2017 Health Team

After very tearful goodbye, we bid farewell to the entire NEA staff at 6:30 am Friday morning. We collectively decided not to say goodbye, but rather, to say “see you soon.” The hope that many of us will return in 2018 made the goodbye less painful.

Our journey to Kumasi was smooth and we arrived with lots of time to spare for our flights to Accra. Fifty of us were awaiting one in-country flight, while the other sixteen of us were awaiting one due to depart 15 minutes later. Our dental colleague Dr. Richard dropped by with gifts for the team. All was well. What could possibly go wrong? (Right Dan?)

Before I tell you, let me rewind by 24 hours.

Friday was a wonderful day as we began bright and early with a devotional time led by the NEA staff. It is one of my favourite moments of the trip when we collectively give thanks to God for his provision, protection and favour during our fortnight. Emotions were running high before we even got to breakfast and I blame Dr. Jo for getting us started!

After breakfast we began PID day. (Our medical readers will get a kick out of this acronym.) For us, it stands for “packing and inventory day.” Each team has to clean, inventory and pack away all of their team supplies, leaving them in order for the next mission. The operating theatres and laser clinic need to be disassembled as they are used for other purposes the rest of the year. Leftover medication and medical supplies are strategically divided up to deliver to various hospitals and clinics. Joan has the responsibility to oversee this entire day and she couldn’t believe that we were were all wrapped up before 3 pm. It was a great final team effort and Joan provided exceptional oversight.

Friday night, many of us dolled up in our new Ghanaian outfits and joined all NEA volunteers and their families for one big party. Large round tables with white tablecloths were set out in the yard and after many pictures were taken, we enjoyed an incredible feast under the stars. After beautiful parting words were spoken by Dr. Mensah, each team member received a container of peanuts from the NEA women’s coop. Dr. Rob and I had the honour of responding to this gift and giving final words of thanks to our Ghanaian team. On one hand we were so happy to be celebrating all we accomplished together, but on the other hand, our impending goodbye was heavy on our hearts.

After dinner, David Mensah himself kicked off the dancing and we danced under the stars with the help of Prosper who was the DJ for the evening. David then decided to hold a “dance off” of sorts. One by one he called each team up to “show us your moves” … the eye team, the doctors, the kitchen staff, the surgical team, the drivers and security team and even the children had a chance to dance in front of the crowd. In the end, our anaesthesia team won the prize as Dr. Perry’s moves could not be beat! What a celebration it was.

Friday morning came all to soon, which brings me back to the beginning of my blog.

At 2:00 pm an airport announcement rang out, “Due to severe weather in Accra, flights will be delayed by 2 hours.” No problem. Our international flights did not leave until 10:00 pm so we had lots of time to get to Accra.

An hour later the next announcement let us know that the first flight to Accra had been cancelled. Oh my. Fifty of us were now officially stranded in Kumasi.

Whenever our best laid plans get thwarted in Ghana, David Mensah always laughs and then says “Murphy has struck again!” Murphy’s law states that “If anything can go wrong, it will,” and David always jokingly reminds us that Murphy is alive and well in Ghana. In fact, this is one of the reasons that resilience is one of our team values.

So when Murphy struck, the team kicked into action. They gathered together and patiently waited for an announcement from our leadership. A decision was quickly made in collaboration with Dr. Mensah that the team would stick together and try and make the journey together to Accra by road. NEA quickly mobilized two busses; one team member bought all the water the airport had to sell; others pooled all snacks in backpacks to divide up; and bladders were drained as much as humanly possible as we knew there would not be much time for pit stops. We had 6 hours and 20 minutes to make a 4-6 hour drive.

Bus number one arrived and it could take fifty passengers. A quick decision was made that all North Americans would go on this bus because their flight took off 30 minutes prior to the UK’s flight. (Dr. Magdi, Dr. Dan, Dr. Neil and Ashley joined us as the second bus could only hold 15.) The second bus would be smaller and would make better time, so the rest of the UK team stayed behind to wait.

45 minutes later Dr. Rob’s team finally departed Kumasi in what he described as a “very cozy bus.”

Onward we went. Let’s just say that Murphy struck many times along the way — bumper to bumper traffic, rain, windshield wipers that temporarily malfunctioned just to name a few. As the minutes ticked by, Google Maps was making it very clear that we would be cutting it very, very close to make our flights. Our GRID team in Canada was in constant communication and helped us get all North Americans checked in online. Surely that would help. Meanwhile, UK family members were doing the same.

What could have been an extremely tense ride was in fact filled with lots of laughter, games, sharing of food, and the UK team spent some of their cozy ride practicing a talent show act for 2018! Everyone stepped up and made the best of our nail-biting 5 hour and 20 minute ride, keeping each other’s spirits high, all the while recognizing that we may be staying a little longer in Ghana than planned.

