy all day and had one case that was so difficult that it required all three of them to work together.

Back on the compound, the surgical team had a full day in theatres and were not slowed down by a small flood caused by one of the sterilizers. Rita, one of our Ghanaian nurses who is training with the team, proudly did her first solo assist with Dr. Magdi.

During dinner this evening, a man who was awaiting surgery on Thursday, developed a strangulation of his hernia. The team didn’t think twice about leaving their plates of food unfinished as every moment counts in this situation. Thankfully, the team was quickly able to sedate the man and successfully reduce the hernia. Our two students Josh and Elsa, together with Dr. Mensah, were able to witness this life-saving procedure. For those of you who are not aware, Dr. Mensah’s father and grandfather lost their lives at a young age due to this very condition, so this was a profound moment indeed.

Thanks to our supporters for their wonderful comments that are read to us by Kim at the end of every day. We laugh and cry, and feel so connected to home when we hear from you.

Dr. Jennifer Wilson, MD, CCFP(EM), FCFP, DIMPH