Shashank's Blog

Recap of a Life Changing Experience

Hello everybody! Sorry for not putting this post up last night. For this post, I want to recap and reflect on my four weeks in Ghana. The experience was enriching and is one that will stick with me for the rest of my life. During my stay in Cape Coast, about 150 kilometers from Accra, I interned in four different rotations at the Cape Coast Teaching Hospital. During the first week, I worked in the pediatric ward where I was responsible for documenting notes and vitals. I also attended child mortality meetings with medical students and residents to discuss different cases and how better health care can be administered to reduce the mortality rate. During the second week, I was shadowing Dr. Juliana Arthur and Dr. Ellen in the pediatric outpatient department. I was able to do many things such as taking a patient history and performing small examinations on patients. I was also able to auscultate patients under direct supervision. The outpatient delivery rotation was a very humbling experience. During this week, I also participated in an outreach in the village of Jukwa. Many different departments that were present included nutrition, public health, eye clinic, and ENT. I think Columbus and the U.S. should do something like this as this is a great intervention strategy. It allows for primary, secondary, and tertiary prevention to occur which is extremely important in public health. I think this was a very nice way to bring health care and the services of the teaching hospital to those who either can’t afford health or who can’t access the hospital due to geographic barriers. I certainly wish I could’ve been a part of more outreaches but I’m happy I was able to get the experience while volunteering and serving the community. In week 3, I was working in the public health family planning department. In this clinic, family members can discuss about how many kids they plan to have and at what frequency. They offer many contraceptives and other birth control options for women who decide to not become pregnant. They also did a great job informing parent’s on vaccinations for their child as well as how to properly take care of them. For example, according to one of my cohort members, the Planned Parenthood Association of Ghana (PPAG) provides free mosquito nets as malaria is a big epidemic in the country. Also, during the third week, I took part in a radio show with three other staff members of the hospital. On July 28th, World Hepatitis Day was observed and a few days before this date, I participated in this show to raise awareness and educate the central region of Ghana about hepatitis and the importance of being vaccinated, screened, and treated if diagnosed. This experience was definitely not obtainable for me in Columbus so I was very honored and privileged to be a part of this show. During the final week, I rotated in the male and female medical wards. I joined Dr. Lovi’s firm team and did rounds with him every morning for the last week. After rounds, I would shadow Dr. Armah and follow him around as he did patient reviews and physical examinations. In Ghana, I was also able to witness a different scope of diseases including TB, malaria, HIV, cholera, and more.

I honestly went into this trip with an open mind to learn more about Ghana culture and health care. I wanted to learn more about how tertiary health care is administered and what the citizens think of the healthcare. Ghana is definitely striving towards universal health care and while they haven’t quite reached that point, they’re going in the right direction. Health care in Ghana is extremely affordable to many citizens. Plus, many of them are very happy with the health care they’re receiving as Dominic (nurse who gave us weekly lectures on Ghana health) mentioned to us. Ghana hospitals and the PPAG have created a very safe learning environment for families to address different issues. However, more education on issues such as teen pregnancy and infectious diseases need to be administered and I applaud the work that the hospital and PPAG does to the citizens. Many of the doctors in the hosptial told me that the medical technology and equipment is not advanced but relative to other West African countries, Ghana is much more stable in terms of their quality of health. In this trip, I was also able to appreciate Ghana culture by doing some sightseeing when I was not working in the hospital on the weekends. One weekend, I explored Accra (the capital of Ghana) and the Arts Center and was deeply immersed by the handicrafts. I also visited the Cape Coast and Elmina Castle which date back to some of the darkest moments of African slavery. Furthermore, I also got to pet a crocodile and walk through a canopy 40 meters above the ground. Overall, my main objective in terms of learning about Ghana’s health care and culture was a huge success and I am beyond thankful to everyone who made my goals possible!

I hope you all enjoyed joining me on my journey through these blog posts. I never thought in a million years that I would be blogging about my maiden journey to Africa but here I am. I have been able to examine and analyze my experiences through a different lens. While my daily blog posts will come to an end here, I do hope to continue blogging occasionally as I begin my third year at Ohio State in under two weeks!

Home Sweet Home

The ten hour flight from Accra wasn’t as bad as I was expecting considering I slept during some of those hours. Furthermore, I was able to speak to the person sitting next to me. She was from Kumasi (Ashanti Region of Ghana) and she mentioned to me that this was her first time going to the United States. She was quite excited especially since she was connecting to Las Vegas! At around 6:00 AM this morning, I landed in New York’s JFK International Airport. JFK airport definitely wins the award for the most confusing airport as I was lost (if you know me very well, I’m usually good at navigating my way through obstacles). I had to ask different staff members directions to a terminal. There was another man who was also going to the same terminal as me so we stayed together all the way until security. The man was a former U.S. veteran and he served the country for 23 years. Now, he is a retired veteran and is currently a high school teacher. He was returning home from Kumasi where he spent the summer with his parents. I certainly enjoyed his company and presence! It’s always nice when I get the opportunity to interact with other people during any part of my travels. At around 10 AM, my flight left from JFK towards Columbus! As the wheels hit the tarmac of John Glenn International Airport, I was extremely excited to see my family! I quickly went to baggage claim to get my bags and quickly headed to the parking lot to see my loved ones. I was warmly greeted by my mom and grandparents. As much as I miss Ghana, I deeply missed all my friends and family here in Ohio and I quickly reconnected with everyone. I was craving some Graeter’s ice cream since I didn’t have a single dessert or sweet in Ghana. I am definitely sleep deprived so I will sign off here and get some much needed rest. I don’t have to worry anymore about street vendors yelling at 6AM and can peacefully sleep in! Tomorrow I will do an overall analysis and reflection of my four week trip to Ghana so I will see you all then.

This is a picture of a nice sunrise as we were approaching JFK airport. It was a very beautiful scenery!

I got my ice cream after a month without having any sweets! My stomach is definitely very happy right now.

8/4/19

Last Day in Ghana!