What struck me the most was how gracious everyone was, and how supportive they were with the decisions that were made along the way. Team Carpenter and our Canadian travel contacts were trying desperately to speak to KLM and Air France to request a delay; meanwhile many of us on those buses and back at home just prayed. I know the entire NEA staff were praying too. We prayed collectively for a safe arrival in Accra first and foremost. And then we prayed we could get everyone home as soon as possible.

At 7:55 pm Murphy struck again with a text from Dr. Rob: “We are all on the side of the road. We have a puncture. Thankfully there is a spare. Standby.”

At 8:21: “The flat tire is stuck on the wheel and they cannot get it off. Progress is slow. Blimey – it’s just like the movies.” I think blimey is my new favourite word.

At 9:00 pm, with one hour until our flight to Toronto, the first coach arrived safely at the airport. Thanks be to God. Steve, Barb and I sprinted in to the airport, leaving the team to coordinate the world’s fastest offload of our carry-on bags and our luggage. Barb stood guard ready to direct our incoming team inside the airport, while Steve and I ran to the KLM gate only to be told it was closed. In no uncertain terms we were informed by agents and management that there was no way they could process 50 people and all that luggage in an hour. I understood where they were coming from but Steve and I were not ready to give up and Barb just kept directing everyone in.

Every type of negotiation technique was employed, including one of my personal favourites — the shedding of tears. Magdi was doing the same at the Air France desk next to us (minus the shedding of tears, I think). Meanwhile our travel representatives in Canada were doing all they could, and many, many, many people were praying that we would just be let onto that flight.

Suddenly, without any announcement, they just started processing us all as fast as humanly possible. It felt like a modern day miracle as we were ushered through. The plane full of people didn’t look too happy when we boarded and I think we made it worse with all our strutting, happy dances and high-fiving.

Meanwhile Rob’s team was back on the road and making a run for it. Fortunately, they made it safe and sound, for which we thank God. Unfortunately, they arrived only a few minutes before their plane was to due depart to Paris, and it was just too late for them to join Magdi, Dan, Neil and Ashley (who did all they could short of lying in front of the door to delay that plane).

The following text came through from Dr. Rob just as we were about to take off: “Dear Jenn. Have a safe trip and I hope you all get home safely. It has been a fabulous trip this year. We have just spoken to David – he is clearly tracking all of us. All will be fine – one way or another. Safe travels and our love to the awesome GHT 2017.” Rob has been an amazing leader to this surgical team so these parting words, in the midst of our happy ending and their not quite so happy ending, did not surprise me one bit.

As I write this blog we are on the final leg of our journey from Amsterdam to Toronto. Magdi and his 3 amigos are already home! Rob messaged saying that they were all smiling now, booked on flights for Sunday night and having breakfast at the hotel in Accra. I know they will have many stories to tell about their Amazing Race Ghana, and we continue to pray for their final journey home.

I believe that one of the greatest tests of a team is how they perform during unguarded moments — moments when they are not expecting to be a team or to function as a team. Today was one of those moments. Our mission was over. We were “off duty.” Our hearts were set for home and then, as David says, “Murphy struck.” A storm, a cancelled flight, a massive traffic jam, a flat tire when we were least expecting it. But this team embraced a situation beyond our control with resilience, creativity, strategy, humour, friendship and trust in our leadership as we faced our last test as a team. And together, with Dr. Mensah’s team in Carpenter and in Accra, and our team in Canada and in the UK, I believe we passed the test. In some ways if feels like a fitting conclusion to this mission, and it certainly will make it all the more memorable!

The important thing is that we are all safe and we are all on our way home. We are are acutely mindful that any temporary discomfort we faced on this one day truly pales in comparison to the challenges that the people of Northern Ghana face every single day. We have learned much from our friends and our patients in Ghana and perhaps we were even able to apply some of what we learned on this very day.

It will be just so good to be home to share all of our experiences with our loved ones.

Signing off for 2017 once again,

Jennifer

Writing a blog about our final day is very difficult. I have run out of time to say all that I want to say about this remarkable team and our remarkable 2017 mission.

Preparation for our last clinic on Thursday began at 0200 when NEA gave out 180 tickets to the elderly, the women and the children sleeping on the ground outside the gate. In a lovely gesture, they moved this large and vulnerable group inside the gate to ensure they would be seen before the big crowds arrived in the morning. Dr. Perry looked great in his birthday tiara at breakfast, but the party was cut short. With crowds swelling at the gate, we were at our workstations by 0730 to begin what would be the largest clinic we have ever run in Ghana. Each team cared for record number of patients and by day’s end, this compound provided high quality health care, surgery, dentistry and eye care to over 900 patients in one day! Our surgical team finished this mission with 296 procedures performed. I still don’t have final laser numbers as the entire eye team rushed out of dinner with an “all for one, one for all” cheer to help run an after-hours clinic. This total also does not include the patients treated and sent home for minor ailments, or the lines of patients who received acetaminophen for their joint pains, or the hernia patients seen and listed for last year. What a day it was!

