GRID and NEA News

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.

The morning commute to Yaara is always interesting. After about 20 minutes on the main road we turn on to a dirt road that I fondly refer to as “Washboard Avenue.” After another turn, the road becomes more of a path lined by tall grass. Every once in a while we would pass a small village or a school. All the while the road seems to get narrower and narrower and the pot holes deeper and deeper. After crossing the amazing Makbraneth Bridge, we got momentarily stuck in a big mud puddle. Thankfully, our expert driver Simon got us out of it before we had to decide who would do the pushing.

Just under two hours later we arrived in beautiful village of Yaara, the place where David Mensah was sent as a young boy after his father died of a hernia. David explained it was a village that mistreated him so severely that he had to escape yet, many years later, it was one of the first villages that NEA brought its development work to. David speaks about this in detail in his book Kwabena.

After such a long and bumpy bus ride, many team members reluctantly headed to the latrines. Suddenly there were whoops of joy as we discovered brand new, never before used latrines built by NEA and the Makbraneth Foundation. These latrines had doors. These latrines had locks on the doors. These latrines had … wait for it … toilets, which quickly became known as thrones! Oh my, there was such a commotion as people started cheering from behind those doors and I believe it was nurse Joan who broke out into the Hallelujah chorus. The latrines were the topic of the day in the lunch room!

The school was quickly transformed into a a clinic due to the coordinated efforts by every member of the team and our Ghanaian volunteers. It is a logistical work of art (thanks Kim, Steve and Dave) as every canopy, hockey bag, table, chair and even garbage bag gets to the proper destination. While we were setting up, the beating of the drums began and soon the women started to sing and dance. The team made their way over to join the dancing, but Dr. Sue and some of our nurses had to miss the ceremony as they were attending to a critically ill teenager who needed stabilizing. David’s brother, Chief Joseph, and his elders were seated and had a great laugh watching us all trying to dance to a beat that we cannot quite find with sweat pouring down our faces in the already well over 30 degree heat. I have to say Dr. Anne and Dr. Charlie won the prize for most enthusiastic dancers!

When the drums stopped, greetings were exchanged and Ashley Gayton (one of our surgical team members who joined us today) presented the chief with a gift and Margaret from the eye team presented a gift to his wife. Dr. Rob and Elena brought a soccer ball for each village and Amelia presented that as wide-eyed little boys and girls looked on. The Assembly Man then spoke eloquently on behalf of the Chief and Elders and explained that our annual visit over ten years has become a strong motivating force to them. Our efforts and our presence year by year has motivated their community to do more and more to help themselves and improve their situation. For example, they have been advocating for many years for a health centre in their community and he announced that approval has been given. Soon a nurse and a midwife will be posted in the newly built Yaara health centre to provide year round care! We have all been praying and waiting for that day! He also commented that their health has improved not only because of the medicine and surgery, but because their community’s consistent interaction and socialization with us has added to their health enormously. The ceremony concluded with the presentation of a ram, more yams and large piles of fresh pineapple, papaya, watermelon and bananas that neighbouring villages contributed to the group gift. The chief then called my daughter forward and his wife Hagar handed her the gift of a live chicken. As Dr. Andy said at dinner, the look on Amelia’s face as she held that chicken was priceless! The chicken fell out of the pickup on the way home but survived his attempt at escape. Poor guy.

All sectors of our clinic ran so well today and one patient at a time was treated with compassionate, highly quality care. Team spirits were very high despite the blistering heat. Our pharmacy and dentistry station were surprised and thrilled to be working in a brand new three-room school with electricity and fans. Sherry’s happy dance unfortunately only lasted for about one hour when they lost that precious power and out came the reliable old generators once again! It was an “hour of power” our pharmacy team will never forget.

Some of you will remember stories of Joshua, David’s nephew who, seven years ago, almost died from severe pneumonia while we were in Yaara. This tall growing young man paid us his annual visit and it seems like yesterday to many of us that we almost lost him as a sweet little baby.

Our newcomers took a brief walking tour through the village and salty bus snacks (highlight of the day) were handed out thanks to our Hunstville friends of John, Jenn, Cheryl and family. With God’s help, we arrived safely back on the compound before dark.