This morning, me and my friend Tania woke up and had a wide range of emotions! We were sad that our time in Ghana was up but we were equally excited to go home and embrace our loved ones who were anxiously waiting to hear about our journey. This morning, I attempted to sleep in a bit since I didn’t have to worry about waking up early for my rounds at the hospital. However, from my four weeks here in Ghana, I’ve learned that it is very difficult to sleep past 7AM since everyone here gets up extremely early. In the late morning and early afternoon, my friend, uncle, and I watched a Bollywood movie. In the afternoon, we went back to the Accra Arts Center to do some shopping. Back at the house, we had some dinner and departed to Kotoka International Airport. My flight was about an hour after Tania’s flight so we were able to chat for a bit at the gates before parting ways. I want to thank my uncle from the bottom of my heart for graciously allowing Tania and I to lodge at his guest house. He made us feel at home and was also very helpful when bargaining at the arts center! Also, I want to thank Tania and the rest of my cohort for making my stay here amazing. I will reflect more about my stay soon. I am currently on the plane right now and must switch my phone to airplane mode so I will see you all soon!

A picture of the famous and iconic African masks.

A selfie with uncle and Tania, my new older sister! I enjoyed their presence in Accra and hope to see them in the future!

8/3/19

Cape Coast to Accra

This morning, I woke up bright and early to complete my last shift at the teaching hospital. I only worked for half the day today since I had to leave to Accra in the early afternoon. Despite my short shift, I was able to learn a lot from Dr. Armah. We had some new cases today since Dr. Armah was doing rounds with a new firm team. After the rounds, Dr. Armah worked in the cardiology outpatient delivery so I was able to shadow him there. It was definitely nice to go to the outpatient unit since my interest lies there. Plus, I’ve also never seen any cases in cardiology. Because I had to leave early today, I was only able to witness one case. I definitely wish I could’ve seen some more cases but overall, I’m really happy with how this week turned out. I did not expect to learn so much at the inpatient wards. In the afternoon, Jacob (taxi driver mentioned in earlier blogs) took me and my friend to Accra so we could lodge at a family friend’s house. Tomorrow, we hope to explore a few more places in Accra before we both depart back to the U.S.

Here is a picture of me and Geegy (my coordinator and mother for a month). I want to personally thank her for accommodating and putting up with me for the past month. I will definitely miss her and I hope to see her again soon!

A selfie with me and Dr. Armah! I want to also give him a shoutout and thank him for teaching me so much this week. I certainly wish I could’ve spent another week with him to learn more. He has a very busy life and has mentioned to me that once he didn’t sleep for two days straight.

8/2/19

Last Day in Cape Coast

Today was my last full day in Cape Coast. The hospital was very busy today. I was once again with Dr. Armah. He was in the hospital overnight and was there until the afternoon today. He told me that he’s gone two full days without any sleep. At around 8:00 AM when I saw him this morning, he was finishing up some notes. Afterwards, we both went to review and examine some patients. Dr. Armah taught me to four stages of patient examination: inspection, palpation, percussion, and auscultation. First, you inspect and observe the patient. Then, you must touch them in the palpation stage either with a little or a lot of pressure. Percussion can give information in regards to tissue makeup and tenderness. Finally, the chest is listened to during auscultation. Dr. Armah had a few patients in the emergency department. We had some more new cases today and I’m so grateful for Dr. Armah as he takes the time to explain everything to me. At around 11:00, we had rounds. Normally, we do these first thing in the morning but however, some members of the team had meetings in the morning. In the afternoon back at the house, Dominic cane in today to talk about family planning and palliative care. For those who don’t know, palliative care is when care is provided for those patients who may not make it alive. Ghana doesn’t have a proper palliative care team in Cape Coast but they do at the Korle Bu Teaching Hospital in Accra. Dominic told us that he’s had to be very calm when delivering troubling news to patients and their families. In terms of family planning, we had a great discussion about women’s health. In Ghana, abortion is unacceptable unless a person has been raped. The Planned Parenthood Association (PPAG) offers safe options for those women who choose to go through abortion. They also educate people in order for them to make informed decisions. Overall, Ghana does a very good job catering to maternal health. Their healthcare system is definitely taking steps in the right direction. Tomorrow, I will be working in the morning only since I leave to Accra tomorrow afternoon.

I never took a picture of food here in Ghana so here is a picture of yams (fries) with stew and fried chicken. This is a signature dish in the country.

8/1/19

Working and Letting Loose

At around 8:15 AM this morning, Dr. Lovi’s team began their rounds. Many of the patients that we saw were follow ups from yesterday. After the rounds this morning, I was supposed to be with Dr. Armah again but he disappeared when we dispersed after rounds. After an hour or so, I found him and he said that he was going to leave since he has to work the overnight shift tonight. Today was definitely a very light day in the hospital. In the afternoon, the cohort and I went to a resort for lunch in Mfantsipim. The food was really good and the views outside the restaurant were breathtaking. Afterwards, some of the cohort members went to get ice cream next to Kotokraba market. That area is perhaps the busiest section of Cape Coast. The traffic here doesn’t compare at all to India even though it’s worse than Ohio traffic. Today’s blog will be very short so I’ll leave it at this. Tomorrow will be my last full day at the hospital and in Cape Coast.

This is a view from the resort today. The city is in the far back on the left hand side (it’s very difficult to see in this picture).

Of course I had to get a picture of the pool here. I was very tempted to jump in the pool especially since the humidity is very high here in Ghana. Although, it’s not very hot outside since July is one of Ghana’s cooler months. It’s winter here!

7/31/19

Rounds at the Medical Wards

Today, I was paired up with Dr. Lovi’s team on their rounds through the male and female medical wards. Dr. Lovi is the head doctor of the team and in addition to him, there are medical students and residents that are a part of his team. Each student/resident would be assigned to a patient or two and they would have to give an update on how the patient is doing and what medications they’re on. Based on their diagnosis and medications, the whole team will decide what the next steps will be. Including me, there were about eight other students who were responsible for presenting different cases. The experience was very beneficial for me as Dr. Lovi would take the time to explain everything to me. Today we saw some cases such as pneumonia, complicated hypertension, and complicated diabetes. These are actually the most common cases in the adult wards. The pediatric ward dealt with different diseases and infections such as malaria. After going on my rounds, I ended up with Dr. Armah for the rest of the day. He was a very nice and caring person. Overall, today was a much more observational day compared to yesterday. Before I close out today’s post, I do want to talk about the food here in Ghana since I haven’t really discussed it. In my opinion, I would not recommend coming to Ghana if you’re planning to have a big appetite. I definitely do miss my meals at home but I know I’ll be back home soon! I didn’t take any good pictures today as we had to deal with some emergency situations in the hospital today.

