Seeing Eye-to-eye

Submitted By Jonathan Porter

As promised to the people in our 'alpha village', Battorkope, we took an eye specialist to the village today. Temi arrived at the field today, Tuesday the 27th, and her eyes bulged in disbelief at what she had agreed to do. "I did not realize the plane was THIS small" were her greeting words as she walked towards the briefing room...

We get used to these comments in the work that we do, so we also have a list of responses....

'This plane is three times stronger than a 747.... a 747 is stressed for +2 / -1 and this little plane is stressed to +6/-4'

'Big planes need big places to land, small planes are practical for landing in small places'

'These planes can be built AND maintained here to high standards - BECAUSE they are small planes'

'How big do you want the plane to be - it is just you and a few kilos of equipment'

So we select an appropriate tirade and then go to the 'why don't you do the pre-flight check with Patricia, and then we can see if you are still interested'.... for those who have done a pre-flight with Patricia, it takes a time and you are flooded with information about control surfaces, hot cylinder, cold cylinder, why the exhaust springs are wire-locked, how much she loves the plane, how it was born in the loving arms of hard working African girls, how many hours service, the thickness of the metal, the tensile strength of this and that.... and before you know it you are also in love with the plane.... she has a manner that assures, and encourages (that is why I don't do the pre-flights with passengers or new students.... Patricia ends with 'So now you get in here, settle down and do your seat belt up.... and we are ready to go... Temee, had the treatment, was happy and secure in her seatbelt with her bag (heavy enough to represent a gold bar or two) stowed in the bagger area.

Now, for the first time in my life, I decided to fly in Wellington boots - rubber boots for those who lack the knowledge of British history. The plan was to reduce the Bilarzia risks when wading in to tie up. Flying in wellies is interesting and requires an adjustment in rudder feeling over flying in my usual safety boots. I tried not to let on, and think I kept the skids and slips hidden quite well, but Temee was a great passenger as we climbed out over the ridge and descended down to splash into the water - the waves were higher than I had landed in before, and the water level was very down compared to previous flights. This needed a new approach, with a ''first timer' sitting next to me. I reassured her and selected the area with the least waves, obstacles and obvious depth - which was a challenge... but, with the undercarriage up, we had a super smooth splash down between two waves and started a challenging water taxi with a lot of wind, drift and current to contend with to the beach..

Once beached, Temi was given the Royal treatment with a canoe and quickly whisked to the 'Clinic' site (the big, incomplete church). As she entered and saw the multitude, her smile slipped for a moment - 'is THIS where we will see the patients' - I looked and reassuringly said 'Yes, everybody will watch.... of course...

Temi smiled, a not very reassured smile - but her confidence in the situation was impressive and after the usual 'greetings and exchanges' we started on the patients... 25 out of the 43 selected cases were seen. The others all had a common complaint of itchy eyes and watering eyes. We established early on that there appears to be a lot of conjunctivitis in the village - and it seems to be related to a particular area. It is also common to wash faces in the lake - a source of potential infections.

Anyhow, Temi's first 'client' was Isiku, a 67 year Fulani man who was a challenge to communicate with. Totally blind with extensive cataracts in both eyes. A lovely smile and a warm, caring handshake, we told him that we would see if we could find a cataract surgeon at some point in the future.

Beatrice, 50, has early cataracts, and the story is the same.

Abiba, 10, is short sighted - needs glasses (we will source some potentially suitable ones for the next flight

Yaw, 12, itchy eyes - the commonest complaint in the village

Dorcas, 1 1/2 , sore eyes, referred to the hospital (some swelling and not possible to diagnose in the location)

Victoria (Dorcas's mummy), 24 with 'itchy eyes'

Mawuli, 15, left eye effectively blind from corneal scaring from birth or an early age (nothing we can do in Ghana) - we told him the story of Nelson and how a man with one eye lead the British Navy - and in a fishing community he could also lead... this made him and the whole group smile

Temi, looked at me, her eyes grew and she realised that there was so much that we could not do, and so many people crowding closer to seek her 'looking at them' - I think that I was more overwhelmed than Temi, but tried not to let on.