Back at home base the laser clinic was busy restoring sight and putting another big dent in the epidemic of glaucoma here in Ghana. Our optometry team is already talking about the next step — which would be cataract surgeries. No pressure Dr Toylin!?I’d love to report on how our surgical team’s day went but they still were still in the operating theatres when we all left for bed at 8:00, completing the 40th case of the day. What a long day they had, but they will be happy to enjoy another amazing meal of Fufu from Lucy’s yams and guinea fowl tomato soup. Apparently Lucy’s guinea fowl gave the NEA staff a very hard time when they tried to catch them.

Today was a day where our team values of service, teamwork, sensitivity, professionalism and resilience continued to come to life in so many ways by so many individuals in Yaara and on the Carpenter compound. Our sixth unofficial team value is “to have fun along the way,” and we are all thoroughly enjoying every moment of our time with our dear friends at NEA and the people of Ghana.

There are moments during every mission when I realize afresh that the beautiful people of Ghana are no different that you and I. I realize that sounds like an odd statement. However, when you are dealing with a culture that is so different from ours and when poverty is staring you in the face, I am embarrassed to say that it happens.

There were two moments when this reminder hit me so hard today that I had to pause and regroup myself. The first came when I received a visitor. Evans was a little boy we saw last year who was born with a stump for a right leg. With funds left over from last year’s mission we were able to arrange for him to be fitted for a prosthetic leg. He and his mom made the journey to Nyamboi to thank us for giving him his life and the mom started to brag about his football skills. An incredible story on many levels, but it was her bragging about her little boy that reminded me that she is no different from any mom who loves to tell of her kids’ accomplishments.

The second reminder came to me when I had three very sick kids with malaria who were so scared of my white face. My clinic nurses back at home, Jill and Kelly, snuck some big Paw Patrol stickers in my bag before I left. The moment those three kids saw those smiling animal faces, they were the happiest kids in the world and would let me do anything.

A proud mamma. A child with a sticker. These parents and these kids are no different than yours or mine, except that they were born in Northern Ghana.

Wednesday was rich. It was wonderful. It was challenging. It required every ounce of teamwork we could muster to manage to care for the large numbers of people and the challenges that arose throughout the day both in the village and in the OR. It is humbling work and flexibility and adaptability and teamwork skills must be applied moment to moment.

When we arrived this morning the crowd was under incredible control due to the arrival of our hard-working Ghanaian volunteers, who were on sight as early at 4:00 am. The clinic began immediately and three of our surgical team colleagues — Dr David, Ted and nurse Mel — enjoyed their first African village experience. Their help was really needed. I was greeted immediately by Letichia, the village nurse. This dear woman is the only nurse midwife in the community. She is on call 24/7 with no back up. She was absolutely dancing with joy with the health care being delivered in her community. She has been through two of the “Helping Babies Breathe” neonatal resuscitation training programs that we ran with the Leyaata team and is now a master trainer. As she shared stories with me about babies successfully resuscitated, she once again was jumping for joy.

Taking off on Ashley’s “Team Awesome” title, Abraham and our logistics team decided to play a game with all of us today. As they visited each station and asked how they were doing, the first word they said was to become their team name. Giggling away, he announced our new names: Weights and Temps: Team Great; Triage: Team Beautiful, Diagnostics: Team Wonder; Nursing Treatment: Team Busy, Physicians: Team Perfect, Pharmacy: Team Happy Feet (Sherry was doing another happy dance at the time); Dental: Tooth Thieves. Abraham is saving the registration, logistics and eye team for tomorrow!

Dr. Bill had a very sick 5 month-old with malaria and sepsis and worked with the nurses all day to stabilize the child. I have no idea how Joan found a vein in the tiny, dehydrated foot, but life-giving fluids and medicine were running through it. Bill confessed he would not have slept a wink worrying about this baby surviving the night if she went home (that’s how much we care for these patients). Although she improved a great deal, we felt she would be best to continue treatment in the local hospital due to her young age. Arrangements were made. Bill shared with me that their plan was to walk to the next village, and get a motorbike to take mom and baby to hospital. Bill noted the injustice that in our shop, an ORNGE ambulance with the Sick Kids team would be landing right now. Instead they will travel 2 hours on a motorbike on a dangerous road as it is getting dark. Nelson Mandela said, “How we walk with the broken speaks louder than how we sit with the great. Overcoming poverty is not a task of charity. It is an act of justice.” Bill lived out that quote today.

Our team Pediatrian, Anne, shared about her special patient and special teamwork moment involving a child drifting in and out of unconsciousness from severe malaria and hypoglycaemia. Anne said it was just the most incredible sight to enter our nursing treatment area and have the diagnostic team (led by Tracey), and the nurses on duty in the station (Joan, Kathleen, Nicole, Leslie and Val) descended on the child and in minutes the IV glucose, antimalarials were running. An hour later Anne came back to find the child sitting up drinking and she was ready to go home by the end of the clinic.

