Annie goes Ghana

So far there has always been at least one thing a day that surprised, shocked or amazed me. The past days I spent at the hospital in Agroyesum have been amazing! a great mixture of all of the above!

When I arrive at the hospital the doctors are already at the operating theatre. To my great surprise (and enthusiasm) I can join them straight way. As soon as I have put on some scrubs, shoes and nurse's cap and mask, I enter the OR and see that I got “lucky” straight away! They are in the middle of a Goitre operation. (swelling of the thyroid gland due to iodine deficiency) These swellings can get really big (bigger than my fists) and in the rural areas in Ghana people believe that women with such swellings are witches. These surgeries are therefore essential to avoid social exclusion. Since the doctors are only here for two weeks they mostly perform surgeries that local doctors cannot do themselves, one after the other! This means that in the two OR’s there are surgeries all day long: hysterectomies, hernias, goitres. The doctors are all very kind, and I’m allowed to watch any operation! Other common surgeries are skin transplants to treat Buruli Ulcer. This is (if I understood correctly) a bacterial infection which “eats away” the skin and is unfortunately quite a common disease here. Sadly, many wounds are horribly neglected, and some children/people are only brought to the hospital when the only way to treat it, is either a skin transplant or in the worst cases, amputation. I get to see both surgeries, and whereas I find the skin transplant very interesting to watch, the amputation is emotionally too much. After several Goitre operations I have become used to all the blood, but knowing that this boy will wake up without his arm, (and will not have the same support we would have in Europe), makes it too difficult for me to watch.

Overall however, I really enjoy watching all the other surgeries and am once more convinced that this is what I want to do and study and I hope that one day I will be able to do the same! I greatly admire the doctors for their work, especially taking into account the primitive conditions. As has been the general rule to basically everything I have seen/done so far in Ghana, things are “never quite the same”. Whether it concerns the ‘hamburgers’ we have looked forward to for a week, the way they change diapers or how they celebrate birthdays: it’s always “just a little different”. This often enriches our experience, but sometimes makes it more challenging. That in this case it means it is more challenging for the doctors, appears straight away as I enter the theatre and see the list of equipment:
Trolleys: 5 (4 broken)
Computers: 1 (not in use)
Anaesthesia machine: 4 (3 not in use)

I immediately understand why the German doctors decided to take their equipment/narcotics etc from Germany. Although I wonder how the local doctors usually manage. Another “little complication” occurs when there is a power cut during surgery, and the surgery needs to be stopped. Fortunately the hospital has its own generator and after 5 minutes power is back on.
On the third day I am allowed to ‘scrub in’ on a Goitre operation! I have to wear the special sterile apron etc. and follow the strict regulations when standing by the sterile table: you’re not allowed to touch anything, except the things covered by sterile cloth/plastics, always keep your hands up etc. etc….(Terrified by being shouted at in German by the theatre nurse, I make sure not to lose my concentration!). During the operation I have to keep the hole/cut in the neck open using several clamps. Sounds quite easy, but after 4 hours(!) both the heat and muscle ache start to kick in! Nevertheless I find it very interesting and realize it's a great oppurtunity, since I'm also aware of the fact that this would not have been possible anywhere else! Only my mask can hide the big grin I have on my face.

Another highlight of the first 4 days, are the two caesarians I get to see. Although it is amazing to see a baby being born, I have difficulty appreciating the “miracle and beauty of birth” since I was overwhelmed by the bluntness with which the baby is delivered (at one point I almost have to laugh since it just seems so contradictory to the idealized idea of "the miracle of life"). After having watched a 4 hour surgery of delicate and intricate cutting, the force and especially the speed with which the baby is delivered astound me. The womb is cut open in one go, but when they start doing the thing I am about to describe, I am grateful for my mouthcap, hiding how my jaw just drops. The two women start tearing the skin on either side with such force, I immediately have a flashback of Fred and Emmanuel fighting for a toy in the orphanage: with full body weight! Everything goes very fast, the water breaking and the baby being pulled out, within 5 minutes!

After four days of watching surgeries and doing ward rounds, I go back to Anwiankwanta for the weekend, since the doctors don’t work during the weekend. But I will go back on Monday and will stay till Tuesday. So I’m curious what other cases are awaiting me!

On Monday the 2nd Bas and I leave for Accra since I have to take my BMAT exam for UK universities. Another 6 hour busride with my favourite Nigerian movies! Fortunately the nuisance of having to take an exam is outweighed by the fact that a) my parents are coming to visit for a week and b) we’re meeting them in a very nice hotel (hot showers, clean beds, potatoes, vegetables and deserts!!) So I actually end up looking forward to this day. I have to take my test at the British Council with three other people. Although the test is hard, I’m relieved that it’s done and excited to take my parents back to the orphanage. My dad has been to Ghana several times now. Ever since Diederick first came here, 5 here ago, we have kept in touch with Paulina and have tried to help the orphanage as much as possible. My mom on the other hand, has never actually been to the orphanage, but having lived in Gabon for 6 years I think she knows what to expect!