We set up two children holding words of different sizes to help with diagnoses - but when the patient cant read or tell letters or speak clearly, it was at times a challenges and innovations came in - Temi learned to innovate very well, especially since she was on a day of many firsts...

Mamana, 4, had a blocked tear duct, possibly an infection, but hard to tell in the environment.

Elijah, 7, Itchy eyes (again)

Afan, 7, Itchy eyes

Mordifa 66, needs glasses ( we are working on getting some)

Felix, 20, eye infection/irritation - probably from the same 'itchy eye' syndrome.

Lynda, 6, Conjunctivitis - possibly related to the itchy eye syndrome

Steven, 77 cataracts

Michael, 50, needs reading glasses (it is good that he can read and wants to read)

Ebenezer 30, eye infection/ itchy eyes

Amelia 35, eye infection, itchy eyes and dry eyes (needs eye drops)

Jacob 48, needs glasses

Mason, 36, dry eyes, possibly hi pressure - referred to the hospital for Glaucoma tests to see if there is a problem.... we will follow up to see if he goes (it will cost him about $7, but we cannot give the money, he must make the effort to save and go himself - it will take him a whole day... but at least he has been referred).

Bismark, 27, (a fisherman) needs reading glasses (he features in an earlier blog for his life jacket when fishing).

Rachel, 20, dry eye, infection, itchy eyes

Chief Bosoka, 90, Temi said his eyes are old, but we translated it to 'he has been a wise chief watching over the village for many years, and now his eyes are tired'. Temi will arrange for some suitable eye drops to be taken in to relieve the symptoms of this gentle leader...

Sodzi, 40, a driver, suffers from symptoms of night blindness - Temi was really excited by this. Her questions started to rattle at the rate of a machine gun as she tried to establish the severity, and smiled at the 'interestingness' of the case. She referred him to the hospital, but we are unsure as to how seriously the hospital would take the case - but there is nothing else we can do.

Keto, 40, a regular 'interessted party' was keen to be seen and have his picture taken with Temi.... His large eyes smiled from just in front of his ears to the tip of his forhead as he got the attention. He needs reading glasses - which may be necessary for fixing nets or looking distinguished and the like for those who cannot read. But as seen here he still is able to make eyes at young ladies!

Finally, a little old chap called Olympio, who claimed to be 60 hung around hoping to be seen, and Temi, quietly told him that he had cataracts, and that there was nothing that could be done without surgery.

Exhausted, we had to seek permission to leave and struggled to get away from a community that asks for nothing and tries so hard to improve themselves. We walked back through the groundnut fields to the waiting Alpha Delta, moored on the sandbank. I could swear that the little plane smiled at me as I waded into the Bilarzia rich water to set her free to fly again. I am glad that our visitors get the canoe treatment... but laugh at the fact that I am seen as a local yokel who can cope!

Getting the plane clear of the sand was not easy and some water slurped over the top of my boots. No such problem for 'Eye doctor Temi' - she was given the canoe treatment AGAIN!

We launched off of waves that were clearly at the limit of the capabilities of our little amphibian (a reason for the airstrip need) - but Temi simply laughed as we got a thorough soaking from the bow waves that broke high over the wing!

An incident free flight back, via Akosombo dam, to land in 18knot winds with undercarriage down!

Thank you Temi - you have made many happy today, and helped to help find solutions to needs. You were such fun to fly, you have to come back (those half closed eye / half smile glimpses that I caught during turbulence should have been caught on camera for all to share....!).

We are looking into the source of the infections (sometimes it seems that we need to be everything, including detectives) - and solutions to the current state of affairs - even if only to relieve the itchy eyes of some 30 odd people. Temi naturally suggested flushing eyes with clean water - but that commodity is a rare, there are no bottles of mineral water, no bags of water even, in the area. Temi also, sensibly, suggested boiling water - a good idea, but then we would need to explain to some people, who may not understand, to let the water cool, without getting contaminated... This really highlights the little things we take for granted in the developed world. Nonetheless, we will find a solution, and deliver to the site of the need - because that is what we do!

Temi gave up a day of her holiday (from the UK) to do this wonderful trip, we only provided the catalyst to bring it to fruition - but I can see on Temi's smiling face and the many smiling faces on the people of the community, that this short time of action, that she generously donated, will have long-lasting effects in all of our hearts and minds.