Here is a picture of the canteen (cafeteria) if the teaching hospital. The workers their definitely know my face very well now so they usually don’t have to ask me what I want to eat!

7/30/19

Beginning of the Final Rotation

This week, I was hoping to do work more in the outpatient delivery unit. Unfortunately, due to some unforeseen circumstances, I was not able to get a spot in the OPD unit. However, I am back at the inpatient wards but instead of pediatrics, I am now working in the male internal medicine ward for this week. I was first introduced to Ezekiel, a nurse at the male medical ward. He gave me and four other nursing students a tour of the ward. Afterwards, I basically shadowed Ezekiel and helped him out with any duties he had. I assisted another nurse with some vitals measurements. Furthermore, I checked up on each patient in the ward to make sure they were doing okay. This is sort of similar to what I would do at Grant Medical Center back in Ohio. Back at the house, Dominic, the nurse from the hospital, came over again to talk more about the CHPS compound. There are some principles that the CHPS services must abide to. They first believe that community participation and empowerment is critical. Second, they must focus on community needs to determine the health “package.” As I mentioned in an earlier blog post, many different areas will have some diseases that are more prevalent than others due to environmental and cultural factors. The third principle states that health services should use a holistic approach in order to target more people. Finally, community health should act as a leader and mobilizer. The nurses that work at CHPS unfortunately don’t get paid much which is why many of the facilities are understaffed. Although, I do appreciate Ghana’s efforts to making healthcare more accessible to the people. I will leave it on this note and will see you all tomorrow when I will hopefully be joining a firm with medical students and doctors as I go on rounds with them.

I didn’t take any pictures today so please enjoy this picture of town square that I took yesterday when I was exploring Cape Coast. It is essentially the equivalent of Independence Square in Accra.

7/29/19

Checking off the Bucket List

Hello everybody, I have some exciting stuff to share with you all including the surprise I mentioned a few weeks ago. Before I share that, I want to first of all say that today is World Hepatitis Day! 80% of people living with hepatitis lack prevention, testing, and treatment. Hopefully we can reduce this number in the future and spread awareness about the disease. The radio show that I was a part of (see Thursday’s blog) is one way we can get the message out there. Onwards with today. At around 10:00 this morning, I called Jacob and asked him to take me back to Hans cottage. You may remember my voyage there two weeks ago. I mentioned that there was something that I wanted to do but wasn’t able to since it was closed. I’ve kept that activity a surprise until now. Today, I got to pet a crocodile at the cottage! His name was Obo and he was a very big crocodile. Frederick escorted me to Obo and he explained how he’s a West African crocodile who primarily gets his food from the air by opening his mouth. In addition, fish and chicken are also added to his diet. Because he was very satiated, Frederick explained that he is very lazy and feeble and thus he doesn’t bite. As I was petting Obo, his back was actually quite soft yet scaly. I was anticipating it to be very hard. Needless to say, I cannot believe that I actually got to touch a crocodile. This was a huge bucket list moment for me! Many of you have asked if I would be going on an African safari. Unfortunately, the closest safari is about 400 kilometers from Cape Coast so it would’ve required more time than I had available. However, petting the crocodile today definitely made up for it! After the crocodile exhibit, Frederick showed me a tree filled with many egret and warbler birds. It was so beautiful and amazing to hear their chirping sounds. After seeing everything in Hans cottage, Jacob took me back home. On the way back, he pointed out a few more places to me and also taught me a few words in Fante! He also mentioned that on the first Friday of September, their is a festival called Orange Friday where everyone wears orange for head to toe. I only wish I could’ve been here during that time. Back at the house, I spent the afternoon relaxing for the most part. At around 4:00, I decided to go and take a hike around Cape Coast. I stopped by the beach to soak up the breathtaking views. Furthermore, I got to watch some kids play soccer and I really got to immerse myself in Ghanaian culture. Overall, today was a very good day! Tomorrow, I begin my final rotation at the Cape Coast Teaching Hospital. I am still unsure where exactly I will be placed but I’ll be sure to update you all soon. For now, I hope you guys enjoy these pictures!

Here are some pictures of me with my new buddy Obo. If you look closely, you’ll notice that there is a tooth that is beginning to come out. Frederick said this happened as he was competing with other males for food and resources.

Here is a picture of a tree filled with egrets. There were so many of them and it was a beautiful sight. The second picture is a nest that was made by the egrets!

A wonderful view of the beach!

Many of you requested a picture of a street in Cape Coast. This street is right next to the Oasis Beach Resort.

7/28/19

Cape Coast Castle

This is my last full weekend in Ghana. I cannot believe that my time here is almost up. Earlier this morning, I saw Roland (another coordinator of the program residing in the Accra house). He was visiting some family and friends in Cape Coast this weekend so he stopped by the house to say hi. It was very good to see him again after only interacting with him for a day in the beginning of the program! After lunch, I set out on my adventure of the city. I am definitely much more familiar with different streets and areas in Cape Coast so I’m more comfortable walking around on my own. I always like to greet people here by saying “good morning/afternoon” as I pass them by. Usually, everyone is very kind and they will warmly greet you back. At the town center today, there was a junior league soccer match going on and many people were spectating the match. I only watched for a minute or so because it was quite hot and humid today. Normally, there’s a cool breeze that travels but not today. After the game, I progressed to the Cape Coast Castle where Kofi, our tour guide, gave us an in depth tour of the castle. I’ll give a brief summary but I highly recommend reading more info about the history of the castle if you’re curious. The castle was built in 1653 (Elmina was built in 1482) by the Portuguese. Many slaves were held in the castle in extremely brutal conditions before being sent off to Europe and America (trans-Atlantic slave trade). Majority of these slaves would never return home. Slaves who tried to escape would either be beaten or put in a death cell. After they died, their body would be taken to the Gulf of Guinea. Former U.S. president Barack Obama visited the castle during his presidency. You can watch a video on YouTube and see his reaction. A major difference between this castle and Elmina lies in the architecture and design. Also, as mentioned earlier, they were built 150 years apart. Furthermore, Elmina castle participated in the trading of gold and other resources whereas Cape Coast castle only dealt with slave trading. Other than that, the history is very similar. Kofi brought up a very good point towards the end of our tour. While this castle explains history from a few centuries back, it’s important to note that slavery still exists today and we must treat people equally to avoid such injustice on humanity. After the castle, I walked around Cape Coast a little more and mingled with some locals. It’s been great getting to know them and they seem to enjoy learning some facts about Ohio. I am very tired from all the walking today so I will sign off here and will see you all tomorrow as I embark on a few more adventures!

