Hello all! After a looooong journey from GMT (Ghana-man time) to EST, I am back on Canadian soil. But I think I'm already experiencing reverse culture shock. It's definitely nice to be home, but I miss so many things about Ghana already. Firstly, this massive cold spell that hit North America was not the most pleasant welcome home present after the tropical weather in Ghana. Secondly, I miss all of the Crystal Eye Clinic staff and my fellow volunteers a lot. But luckily I have an awesome CD, courtesy of Ernest, with all of our favourite songs from the trip on it, as well as 577 pictures full of memories (I will post the pictures ASAP!). Hopefully those will help with my Ghana withdrawal. But, I can't help but say it again and again: MEFI WO PAA GHANA! (Twi for "I'll really miss you, Ghana!").
Aside from ranting about my Ghana withdrawal, however, I do still have to tell you about my final days in "la Côte-de-l’Or" (the golden coast) as Ghana is also known. My last week in Ghana was awesome, and just as busy as the the weeks before. On Monday, I went on an outreach with the team from North Western Eye Clinic. North Western is another fantastic partner eye clinic with Unite For Sight. Like Crystal Eye Clinic, they run outreaches to villages, and refer patients to the clinic in Accra for surgery. Dr. Gyasi is the ophthalmologist who works at North Western and performs the surgeries. North Western very recently celebrated its one year anniversary! For being just one year old, the clinic and staff have certainly accomplished a lot! North Western followed a very similar outreach structure as Crystal. The major difference I observed between the two outreaches When we performed visual acuity testing for the patients, we also tested visual acuity using a pinhole. In circumstances where a patient's vision was very poor, we asked them to place the pinhole cover over their eye, and to read the chart with it. The pinhole most of the time resulted in an improvement in the patient's visual acuity. The pinhole achieves this by allowing the eye to focus light and temporarily remove the effects of refractive errors, such as myopia. In this way, an eye specialist can can estimate the maximum attainable improvement in a patient's vision by lenses corrective lenses. The pinhole can also be an indicator of glaucoma. While this is certainly a very useful diagnostic tool, when there are hundreds of patients to screen, using the pinhole during visual acuity can become very time consuming. But overall, it was a fun outreach with the North Western team!
Tuesday was a very exciting day because it was: Surgery Day (dun dun dun). Many of the other volunteers had already observed surgeries while in Ghana, but this was my first (and last) day at the clinic. It was particularly exciting because I observed surgeries for many of the patients we had screened two weeks earlier on outreach in the village of Teshie. Also, for every surgery we observed, we signed off on a time sheet to certify that the surgery was indeed sponsored by Unite For Sight. We observed about 18 cataract and pterygium surgeries. This day in particular was not as busy as a typical surgery day at the clinic. Usually, the ophthalmologist, and head of Crystal, Dr. James Clark, would operate on many more patients. But either way, it was very exciting! We "suited up", wearing our hair nets, face masks, surgery gowns, and crocs, and entered the operating theatre, as it is called in Ghana.
Dr. Clark is not only an amazing ophthalmologist, but he is also fantastic at explaining things to us novices. For every procedure, he explained what was going on, and the purpose of each of the surgical tools he was using. Jerome was Dr. Clark's right hand man during the surgery, passing him important tools, and assisting with the surgery itself. Everyone in the operating room worked as a team to ensure that each surgery went smoothly and efficiently. Rose, Dan and I took turns observing surgeries throughout the day. I first observed a pterygium surgery. Pterygiums are most often benign growths of the conjunctiva on the eye. It is associated with, and thought to be caused by ultraviolet-light exposure (e.g., sunlight), low humidity, and dust. Since the all of these describe the climate in many rural areas of Ghana, pterygiums are quite common. Pterygiums cause severe irritation to the eye. Dr. Clark mentioned that pterygiums have a high chance of recurrence, and thus the surgery must be performed very carefully. Dr. Clark used various surgical instruments to scrape the growth off the eye, and then used a small tool to cauterize the blood vessels.
