Jet lag was large and in charge as I was wide awake from 130 until 500 am. My alarm went off at 6 and was mostly ignored until 645 (hopefully the walls were thick), when I had to get up if breakfast was going to happen for me. Breakfast was a veggie omelet, salad and marinated veggies and a piece of bread.
We were picked up in a hospital provided van and headed through pretty significant traffic to the hospital at 730. We arrived at the hospital and were dropped off in front of the clinic space. Today was going to be our one and only clinic day. It’s purpose: to see what cases we could and wanted to book. People were already gathered with their children waiting to see us.
We had two rooms 8 and 9. We were given several forms to fill out as we saw the patients. We decided to also take pictures of the surgical site on the kids and their sheet so we would be able to appropriately schedule them and remember them when their turn for surgery came.
We divided up. S and I were in room nine and A came to take pictures and help and everyone else was in the other room. I saw the epispadias kiddo first and decided I could do it. Our room then saw 29 patients over the course of the next 3 hours. In the end we were covered in glove powder, and I for one was a wide-eyed and wary about the severity of disease and the number of redo procedures we had seen. It is one thing to “know” and expect it, but quite another when the physical reality of how difficult these surgeries were going to be even in the best conditions is right in front of you. The children were of all ages (as old as 20 years), instead of the usual 10-12 month-olds that we operate on in the United States.
A traditional Ghanaian lunch was served that included chicken, salad, plantains and jollof, a spicy rice. While lunch was happening we started planning for the cases and which days they would be done. The case that I wanted to do first because I wanted him to be able to see him could not be done until later in the week because he had a low hemoglobin (anemia). We scheduled the kids that came from afar in the first two days and they were immediately admitted to sit in the hospital and wait for their day and time.
Throughout lunch and even the rest of our time at the hospital kids would occasionally show up to be examined. No one was turned away from an examination standpoint. Some were told they had to get echocardiogram (heart exams), or come back and be re-evaluated because they were sick. Several were told they needed to have testosterone prior their procedure and could not be scheduled at this time.
After scheduling 38 of the 41 patients seen for procedures, we were taken on a tour of the operating room and the hospital. The OR had all of the essentials. The wards were very similar to the wards in Addis Ababa. We had admitted a lot of children so they were all over. The children’s ward was bright and colorful with cartoon paintings (and lots of Mickey Mouse). Some of our kids shared beds with each other because the wards were full. One of the women we passed was very ill and surrounded by other women.
It is worth noting that they do not have the capability to keep children intubated. I do not know about the adults. This means all kids have to be healthy enough to be extubated at the end of a surgery. Families provide their food and medicine.
After the tour we went back to the hotel. My room had just been sprayed with a mosquito repellent which was so strong it made me cough until I threw up (I sure that has long term good effects). When I went to the front desk to ask them not to spray whatever plastic melting chemical they painted my room with again, they offered me a bottle of water. I decided would take my chances with malaria and the other fun things biting mosquitoes in Africa might give me.
We met up in the lobby and caught two cabs to Kejetia market, the largest single market in West Africa with over 45,000 stores and stalls. It was a great introduction to the food and Ghana (but I am ridiculously biased because as almost everyone knows: I LOVE MARKETS).
I got yelled at for taking a picture of some peppers.
Most of us showered and got ready for dinner, the hospital was going to take us out at the cultural center. We got to Ike’s restaurant and they also had a DJ (old school hip hop. With my new Hip Hop Dance lessons I had to restrain myself from using my “moves”.) and in the sky above there were thousands and thousands of bats (think Blue Planet or Planet Earth numbers of bats). Very early in the dinner A had to leave because she wasn’t feeling well.
We ordered traditional food and shared. It was excellent and I was excited (Food sharing is almost a requirement for friendship as far as I am concerned).
We got red red (a bean dish) and chicken, Fufu with chicken soup, Fufu Ebunebu, and Jollof and chicken. P got a delicious drink that tasted like ice cream, sugar, perfection, R and S got Club beers, and I got palm wine.
Fufu is made by “pounding” cassava and unripe plantains together into a paste, which is then molded by hand into a ball shape and served with a special sauce or soup. It’s gummy but also yummy. Ebunebu is a green soup with various proteins including seafood, a whole crab, who knows what else, and in my case a really large snail sans shell (which was eaten/stolen when I asked S to identify it).
Palm wine is from palm trees that are tapped. The sap is then allowed to ferment (which immediately begins and they say within 2 hours has up to 4% alcohol. If it is allowed to ferment longer it is stronger.). It tasted kind of like kombucha and was really good. It can also be made into gin. Dinner was fun. I already knew that I really liked the team, who I had met at the airport a little over 24 hours before. It was going to be a great week.
On our return to the hotel the DJ was still playing and there was a party at that pool. We decided to join for a drink before we headed to bed.
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