A picture of the courtyard. You’ll notice that the design is different than Elmina castle. The concept is similar though where slaves stayed in the bottom and the governors would reside at the top. The graves in the bottom of the picture are from the governors of the castle.

A picture of some cannons. The water view was quite nice but it was hard again to enjoy the view.

This is a picture of the female slave dungeon. More than 200 females would live in this small area back in the days. There was no lighting and the window (in the back) was their only source of ventilation. Many slaves also succumbed to different diseases such as malaria and would die due to no treatment options.

These are some fishing boats. I’ve never seen so many boats lined up like this before so this was very cool to see!

A view from the governors bedroom. In addition, the governor would also receive wooded flooring whereas slaves slept on the hard cement floor.

7/27/19

Last Day at the Public Health Clinic

Hello everybody, hope you are all doing wonderful! Today was my last day in the public health family planning clinic and it was a good day. The family planning clinic has three different sections based on what I’ve observed: a procedure unit, a pediatric area, and an adult area. On Wednesday, I was more involved in the adult and procedure area where I saw a contraceptive implant procedure as well as some family planning counseling. Definitely read Wednesday’s post, “Family Planning Clinic Day #2,” if you want to know more about it! Today, I was immersed in the pediatric area of the clinic where I started out at the registration desk. I assisted a nurse who was working there with some paper work as she would ask questions to the parents. These questions included topics such as the use of mosquito nets, breastfeeding, and more. Based on their answers, we were able to advise them on ways to keep their child healthy. One way of course is vaccines. The maternal child and health book (see Monday’s post for a picture) has info for all the recommended vaccines at different ages. In the late morning and early afternoon, I helped two other nurses with some vaccination documentation. We would tell the parents what shots their child would get as well as when to follow up for the next round of vaccines. Immunizations are very vital for primary prevention. Primary prevention is the prevention of disease before the disease onsets. Towards the end of the day, Clifford showed me how to read an HIV and malaria test screening. This is a great example of secondary prevention, which is the minimization of the disease when it has occurred in the early stages. Screenings can detect these diseases at an early stage so that proper treatment is administered. In tertiary prevention, the long term stages of a disease are managed. In the family planning clinic, there are support groups and counseling to help people live a happy and healthy life. The community of Cape Coast is very close so that helps a lot. In public health, a great intervention has all three of these degrees of prevention so I think the family planning clinic gets a big thumbs up!Overall, I enjoyed my week in the public health department and I cannot believe that I only have one more week in the hospital! This weekend, I have a few things that I hope to do so I will see you all then!

I didn’t take any pictures today, sorry! This is actually a picture of a view outside the radio station. I know I put a lot of pictures on yesterday’s blog post so I thought I would put another one!

7/26/19

World Hepatitis Day Radio Show

Today was a very great day. Earlier this morning, I was at the hospital to observe a ritual clinic. I didn’t get to watch a whole lot since I was with other people discussing the outline for the radio show. At around 10:30 in the morning, I went along with three other nurses and public health officers who work at the teaching hospital to the Ghana Broadcasting Corporation radio station to give a one hour segment regarding hepatitis. Sunday, July 28th is World Hepatitis Day so we spoke on the radio today to raise awareness on the issue since Ghana is a high prevalence country (more than 8% of the country has some form of hepatitis). We talked about the history, causes, symptoms, and then I was responsible for discussing the prevention and management of the disease. Oddly enough, I wasn’t nervous throughout the show since public speaking is not a big issue for me. I talked about the importance of being vaccinated and screened for hepatitis. Unfortunately, many people are not well educated on the disease in Ghana so as long as we were able to impact one person today, I would say it was a job well done! More than 325 million people around the world have hepatitis. I think one way to reduce this number is to do more radio shows like this to raise more awareness. A big issue that I found out regarding the radio show is that the areas we were trying to target may not have had access to a working radio so another solution would be to physically go to these communities to educate about different diseases. Overall, I was able to successfully check another thing off my bucket list! I never imagined that I would be speaking in a radio show with over 10,000 people listening. I want to thank Clifford for giving me this once in a lifetime opportunity! I learned so much from this experience and had a great time doing it. Tomorrow is my last day in the public health family planning clinic so I will see you all then!

Here are some pictures from the radio show today! Majority of the event was spoken in the local language (Fante) but I was able to understand some of it as I did countless hours of research last night and also was able to pick up a few phrases each sentence. I am beyond thankful and grateful once again for this opportunity!

I ran into Chandi again today and have been with him for a good part of this week. He was actually at an outreach event today that I was initially going to go to but I instead opted to do the radio show which was hands down the best decision. Also ladies, he is on the market and is ready to mingle!

This is a photo of the ritual clinic. It was very busy this morning but I didn’t get to observe a whole lot. They did reviews for HIV and TB today.

7/25/19

Family Planning Clinic Day #2

Hello everyone, my apologies for not blogging yesterday. I decided not go to the hospital yesterday and decided to recover a bit. I’m feeling a lot better now so I was able to go back to work today! Today, I was able to watch a contraceptive implant procedure. We had one person who was beginning it and another person who was finishing it. This is one of several methods that the family planning clinic offers to control pregnancy in women. A small capsule is injected in a woman for three years. Afterwards, the woman comes back to the hospital to get it removed since it’s no longer effective at that point. I also was with Afua today where she counseled different people about all the family planning options. There weren’t many people today (Monday and Wednesday tend to be the lighter days at the clinic) so there wasn’t much else to do. However, I do have some exciting news! Tomorrow, I will be going to the Ghana radio broadcasting station where I will be talking and educating the locals about hepatitis. July 28th is World Hepatitis Day so I will be doing this show along with three other staff members to raise awareness on a disease that is the second leading causes of death in the country! I spent the rest of the afternoon and evening doing some research and preparing for the radio show. The show will happen tomorrow at 11:00AM local time on Ghana Broadcasting Cooperation 92.5MHz so feel free to tune in if you would like to listen. Of course, I will update you all tomorrow about how the show went. See you all then!

This is a picture of the family planning record book that’s given to every person. The formatting and content is very similar to a patient portal. I will try to get some more pictures tomorrow so stay tuned!