By road with a pick axe

Submitted by Rosina Maku Matey

Saturday 24 July 2010, Paul Michael and Rosina (me) set off from Kpong Airfield at about 07:15 to Battorkope. Our mission was to inspect airstrip progress, donate pickaxes and machetes to the community as well take 50 children's books to start the school library. We got Asesewa about 09:30 and started the dusty craggy and gully ridden descent into Battorkope. Thankfully Paul has a Land-cruiser which made it easier but it still took a long time to cover the last 18 km. We arrived in Battorkope at around 11:00, as we came in to the town we saw AA lying above - piloted by Hisham, who only took 20minutes to get there. The whole community was out and homes, no how simple, they came to see the 'MoM inspectors'!

9G ZAA circled around and waved its wings at us now that it was clear that we had arrived safely.

We were welcomed into the church hall in the middle of the settlement. The Chief of Battorkope, Togbe Bosoka and the Queen Mother, Mamaga Rebecca Awuitor lead the village leaders in the welcoming committee. They were very pleased to see us in their village once again, and expressed grateful thanks for the assistance being given in the way of moral support and practical encouragement. After speeches Paul presented the tools and books, which the chief and two elders received with big smiles.

The people put on a special cultural drumming and dancing display for the land-MoMmers after the welcoming ceremony. As part of our visit we were schedule to see the progress on the airstrip. It took about 20 minutes to walk to the strip, and Paul managed very well despite still recovering from his motorcycle leg-breaking episode. What we saw on the airstrip took our breath away as we witnessed the work of a Liebherr bulldozer done by the mere muscles of a few determined, self-realizing men and women - without any mechanical or motorized interventions.

We praised them for the work done and encouraged them to complete the remaining challenges of final stump removal, leveling and compacting. One of the community leaders has indicated that the remaining work will be completed within a few weeks.

Battorkope is a village 18km east of Asesewa and the people are farmers and fisher-folk, they grow and sell rice, groundnuts (peanuts), potatoes, pepper, onions, aubergine, okro (ladies fingers), fish and charcoal.

One of the elders told us they do communal labour every Saturday when they weed, clean and sweep around the village; but for now they are concentrating the communal labour on the airstrip to make it easier for MoM to take support to them. This explains why the village is very clean and neat, because during earlier visits it was pointed out the airplanes don't like rubbish - and the best way to keep plastic bags from blowing onto the airstrip is to keep the whole village and surrounding areas clean.

Before we left we took samples from the five boreholes in the village because there is a possibility that there may be some compromise to the safe drinking water supply (ask Capt. Yaw how sick he was from sipping a little water from a bore-hole here!) - results will take a couple of weeks and then we will know if any action is needed to ensure a continuous safe water supply.

As we left the village around the village 12:30, it was clear the people of Battorkope would need special exemptions from the charges of GCAA if their airstrip is to become functional.

To the Chiefs and People of Battorkope a special well done and congratulations for the efforts and energies put into this project have brought about a positve change for an entire community.

Ariving back at Kpong Airfield in the mid-afternoon. We were all tired but happy and received a warm welcome from the airfield team as we shared the excitement of our trip...

H.A.L. Meeting in Accra

Submitted By Jonathan Porter

Humanitarian Aviation Logistics (H.A.L.)

The Information and Interaction session in Accra, held at the Ghana Aviation Training Academy, was a great success.

We were exceptionally pleased to have one of our Manya Krobo Queen Mothers, as well as two of the Chiefs from Manya Krobo Traditional Council sitting at the front of the room and vocalizing their support. Other delegates included representatives from the health organisations, Ministries, several hospitals, rural Communities, major companies, GCAA, press, pharmaceutical companies and more.

Audrey Biney made the welcome address and was inspirational in the way she recalled her 'flying visits'.

Rosina Matey then spoke of the varied needs of communities and individuals and related it to the Maslows triangle.

Capt Yaw then spoke about the history of Humanitarian aviation Logistics, the aircraft available in Ghana and their relevance to being the catalyst for taking solutions to the site of needs.

Lydia spoke about her desire to be a pilot and helping people. Juliet spoke about how the airstrip where she lives has changed the lives of everybody in the area.