I could write a book on the stories that happened on this day alone: a visit from the District Chief Executive from the Ministry of Health; a visit from a NEA hospital board member; a thermometer that read 43 degrees in the sun; a visit from a little boy born with a stump for a left leg who was proudly running around playing football with the prosthetic leg that donations to last year’s team supported; a final emergency whistle call as a woman started to seizure in the clinic; a very ill 5 month old baby that our nurses Esther, Renee, Kathleen, Rita and Dr. Anne literally provided ICU care to until we could transfer the baby to the nearest NICU.

The funniest moment of my day came when I popped into the David theatre at the end of the day where Dr. David Hunter was operating. He looked up at me and through his surgical mask said “One more kiss, Jenn, one more kiss.” It was an awkward moment … until I realized that an Irishman pronounces ‘case’ exactly like ‘kiss.’

At 3:00 pm I received my inspiration quote from Caitlin while I was consulting on a patient. I glanced down and what I read made me start to cry:

‘You have been my friend,’ replied Charlotte to Wilbur. ‘That in itself is a tremendous thing.’ – E.B. White, Charlotte’s Web.

This little line from this famous children’s story tugged at my heart in a big way and my poor patient and my poor translator thought I was having a mental breakdown. These words, said by a spider to a pig, crystallized for me why this mission has been such a tremendous thing.

The growing friendships amongst our leaders and team members, our deepening friendship with NEA staff, and the professional friendships we have developed with our Ghanaian colleagues all while serving wholeheartedly together is very unique and very special. So it seems really fitting to me end off with a tribute to our Ghanaian health care colleagues who will continue this work when we are gone.

These are our colleagues. These are our friends. And these are the tender hands into which we will leave our patients when we leave. These heroes are the future of health care in Ghana and they are ready to change the way health care is delivered in Ghana. They all believe, as do we, that under NEA’s leadership, with ongoing support and training from their friends in Canada and UK and around the world, that this NEA hospital will be a model for the entire country that could impact generations to come.

And so, together, this enlarging group of friends eagerly await the opening of the doors of the NEA hospital. Everything is in place and everyone is ready to move full speed ahead. Momentum and excitement are at all-time high. If we could raise just raise a few more million dollars (obvious fundraising pitch), the capital campaign will be complete and this self-sustaining, model hospital can open its doors to meet a critical and desperate need. After what we have witnessed these two weeks, we collectively agree that the day cannot come soon enough. Until the time that our Ghanaian colleagues and friends can stand on their own, we, the enlarging “NEA fan club” … or perhaps I should say “NEA friendship club” … will continue to do what we can to help, by all means, because that is what friends are for.

Friday we will spend packing up, inventorying everything and distributing left over supplies and medicine to the local clinics and hospitals. A big party is planned for Friday night and Esther has made a record number of dresses and shirts so we should all be quite a sight. Now that our work is done, we are all missing our loved ones and ready to begin our long journey home. This is a great opportunity to say a big thank you to all our families, friends and colleagues who have made it possible for us to spend these two weeks in Ghana. Without your love, practical support, and financial support, this could never have happened. Thanks for journeying with us!

I’ll close off this mission with one of my favourite little prayers by John Bailee:

Make me a more worthy following of the One who cared for the sick and the oppressed. Let your power, O Christ, be in us all, to share the world’s suffering and redress its wrongs. Amen.

Today, all 66 of us ran our clinic right on the NEA compound for the many, many, many villages that surround the Carpenter area. We were shocked by the crowd already gathered outside the gate as we walked to breakfast at 0615 today.

It was so lovely for all of us to be working so closely together on the compound with the luxuries of bathrooms, hand washing sinks and improved crowd control due to the fence around the NEA compound.

Preliminary numbers from yesterday indicated that today was the largest clinic ever run in the history of our Ghana Health Team with approximately 750 patients being cared for by our medical, surgical, dental, eye and laser team. At 3:30 pm I snuck away from my workstation to pay a little visit to tall our teams. I’m hoping I can take you all on a little tour.

Our triage and weights and temp team were packing up for the day when Dave pulled a very sick little girl out of the crowd. Her temperature was 39 degrees and she had severe malaria. Thank God that mom got Dave’s attention and his tender heart insisted we add just one more.

Our diagnostics station was humming. This station, led by our lab technician Tracey, has run like a finely oiled machine this year as they dealt with a constant stream of testing for malaria and HIV as well as urine, pregnancy and glucose tests. These tests, often ordered by triage nurses before seeing the physicians, allow us to get to our diagnoses so quickly. It is an invaluable tool to help us provide the best care to large volumes of patients. Tracey and Elena had a thermometer propped up on their table. It was actually 40 degrees under her canopy today!