7/23/19 and 7/24/19

1st Day at the Public Health Department

Today’s blog won’t be too long. My fever was a lot better but my throat was hurting. I went to see an ENT specialist and he gave me some antibiotics so hopefully I should recover in the next few days. I startedmy new rotation at the public health family planning clinic today. However, I was only there for a few hours due to my illness. I attempted to learn a few things but many things went over my head so I apologize if this post is a bit ambiguous. In the morning, I was first greeted by Chandi from the outreach last week. He introduced me to all the other staff members in the department. The family planning clinic is where families can decide the number of children they want as well as the frequency (how far apart should each child be). Families can sit down with somebody from the clinic to discuss the methods of achieving their ambitions. The clinic supports the health and community which I found to admire today. Furthermore, the clinic also offers vaccinations to neonatal and infants at a very low cost. Every mother is given a book when they have a new child from the Ghana Health Services. The book highlights many things such as nutrition, vaccination charts, breastfeeding tips (very common in Ghana), and other things to ensure a healthy life for the child. I am excited to see what the rest of the week has to offer at the clinic. It’s good to get a break from the medicine side and explore more into my undergraduate coursework. Hopefully, my throat allows me to go to work tomorrow so I will sign off and get some rest!

This is a picture of the maternal and child health book that I mentioned earlier. It is very informative and self explanatory to those who are proficient in English. For those who prefer to speak the local language, the clinic helps to clarify material in this book.

7/22/19

Weekend Getaway to Accra

Hello everyone, my apologies for not posting yesterday. I was having a fever and sore throat yesterday so I had to go to sleep early. Today’s post will highlight events from yesterday and today. Yesterday, me and another cohort member woke up at around 5:30 AM to catch a bus to Accra (the capital of Ghana). The bus ride was about three hours long and very bumpy. As soon as we got to Accra, we were warmly greeted by a family friend member (uncle as we like to say in Indian culture) who graciously allowed us to stay at his place in Accra for the night. He was such a nice and wonderful man. We had some omelette with Maggi ketchup! I have missed Indian food since being here so getting to have some of it in Ghana was awesome. After lunch, I took a small nap to recover a bit from my illness. About 3 hours later, I felt a little better so we set out to the Accra Arts Centre to buy some artwork. I’ve never seen so much art in a small area! It was so beautiful (even for someone who isn’t an art enthusiast). Afterwards, we went to Independence Square where Ghana’s Independence Day is celebrated. In addition, the black star on the middle of Ghana’s flag represents light and unity. This was a huge symbol of the African liberation movement. Across the street, there’s another area with a soldier and Ghanaian arch. I noticed the soldier was looking directly at the arch and I asked a local the importance of that. He said the soldier is saluting to those who lost their lives during the battle for Ghana’s independence from Britain. It was a very powerful moment and me and my friend took a brief moment of silence to honor those who sacrificed their lives for a prosperous nation. The Accra Stadium is also adjacent to Independence Square. After seeing the square, we went home and had an Indian cuisine for dinner. I’ve dearly missed Indian food and my friend and I were extremely happy. Today, we woke up and my friend was very kind enough to make an omelette with bread for me while I was still having a fever. We also had leftover Indian food for lunch. I am very thankful and forever grateful to my friend for taking care of me. She was very understanding of my health and was perfectly okay with skipping out a few places in Accra. She took care of me like a little brother! Samuel, a staff worker, took us to Kaneshie Market in the afternoon where we took a bus back to Cape Coast. Overall, I’m so happy we were able to spend some time in Accra this weekend and have some much needed Indian food. I only wish I wasn’t ill throughout the entire trip as we didn’t get to see a whole lot. My friend and I are very hopeful that we can come back again prior to our departure to the states. Tomorrow, I begin my new rotation at the public health clinic. I will get to take a break from the clinical side of my internship and will now get to see the other side so I am excited. Hopefully, I feel better by tomorrow!

This is a picture outside of the house in Accra. In the far back, you’ll see a waste dump where they’ll burn all the trash (very common in Ghana).

This is Bruno. He is one of six dogs that my uncle has. The other five dogs however live in my uncle’s other house so it was just Bruno at the guest house. He’s such a cute and good boy!

This is a picture of a stand in the Accra Arts Centre. There were at least 100 stands like this one so we didn’t get to see it all!

A picture of me in front of Independence Square. Ghana gained its independence from Britain in 1957 as shown in this monument.

7/20/19 and 7/21/19

Last day of Pediatrics OPD

Today was a normal day and many similar acute cases from yesterday were also present today. I was also able to do Dr. Arthur’s notes (she wanted to see if I could type fast)! Overall, this week in the pediatric OPD was very successful. I was able to learn and do many things that pushed me out of my comfort zone. I never thought I would be able to examine patients, take their history, and also come up with a diagnosis but Dr. Arthur was able to put a checkmark on all of these things. She taught me a lot and I sincerely thank her and Dr. Ellen for a great week! Dr. Arthur asked me to be on the lookout for medical conferences in the US as her dream has been to attend one. I promised her that I would do that. Back at home, I went shopping on my own for the first time (normally I go with another cohort member) to gather a few things. In the evening, I played the Ghanaian version of Ludo with Geegy and I unfortunately lost. It’s a lot harder than the regular version if you ask me. With that being said, I will sign off and see you all tomorrow!

This is a picture the OPD room I was in all week long. You’ll notice that there are two computers on the desk (one for Dr. Arthur and one for Dr. Ellen). This meant that there was always two patients in the room speaking with either doctor. In the U.S., it’s typically one on one.

