7/25/17

I had a wonderful weekend! I celebrated my birthday in the traditional Ghanaian way- cold water and beer poured on my head! Even though I was freezing, I had a huge smile on my face. It was such a fun and different way to celebrate a birthday! At that moment, surrounded by the friends that I had made over the last month and a half, I knew that it would be very hard to top this day.

It is crazy that I will be heading home in just a few days; I cannot believe how fast the two months I spent in Ghana went. Although my experience started off on the wrong foot, it turned into an extremely rewarding and useful summer. I learned so much about the amazing culture, the health care system (including all of its strengths and pitfalls), and most importantly about myself. When going on programs such as CFHI, I discovered how frustrating it can be to be an undergraduate or pre-medical student. I wished every day that I could help do something or offer my own advice or even interact in a meaningful way with patients, but unfortunately I am not trained to do such things. In my time at Princess Marie Louise Children’s Hospital I found in most rewarding to work in the physio therapy department and the malnutrition rehabilitation center. In both places I was able to work with patients and learn from that hands-on experience. In physio-therapy I was able to help with the therapy sessions for children with cerebral palsy and downs syndrome. The sessions change for each child. Some spend most time practicing the sitting position, while others spend more time learning how to move from laying to sitting, crawling, walking, standing straight, and bilateral movements. One day we saw at least three patients with nerve damage that causes atrophy in one side of the body. With these children we focused on strengthening their muscles so that they would have almost full function despite the nerve damage.

On Friday some of us spent the day in the malnutrition rehabilitation center. This was probably my favorite day at the hospital because the nurses let us handle all the patient care. We learned that the center has a wide array of specialties, including teaching mothers how to cook for their children, weekly check ups, and a FREE program that provides families with RUTF (Ready-to-Use Therapeutic Food). The system they have set up is doing its part in reducing child malnutrition rates in the Greater Accra region. If a child is admitted to the hospital and is malnourished, determined by body mass index and MUAC (Mid-Upper Arm Circumference), then they are referred to the center for counseling. Sometimes the child isn’t well fed because the mother cannot produce enough milk and the family can’t afford formula. Ghana Health Service strongly recommends solely breast-feeding until 6 months because so many cannot afford the formula. Additionally, after 6 months many mothers start to feed their child traditional food. Because the Ghana’s food has many spices, the baby usually cannot handle it and requires a significant amount of water to soothe its mouth. At the end of the meal, the child will only have eaten a very small amount of food and taken a larger amount of water so they will not have received the proper nutrients to gain weight. The counseling of mothers includes lectures on what babies can and cannot eat as they are growing. They also teach them how to cook the meats and vegetables and to pound them properly so their children can eat enough.

Because the program is free, each Friday, the mothers are expected to bring their children in for a check up and to replenish their rations of the RUTF. This is where we came in handy as we did all of the check ups. It was so much fun to be useful for once, ha! We weighed the children (actually much more of a task than you would first think; the mother stepped on the scale and then the child was given to her, however the scale wasn’t working very well so it took longer than usual), measured their MUAC, took the temperature, and gathered a brief history from the past week about overall health. Based on the weight of the child we would give a certain amount of the RUTF, for example if the child weighed between 8.5-9.4 kg they would receive 25 packets of the food and we would instruct them to feed their child 3.5 per day. The RUTF that we distributed was actually very delicious. It is a complete meal and is made up of peanut butter and sugar and is packed with essential vitamins and nutrients. It tasted like peanut butter cookie dough! As we went through the day it was interesting to see the patients and their mothers. It is clear that they care about their kids if they are participating in the program, which warmed my heart. One mother came in and she had missed two consecutive weeks and had to beg to keep her spot in the program. Because it is a free program, they only want dedicated participants and unfortunately her actions showed that she wasn’t taking it seriously. Her child was losing weight and she hadn’t replenished her RUTF supply in three weeks, so the head nutritionist expressed her anger. Fortunately she was allowed to stay in the program but was on “probation.” Only one time did a mother ask me what her daughter’s weight and MUAC measurements were. This put a huge smile on my face as she said, “please, can you tell me her stats? I want to know if she is improving or not!” Obviously I know that each parent cares for their child and for their health, but this was the first time I felt like a parent was 100% focused on her daughter’s improvement (I also have to disclose that many mothers do not speak English very well and were a little bit uncomfortable having us helping them, they very well could have asked the nurse in their native language!). Although it is sad to see the malnourished children it is so amazing to learn about the program they have in place at the hospital and know how much of an impact it is having on Ghana’s youth. We learned that in the northern part of Ghana almost 50% of children have stunted growth due to malnutrition, so hopefully programs like this will spread and reach a wider group!

I am so thankful for my time at the Children’s Hospital. It was such a good experience and I learned so much! I wish I could stay longer just to monitor the progress that the children I saw continue to make, but sadly I have to leave to return home.

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