The physicians were spoiled as our consultation room was the large, air-conditioned training centre. We felt so guilty (well.. kind of) as we worked so comfortably. Our translators were not comfortable at all. It was far too cold in there for them!

The big NEA gazebo was our nursing station today and once again our nursing team were busy dressing many terrible wounds and skin ulcers, giving oral rehydration to sick babies and IV lines were hanging once again from the rafters.

I then popped into the eye clinic. Their home base is the peanut storage facility which we like to call the ‘nut house.’ This eye team was processing patients at top efficiency it was a joy to watch.

Meanwhile, Dr. Toylin and Dr. Angela were busy restoring sight to 35 glaucoma patients in Margaret’s well run laser clinic. To finish off their day with a bang, Dr. Toylin talked the surgeons into giving her one OR and 2 nurses and together they performed a bilateral ectropion surgery with the assistance of Dr. Stephen.

Pharmacy was cheerfully in very high gear today. On the wall of the pharmacy there is a big poster containing the list the drugs we have run out of and those that we are getting low on. With only one day left to go, there were only 4 non-essential drugs on that list and a small handful of drugs we are getting low on. This confounds me that after the numbers of patients we have seen, our pharmacy still has everything we need. It feels a bit like the Bible story of the loaves and fishes. Way to go Sherry! As soon as clinic ends, we have an “all hands on deck” rule that everyone helps everyone prepare for the next day. After such a gruelling day I was touched to see our team docs and even our Team Leader Abraham helping pharmacy pack pills for our final day.

The dental team had a constant stream of patients under the mango tree and it appears that Francois received his first marriage proposal. In medicine we have a term called “last case syndrome” meaning that just when you think you are done for the day, your most serious case arrives. Well the last case syndrome hit the dental team today when Garrett pointed out a man “with an unusually big face” to his dentists. Sure enough, a serious dental abscess needed to be dealt with. Way to go Garrett!

Our surgeons too were hit with a last case syndrome as a small child needed surgery right at the end of the day. He had a rocky recovery but thanks to our incredible anaesthetic and recovery room team all was well.

The team broke the 250 procedure mark and a large of number of children received operations today.

Dr. David Hunter, Aaron and Emilia stayed late to drain two serious finger infections that were seen by the medical team.

One of the funniest stories of the day requires a small explanation. When a surgeon is examining a groin hernia, they place their hands on the patients’s groin and they ask the patient to cough. This manoeuvre pushes the intestines down through the hernia opening so that the surgeon can determine the true size of the hernia and type of operation required. Because this is done over and over again in the preop clinic, our surgeons quickly learn the word for “cough” which is “boa.” Today it was pointed out by a translator that for the past two weeks, while examining their patients, the surgeons have inadvertently been adding an “a” to boa. When they have been place their hands on the groin hernia and saying “ABOA!” they have been actually been saying “ANIMAL!” David Mensah was almost on the floor with laughter when he heard about this.

As darkness fell, Soale and I left the operating theatres and he repeated, “There are no cowards in this place; there are no cowards in this place.” It was a profound statement that I had never really processed before. Soale is right. It takes a special kind of health professional who is courageous enough to work in this place. It is one thing to care for patients with all of the resources of our health care systems back home but working in a low resource setting with all the challenges I have written about over the last fortnight takes a lot of guts. I believe that the courage that we have been able to muster up comes from the constant support and collaboration we receive from this multidisciplinary team and from God himself.

One of our 3pm quotes today was Joshua 1:9:

Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord God will be with you wherever you go.

Despite all that happened today, we were so happy to join one other for dinner by 7:00 pm, and I’m sure you have realized by the title of this blog what was on the menu. That’s right. One of the emus who many of us love to visit regularly “took one for the team.”

We felt bad for the poor guy until we tasted how delicious he was — as was the carrot and ginger soup, whole wheat rolls, chicken stir fry with rice, salad garnished with beets, beans and carrots, french fries, roast potatoes and fresh watermelon. Teams of NEA kitchen staff are essentially working around the clock to prepare our food every day.

Although today was an amazing day for me, it was also very difficult. Some of the cases I saw involved so much suffering. After consulting on a group of women who had very serious but easily treatable conditions that they had been suffering with for years, I needed to take a minute to compose myself. Even my translator was rocked. “The women really suffer in this place,” he said to me. He is right. I’m beginning to understand why so many of NEA’s programs focus on the women, as the suffering they endure is beyond my comprehension at times.

As we walked out of the main gates to our residence tonight, many men and women and children were already sleeping on mats by the front gate, trying to secure a place in our last clinic tomorrow. It seems a good part of the country knows tomorrow is our last day and my prayer, as this day ends, is that tomorrow we will finish well and our hands will get to those who really need our care.