When we arrive, the kids are thrilled about the new batch of Obrunis: “Mr. Robert and his wife!” During the week my parents are able to get a lot of things done. Since the two new houses are now finished we want the kids to move in as soon as possible to reduce the chaos in the other house. Therefore beds, tables and couches etc need to be bought. But of course my parents also spend time with the children in the orphanage, participating in the daily routine of feeding, washing, changing and playing games. Having brought 3 suitcases full of clothes (thank you so much everyone!) the children are over the moon, literally jumping up and down in the suitcases and the little ones all try to fit in!

The following Monday is an extra special day, as the two new houses will be officially opened and the older children cannot wait to spend their first night there. (The toddlers and babies will stay in the old house) All dressed in their church clothes, the kids join in prayer. A priest has been invited to bless the house, asking for God’s support and to keep the devil out of the house. This goes on for about an hour, and despite their excitement the kids all obediently participate. Fortunately the, in my opinion slightly frightening, repetition of the children: “I will not fear the devil” and people mumbling in Twi while nervously walking up and down, is eventually replaced by more cheerful singing and clapping. And the actual ‘party’ can start!
On Tuesday, the last day that my parents are here, we go to Agroyesum, where the old orphanage used to be. Since I have great memories from the three weeks I spent there last year, and because my mom would like to see “where it all began”, we decide to go back. I had forgotten how remote Agroyesum actually is. Whereas Anwiankwanta still has hard roads, Agroyesum is really in the middle of nowhere and can only be reached by very bad dirt roads. The ‘village’ itself is extremely small, maybe 300 metres of small stalls. The only reason why it is significant is because there is a small hospital. The old orphanage is located in the hospital compound, which is generally a very peaceful and friendly place. This tranquility is quickly interrupted however, when we are spotted by the kids from the primary school. They all come storming at us: “Obruni!! Obruni!!!” and will literally not let go of us. And so it happens that the otherwise deserted orphanage is immediately filled with about 50 screaming children. Comparing this tiny little house with the 3 new houses, filled with children, in Anwiankwanta, it’s hard to imagine that it all started with one baby 16 years ago!

Since we are at the hospital I would like to check if there are any volunteers working there. We’re incredibly lucky: a team of German doctors just arrived two days ago and they will be staying for 2 weeks. When I explain to them that I would like to study medicine and would love to have a look at the hospital they kindly say that I can join them for some days next week. I am incredibly happy and cannot believe how lucky I am, since this is almost like a dream coming true: working in a small clinic in the middle of nowhere in Africa!

Unfortunately my parents leave on Wednesday, which is a real shame, it went by so fast! But it was really nice to be able to share this with them, since although I try really hard on this blog, some things you really can’t explain in words!

I cannot believe that we have been in Ghana for a month now! It has gone by so incredibly fast. But so far it’s been great! Yet, it also feels ages ago that we were at Schiphol airport, just because we are living such different lives right now! Looking back it’s funny to see how quickly we have adapted ourselves and how we have become so used to the routine: working at the orphanage from Monday till Friday, 8:00 to 17:30….

When we arrive at the orphanage at 8 ‘clock in the morning we are welcomed by seven toddlers neatly sitting in a row on their potties. Once they have all finished they are washed, one by one, in a big bucket. It is then up to us to dry them and dress them. But first we have to cream them with special cocoa butter. This task immediately allows us to fulfill our morning work-out, since most kids turn this into a game of hide and seek and we end up running around the room for about 15 minutes. We then have to put their diapers on… the Ghanaian way! But I am proud to share that after some struggling I have finally mastered this ‘skill’, which at first was like advanced origami to me: three different layers of cloth folded in a special way.

Although pretty chaotic, I think this morning routine is my favourite time of day, admitting that the prime reason for this is, that all the kids are still clean! Somehow, every single one of them manages to be covered in dirt within the next three hours. In the meanwhile, the five babies also need to be washed, dressed and fed. After nearly a month at the orphanage I’m very happy to see how “little Henry”, (who was only one week old and malnourished when we arrived) is growing slowly but surely. Although he is obviously still very small: not yet a chubby baby with round cheeks like the other babies. He’s nowhere near Samuel, that is! Samuel is about 6 months old and always smiling. He has the best facial expressions: he can give you the most arrogant look, skeptically raising only his right eyebrow, or the biggest toothless smile: immediately making my morning! But Paulina told me that when Samuel was brought in, he was also malnourished, so I am positive that Henry will be fine!

The rest of the day pretty much revolves around changing diapers, cleaning “little incidents” and of course playing games with the kids and feeding them. In order to make the distribution of tasks as fair as possible, we have introduced the “finders keepers”-rule among the volunteers… Pretty unfortunate at times, but effective! Although it’s a lot of work and despite the fact that not all moments are equally glamorous or entertaining we still have a lot of fun, or it might be because of those moments…. All together we are 5 volunteers: my cousin Bas, two Norwegian girls and one American girl. I think I offered the best entertainment in a month when I took our precious little, one year old, Blessing, with Snoopdogg hairdo and pink dress, on my lap and suddenly felt that Snoopdogg Dizzle had left a not so subtle ‘signature’ on my lap…Didn’t feel so blessed after all!! But after a month I have gotten used to those things. I have given into the fact that I’ll never be clean for longer than 2 minutes and have acknowledged that my little European bottle of disinfectant is not going help me fight the daily cocktail of germs from all the kids!

