Reflections on Unite for Sight and Ghana

Map of Ghana:



I returned from Accra last weekend, and am now back in Toronto to give you a full report about the last leg of my trip!

My blog entry today has three sections. The first one contains some of my own estimations of what our Unite for Sight program accomplished in the two months that I was there. The second section is a reflection about my experience as a whole and the perspective it has given me on many things in life. The third section, thanks to Amy, is composed of some answers to her (yet again!) wonderful questions.

Thank you to everyone who supported Unite for Sight on my behalf, and who have encouraged me through this journey. I owe all of what I was able to accomplish in Ghana to your love and generosity. I hope my blog was able to give you some new perspectives on Africa, volunteerism, global health, and life. All in all, my experience with Unite for Sight and volunteering in Ghana was nothing short of amazing, and I encourage anyone you to write to me if you have any questions about what I’ve blogged about! Christine.yeung08@gmail.com

If you would like to make another donation to Unite for Sight, please re-visit my fundraising page at https://maestropay.com/go/uniteforsight/volunteers/ref/7ae1fa7ff02e4bbe897f635669d3700f. Thank you!

I hope you enjoy this final blog entry about my spring trip in Ghana.

yours,

Christine

Pictures from my first overnight outreach in New Edubiase (Adansi South). The woman in the centre of the collage is an old woman who had received free cataract surgery from the Crystal Eye Clinic in Accra. When I checking her visual acuity, she kept telling me how thankful she was to the program, and how when she first came to a Unite for Sight screening, she had to be lead by the hand in order to walk. I didn't think of taking a picture of her until she had ran around the church, so I had to chase her to get this photo. When she saw me she hastily dropped all the things she was carrying in her hands in order to pose for the camera. This shot is actually from a short movie clip I took of her running.

Statistics!

For the last three weeks, we continued to do outreach, and to observe surgeries at the clinic. In my last week in Ghana, I made a second trip to New Edubiase (Adansi South) with the outreach team. Here are some stats about the impact of Unite for Sight in the two months that I was in Accra: (These are my personal estimations.)

2700 – patients were screened (300 patients/week)
360 – patients received Unite for Sight sponsored cataract and pterygium surgeries (40 patients/week)
16 – villages hosted Unite for Sight’s free eye screenings
4 – regions of Ghana (Central, Eastern, Volta, and Ashanti) were visited on outreaches
2 – overnight outreaches in New Edubiase (Adansi South), for one week each
1 – week in an eye camp in Offinso, neark Kumasi, where Unite for Sight sponsored 76 surgeries.

This is us partnering with the Tema Christian Eye Centre. They have an ophthalmic nurse by the name of Moses who screens patients, but they do not have any full-time ophthalmologists. Instead, they invite foreign medical doctors as volunteers to perform surgery. When they do not have any doctors scheduled to come, they will partner with Unite for Sight and the Crystal Eye Clinic so that their patients can still receive eye surgery.

A New Perspective on Life.

My experience in Accra, Ghana, contributed greatly to my personal growth, and I believe it has prepared me well for not only the practice of medicine and public health, but any challenge I will be faced with from now on in my life. The experience of fundraising, collecting glasses, and training for the Unite for Sight volunteer program taught me the power of implementing many small but well-designed initiatives, and the power of preparation. Each Unite for Sight volunteer must collect $1,500 US to sponsor surgeries for people living in extreme poverty, and obtain 300-600 pairs of reading eyeglasses and sunglasses. There was also over 36 hours worth of reading, writing, shadowing, and viewing videos that volunteers needed to complete before their departure. When I stepped back to admire the work that I had done even before I arrived in Accra, I was impressed with the genius of it all. Why not have students eager to make an impact through volunteering in global health take on some of the fundraising and collection responsibilities, and then prepare them through online training for their jobs as volunteers? The initiatives enabled Unite for Sight to sponsor many more surgeries than they could have through their other fundraising sources, and the preparation before I arrived in Accra certainly made a difference in my ability to contribute to the program on the ground. With little orientation I was able to jump right into the work I had to do. In fact, I did not have a formal orientation until the last week that I was there! It is a forgivable mistake only because my training was so thorough and complete even before I reached Accra.