Tuesday morning while we were eating breakfast, the rains came down. While this delayed the departure of our mobile team and made the condition of our road to Asantekwa rather “interesting,” we were thankful for the storm. It cut the humidity and with the temperature dropping by just a few degrees, we had a much more comfortable day of work for us. I noticed a few hoodies and winter coats on some of my patients.

Anticipating a very large crowd, our NEA logistics team arrived at Asantekwa at 0400 to organize the lines using ropes and vehicles. Let’s just say they got a standing ovation from us all at dinner, as their creative crowd control measures allowed us to do our job with greater efficiency and effectiveness.

Some of you might remember that this is the village that a young woman died in our clinic two years ago. She came too late with a very serious medical condition, and despite our best efforts we could not save her. This death has and continues to deeply impact those of us who were there that day, and the root cause of her death has been a catalyst for some specific NEA programming that is now in place as part of the Leyaata Project. Today, Dr. Carlye and her translator Rachel, who is a Leyaata staff member, consulted on another young woman, who they were able to quickly discern was in that same situation. They intervened quickly and with help from NEA arrangements were made to urgently transfer the young woman to a hospital to prevent what surely would have been another needless death.

The eye team has been very busy seeing lots of interesting cases like vitamin A deficiency, central vein occlusion, congenital cataracts and glaucoma. Our laser was hard at work with 21 patients, and many of last year’s patients are returning for follow-up with wonderfully normal pressures in their eyes. As Dan reported tonight, their “clinic ballet” is so highly rehearsed that the team is working at maximum efficiency. “We may not be saving lives, we are making lives,” he said at dinner. I don’t disagree with Dan often (he is much smarter than I am) but I would argue they are doing both. When a farmer is given his sight back, he can now farm, and his children can now eat and go to school and are saved from diseases of poverty. The child growing up blind with congenital cataracts will not live to adulthood here. Their interventions and the ripple of their intervention are both making and saving lives!

Our dental team were faced with three very serious cases and with the assistance of our Ghanaian maxofacial surgeon Dr. Richard, all three cases were successfully dealt with. One was so serious that Greg, our team paramedic, had to rush in with his backpack crash cart and start some emergency IV medication stop a hemorrhage. Dr. Richard is now one of us. In fact, I just passed him placing a game of cards with Greg, Aaaron, Renee, Esther and Nicole under our gazebo!

The medical team applied every LEAN principle of efficiency to get through our massive crowd. With nursing constantly screening the crowd for the sick and treating minor ailments right from triage, we all worked steadily until the entire crowd was seen. Pharmacy carried a very heavy load of prescriptions with their usual grace, despite dodging bat droppings all day. At one point our nurse Esther (who works on an adult cardiac surgery ward ) was managing with ease at least four patients on IV fluids hanging from the rafters … half of whom were kids.

Back on the compound the surgeons started their day with another emergency case involving a two year old with an incarcerated hernia. He had been up all night screaming and vomiting in pain. Dr. Perry noted how rewarding it was to finally see that little one settled and comfortable as he recovered from his successful surgery. They had a very long day as eight of their cases required general anaesthetic. Oh, and there was an escape! Their last patient of the day was prepped and ready for a hydrocele operation and when it was time to roll him into the OR, he was gone. NEA staff went to try and find him but word on the street was that he was just too scared, ran away and was now in hiding. Poor guy.

There were many special moments scattered throughout this extremely busy clinical day. Dr. Carlye had a marriage proposal and wisely began to tell this gentleman about the weather in Canada. The proposal was revoked! One of the NEA pastors has been working very hard in his orchard this season to bring us a bag of his best oranges. Francois offered to say grace for dinner reciting the grace that he learned in as a little wee cub scout just a few years ago. And last but not least, I got a 20 point cribbage hand (without cheating) and almost skunked Dr. Charlie.

But the truly unique moment of this day involves the title of this blog. It happened to David Mensah, who went out to the village to search for the runaway surgical patient. As he was coming back towards the gate, he heard two men arguing. The topic of their argument — angels — caught his attention. One man was saying that these white people, bringing healing to the region, must be endowed by God with the spirit of angels. The other man was saying that no — we were just humans who have chosen to develop an angel spirit here on earth. David thought he would stop and listen. Just then Dr. Martin popped out of the residence to say that the power was off. The man turned to David and said “See, there is an angel right there.” (Side note to Heather: we are really trying not to let that go to Martin’s head.)

The one man then started to roll up his pant leg and started banging his leg. He told David that last year he had been to every hospital in Ghana with an infection that was causing his leg to rot. No one could help him until he visited our clinic and now his leg is perfect. He continued to argue with his friend (all the while banging on his leg) that the doctor and nurse who treated him were real human beings but they had developed the spirit of an angel to the level that was finally able to cure him. He was at the gate because he wanted to be first in line to come find his human angels to thank them.

Finally, not knowing they were talking to Dr. Mensah, they said to him, “And we also hear that there is a Ghanaian angel who coordinates all of this help from afar. Are you from around here? Have you heard of him?”

