Amazing Village week

 I was so fortunate to be able to spend my final week in Ghana living in a small rural village 1 hour outside of Takoradi.

Fasin Village is a farming community of about 1,000 people. Emma and I lived with a farmer named David, his wife who trades the cassava that he grows in the local market, and 2 of his children who are still living at home. The house they live in has 2 rooms and the kitchen is a separate building next door. They have one of the nicer homes with a finished floor and roof. Outside of the house is the shower area. Without running water you have to go fetch water from the river and bucket shower. David's brother Prince lives next door and both families share his long drop outhouse. 

The living area 

Shower area 

Squat style bathroom with a smell like no other. 

During the week Emma and I worked in the health clinic from 8 to 2. We split time working in the outside area (collecting information and doing vitals on each patient) and the inside area (talking with the patient about complaints, doing malaria quick tests, determining diagnosis, and prescribing medications from the small selection at the clinic). At this clinic the main diagnosis is malaria and GI worms. They also do some wound care and family planning. All sever cases and referred to the large hospitals near by. The staff are all nurses who are sent to the small clinic to work by the government. 

The clinic is not as busy as the hospital so people come from all over to visit this clinic (even people from takoradi come to get care). They take both insurance patients and cash patients who do not have insurance. It was very cool to work in this general health setting and get the exposure to medications and diagnosis I do not see in physical therapy. The clinic gives injections so I even learned how to give them!!

Very few of the patients come with symptoms that could benefit from physical therapy. I did see 2 patients and tried to work with them how I normally would in an outpatient setting. This clinic had never had a Physio before and it was very evident that the staff was unfamiliar with the treatment and concept. The people in this area belive that the only way to make you better is a medicine so they are not satisfied when you educate and give them exercises. 

Clinic 

After clinic our guide, Ebineser, showed us different aspects of the village. We met the chief and the linguist and got a history of the village and it's people

The linguist always sits infront and speaks for the chief. 

We also got to see how the village people make coconut oil and palm oil

Helping stir before extracting the palm oil

Straining the coconut oil 

Went to Busua beach for one afternoon and after we went to the market to see David's wife Mary selling the families cassava.

We even got to spend an afternoon learning how they make local Gin from the Palm tree. They add a local root to help give it a yellowish color and fruity flavor 

I was very interested in this afternoon because of my interest in brewing beer. It was also the first time in 4 and a half weeks that I got to hangout with more then 3 guys my own age at a time.

We also got to visit one of the farms and helped to weed the cassava plot with machetes. After that we helped the cook prepare dinner by pounding the Fufu (cassava and plantanes that are pounded together into a sticky paste like consistency).

Preparing the spicy fish soup you eat the fufu with. 

Finished product 

Ebineser was a great resource and friend. He treated is like family and even had us meet his friends. We got along so well with one of them that he decided to join us for dinner and brought a bottle of wine to enjoy our Fufu with 

Myself, Messick, David the father of the family we lived with, and Ebineser. 

In the afternoon I was able to do some exercise every day (running on the beach, running from Fasin to the neighboring villages, and even getting creative with the cement blocks laying around). At first the kids just watched but as the week went on they started to join in. It was so much fun and great to have them join in. Emma took a few pictures one of the days.

The village kids were the best part of my time in Fasin. Everyday we had a group who walked us to clinic, walked us home, and even sat near us during dinner so that as soon as we were done we could play with them. They taught us dances, games, songs, and we showed them some games we used to play. 

These kids were the hardest thing to leave on Saturday. They were so much fun, always had a smile on their faces, and were so caring you would have no idea that they only have 3 outfits and very few toys (unless you count the sticks and natural resources they turn into toys). It will be great to see boys like Daniel, Darius, Jacob, Wisdom, and Dadi grow up and have great success in life. 

Darius and I hanging out before dinner. 

Overall this was an amazing week. I loved living this basic lifestyle and getting to really feel the culture. It was a great way to end this amazing adventure and I cannot wait to tell everyone about the trip when I return home!!! 

My favorite picture from the entire trip. After the workout the boys wants to compare muscles so Emma snapped this photo. 

 

Stilt village weekend

So when I left clinic on Thursday I was told that everyone in Physio would be on strike and not going in. I was already planning my day to be a nurse in the hospital. Late that night the senior therapist called Joe and said they will not be striking and I willl get to work my last day. 

I began the day with my favorite Erbs Palsy patient. I told the family it was going to be my last day and so they brought their other 2 children because they wanted a picture as a family with me. I thought it was awesome and felt so honored that they enjoyed the experience so much. 

(They gave me permission to use this photo.) 

The next few hours I worked with the physios to implement some of the exercises and programs we talked about at the inservice yesterday. It was really nice to see them using these new concepts.

I also got to evaluate an ankle sprain. I was able to teach the senior therapist joint mobs, cross friction message to the ATFL, and dynamic exercises. She was shocked how he came in with pain and after treating and reassessing he did not have pain anymore. She will be treating this patient during the rest of his time at the clinic so we made sure to practice techniques before he left. After the session she said she really wants to go back to school and learn more to have that kind of thought process. She also told me I need to come back and teach in Ghana!  I was so pumped that I almost planned my next trip right in that office. 

The physios used the exercise log today and also were writing objectives and assessments in the folders today. I was so happy to see the ideas being carried out!! 

In the afternoon we headed to Axim which is a coast town about 1.5 hours towards Ivory Coast. We spent the afternoon in the ocean. The hotel was very nice and the showers were luke warm so everyone was very happy about that (compared to the cold showers we have everyday at the house). We had the dinner at the resturant in the hotel and the coconut chicken was pretty amazing. 