Our clinic ended with the Chief of Nyamboi presenting our team with a large pile of yams and a beautiful ram. His parting words were that our delivery of health services to his village was highly beyond their imagination. The ram rode home in the back of the eye team truck (with all of their very valuable equipment). Apparently that didn’t go over too well with our optometrists!

Our surgical team had a fantastic day full of challenges that were overcome with team work, and our Ghanaian anaesthetist shared how he was left in charge of a case when Perry was called out for an emergency. Eric felt his courage slip as Perry left but quickly realized that “when you are trained by master trainers, you will be ready to overcome.” The team had the privilege of operating on one of David Mensah’s family members. No pressure!

Dinner was waiting when we returned. I know some family members back home were worried about what their loved ones might be eating in Africa so I thought I’d give you our dinner menu from last night: pumpkin and ginger soup, fresh bread, rice garnished with corn and peas, rice sauce, roast beef with BBQ sauce, salad with fresh vegetables and eggs, yam fritters (made with Lucy’s yams) and fresh watermelon, grapes and pineapple. Needless to say we may not lose any weight in Ghana!

Our special dinner guest tonight was Dr. Mensah himself, and he updated us on some world news and weather reports from home. He gave touching words to us all on behalf of his people, reminding us that many of them have never sat in front of a nurse or a doctor in their lives. He prepped us for Yaara, his village — a village where health is returning due to the consistent efforts of the medical team. Unfortunately a crew of our people missed his speech (Dr. Carlye, Lisa, Bill, Val and Joan) as a medical emergency arrived during dinner time.

We thought our day was finally over but as we walked back to our residence a hysterical mother brought her daughter to the gate who they thought had been bitten by a snake. Thankfully it was “JUST a scorpion bite” and we were able to send her home with some pain medication.

As this day closes, I must say that it is the chief’s final words to us that are ringing in my ears. What occurred today in the village of Nyamboi and in the operating theatres and the eye laser room in Carpenter was highly beyond anything any of us could have asked for or imagined. These words come from one of my favourite Bible verses. For those of you praying for the team, your prayers are being heard.

On to Yaara we go!

The medical team set out at 0630 for the remote village of Nyamboi. The chiefs and elders were waiting to greet us and we quickly moved to the greeting ceremony where the chief’s closing remarks were, “I pray this consistent relationship will endure forever.” My Amelia presented a gift to the chief; Elise, our star pharmacy student, presented a football to the village; and our birthday girl presented a gift for the chief’s wife. Renee celebrated her birthday with us and Nyamboi village invited about a thousand people to her party!

Our logistics team had their work cut out for them today as the crowd was very large and loud and pressing in constantly. They have a very tough job.

Our triage team of Sandra, Greg and Les did a great job screening the crowd, deciding who could be treated for minor ailments and sent home, and who needed to be seen by the doctors.

Before our nursing station was even set up, the whistle blew. The whistle sounds when there is a major emergency. Every day we have one physician assigned to deal with emergencies and they respond together with Greg, our advanced care paramedic, and one of our nurses. Two unresponsive kids with severe malaria were carried in as Dr. Charlie got to work. Soon thereafter a man having severe angina and heart failure arrived. It was no coincidence that Dr. Charlie is a cardiac specialist. Set up or not, the team was ready. That is one thing I love about this group of people — they are always ready, always prepared for anything.

All team members worked extremely hard in extremely hot and loud conditions today and provided such compassionate and excellent care to a large number of patients. We thank God that all the critical patients turned around in time to go home.

The eye team tells us they had awesome day as all systems were running effectively and the volunteer eye team — now called “Badama” (Barb, Dan, and Margaret) — have really caught on to their new roles. Back the compound, Dr. Angela and Marion restored sight to 2 patients with glaucoma and dealt with some eye emergencies.

Our surgical team started their day with an unexpectedly challenging case that required all hands on deck. Dan was so impressed with the teamwork that is necessary when working in our low-resource conditions here. Twenty-three lives were changed in that OR today.

At dinner, each team leader designates someone to report to the group on how their day went. We share about the patients we meet, the challenges we face, and of course there is always a lot of laughter as we hear about things like … wedding proposals (Sue has had 3!), dental drama (Francois), aches and pains that surgeons didn’t know they had (Dan), and happy dances over simple things like power (Sherry) or frozen Fandago at lunch (all of us).