Oh, how David laughed when he told us this story, but he wanted us to know that his people are absolutely confounded by what they are seeing here. “You are angels to the people of the Mo tribe. Angels that come to stir the waters at the pool of Bethesda,” David concluded. He ended our evening by challenging all of us to continue to develop the spirit of love, compassion, generosity and service to humanity that brought us to Ghana — to this special place for this very special time of service.

Today’s blog is dedicated to Dr. Joshua Smith, our colleague and team member who could not be with us this year. Our team misses you, Josh, and our best wishes and prayers are with your family at this time.

When David and Brenda Mensah returned to Ghana to begin their integrated development work, David became very discouraged. Everywhere he looked there was suffering. Simple basic human rights like having clean water to drink did not exist. At one point he said to his wise wife, “Brenda, did we make the right decision to come here?”

Her response was this — “David, we will save them one by one”.

David is very wise too and he knew that we needed to hear this story today. As the crowds swell to proportions we have not yet seen and a hernia wait list that seems likely to reach 400, discouragement can set in as we begin to feel like the dent we are making is so very small. David reminded us that the only way to move forward is to deliver quality health care one by one and then watch to see the ripple effect. We must never underestimate what God can do with one life saved. We might be saving a David Mensah who will grow up and be a game-changer for his people. We might be saving a child who will one day be a difference-maker to his or her generation. When we save one man from hernia we save up to a dozen lives, because now that man can go back to his farm and there will be income to feed his family and send them to school. The ripples can spread far and wide as individuals are healed, communities are strengthened.

Today I had a special little “one.” Dorcas is 4 years old. She swallowed battery acid and was dying of malnutrition when she came to see us a year ago. It was a devastating situation and we did not have the capacity to do anything to help her. Leaving her in the capable hands of NEA with extra funds we raised, a referral was made to the highest level of care in Ghana. A lot has happened over the year and today this beautiful, happy, robust little girl paid us a visit, along with her mom and 3 uncles, just to say thank you. Dorcas’ only problem was that the family could not afford a critical medicine that she needed. Our wonderful pharmacy team happened to bring a 6 month supply of a very similar medicine and we were able to provide it to this family whose love for this little girl was just so apparent.

At dinner Dr. Chris gave a brilliant surgical team update that he organized by talking about something sad, something nice and something funny. I don’t think Chris will mind me copying his idea, so I present to you my top three list of sad, nice and funny events of today along with one extra category — interesting.

Sad

1. A surgery was cancelled today as the patient appeared to have advanced lung cancer with little time left to live.

2. A child from a very remote village who had a very, large painful growth between 2 of his toes for the past 2 months with no medical care. He could not walk. The suffering of this little one pierced my heart and the heart of Dr. David Hunter, our mobile surgeon, as we collaborated on how to help him.

3. We are seeing an unusually high incidence of orbital tumors that appear to be arising from the sinuses. Research is definitely required.

Nice

1. My Amelia was given a very special medal of honour by her nursing colleagues at dinner. Amelia worked in the oral rehydration (ORS) station today. She was responsible to ensure the mothers gave specific amounts of ORS every 15-30 min over a 2-hour period to the dehydrated babies. At one point there were about 8-10 babies in ORS at once and it was madness in that room. Her medal was a sachet of ORS tied around her neck with a string.

2. Dr Richard, a Ghanaian oral maxillofacial surgeon from the teaching hospital in Kumasi arrived today to join our dental team.

3. We found a short cut home tonight that shaved 55 minutes off our commute!

Funny

1. The places (on our bodies) we place our little package of frozen Fandango that Steve delivered around 2:00 pm as we are all wilting from the oppressive heat.

2. How easily you can talk yourself out of really needing to go to the washroom when you walk into certain latrines.

3. A team member who, in an apparent act of revenge, used another team member’s personal tupperware container as a receptacle of a certain bodily fluid. Said tupperware shall not be returning home.

Interesting

1. That a 10 year old girl can carry a huge pile of 3-4 foot thick tree branches on her head and remove one hand from the load to wave to us.

2. Ghana children don’t whine and seem to always do what their parents say the first time they are asked.

3. There is such a thing as a mushroom sandwich!

One of the quotes that Caitlin delivered during her 3:00 pm visit to us all said

I will not change the world; Jesus will do that. But I can change the world for one person. So I will keep loving one person at a time. – Kate Davis

Thanks to Brenda, David and Kate. The message we needed to hear on this day was very, very clear, and despite all that we are seeing, hearing, feeling, experiencing, and processing we will spend the next 3 days bringing our very best love and deep hope and tender healing to these wonderful people of Ghana … one by one.

Sunday morning began with a church service under the trees and canopies of the Carpenter compound. David Mensah arrived wearing his traditional regalia of the senior chief position he holds in this tribe, a role in which he leads other chiefs. The service was full of dancing, singing, testimonies to God’s faithfulness over this mission and then Pastor Jacob preached the sermon. He spoke on the story of Esther. When impending danger and death were facing her people she took action and she arose ‘for such a time as this.’

