Heart to Heart

The ICHA Blog

Four days in by Sujatha Sankaran on September 25, 2009 | 1 comment

We’ve been in Ghana for four days now.  Needless to say, it feels like we’ve been here for much longer. It’s been an odd sort-of-homecoming for me.  I’ve had emotional reunions with dear friends I left behind, and have spent the past couple of days reacquainting myself with the sights, smells, and sounds of this town.  The sight of the fishing boats moored in Elmina, the pungent burning smell in the air, the thick warm humidity, the sounds of singing and clapping in the distance…are all strangely comforting in their familiarity.  It makes me remember how, when I came back from Ghana last time, I found myself homesick for this place that was only temporarily my home. 

As for the clinic, it is the same bundle of contradictions that I remember from three years ago. The patients are very sick, sweating in the overcrowded waiting area, glassy-eyed and listless, babies shrieking in the background.  Everything feels haphazard—patient records lying in piles on the table, medications scattered in boxes on the floor, patients waiting in a throng at the front of the clinic—but there are also glimpses of organization.  On the first day we learned that we would not be training 10 health workers, as we had originally been told, but forty.  The Ghana Health Service had been so excited about our program that they had arranged for staff from surrounding clinics to be bused in daily.  The health workers were enthusiastic, engaged, excited about learning this material that would help them better care for their patients.

And the health workers at the clinic have given us tremendous autonomy.  We were able to set up a glucometer in the patient triage area, to train the triage health workers to properly check blood pressures, check blood glucose levels, and determine body mass indices. In the exam rooms, we teach health workers to identify high risk patients, to give them advice and to treat with medications. They are busy, and we encounter resistance to adding to their extraordinarily heavy workload.  They see 150 patients a day, and we are probably asking too much of them.  

But, slowly, we are finding ways to work around these issues. There is a public health nurse in the clinic who works as the de facto nutritionist, counseling mothers of malnourished children.  We teach her about overweight and obesity, a growing epidemic in the clinic. And the nurses are now starting to send overweight and hypertensive patients to her for diet counseling. We have joined the community outreach teams that provide vaccine administration to children and prenatal screening to mothers in remote villages. We teach the community outreach nurses to also check blood pressures on people over the age of 45, and on the first day, 20 of the 120 patients screened were hypertensive.

So, we are here, working with limited resources in this deeply generous community, grateful and hopeful about this promising beginning. And I find myself personally touched by gratitude—gratitude for the kindness of this community we are living in, grateful for the insightful and compassionate volunteers we have brought with us, and grateful for the organic way that something important and meaningful is beginning to take shape here.