I am so thankful to God that our team’s health has been wonderful. The only exception is that latrine phobia has kicked in. It is real and is it quite common to hear team members wishing each other luck as they pass one another on the latrine path. Dr. Carlye, our team doc, kindly ran a constipation clinic after dinner and it was appreciated by many. Our gazebo is now buzzing with excitement as Esther the local seamstress is selling her cloth for the outfit she will make for many of us.

Well, 0545 is coming very quickly and it is time to rest. As they say in Ghana, may God grant us tomorrow.

Much love to everyone back home — we appreciate your support and comments that feel like a little lifeline to home.

Every morning, the entire staff of NEA gather together under their big gazebo to pray for one another and pray for the day ahead before they begin their work. We were all invited to join them this morning. After a time of singing, an elderly woman named Lucy from Carpenter village walked slowly to the centre of our gathering and thanked our team for the kindness that had been extended to her people over the past 10 years. She told us she was a poor woman but she needed to return the kindness so she worked and planned all year in able provide us with a gift from her farm. Her gift was a bowl of 10 very large yams and 9 guinea fowl — a gift we might expect from a village — not one woman. The significance of the value of this gift was not lost on any of us.

David Mensah shared a passionate message from the book of John in the Bible. He told us the story of Jesus healing a man who had been ill for over 30 years at the pool of Bethesda. None of the disciples wanted to go to that place of suffering except for John. He explained that to his people, we have become a pool of Bethesda — a house of mercy, hands of healing. He then gave examples of patients he has met with in recents months. A man whose daughters would have been orphans if not for the emergency surgery performed by Magdi’s hands of healing; a woman who can now thread her needle to make income from sewing thanks to the “tall man” (that’s Martin McDowell, our lead optometrist); a man who can now “crack bones with his teeth” due to Kyle’s hands of healing; a child saved by the IV placed by nurse Joan’s healing hands years ago. The examples kept coming as David walked around the gazebo … Charlie’s healing hands, the pharmacists’ healing hands, the nurses’ healing hands. You could have heard a pin drop in that gazebo.

After omelettes, porridge, fruit, beans and Tim Horton’s coffee, all of the newcomers went on a 30 minute tour of the NEA compound with David.

Two hours later, that group came back stunned and amazed and so excited about at what they had just witnessed. NEA’s integrated development projects from fish to rabbits to peanuts to ostriches left them speechless. Caitlin, who is studying international development in university, said that everything she has been learning just came to life. Whilst (love hanging with UK friends) the tour was going on, Kim worked with our local hosts to train the translators and volunteers who will be collecting our registration and important stats for the Leyaata program.

After lunch the surgeries began and by dinner, 20 surgeries were successfully and safely treated. I popped my head into the Brenda theatre mid afternoon to hear Ashley’s voice announce “Welcome to Theatre Awesome!” Awesome it was with the glowing faces and healing hands of Emilia, David, Dan and Ashley cheerfully going about their work. Our young Canadian nurse Emilia was definitely keeping those three British chaps in line! All of them were wearing brand new scrub hats donated to the team by Esther, a local seamstress.

While surgeries were being performed an amazing sea of white shirts provided care to the NEA staff and their families as the medical, dental and eye teams kicked into action along with their translators and volunteers. I couldn’t believe how smoothly it went for a first clinic — especially with half of our team being there for the first time. Despite a few hiccups, such as losing power to our automated pharmacy, problems were identified and fixed with great speed.

After another awesome dinner, awesome stories of the day were exchanged by our awesome team leaders while Eric, our Ghanaian anaesthetist, told me he could write a book on all he learned in one day from Dr. Perry. We love our Ghanaian colleagues and are thrilled that a new Ghanaian physician graduate, Dr. David, and a new nursing graduate, Rita, will also with working with us for these 2 weeks.

We all headed off to bed leaving Dr. Toylin, our ophthalmologist in deep conversation with Abraham and Soale, our local leaders, about a life-threatening case involving a young woman with a very large tumor behind her eye. We need great wisdom to discern the next steps to help her in her great suffering.

The surgical team headed back to their residence for a team debrief and the medical team unwound under our gazebo with a good dose of journalling, puzzling, colouring, very competitive banagramming and playing some euchre. My daughter Amelia was amused by how health professionals choose to unwind.

Off to a village tomorrow — our day begins at 0545!