7/19/19

Routine Work with Some Free Time

The OPD today was very normal as indicated by the first part of this title. Many cases today were all acute illnesses. I was able to learn more about the oral drug for malaria. After work, Dominic (nurse from Monday) came over again today to talk more about communicable diseases. I will give a quick summary of the meeting based on the notes that I took. Malaria and upper respiratory tract infections are the most common communicable diseases in Ghana. 75-80% of cases seen at the teaching hospital are communicable. HIV has improved a bit but there’s work to do in this department to lower the incidence rate. We discussed four main environmental causes of communicable diseases in Ghana: water supply, sanitation, food, and climate. Rural areas lack proper draining systems. Some may end up consuming unhealthy water from the rivers and streams. They also lack proper sanitation and people may not wash their hands before preparing a meal or the vegetables prepared may not be clean. In terms of climate, we talked about how mosquitoes can be very active during rainy and humid seasons. This is the time when the prevalence of malaria is high. Due to the increase in communicable diseases in Ghana, the government intervened in 2010. They have sent free gadgets such as mosquito nets and condoms to rural areas. Ghana also initiated a program called CHPS (Community Health in Planned Services). All 212 districts in Ghana have at least one of these services. They essentially educate people about proper sanitation and ways to avoid contracting different diseases. Dominic will talk more about this program next week so I will leave it at that. In the evening, we went to the Abura district to do some street shopping. We didn’t find many things. However, we ended up going to a restaurant to try chicken shawarmas for dinner. It wasn’t a Middle Eastern shawarma but nonetheless it was very delicious. Tomorrow is my last day at the pediatric OPD with Dr. Arthur!

This is a picture of the main street in Abura. It is very busy during all parts of the day.

7/18/19

Back to OPD

I’m back in the outpatient delivery (OPD) rotation at the teaching hospital! Unfortunately, Dr. Arthur was not feeling well this morning so I ended up working with one of her colleagues, Dr. Ellen. She was a very nice lady who taught me a lot of things. Today, I got to try something new. Dr. Ellen asked me to take a history of all the patients. This meant I was responsible for questioning the patient’s parents in order to come up with a provisional diagnosis. It took me a few patients to get better at doing this and Dr. Ellen was right next to me. She assisted me when I ran out of questions or if the patient preferred to speak in Fante (the local language). She also of course would eventually make the final verdict on the diagnosis, medications, and referrals (if needed). However, she challenged me to think critically today and pushed me out of the observational role that I’ve been accustomed to back in the States. She would ask me what I thought about each case. Afterwards, I would turn to Dr. Ellen where she would ask some questions that I may have forgotten or some follow up questions to better understand the child. It’s nice to see that referrals happen on the same day whereas in the U.S, it can take days or even weeks for referrals to occur. Same day referrals definitely adds a lot of convenience and it also reduces the stress of the patients. After using my brain for about six hours, I came home and did some basic research on some of the cases from today. In the evening, one of our cohort members who was been working at a family planning clinic came home with her mentor. His name was Michael and I had a great conversation with him. He talked about how many kids in Ghana will have sex as early as nine years old. This was very disturbing to hear and some of the kids are raped. I applaud all the work that they do at the family planning clinic to help promote good public health education. Tomorrow, I will continue with the same procedure and hopefully see some new cases!

My apologies for not taking any pictures today. OPD was very busy today especially since Dr. Arthur was not present! I thought today might be a good day to upload a picture of the outside of the house that I’m staying at. The house is on the left and this is a walkway. You can see some more houses in the background which I think is pretty cool!

7/17/19

Outreach in the Village of Jukwa

Today I was able to get a break from the teaching hospital environment. Early this morning, we took a bus along with some nutritionists, nurses, and a few other staff members to the village of Jukwa. It was about a 45 minute drive. During this drive, I met a public health department worker named Chandi. He was a very nice and funny guy. When we got there, I instantly took note of the village as a very small community. When we got off the bus, there was an event going on at the pavilion. The entire village was present so I was able to witness the vibe of a close knit community. After the event, the different stations were set up turning the pavilion into a mini clinic. There were many different stations including eye, dental, nutrition, health insurance, and more. I started out in the public health station where I checked blood pressure of many people. There were at least 300 people to do blood pressures for but luckily I had Chandi along with me. They also offered HIV and malaria screening tests to everyone. After a couple of hours, I headed over to the nutrition department where I was responsible for noting down the weight and height of people in order to calculate their BMI. This number would be further discussed with the nutritionist. I did get some free time as the number of people requiring medical assistance decreased in the late afternoon. During these moments, I sat down and talked with Esther. She was working in the health insurance station. We talked a lot about food and now I have some places and new things to try! It felt good to talk about something off topic after a long day. We returned to the hospital where I called a taxi in order to go home and relax. Overall, I found today to be a very great day. I am a big supporter of these outbreak events that the teaching hospital does. On average, they will do one a week. This kind of intervention provides care to those who don’t have access to health care. By doing this, we can promote health across the globe. Health equity and equality are a big topic and public health and they both differ in meaning. Health equity assured that everyone is given what they need to be successful. On the other hand, health equality occurs when everyone gets the same thing so the people who require more attention may not benefit. I think this program provides health equity whereas many health programs in the U.S. lean more towards equality. Other health systems should mirror the Ghana health system and the teaching hospital intervention to reduce the burden of disease. As discussed in yesterday’s post, rural areas are more at risk for non communicable diseases due to their lifestyle. I’m extremely tired as we got home at around 7:30 (normally I’m home at around 3:00) so I will leave it at this and see you all tomorrow! As promised, I got plenty of pictures today!

This is a picture of the village during the event that occurred in the morning. There are so many people!

This picture displays the setup of the stations where all the different tables and black tent (in the back left) resemble the different stations offered to the community.

Me doing blood pressure checks along with Chandi. We also were able to get a selfie together.

The village of Jukwa. It is definitely a lot smaller and isolated!

7/16/19

Inpatient to Outpatient Pediatrics

Today marked the beginning of my new rotation at the Cape Coast Teaching Hospital. Last week, I worked alongside nurses and medical students in the pediatric ward by documenting vitals and patient history. In addition, I sat alongside the students and residents to discuss different child mortality cases. This week, I will be shadowing Dr. Arthur in the outpatient pediatric clinic. She has been working at the hospital for a little over two years. We had a great conversation as I attempted to learn more about the distinctions between U.S. and Ghana health tracks for students. I would say today was a big success in the hospital and I certainly can say that I like the environment of outpatient better than inpatient. After work, we had a nurse named Dominic from the hospital come to the house to give us a lecture about non communicable diseases and Ghana health care. Malaria is a big problem for many people in rural areas particularly due to lifestyle. For example, this may include the lack of mosquito nets. Furthermore, chronic cardiovascular diseases such as hypertension and diabetes are now the leading cause of chronic death in Ghana (it used to be the seventh). Dominic told us that culture was a big hurdle. There are some tribes in Ghana that refuse to take oral medications and will only take injections. Plus, based on what I’ve eaten here so far in Ghana, diet also plays a big role in this criteria. Dominic also elaborated on the health care system in Ghana. The country strives to provide health care to everyone regardless of their socioeconomic status. Ghana does a better job than the U.S. in terms of health equity. It’s great to see how far Ghana has come with their health care system considering they’re a relatively new country. Even though quality of health care can be improved, they’re going on the right track to get there! After the meeting with Dominic, me and another cohort member went to the supermarket to get a few things. We walked to the market and enjoyed greeting the locals as we walked past them. I will sign off a little early tonight as I have to be up at 6 AM tomorrow. Instead of going back to the outpatient clinic, I will be heading with the outbreak program director of the hospital to a rural area of the country to do some public health and medial outreach to these communities. It will be nice to get away from the hospital environment. Unfortunately, I was extremely busy today at the clinic so I was not able to capture any pictures but I promise to get some tomorrow at the outreach program!

