Ghana Health Team

It was quite a party last night on the NEA compound. The entire team, all the NEA staff and their families feasted together outside under the stars. A cow and a goat given to us at the Durbar made a delicious contribution to the main course. After dinner, speeches were given by Dr. Mensah’s mother, his brother Chief of Yaara, Dr. Mensah, and then Dr. Rob and I gave a tag-team address. Our leaders stood to pledge our support as advisors to the Leyaata Hospital for all of the clinical programs during these next months of intense planning. This announcement was extremely well received!

Dr. Mensah and Brenda kicked off the dancing and we enjoyed a fabulous celebration together.

At 5:30 am this morning, it was time to say good-bye. While it was difficult to part with our dear friends here, we are all ready to begin our journey home and look forward to sharing our stories and pictures from this memorable and exceptional mission.

Signing off again…

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

Yesterday was the final day of our Ghana Health Team clinics. We were operating, lasering, pulling teeth, making house calls and seeing patients by 7:30 am. I could write a book on the stories of this very day alone. Our goal was to finish strong and we did. In fact, we finished the way we started — with excitement, teamwork, resilience, compassion, excellence and a lot of laughter. Then the emotions began to flow as the reality of the end of our GHT (and our fatigue) set in.

This morning, many were up at 6:30 am for running or yoga after which we met under the gazebo for final devotions. The pastors sang two beautiful songs to thank God and our team for all that has happened, and I’m sure there were at least five or six harmonies. Dr. Mensah spoke on Exodus 36: 2-7 and Shmuel read the scripture in Hebrew. It was powerful! This passage talks about how Moses asked his people to give of their belongings to build the temple but they gave so much that he eventually had to restrain them from giving more. Dr. Mensah used this story to thank us and the entire Ghanaian team for giving and giving and giving so much that now, he needs to restrain us. “You have given more than enough”, he said over and over. We were grateful for his words to provide some closure for us today.

After devotions, we walked to the construction site of the Leyaata Hospital and took our picture on the doorsteps of the future emergency room. My heart was actually racing with excitement at this special moment which felt a bit like the passing of a baton from our short-term medical care to what will be the sustainable health care of the future in Ghana.

After breakfast, all the team leaders shared a brief report and we said our final words to this wonderful, wonderful team. I was holding it together well, until Kyle shared what a little boy said to him after his dental procedure yesterday. The boy looked at Kyle and said, “We are friends now.” Indeed — these four words sum it all up. This work is about all the precious relationships amongst our international team members, our Ghanaian health care colleagues, NEA and most importantly our patients. It is the relationships that have been the foundation for the success of this team and these relationships will continue to be the foundation of the future.

In 2007, a Ministry of Health official came to visit our first Ghana Health Team. He thanked us and asked for our ongoing support “until we can stand on our own”. I have never forgotten those words and it is truly what NEA and our GHT leaders have been working towards. Well, that time is fast approaching. The hospital construction is ahead of schedule and it is now the right time to close our short term work and pour all resources into helping NEA open the doors to the Leyaata Hospital.

There is much to be done. Our leaders are meeting after lunch to map out the next phase of our involvement which will involve mentoring and consulting as we launch this model hospital together. Oh, how exciting it is!

On behalf of our team, I want to send such a heartfelt thank you to each and every friend, family member, colleague, supporter, former team member, and donor who has made this mission and the other 10 missions possible. Without your support, none of this would have been possible and 7,080 patients would not have received the care they so deserve. I hope you will continue to follow us along as we work toward the launch of the Leyaata Hospital in two years time. You can do that by subscribing to the GRID newsletter.

One of my favourite songs I’ve learned in Ghana was sung this morning and is perfect — just perfect — to express what is in my heart as I sign off…
“Unto the Lord be the glory, great things He has done. Unto the Lord be the glory, great things He has done. Great things he has done, greater things he will do. Unto the Lord be the glory, great things He has done. Amen.”

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

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