My cast away outfit

The nice showers

Coconut chicken with jallof rice and veggies 

I woke up pretty early on Saturday morning and spent a few hours relaxing on the beach and having some time for myself to take in this entire experience. The sun came out and I felt like I was on my own little piece of paradise . As I walked along the beach a few locals were collecting firewood but beside that it was me and the sounds of the ocean. Very refreshing after so many weeks of non-stop people.

After everyone woke up we had breakfast and set out for our trip to visit the Amanzule Stilt Villlage. It was built 600 years ago and is still maintained and inhabited by 450 people. We took a 45 minute canoe ride out to the village after the Tro-Tro. It was a nice workout but crazy to think that these people need to do that trip every time they need to go anywhere. 

Once we got to the village we were given a history and tour by a few of the locals and a tour guide.

Family kitchen 

Fish traps

Classroom 

The village was very cool to visit and something that many people do not see while in Ghana. 

Small block in the road on the drive back 

Heard of cattle 

All in all it was a nice weekend before I head to the village on Sunday.

Another student, Emma (nursing student from the UK), and I will be living the next week with a family of 5 in a small village called Fasin. It is primarily a farming village of Palm, rubber, and corn about 1 hour outside of Takoradi. We will be sleeping on mattresses on the dirt floor of the families home, be without running water and electricity (so bucket showers and no lights when it gets dark outside, and no more blog posts) and very little English is spoken. We will be working at a general health clinic Mon-Fri from 8-2 and then each afternoon we will participate in different aspects of the village (preparing FuFu, making wine, seeing how the Gin is made, visiting the  market they sell the village goods, and learning more about the way of life/culture of a small village. I am so pumped for this week and can't wait to write about it when I get back!!!!

Just a recap of the beard progression...

Day 3 in Ghana

Day 28 going strong 

 

Week 4

Got a little behind with posts so I will combine Tuesday through Thursday.

Tuesday: I did an evaluation on a patient who had a severe fracture of his distal

Humerus, ulna, and radius. He was on the wards for 3 months and after one month of being there they found more fractures in his proximal humerus. He was discharged from the hospital and sent to OP PT. Without x-rays we were not comfortable with doing anything more then isometrics and PROM even though it has been 3 months. For the rest of the day I went on ward rounds to the male and female medical wards to treat patients. It was a very interesting experience. The pace and attention of the nursing staff here is much slower and less patient centered compared to the US. 

After clinic the other American and I did a workout and then I signed up to take the National boards exam in October. The house had another Famte lesson and we learned the days of the week. Here many of the people are named for the day they are born.  

My name is Kwame (many people in the clinic call me this because they like to say it more then Kyle) which means a male born on Saturday. 

Wednesday: I spent the whole day working in all areas of the clinic. I worked with my favorite Erbs Pasly patient first and then another baby later, 3 stroke patients, one deconditioned patient, the orthopedic arm fracture patient from Tuesday, and one paraplegic patient. After clinic went home and did a workout. At night an ER doctor came to the house and gave a lecture on malaria. It was very interesting but the amount of detail was almost a little to much for my attention span. 

Thursday: Today all government workers have gone on strike. The entire staff at the hospital is employed by the government. For the entire year taxes have increased for government workers and prices on fuel and goods has also increased. The people have been trying to fight this and nothing has happened so today they decided to make a stand. Luckily most of the staff came in for the wards and emergency department. The entire outpatient section of the hospital did not show up. Today I was going to do an inservice presentation for the Physio staff so the entire department showed up. However they were on strike so they wore red/black and did not see many patients. Many of our patients did not show up because they had heard the news on the TV and radio, but overall 14 people still did. I ended up seeing 7 of the patients because I wanted to help and let them continue to make their stand but also give the patients care they deserve. I am glad that the people of Ghana can come together to make their voices heard and try to keep their government in check. 

We closed early so that I could give my inservice on stroke rehabilitation (it is about 65% of the caseload), Bell's palsy, and documentation. It was planned for 30-45 minutes but with many questions, demonstrations of the exercises and concepts, and discussion it ended up lasting 1 hour 40 minutes. I was so happy how much I could teach them

And how engaged they were in the information. Overall it went so well and I really think that some more of the ideas will be implemented.  They have decided to begin using exercise logs and doing short (1 sentence) daily notes. I am also going to stay in touch and follow up to provide more information and help make changes as needed.

After the presentation the senior therapist PT Mina stood up and thanked me for my work ethic, commitment, and education during my time here. I feel that I got just as much if not more from this experience then I could give them. She ended by presenting me with a traditional Ghanian dress shirt that was handmade for me by the mom of head of the Physio department. I was so honored and in shock that all I could do was hug everyone. I feel like this experience has been amazing but never in a million years expected them to give me anything. I put it on right away and then we took pictures together. 

My new shirt and the 2 senior physios 

The group and the shirt I wore to do the inservice.

Three physios I became great friends with during my time here!

The Physio department willl be on strike tomorrow and entire staff will not be going in to work so today was my last day with everyone. It was very sad to say goodbye to these new friends. By the end of the time together we were joking around, making fun of each other, learning about each others lives, and acting like we have worked together for years. I plan to stay in touch with them on a personal level but also on a professional level to keep providing information to help with care. 

Tonight is my final house BBQ and I plan on eating a lot, dancing in my new shirt, and getting ready for a fun weekend before my village experience!!!