These are pictures from my second time in Krobo Odumasi. That outreach stood out to me because in the same day, I saw two very unfortunate cases: a mother with her blind son, and a young baby with cataracts and her young father.

I realized two very important bi-products from this design were, first of all, increased awareness about preventable blindness in developed countries (you, my wonderful donors, represent three countries, Canada, the US, and Hong Kong), and an improved appreciation for important global health principles such as ethics and professionalism among participating volunteers, and thirdly, financial support for local healthcare professionals which helps to reduce the brain drain of medical professionals away from developing countries. I am noticeably still in awe of the organization because it has enriched the scope of what I believed what students, nurses, physicians, and regular citizens are capable of doing. Having experienced being part of such a well-designed organization, I am inspired to do something similar once I have my medical training and help more people in need.

The Crystal Eye Clinic. Although most of the cataract patients are elderly women and men between the ages of 60 and 75, and pterygium slightly younger, I saw a couple of cases where the patients were very young, like the babies pictured in the top left hand cornner of this collage. The one in front had congenital cataracts, while the one behind her was completely blind.

Another aspect of my experience that helped me grow personally was my interactions with the youth there. I became good friends with many young people like myself; people who not only had dreams for themselves and their family (as I did for me and my family), but had dreams for their communities and their country. Two fourth year undergraduate students I met wanted to become Members of Parliament in their home districts, and another young man I met, having barely graduated from university, even started his own NGO to develop the Upper West region of the country using three pillars: agricultural development, education, and microfinance. It just strikes me as amazing that people who live in such a challenging environment can have such big aspirations. One of my good friends was periodically skipping meals and studying while hungry because his father could not afford to give him more money for the week. He developed stomach ulcers and was admitted to the hospital for the first time while I was in Ghana. Another young girl that I befriended had to work very hard in the morning selling boiled eggs in order to make enough money to pay for the printing costs for her examination paper. The challenges I face in Canada pale in comparison to the ones my friends face in Ghana. Their hard work and commitment inspires me to forge ahead despite my fears and insecurities. My experience in Ghana taught me that as long as you have a vision for the future, an action plan to match it, and a group of committed friends, you can achieve anything.

I see all of these bright and talented men and women who are working hard so that they can excel in the classroom, get far in life, and learn how to build and help their country. Then, I see another young medical student across the Atlantic in the US, Jennifer Staple, who is hard at work directing her grassroots NGO, Unite for Sight, which provides poverty-alleviating, life-changing cataract and pterygium surgeries in and around Accra. Seeing these two examples, I cannot help but think, “Wow. I gotta get out there and do something.”

More outreaches in the Eastern and Volta regions. Somanya, where we saw the most patients I had ever seen in my life, is in the Eastern region. I remember that place well because we saw over 200 patients, and that day, my task was to do visual acuity, but they had placed the E-charts on the wall of the church, two steps away from the urinal. It was hard to focus that day.

Most of my learning and experiences have come from studying science, social violence, and health, so being in Ghana and seeing such a high demand for education really forced me to re-think my values. I always believed that health was most important because without it, you cannot do much, but there are so many people out there, living at less than the optimal level of health, who are still achieving things, getting degrees, working in jobs, and having successful careers that allow them to give more opportunities to their children. I realized that education is such a powerful tool that helps people get out of poverty. I also realized that in Canada and the US, having an equal opportunity at education is such an enormous privilege. I met many young men in their mid-twenties who were still waiting for acceptance from universities. First of all, in Ghana, education is expensive, so if you don’t have enough money to pay for school, you have to make it yourself first, secondly, it is competitive, so you have to earn top grades in high school, or have connections to help you get in. It is therefore a real privilege to be able to be accepted into a school solely based on merit, and for this reason, I hope to donate to my school to create more scholarships for international students. I still think that health is important, because it removes the burden of certain illnesses from families who are living in extreme poverty, but I now see the value in supporting other poverty-alleviating initiatives like improving access to education, skills-development, and micro-financing.

Outreaches in Krobo Odumasi, and the Volta Region. These were all very well organized eye screening locations. Well organized means that when we arrived, there were at least 100 patients waiting to be screened, and that the organizers were able to successfully manage the crowd of patients so that they would flow systematically through the different stations (registration, visual acuity, eye examination, and dispensiary of glasses and medication). They were also some of the most welcoming - food never fails to make me feel welcome. =P

Amy’s Question Corner!