I next observed several cataract surgeries. Dr. Clark performs small incision cataract surgeries (SICS) to remove cataracts from the eye. A cataract is a clouding that develops in the lens of the eye or in its envelope, varying from slight to complete opacityand obstructing the passage of light. If left in the eye, cataracts can cause blindness. However, cataracts are a common part of aging, and can be removed through surgery. Small incision cataract surgery is minimally invasive. A small incision of about 2-3 mm is made, and saline is used to loosen the cataract from the capsule. Once loosed, the cataract slips out through the small incision. Since the incision is so small, the wound usually heals itself and sutures are not required. Antibiotics and steroids are administered to prevent inflammation and infection.
Each surgery took only about 10 minutes. There were two operating beds side by side in the room, and Dr. Clark moved back and forth between the two beds, performing all of the surgeries. Dr. Clark and Jerome worked very quickly and efficiently. Aside from all of the cataract and pterygium surgeries, we also observed a very interesting case. A woman came in with a very large cyst on her eye. It was so large that it appeared as if she couldn't even close her eye. The most shocking part was that the woman had lived with this cyst on her eye for 24 years! Within 5 minutes, Dr. Clark removed the cyst, enabling the woman to see, and to close her eye. Just imagine, not being after to close your eye properly for TWENTY FOUR YEARS! Unbelievable. This is yet another reason that it is so important to engage local volunteers and school children in spreading the word about eye care services and good eye health to their families and friends.
The day at the clinic was very interesting, and I learnt a tremendous amount about ophthalmology. It was a particularly special day for me because I saw from start to finish the transformation that a patient makes from blindness or impaired vision to seeing, starting from the Unite For Sight village outreach screening, to the Unite For Sight sponsored surgery. It was so wonderful to know that every dollar that I fundraised went directly to supporting the surgeries for these patients, and giving them the gift of sight. I have a lot of respect for Dr. Clark, Jerome, and all of the staff at Crystal Eye Clinic. The work they do is just incredible, and they have a tremendous impact on the lives of many people in Ghana.
Wednesday was my last outreach with Crystal Eye Clinic. It was a sad day for me because after spending most of my time over the last three weeks with CEC staff and UFS volunteers on outreach, I had become very accustomed to the daily long drives in the "party bus" (aka the UFS van that has been through EVERYTHING) to the remote villages, and listening to Ernest and Jerome singing "where my baby girl". But most of all, I enjoyed going on the village outreaches because we had the chance to interact with patients, young and old. Even if our interactions were brief, they were very meaningful. Many of the patients were so grateful for our work, and made us feel so welcome in their village. It is also amazing to watch Ernest and all of the CEC staff at work on outreach. They work nonstop until all of the patients have been examined. Their determination and dedication to the patients is really inspiring. I am definitely going to miss the outreach aspect of my trip most of all.
This last outreach was similar to the outreaches we carried out in Jasikan: lots and lots of patients. I'm pretty sure we saw over 100 patients. However, at this outreach, many of the patients had no money at all, and were unable to pay for the medications. Unfortunately, we are unable to give the medications for free because they are very expensive, and we already provide them at a highly subsidized cost. To compromise, we provided the eyeglasses for free to the patients. To ensure that patients take care of their glasses and medicines, we make note of the things they receive in our patient data spreadsheet. That way, we can check in the future if a patient has already received medicines or glasses from UFS. The outreach took pretty much the entire day, and concluded with a nice meal of rice and stew provided by the local people.
Thursday was our last day in Ghana. We luckily had the day free to do some last minute site-seeing, shopping, relaxing, and packing before our 11 pm departure from Accra. We all decided to spend most of the day at Labadi Beach. It was a lovely day, and we met some interesting people there. We now have a new friend named "Cream", a Liberian soccer player who has played for Cameroon and Liberia. Also, one of the beach vendors loved the fact that I am Indian, and gave me free jewelry (I could get used to that!). We also made a pit stop at the Accra Cultural Center market to visit our favorite wood handicraft shop to get some more souvenirs.
Afterwards, we headed back to the Telecentre, our Accra home, and said our goodbyes to Ernest, Dennis, Dorcas, and Magdaline. Bibi kindly took us to the airport, and bid us farewell. After some tearful "MEFI WO PAA's", we headed off into the chaotic Kokota Airport. And now, here I am, back where I started.