7/15/19

A Trip to Elmina

Today was filled with another day of tourism. We only were able to go to one place. The sun sets very early here in Ghana and many places close early. However, we have three more weeks to cover other places! Today, we called a new taxi driver that was recommended by Geegy. His name was Jacob and he took us to Elmina Castle in the city of Elmina. It is about 20 kilometers from Cape Coast so it wasn’t a long drive. When we got there, we were instantly greeted by Seth and we ended up having a small conversation with them. He offered us a small bracelet with our name engraved and the Ghana flag would be on it. I accepted the offer and he said it would be ready by the time I finished the tour of the castle. Elmina Castle was built in 1482 by the Portuguese. That’s 537 years ago! The castle unfortunately has a dark and horrifying history behind it even though it looks beautiful from the outside. Our tour guide Nicholas elaborated on the history. To give a quick summary, the castle was a part of the Atlantic slave trade between Africa, Europe, and the Americas. For many enslaved Africans, it was the last time many of them would see their homeland and loved ones for the rest of their lives. Many of the slaves who resided in the castle primarily lived in dungeons on the lower level in extremely harsh conditions. “May humanity never again perpetrate such injustice against humanity.” These were some lines engraved in the mission statement of the castle and it definitely serves a very powerful message. I highly recommend reading more about the history of the castle and the slave trade to have a better understanding of everything as there is so much history! After the tour, I was able to get the bracelet with my name engraved along with a shell from Seth that stated, “to my friend Shashank, have a great trip at Elmina Castle!” I found this to be a very nice gesture. We then drove back home and hung out as a cohort during the evening by playing some board games and watching a movie. Now it’s time to sign off in preparation for my new rotation tomorrow at the hospital!

A picture outside of the castle.

The inside of the castle. Slaves resided at the bottom and the governor would stay at the top floor.

A very nice view of the beach from the castle. It was a bit hard to enjoy this view given the horrifying events that once occurred a few centuries ago.

A selfie of me and Jacob, our taxi driver. We had a great conversation and he was a very nice person!

A nice view from the road on the way back to Cape Coast!

7/14/19

It’s the Weekend!

It’s finally the weekend so I get a small break from my rotations at the teaching hospital. Today me and my cohort drove about 45 minutes north of Cape Coast to Kakum National Park. According to our tour guide Kofi, the park has been around since 1992 and many of the insects are nocturnal. The park offered several different options for hiking. According to Kofi, The canopy tours was the most popular option so me and my cohort decided to do that. We ventured across seven different canopies. Each canopy was very skinny and about 130 feet above the ground. There were some people that were extremely scared but somehow it didn’t hit me. I was able to make it through without a sweat (aside from the humidity)! The views were absolutely phenomenal and I highly recommend it to anyone visiting Ghana. After Kakum, my cohort and I went to Hans cottage, a nice resort to have some food. I was not very hungry but I was very keen on trying some pineapple ginger juice. Personally, I thought it tasted very good but it has a very sweet aftertaste in my opinion. There was an activity that we wanted to do at the cottage but we were a little too late. We will plan to do it in the coming weeks and for now, I will keep it a surprise! Afterwards, we went home to eat dinner and hung out with Geegy. Throughout the day, our taxi driver Joseph was with us and I’m extremely thankful that he stuck with us the entire day. He and all of us will now take some rest tonight as we will all head out again tomorrow to do some more sightseeing!

A picture of one of the seven canopies. I truly enjoyed the greenery scenes on all of the canopies! The planks were so skinny that it felt like you were walking on the balance beam.

A picture of our cohort! One of our members departed today to go back to the U.S. as her program time was up. We will most likely have two more people join us next Saturday so our cohort will get bigger again!

This is Hans cottage. The place was super nice and it had lodging, a pool, and other fun activities. We will definitely visit again to do an activity (surprise for now)! The water is so clean and you can see the beautiful reflections perfectly!

7/13/19

Last Day of Inpatient Pediatrics

As indicated by the title, the head of the pediatrics ward was able to get me into outpatient pediatrics rotation next week! Based on what I’ve observed in inpatient settings here in Ghana and in the U.S, I think my interest lies more in outpatient care. Today was a normal day again starting out with the child mortality meeting. The biggest takeaway from the meeting was that water quality is an extremely important public health burden. After the mortality meeting, the rounds and documenting began as usual. The power went out quite a few times today. You could feel the humidity in the building as there is no air conditioning as well. I think it’s important to note that not only is access to health care important, but also quality of health care matters a lot. Ghana health systems don’t have adequate health facilities and it’s important that they have funds to improve the environment of the hospitals. Overall, today was a great day to delve into the public health side of my internship. Ghana has made a lot of advances over the past few decades in their health system, but they have the potential to do better and as a public health student, I hope I can raise awareness on this issue along with other public health students and faculty at Ohio State. Tonight, I went to the city with my cohort to explore a bit of culture and night life in Cape Coast. We went to a local club right next to the beach. They had an African dance show and the guys performed so well. In fact, they invited many people from the audience to come up and learn their dance. I was one of those people. I was definitely embarrassed because I’m a very horrible dancer but at the end of the day, I give myself an A for effort. In fact, I am actually so grateful for those guys because they pushed me out of my comfort zone and made me try something new. I also had a lot of fun doing it and the crowd acknowledged my effort! Now it is time to get some much needed rest because it’s the weekend and I can finally catch up on some sleep!