Amy: How do you wash clothes by hand? Do you have board? You said you had a bucket, so I'm thinking you just scrub the material against each other? Do you just get the water from the tap? Or do you have to go to a river?

Christine: Well, it was quite simple really. You don’t have a board, and you don’t need to go to the river. In most guesthouses, you’ll find a backyard where there are clothes lines to hang your clothes. To wash them, you just grab two buckets, and fill them with water from an outdoor tap (kind of like the ones you would find to attach your garden hose in order to water your lawn). Then you use one bucket for washing, and the other for rinsing. You take the clothing, soak it in the water, grab it lengthwise and lather it with a bar of soap (body soap works fine, but they also sell special laundry-washing soaps which are bigger and therefore easier to handle in the soapy water). Then you grab the clothing lengthwise, say half-way through the middle, and...(this gets a little difficult to describe), place it on halfway up the inside of your forearm. Use your other hand to squish the clothing from the middle of your forearm to the palm of your other hand. This is when you hear a very satisfying sound of water and soap coursing through the weaves of your clothing (I’ll attempt an onomatopoeia...Sqrrruishhhhhh!). You keep doing this down the length of the clothing and add water and soap as needed. When you’re done, you fold the clothing lengthwise, and then ring the clothing in such a way that the water drains right into the bucket rather than everywhere, as it does when you ring clothes in Canada...I won’t even try to describe this because I already know I will fail. If you want to learn, I can teach you in person! Then you plunge the clothing into the “rinse” bucket, and ring it again before laying on the clothesline with some clothespins. Ta-da! Clean clothes. It sounds like it would take forever (as it did when I was just learning) but after a while, you can clean your clothes even faster than the washing machine!

Amy: Do you get nervous about eating street vendor foods? When I visited China with my mom last summer, my uncle would never let us eat anything from the street vendors because he was afraid we would get sick. But I bet since you're going to be there long, it's good to build up your tolerance!

This was my final overnight outreach experience in Adansi South. We saw a lot more patients this time around. Some highlights were the impromptu soccer game that Pastore Mike, Sammy, Simone, Dennis, and Bismark played with the primary school students where we were holding an eye screening. The shirted vs. the no shirts.

Christine: If you really want to eat street vendor foods (I encourage you to try it, because it is often the tastiest things you’ll ever eat in your life, am I right?), you should plan to stay in Ghana for longer than 3-4 weeks. That way you’ll have time to overcome the inevitable negative bodily reaction to some of the bacteria in it. I was taking broad spectrum antibiotics throughout my stay, so I got diarrhea for a week, but then I was pretty much fine after that. I would recommend traveling with somebody who is familiar with the food and its risks so that you can learn what is safe to eat and what isn’t. The only thing I found to be risky eating on the street was when I saw a hamburger (in downtown Accra) and bought it. I bit into it once and saw that the meat was not cooked, so I immediately spit it back out. Dennis, one of the nurses at the Crystal Eye Clinic, when he moved back to Ghana along with his two kids, he also had to take some time to adjust to the water and food here. His kids (3 and 5) alone took two months to adjust completely. Of course everybody body is different, and I can only speak of my own experience in Ghana, so please don’t get mad at me if you get really sick after eating some street food in a different country! The nurses I worked with in Accra kept commenting that I had a rather strong stomach (capable of eating anything!), so perhaps I am a bit of an outlier, too. To sum up, I enjoyed Ghanaian street food a lot, but please take what I say with a rather large grain of salt.

Amy: How often do you work? When you're not working, what "social" activities do you do?

In Accra, the volunteers worked 5 days a week, about a quarter to a third of the day is usually spent in transit (driving to the outreaches can take anywhere from 1-4 hours). We had Saturdays and Sundays free (except when we needed to travel to overnight outreaches which took an average of 4-6 hours, in which case you can expect to be traveling the whole day). In terms of social activities, I regret not having found a soccer team to join, although there were a couple that I knew of or saw). I visited the beach (Labadi Beach), the University of Ghana Legon and Islamic University College, Accra Mall (a new American-style mall complete with food court and movie theatre), shopping at the souvenir/craft markets, the National Museum of Ghana (which is in serious need of government support), the Kwame Nkrumah Memorial Park, Kakum National Park near Kumasi, and Elimina Castle at Cape Coast.