I am going to end my post here. I am still in denial that I have to go back to college, that I don't drink water from plastic bags anymore, and that roosters, goats, drums, and Mr. Akapo's laugh don't wake me up at 4:30 am anymore. It hasn't hit me that I am not going to wake up tomorrow and go on outreach, or go to the clinic, or go on some adventure in Accra. So, I will be writing another post (not a long one, this time I REALLY promise!) once I decide how to "conclude" this blog. Stay tuned for a short and sweet post...and "Ernest and Jerome Uncovered"!
Aside from ranting about my Ghana withdrawal, however, I do still have to tell you about my final days in "la Côte-de-l’Or" (the golden coast) as Ghana is also known. My last week in Ghana was awesome, and just as busy as the the weeks before. On Monday, I went on an outreach with the team from North Western Eye Clinic. North Western is another fantastic partner eye clinic with Unite For Sight. Like Crystal Eye Clinic, they run outreaches to villages, and refer patients to the clinic in Accra for surgery. Dr. Gyasi is the ophthalmologist who works at North Western and performs the surgeries. North Western very recently celebrated its one year anniversary! For being just one year old, the clinic and staff have certainly accomplished a lot! North Western followed a very similar outreach structure as Crystal. The major difference I observed between the two outreaches When we performed visual acuity testing for the patients, we also tested visual acuity using a pinhole. In circumstances where a patient's vision was very poor, we asked them to place the pinhole cover over their eye, and to read the chart with it. The pinhole most of the time resulted in an improvement in the patient's visual acuity. The pinhole achieves this by allowing the eye to focus light and temporarily remove the effects of refractive errors, such as myopia. In this way, an eye specialist can can estimate the maximum attainable improvement in a patient's vision by lenses corrective lenses. The pinhole can also be an indicator of glaucoma. While this is certainly a very useful diagnostic tool, when there are hundreds of patients to screen, using the pinhole during visual acuity can become very time consuming. But overall, it was a fun outreach with the North Western team!
Tuesday was a very exciting day because it was: Surgery Day (dun dun dun). Many of the other volunteers had already observed surgeries while in Ghana, but this was my first (and last) day at the clinic. It was particularly exciting because I observed surgeries for many of the patients we had screened two weeks earlier on outreach in the village of Teshie. Also, for every surgery we observed, we signed off on a time sheet to certify that the surgery was indeed sponsored by Unite For Sight. We observed about 18 cataract and pterygium surgeries. This day in particular was not as busy as a typical surgery day at the clinic. Usually, the ophthalmologist, and head of Crystal, Dr. James Clark, would operate on many more patients. But either way, it was very exciting! We "suited up", wearing our hair nets, face masks, surgery gowns, and crocs, and entered the operating theatre, as it is called in Ghana.
Dr. Clark is not only an amazing ophthalmologist, but he is also fantastic at explaining things to us novices. For every procedure, he explained what was going on, and the purpose of each of the surgical tools he was using. Jerome was Dr. Clark's right hand man during the surgery, passing him important tools, and assisting with the surgery itself. Everyone in the operating room worked as a team to ensure that each surgery went smoothly and efficiently. Rose, Dan and I took turns observing surgeries throughout the day. I first observed a pterygium surgery. Pterygiums are most often benign growths of the conjunctiva on the eye. It is associated with, and thought to be caused by ultraviolet-light exposure (e.g., sunlight), low humidity, and dust. Since the all of these describe the climate in many rural areas of Ghana, pterygiums are quite common. Pterygiums cause severe irritation to the eye. Dr. Clark mentioned that pterygiums have a high chance of recurrence, and thus the surgery must be performed very carefully. Dr. Clark used various surgical instruments to scrape the growth off the eye, and then used a small tool to cauterize the blood vessels.
I next observed several cataract surgeries. Dr. Clark performs small incision cataract surgeries (SICS) to remove cataracts from the eye. A cataract is a clouding that develops in the lens of the eye or in its envelope, varying from slight to complete opacityand obstructing the passage of light. If left in the eye, cataracts can cause blindness. However, cataracts are a common part of aging, and can be removed through surgery. Small incision cataract surgery is minimally invasive. A small incision of about 2-3 mm is made, and saline is used to loosen the cataract from the capsule. Once loosed, the cataract slips out through the small incision. Since the incision is so small, the wound usually heals itself and sutures are not required. Antibiotics and steroids are administered to prevent inflammation and infection.