“We are writing our own Bible story here,” Pastor Jacob kept repeating over and over again. It was a service none of us will soon forget.

After church, Dr. Rob Hicks asked David to explain his role as senior chief, and, gathering under the mango tree, a large group of the team received an amazing lecture on Peace and Conflict in Ghana. This is a key sector of NEAs development work and David uses his role as senior chief to train local leaders in peace and conflict resolution techniques. He works very closely with the chiefs, many of whom are now Christians, to teach them to lead ethically and Biblically. Maintaining peace in the Mo tribe is so critical to the development work here.

After a lunchtime celebration of Margaret’s birthday with our little banner and tiara and a shoebox of treats collected by Francois, our afternoon was filled with wonderfully relaxing activities: napping, attending one of three book clubs and playing games under the gazebo. Dr. Neil ran a fun activity in the dining hall where everyone brought their devices with 5 favourite pictures from back home and pairs would have 5 minutes to share with one another about their 5 pictures after which you would rotate to a new partner.

At 4:00 pm our weekend of rest came to an end and all teams went to work to prepare for what will be four more very busy days of work. By suppertime we were ready to go. Suppertime is definitely worth noting. David Mensah carved two big NEA turkeys and we enjoyed fresh tomato soup with homemade croutons followed by turkey dinner complete with roast potatoes, gravy, stuffing and fresh vegetables from the NEA gardens.

I didn’t think I would have any patient stories to tell you today as we try very hard to allow our team to rest and be off duty on Saturday and Sunday. It is the only way they can maintain the pace of their work for the rest of the week. We put measures in place to have all medical emergencies directed to Dr. David and Collins, our Ghanaian colleagues. This is why I was so surprised to received the report at dinner of four very special patients and a truck.

Dr. Andy noticed a sick child sitting near him during the church service and recognized impending danger. The grandmother scooped this limp child up to take him home but Dr. Andy intervened. He mobilized his nursing team and diagnostic team and they treated this child for severe malaria with injectable antimalarials and watched him until he was safe to go home.

Nurse Sandra and Dr. Carlye were heading to the residence for a nap when they came across an exceptionally unhappy child and a worried mother. This 2 year-old had a strangulated hernia — impeding danger once again. They quickly brought him into the compound where one of our surgeons, Dr. Elke, was just exiting the lunch room. Her hands of mercy reduced the hernia and the child’s screams of pain immediately stopped. His surgery would have been done in the morning but he also has malaria so it will be deferred until Thursday.

Surgical nurse Aaron was strolling around a noticed a woman slumped over at the gate. Taking the time to find a translator he discovered this woman had been walking for three days to get to our eye clinic to have her glaucoma treated in her left eye. She was blind in her right eye already and was desperate to get to our eye team to save her from blindness. Aaron took it upon himself to find Dr. Martin and Dr. Toylin and within minutes the laser was fired up and her eye was saved. She was then given food and a place to stay before she would make the long three day journey home.

Dr. Kyle and Garrett and Greg were heading to the residence for some R&R when they noticed a big truck stalled on the side of the road. The driver was under the truck dealing with a leak of some sort. With dental head lamps on they tried to fix the problem but to no avail. The took it upon themselves to find NEA’s chief mechanic and successful emergency surgery was performed with a welding iron. I wish I could describe the look on David Mensah’s face when he heard this one!

So much for shielding the team from work today! Each of these cases involved impending danger or death (well maybe not so much for the truck) and like Esther, our team made a choice not to turn a blind eye. Rather, they chose to arise, to take action for such a time as this.

At the end of the church service we were asked to greet one another with a hand shake and the blessing “May it be well with you,” and so it seems fitting to extend the same to all of you — our loved ones, family, friends and colleagues following our time of service here. May it be well with you.

With love from Carpenter and thanks for all of your wonderful comments. They continue to be one of our daily highlights!

Everyone in the clinic eagerly anticipates 3:00 pm every day when Caitlin, our international development student (who is responsible for our medical records and statistics) visits every team member. She carries a “Keep Calm and Carry On” tin which contains a little sheet of paper with inspirational quotes and a small treat. Today I will open and close with two of yesterday’s quotes that arrived to us with a piece of ‘Double Bubble” chewing gum.