My favourite was when I followed a young girl who worked at the guesthouse (her name is Rahina, she is 13 years old but is just as tall as me!) to the local food market. It was the wildest thing because it was like the food markets in Hong Kong (crowded, full of scents and odours, shoppers had their favourite vendors, and it was incredibly confusing for the newcomer not familiar with the layout), except it was outdoors, they sold a lot of goat, the ground was sometimes uneven, there were a lot of babies and children there (some were working, selling goatskin for example), and there was an evangelist walking through the stands, yelling and shouting at the top of his lungs with much fervour. We returned back to the guesthouse with two giant bags of cassava, plantain, an assortment of dried fishes, goat mean, cow stomach and intestines, tomatoes, onions, and of course, my worst enemy, spicy peppers! (Brief digression: In Ghana there is also a shortage of plastic bags, or what they call “rubbers” or even “poly,” so you have to buy them yourself for 5 pesewas, or 5 cents. There are even stands that sell nothing but sturdy plastic bags, the kind of bags we would get for free by virtue of shopping.) Rahina unloaded the foods we had bought, and Margaret, the guesthouse’s cook, prepared all the foods and made it into the best-tasting fufu and light soup I’d ever tasted.

People in Ghana love to pay visits to each other and eat. People will even walk into a stranger’s home, or hang around a particular vendor, just to befriend them. Once, when we were in Offinso (a small town 20 minutes away from Kumasi) and it was a Friday, Dennis, our accompanying ophthalmic nurse from the Crystal Eye Clinic, took us for a walk around town. There was not much to see, but we stopped by a Coca-cola stand to by some things to drink. Next to the stand was small table surrounded by a couple of plastic chairs. On the table was a board game, the name of which I think is “Loot.” The rules are simple, and there are four players (on our board, it was Princess Diana vs. Nelson Mandela vs. The Dailai Lama vs. Ghandi) but it becomes very difficult particularly when your opponents are quick thinkers and fast players. Dennis invited the girl running the stand to play with us, and it turned into the wickedest battle between the two of them. I was playing, too (or was I?), but I clearly couldn’t think fast or deeply enough to make the right moves, so Dennis and Porshia (the girl running the stand, she was 18 years old) would take turns telling me what move I should make. After playing the game, I noticed that she was also selling some shortbread cookie (I love shortbread cookies), and so I told her I’d like to buy one. She decided to give it to me for free, as a gift. I will never forget that cookie.


4. How is access to education for children? Do both girls and boys have an equal opportunity? I read your blog about that gentleman making it through the University and his year of service, and so, are many families pressured to have their children work in the fields, etc in order to make ends meet?


One of the greatest things about Ghana is its relatively high late of literacy. Access to education is good, with government-run schools as well as private schools available for parents to choose from. Still, there were always children that I suspected did not attend school, even though they would often say that they did, because they were either selling things in the street, or playing outside with their friends during school hours. Even though the government schools (primary to senior secondary) are free, you still need to pay for your own uniform, stationary, food, and assignment/examination printing costs. Girls also tend to have a less equal chance at going to school than boys, particularly in the north where it is largely ignored by the government and therefore less developed. Like in many other parts of the world, parents choose to educate their sons rather than or before their daughters. Near Kumasi, where there are a lot of cacao farms, there are also a lot of children who work on their parent’s or relatives’ farms. You could consider this child labour (in fact the first time I visited Adansi, there was a week-long conference being held at the guesthouse about child labour in Ghana), or you can consider it just part of real life. As you mentioned in your question, Amy, children are considered a very big family investment because of poverty. If the parents did not need their children to help out on the farm or at homes in order to make ends meet, then my belief is that they would surely send their children to school. In order to encourage more students to attend school, we need to find strategies to reduce poverty, and one of those ways, I believe is by helping to reduce the burden of their health problems, like preventable blindness.

Sleeping and napping after a hard day's work.