Each surgery took only about 10 minutes. There were two operating beds side by side in the room, and Dr. Clark moved back and forth between the two beds, performing all of the surgeries. Dr. Clark and Jerome worked very quickly and efficiently. Aside from all of the cataract and pterygium surgeries, we also observed a very interesting case. A woman came in with a very large cyst on her eye. It was so large that it appeared as if she couldn't even close her eye. The most shocking part was that the woman had lived with this cyst on her eye for 24 years! Within 5 minutes, Dr. Clark removed the cyst, enabling the woman to see, and to close her eye. Just imagine, not being after to close your eye properly for TWENTY FOUR YEARS! Unbelievable. This is yet another reason that it is so important to engage local volunteers and school children in spreading the word about eye care services and good eye health to their families and friends.
The day at the clinic was very interesting, and I learnt a tremendous amount about ophthalmology. It was a particularly special day for me because I saw from start to finish the transformation that a patient makes from blindness or impaired vision to seeing, starting from the Unite For Sight village outreach screening, to the Unite For Sight sponsored surgery. It was so wonderful to know that every dollar that I fundraised went directly to supporting the surgeries for these patients, and giving them the gift of sight. I have a lot of respect for Dr. Clark, Jerome, and all of the staff at Crystal Eye Clinic. The work they do is just incredible, and they have a tremendous impact on the lives of many people in Ghana.
Wednesday was my last outreach with Crystal Eye Clinic. It was a sad day for me because after spending most of my time over the last three weeks with CEC staff and UFS volunteers on outreach, I had become very accustomed to the daily long drives in the "party bus" (aka the UFS van that has been through EVERYTHING) to the remote villages, and listening to Ernest and Jerome singing "where my baby girl". But most of all, I enjoyed going on the village outreaches because we had the chance to interact with patients, young and old. Even if our interactions were brief, they were very meaningful. Many of the patients were so grateful for our work, and made us feel so welcome in their village. It is also amazing to watch Ernest and all of the CEC staff at work on outreach. They work nonstop until all of the patients have been examined. Their determination and dedication to the patients is really inspiring. I am definitely going to miss the outreach aspect of my trip most of all.
This last outreach was similar to the outreaches we carried out in Jasikan: lots and lots of patients. I'm pretty sure we saw over 100 patients. However, at this outreach, many of the patients had no money at all, and were unable to pay for the medications. Unfortunately, we are unable to give the medications for free because they are very expensive, and we already provide them at a highly subsidized cost. To compromise, we provided the eyeglasses for free to the patients. To ensure that patients take care of their glasses and medicines, we make note of the things they receive in our patient data spreadsheet. That way, we can check in the future if a patient has already received medicines or glasses from UFS. The outreach took pretty much the entire day, and concluded with a nice meal of rice and stew provided by the local people.
Thursday was our last day in Ghana. We luckily had the day free to do some last minute site-seeing, shopping, relaxing, and packing before our 11 pm departure from Accra. We all decided to spend most of the day at Labadi Beach. It was a lovely day, and we met some interesting people there. We now have a new friend named "Cream", a Liberian soccer player who has played for Cameroon and Liberia. Also, one of the beach vendors loved the fact that I am Indian, and gave me free jewelry (I could get used to that!). We also made a pit stop at the Accra Cultural Center market to visit our favorite wood handicraft shop to get some more souvenirs.
Afterwards, we headed back to the Telecentre, our Accra home, and said our goodbyes to Ernest, Dennis, Dorcas, and Magdaline. Bibi kindly took us to the airport, and bid us farewell. After some tearful "MEFI WO PAA's", we headed off into the chaotic Kokota Airport. And now, here I am, back where I started.
I am going to end my post here. I am still in denial that I have to go back to college, that I don't drink water from plastic bags anymore, and that roosters, goats, drums, and Mr. Akapo's laugh don't wake me up at 4:30 am anymore. It hasn't hit me that I am not going to wake up tomorrow and go on outreach, or go to the clinic, or go on some adventure in Accra. So, I will be writing another post (not a long one, this time I REALLY promise!) once I decide how to "conclude" this blog. Stay tuned for a short and sweet post...and "Ernest and Jerome Uncovered"!
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