Photos from Ghana

Spent quite a bit of time on the beach.



The lovely coast.



Our accommodations near Busua.



Helping out with a procedure in the Mampong District Hospital.



Suspicious finding on an X-ray.



Helping out with training.



This boy had been hit by a car and needed a leg splint.



Working with the plaster of Paris.



Another satisfied customer!



The countryside near Mampong.



The balcony of the Doctors Transit Bungalow.



Sunset from the balcony.

Evening in Accra

All alone in Accra tonight, having left the gang behind in Mampong. The highlight of the flight from from the north was seeing Lake Bosumtwi -- a water-filled meteorite impact crater -- from the air.

Made it to the happening Osu district without much hassle and took myself out for what turned out to be kind of a nostalgic dinner. Needing to spend the last of my cedis before I fly out, I picked an expensive Chinese restaurant that came recommended where I had a delicious fish dish (the fish all along the coast in Ghana has been first-rate). Dining alone, I found myself reading over the meal in a Chinese restaurant full of Africans; weirdly reminiscent of many of my meals during my time in East Africa. And the waiter even brought a candle to the table for reading light!

Afterwards wandered around for a while, taking in the frenetic sights and sounds (and music) of Saturday night in a big West African city. But an early morning to catch my flight looms over me, so it'll be back to the hotel soon.

The Doctors Transit Bungalow

The electricity bill on the dining room table reveals that the physicians' residence officially goes by the delightful name of the Doctors Transit Bungalow. I'm spending one last morning on the second-floor balcony here, which has become one of my favorite spots anywhere. Following a downpour earlier this morning, there's mist lying low over the green hills, with solitary trees sticking up above the canopy and bright flowers everywhere. And, as always, there's a rich variety of birdsong on the breeze.

Yesterday morning I took a long walk out into the countryside (where I noted the formidable local insects -- do not mess with the ants and bees here...) and then back through the adjacent village. In the afternoon we made an expedition to the clinic in the nearby town of Kofiase. This is one of the feeder clinics for the district hospital here in Mampong. Although resources may seem limited at the hospital, the clinic in Kofiase really has to make do with the bare minimum: no doctors, half-stocked shelves in the dispensary, no running water. The delivery room in the maternity ward left us all a little thoughtful: a bit of a grim prospect to be there as either a patient or a provider.

Last night we headed out to one of the two restaurants in Mampong, the Farmer's Cave. Far out of town on rutted roads, it's the Ghanaian equivalent of a midwestern supper club. We stuffed ourselves on jollof rice, goat meat, chicken, and yams while watching distant lightning on the horizon.

Sadly, I need to leave Mampong this morning. I'm off to Kumasi, capital of the Ashanti district, where I'll catch a flight to Accra; then tomorrow I leave for home. However, I've already been talking with the program coordinator here about the possibility of coming back for a rotation when I'm further along in my residency and get some elective time. Until then, I'll content myself with fond memories of the balcony of the Doctors Transit Bungalow.

Training day

Yesterday I helped out with the Basic Life Support training here at the hospital. It went well and turned out to be a lot of fun. The program had brought a set of adult and peds training mannikins and there was a good crowd in attendance. Everyone was very involved. When we were teaching the Heimlich maneuver, the enthusiastic nurse I was working with practically left bruises on me. Very curious to see whether the next patient to arrest in Casualty will get CPR.

Ghana

Writing this sitting on the balcony of the doctor's house on the grounds of the Mampong District Hospital. We just had a refreshing mid-afternoon rain, and now I'm looking out across the dripping trees and listening to all sorts of birdcalls.

Last week was spent at a series of lovely beach resorts along the coast. Beautiful beaches, almost no one around, and surprisingly fantastic food. And nothing beats falling asleep to the sound of surf.

Heading north to the hospital involved a fairly typical 12-hour trek involving multiple taxis, long-distance buses, roads in various states of repair, and that workhorse of intercity travel around the world, the mini-bus (called a "tro-tro" here). Had an interesting changeover in Kumasi, Ghana's second city, where we waited after dark in a what was basically a smoky, excavated pit for a tro-tro that turned out not to be coming. But the daylight segments on the roads were very scenic -- lush greenery and all sorts of interesting roadside activity.

Mampong is a town of about 20,000 with a district hospital. I've been hanging out in Casualty (basically the emergency room) and following along on rounds. Have already seen some interesting cases, including a relatively rare tropical worm infection.

Today was market day. On the way back to the hospital we passed what was obviously a recent and serious two-car collision and hustled back to Casualty, figuring that the victims had probably been taken there and to see if we could help. As we pulled up we saw two men wheeling a person-sized metal cart from the mortuary to the hospital, and inside we found one of the patients dead in the room used for resuscitations. Another patient from the accident was also being treated and was fine, and a third person had already been seen and released. We tried to figure out what had happened to the dead man, but realized that it would have been unlikely that we could have done anything for him, given the limited resources available.

Tomorrow is a big training day and I've offered to help out; we'll see if my vacation-dulled mind can recall any emergency medicine.

Back to Africa

12 years ago I started out for an adventure in Africa. That trip changed my life and set me on the path I've been following ever since. In just a few hours I leave for Africa again....

Smoke and a roar

I've been sleeping during the day, working night shifts, and this afternoon I was awakened by loud jet airplane noises. It took me a moment to realize that it's Fleet Week, and the Blue Angels were practicing. We live pretty far up the hill where the hospital sits, so those F-18s were flying just a few hundred feet above our apartment, rattling it pretty good. Ordinarily I'm into loud fast things, but I realized with a sinking feeling that they're going to be flying every afternoon -- on the days I need to be sleeping! Basically, I'm gonna have jet flighters waking me up at my equivalent of 3 am for the next several days. "Smoke and a roar," according to the Chronicle. Even more sleep deprivation than usual, according to me.

Back on the road

Off to Ghana next week to visit Dr. N, and since I'm now on nights I was actually able to stop by a travel store during business hours for some odds and ends. It was a bit of an upscale place. The woman working there asked where I was going, and when I told her she looked up and said "that's great! Mostly people say Florida. I didn't think people did adventure travel anymore." I think it made her morning -- and I hope she gets a vacation and a chance to travel soon herself.

Neurological exam

We see large numbers of intoxicated people in the emergency room who come in after unknown events. The problem is, most of them are just drunk or high, but some of them have had injuries including head trauma. So we need to watch them and see if they sober up or if they have other problems that we need to take care of.

The other night a young lady came in, apparently drunk, and spent a few hours face-down on a gurney. As she started to clear and move around, it was time for a repeat neurological exam. I looked down the hall, and saw that she had put on her 4-inch stilettos and was starting to walk around. I figured that anyone who can walk around in those shoes must be neurologically intact, and started printing out her discharge papers.

Unstormy weather

Today I was going back through some older posts, looking for something that might be expanded into a larger piece. (Any suggestions?) I'd forgotten that I used to have a category called Weather Geek. Gotta say that moving from the extremes of Iowa weather to the Bay Area's temperate climes has kind of eliminated that category for me. Time was when I would blog about tornadoes (even live-blogged a couple), ice storms, heat waves, blizzards. I think the most I've managed from the Bay Area was a short post about rain. Not even a torrential, car-floating downpour; just noting that it was raining, as opposed to not.

Washing up

This recent exchange with a houseguest is what passes for normal in our little apartment full of residents:

Houseguest [noticing something in a plastic basin]: "What's that?"
Me: "It's a bloody shoe that I'm soaking in hydrogen peroxide."
HG: "Is it your blood?"
Me: "Is it better if it is, or better if it isn't?"