Since we are with so many volunteers we thought it would also be a good idea to organize things at the orphanage, while some of us watch the children. There are so many boxes stacked everywhere: on top of cupboards, in corners etc etc. We were therefore hoping to find a lot of useful stuff brought in by other volunteers. Unfortunately this is not always the case, most of the boxes are 65% garbage and 30% useful things. The remaining 5% consists of the occasional lizard (both dead and living), spider or cockroach. As a result we open every box with slight hesitation... Although it is nice to sort out all the things that could be useful, it is also frustrating and upsetting to see that everything just gets thrown onto a big pile. But we’re hoping that when the two new houses are finished we have more space to organize things so that they will be of better use.

At around 4 o’clock all the other children come back home, wearing their school uniforms and politely making a little ‘bow’: “good afternoon! But as soon as they change into their normal clothes the chaos begins! Imagine, 50 kids! Luckily they mostly play games outside, because in the meanwhile we have to start folding all the laundry! I am always amazed by how much laundry there is! There are about 3 women continuously doing laundry in big buckets, every single day, all day long…

All together, we are pretty tired after a day of work and are always looking forward to a shower! Today by the way, I had my first hot shower in a month! Heaven! Although it is very hot here, the cold showers are also very cold! So, in addition to our weekly internet access and the oreo’s and M&M’s we are still enjoying from my birthday (could not have wished for a better gift here in Ghana!) that shower was definitely a 'European highlight'! Funny how much you start to enjoy such little things! Because even though it’s only been a month, a really great month, am I allowed to admit that, secretly, I miss Swiss chocolate and hot showers?!

My 18th birthday, was not exactly the typical birthday, but definitely a very special and memorable one! I decided to use some of the money I got for my birthday to throw a party for the kids, because the children don’t celebrate their own birthdays and so only have a party once a year for Christmas. This meant we had to go to the market in Kumasi and buy food and drinks for 55 kids! Fortunately two older girls from the orphanage helped us, so that we didn’t pay the “Obruni price” which is usually twice as high. After quite some time negotiating on the market, we were finally able to start loading the car with all the ingredients to prepare a real ‘feast’ for the kids: chicken, vegetables, rice and spaghetti and fruit juice, lollipops and ice-cream for desert!

When we return to the orphanage the evening before my birthday, all the kids are dressed in their church clothes. Some of the girls are wearing ‘wonderful’ dresses, white and pink with lace and shoes with little socks! Really cute! The tables have also been put inside so that everyone can sit together, whereas usually the kids just eat outside, half of them at the table the other half all over the place. It’s really nice to see how excited the kids are, but before they can start eating from their big plates we all have to pray. The kids all really enjoy it, especially the icecream. Some of the smallest toddlers have never had ice cream: some really love it and others are just too scared!
The real party is only about to begin when after dinner we get the balloons out and the music starts: “God is great! God is great! At all times! At all times!”. This suddenly makes me realize that I am in fact in Ghana, celebrating my 18th birthday! I’m having a lot of fun watching the kids singing along and dancing like only Ghanaian 5 year olds can dance! But in order not to look like the biggest idiot ever, trying to dance like an obibini, I decide the safest option is to pick up a toddler, and try to get away with spinning around the kids and pretending to sing along to the songs I really don’t know the lyrics to! But as has always proven to be the case you can’t ‘hide’ as an obruni and therefore, before I know it I’ve got a hat on my head and am literally being carried by the (older) kids! What a stylish way to start my 18th year! And so I end up partying it up with a bunch of toddlers dancing to the full repertoire of God and Jesus songs on my 18th birthday! After all, the lyrics are not that hard, they basically all praise God and Jesus, so I will just have to sing along! As I said, not quite the typical birthday, but definitely a very memorable and funny one!

When I wake up the next morning my cousin has decorated our room! A really sweet surprise! An even greater surprise is the mail I get from family and friends (that they had sent to my cousin in Holland) and the gifts! Thank you all so much!

When we get to the orphanage they sing “happy birthday” while they throw baby powder on me! (Well at least it must have covered my red cheeks as I was singing my ‘favourite’ lines: “I’m 18 years old”) But it was fun, especially since I wasn’t really counting on getting to celebrate my birthday! In the evening we ‘go out’ for a drink with the three other volunteers (Two Norwegian girls and one American girl). The local ‘bar’ here in our small ‘village’ consists of a wooden enclosure, a few plastic chairs and a little light and they only serve beer! But we have a lot of fun, especially since it’s the first time we discover ‘night life’ in Anwiankwanta, obviously not quite the party place, but with a few beers on an empty stomach we soon have the best time!

At this very moment I’m enjoying the after party to my birthday, since I only got to read all the birthday messages today! Thank you all so much!!!!!

I’ll try to keep you all up to date, but so far the internet access has been quite limited! But thank you so much for all the messages and comments! I look forward to reading them every time!!!