I finally was able to get a picture of our mortality meeting. The meeting consists of residents and medical students. Dr. Okai (far right) has been a practicing physician for 16 years and he definitely challenged all of us to think critically during each case. He would always ask all of us to come up with a diagnosis for each case.

Just a casual picture of me in the hospital. The two different buildings in the background represent two different wards. There are a lot of palm trees in Cape Coast which is always nice to see!

This is the African dance group from the night club. They were extremely good!

7/12/19

Close Community of Cape Coast

Today was a very normal day with some excitement at work! The day started off with the mortality meeting as usual. The different Ghanaian medical students are responsible for presenting different cases to the group and I have actively been engaged in the discussions. The rounds along with busy vitals and patient history documenting began shortly after the meeting. However, today presented a different vibe during the rounds because many of the medical students, doctors, nurses, patients/families, and me were glued onto the TV/radio as the finals of the National Science and Math Quiz competition of Ghana was being held in Accra. Many of the staff members would watch when they had a small break or when they weren’t busy. The event was broadcasted on the news channel which implied to me that this was an extremely important competition. It was even more interesting as St. Augustine College, a high school in Cape Coast, was competing in the finals. Everyone in the hospital was behind their back rooting for them as they answered many tough questions correctly. I was very impressed with their knowledge! St. Augustine ended up winning and everyone in the hospital was celebrating. It was at this moment that I realized how close of a community Cape Coast is despite having a large population in a small area. Back at home, I was busy catching up and reading over all the notes I took at the hospital the last two days (slow internet yesterday). The power just went out here at the house so I will sign off and conserve my phone battery! Tomorrow may be my last day in the pediatric ward as I requested the director to work in the pediatric outpatient clinic next week.

This is a picture of the science and math competition that was held today. These two people represented St. Augustine and the city of Cape Coast in a very dignified way.

7/11/19

Working and Wandering

Today at the hospital, we continued our child mortality meeting from yesterday with the Ghanaian medical students and residents. Many similar diagnoses were present from yesterday which got me thinking: so these diseases have no treatment or does Ghana lack the proper treatment. Plus, are these diseases prevalent in the US and if so, what measures are they taking? Afterwards, I continued my rotation at pediatrics and saw some new children being admitted today. I had rice for lunch today again which has been a very common theme since I’ve been here. A lot of carb loading goes on here. After work today, I went home and relaxed a bit after a long shift. In the evening, me and a few of my friends in my cohort went out to do a little sight seeing. On the way, I stopped by the supermarket to pick up some water bottle and snacks. Water had been a big challenge for me since getting here since Ghana does not provide clean water. I’ve even had to brush my teeth with bottled water and close my mouth while showering. I think I’ve gotten used to it now though! After the supermarket, we walked along the road next to the beach and took some photos. We were even able to see some dancing and other cultural traditions which was extremely cool. Unfortunately, the sun sets here quite early so we had to go home. But nonetheless, it was very nice to soak up a beach scenery after a long days at work!

Beach view just next to the Cape Coast Castle!

Front entrance of the hospital.

7/10/19

Day #2 of Pediatrics

Today’s day began with a 2 hour child mortality meeting with the Ghanain medical students. We discussed 10 different cases. Many of these cases contained children who only lived for about a few days. This was very upsetting to see. After the meeting, I resumed my work with the nurses logging in vitals and other patient data. Many of the patients were familiar from yesterday so I was aware of their diagnosis and medications. It was nice for me to get a scope of how the doctor progressed with the medications. I then did more work and then went home at 3:00pm. Today was a very relaxed evening as many people in my cohort had work to do including me. I have been noting down different diseases and medications that have come along my way. I find myself researching more about these things at home. Tomorrow, I hope to explore Cape Coast a bit more and also interact with the neighbors!

This is a picture of the outside of the hospital. Definitely feels more like a college campus than a hospital. The different buildings represent the many unique wards.

7/9/19

1st Day of Rotations

Today was my very first day at the Cape Coast Teaching Hospital. I went to the hospital at 9 this morning and was given a tour by Madam Beatrice. We were shown all the different wards. Afterwards, the director of the hospital gave me my first rotation assignment. For the first two weeks, I will be in the pediatrics unit of the hospital. Today I was with nurse Desiree where she showed me around the place and I was then tasked to document and enter vitals and patient summaries on the computer system and in a very big book that has all the patients in the pediatrics ward since March. It’s very interesting how in the US, everything is digital. It’s the complete opposite here. There was only one laptop available to share amongst the nurses and I was the main holder of it today. We got home at around 3:00 where I called my mom and grandparents where I told them about my day. In the evening, me and my cohort had dinner and some of us played a game of spoons (cards). We then spent time with our coordinator Georgina where me and another member of the cohort introduced Bollywood music to her. She briefly discussed Ghanain culture to us. There are 10 regions (states) in Ghana. Tomorrow, I will be continuing with the pediatrics portion of the hospital!

7/8/19

Accra to Cape Coast

The day started with meeting a few more people from different programs of CFHI. At approximately noon, we headed towards Cape Coast which was about a two and half to three hour drive (highway was only one lane). After we arrived, we immediately went out with our coordinator Georgina (Geegy) to explore the city. We saw many places like the Gulf of Guinea (beach), a castle, the supermarket (bought water, parle-g cookies, and mango juice), and the Cape Coast Stadium. We ran across many people. The kids were very friendly and would wave their hands at us as we were greeting them. We then ate dinner back at home and had chicken, Ghanaian, and some French fries. In particular, the stew was my favorite! Tomorrow will be my first day of my first rotation and I’m looking forward to it!

This is a picture from the inside of the Cape Coast Stadium in Abura. I wish I could’ve ran a few laps around the track!

7/7/19

Landed in Accra

Akwaaba (welcome)! After a ten and a half hour flight from JFK, I was speechless and humbled as we landed in Kotoka International Airport. Never in a million years did I think I would go to Africa, but here I am as a college undergrad! It all hit me right when we landed. Just for tonight, I am staying at the CFHI Accra house. Spending the night here in Accra without power was very interesting. I also had to learn to conserve water (something I take for granted and tend to waste in the US). I also had to learn to sleep in the heat. I had African rice with chicken for dinner.The people here are very friendly and I am very excited for the next couple of weeks! Tomorrow we head to Cape Coast!

A picture of the Accra accommodation. Pictured in the background is Roland who is one of the coordinators. Very nice and lovely guy to talk to (especially about soccer)!

7/6/19