The world is full of good people. If you can’t find one, be one. – Mother Teresa

Dr. David is a new Ghanaian physician who was sponsored through school by NEA. He divides his time learning new surgical skills with our hernia team and working with the medical doctors in the village. When I work with David, I am reminded of how special our Ghanaian physicians are. They are very well trained, very thorough, and they remain so compassionate and patient regardless of the many challenges that come while (or should I say whilst) trying to provide care in a low-resource setting. We had a surgical emergency in the village today where I was reminded yet again of the calibre of Ghana’s health professionals. Dr. Elke was our surgeon in the village who dealt with this emergency. We consulted with Dr. David, whose first question to the patient was “Do you have health insurance?” When the answer was no, we asked each other whether our surgical team at Carpenter could handle this case. Dr. David’s response, “Please, it is his only hope. If we don’t try and save him he will simply die. By the time we got home from the clinic, this young man had been operated on by Dan and Magdi (with David Mensah observing, I hear) and the surgery was a success. The world is full of good people.

Nurse Rita just completed her nursing training in Ghana and is another one of NEA’s scholarship students. Rita has been a joy to work with and is bubbling with enthusiasm. As part of this team she has a chance to work with 13 nurses with a wealth of experience and she is soaking up every minute. We had a little boy in the clinic with a very unstable knee due to a football injury. His MCL and ACL was ruptured, so walking was difficult. I sent him over to our nursing station to see if they could rig up some kind of support for his knee. That sweet boy returned with the biggest smile on his face with nurse Rita, Nicole and Judy, wearing a perfectly fitted knee brace that gave him enough stability that he now walk freely. Team funds will be needed to assist him with the surgery he will need. The world is full of good people.

Our dentist Kyle is here for the 7th time. He had a very special patient from the Fulani tribe in 2009 and she returns for her annual check up every year. Kyle has been taking a picture of her and her large family every year. This year, he gave her printed copies of these family pictures. Can you imagine? Later than afternoon this woman presented Kyle with a chicken. You must understand the Fulani tribe of migrant cattle workers are the poorest people in Ghana. Yet she has given her dentist this expensive gift. The world is full of good people.

After dinner, team reports were enjoyed by all. Our surgical team say there are not enough adjectives to add to awesome to describe their last couple of days. Thus far, 150 hernias have been repaired and Rob believes they will meet the target of 300 by the end of the fortnight. (By the way, fortnight is my new favourite word). Perry and Eric (now referred to as Team Stellar) diagnosed a child with congenital heart disease, and this morning he will be seen by Dr. Anne our paediatrician and Dr. Charlie our heart surgeon. Oh, and newlywed nurse Mel received her first marriage proposal — I think that is 4 in total for our surgical nurses.

Nurse Sue gave a wonderful report on behalf of our surgical nursing team, Garrett on behalf of our dental team, Elise on behalf of the pharmacy team (who enjoyed 30 minutes of power today), and Jane on behalf of the eye team. We are not driven by numbers around here, but just to give you a sense of the scope of the work of our medical, dental, and eye teams, over 2,000 patients have already been cared for. Wow.

After dinner we gathered in the Mensah living room where David gave us his own quote worth noting: “We have come into agreement with tender hearts that everyone deserves things like clean water, food, education and health care. He introduced Mumuni, who is manager of the Leyaata Ane Project designed to rescue moms and babies from dying in childbirth. Between 2016 and 2017, 3814 pregnant women have been visited and assisted to deliver in a health facility and all of those babies are visited 3 times in the first week of life to look for danger signs such as fever, poor weight gain and jaundice that would require an emergency referral. Support and capacity building in neonatal resuscitation was provided by Dr. Carlye and me in 2015, but our Ghanaian master trainers have scaled up the ongoing training and support: neonatal resuscitation and early newborn care has been extended to 79 health workers and 105 traditional birth attendants. As a result, 1145 babies who would have died at birth were successfully resuscitated between 2016 and today. Our team was speechless. As a result of this program, which receives funding support from Global Affairs Canada, the neonatal death rate has dropped from 40-50/1000 to 5/1000.

Dr. Mensah concluded our evening but sharing a little bit about the vision for the “Leyaata Hospital“: a 50-bed model hospital, staffed and run by Ghanaian health workers under the leadership of NEA. A hospital that is desperately needed right now. Back at home we are working very hard to complete the capital campaign and we are well over the half-way mark. This campaign will provide the funds to build and run the hospital for 3 years after which it will be sustainable — just like every other NEA program. Dr. Rob, who was part of our one-year hospital feasibility study, is hoping to put some of the engineering drawings up in our dining room for the team to enjoy. Please see the GRID/NEA website if you want more information about this hospital — our collective dream come true!

The last quote on our little piece of paper yesterday was

Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy. (Proverbs 31:8-9)

This week our team with tender hearts have spoken up and we have defended the rights of the poor. Every day the Leyaata team with tender hearts is speaking up for the babies that cannot speak for themselves. And the day is coming soon when the Leyaata Hospital, full of tender-hearted Ghanaian health professionals like Dr. David, nurse Rita and pharmacist Emmanuel, under the leadership of NEA, will be defending the rights of the poor and needy for generations to come. I pray really hard that as we add more good people and more tender hearts to the NEA fan club, these hospital doors could be open sooner than we think.