All delegates then participated in in need and solution identification and how or if H.A.L. could have a place in it.

Finally Patricia Mawuli Nyekodzi thanked all delegates for their participation and invited them to the airfield to see more.

* The press were very enthusiastic and provided a lot of encouragement - participating enthusiastically in the interactive sessions.

* The SAR unit of GCAA was pleased to hear we may have a 50% greater POD (Possibility of Detection) than the faster aircraft.

* A Hospital from the North showed interest in us looking at what is involved if they want to establish a medical airstrip

*A ' Traumatoligist' and surgeon was very supportive and prepared to do a mission flight. Also agreed that 10cents of antiseptic would often save thousands of dollars of treatment. So many amputations are avoidable with early treatment (see Red Cross rep comment above!).

* An Eastern region Hospital seemed to think that is was not practical to build airstrips - we believe that is because they are thinking that aircraft need tarmac - it is a hard convince to do for those who see all aircraft as 747's - we will continue to work on getting a strip into their area since seeing is believing...

* The MD of a pharmaceutical company expressed interest in helping with supplies.

* An Air Traffic Controller came along providing support and encouragement - it is great to have people like that showing interest.

* An Ophthalmologist from the UK, visiting, came along and agreed to do a mission to a village next week.

GCAA agreed to consider our desire to investigate aerial supply drop in case of emergencies in Ghana.

Thanks go to all involved especially to WAASPS who sponsored the event (http://www.waasps.com)

This little Piggy Went to Market...

Submitted By Jonathan Porter

We all remember the nursery rhyme... based around our finger or toes... but this week one of our local Fulani women came to us with a very very swollen little piggy - her left thumb. It was enormous and swollen down into her hand. She had used herbs and gone to the hospital, but the hospital refused to treat her due to some bureaucratic trash. They sent her away, and she did some more herbal stuff, and then asked us if we could help.

Basically, she got a thorn in her thumb. No big deal if you use antiseptic cream. However, one of the men-folk in the camp (Fulani's are nomadic and although they stay a while they really do not build anything substantial to live in), decided he could cure her sore thumb. He used a (already non-sterile and probably blunt, used) razor blade to open the thumb and then stuffed a mixture of herbs, cow-dung and dirt in the wound. Obviously she was instantly cured.

We used it as a training opportunity at the airfield. All the staff watched (apart from the gory bits) - and learned.

 

Cleaning the wound was a challenge. Repeated soakings in hydrogen peroxide, rubbing with cotton wool (all whilst wearing surgical gloves, I hasten to add - several pairs) as we reduced the amount of non-sterile materials and pus. As we worked over about forty minutes we started to get a strong ooze of a green and brown substance - to be honest, it looked like decomposed insect body, as I gently squeezed the swollen thumb it burst out - not dissimilar to the Sigourney Weaver scene in Aliens... Everybody but I looked away. I simply struggled to hold back the tears as the pretty heart shaped face of Amina turned towards me and smiled.

More soaking with peroxide, more pus and then, finally, a little bit of red clean looking blood. The table was covered with swabs, bits of 'herbal' remedy and spots of blood. A generous application of triple action cream and a clean bandage, topped with sticky tape and the date written on it (so we know if she touches the dressing before we change it in two days). Amina, her eyes wide, her skinny body, weighing in at around 45 kilos, relieved at the reduction of pulsating pressure in her thumb, spoke to me through Patricia and Jane, asking how much it would cost for the treatmentt. I decided on a high price.

It is going to cost her agreeing to train to do first aid, promise to never use herbs in a cut again, and to use 'triple action' cream on future wounds (anti fungal, anti bacterial and anti inflammatory) - and to promise not use the cream on the cows, goats, sheep, chicken or dogs. And ,in case that is not enough - to give me five smiles. And we would give her the half bottle of hydrogen peroxide and the rest of the antiseptic cream too.

She agreed, and donated the first smile. The final four emerged, without effort, in the next five minutes. So we are quits.

We've worked around the clock

And now after years of education, training, fighting for regulatory change, and building runways, facilities and aircraft, Medicine on the Move is at a crossroads. We need help. All our personnel are volunteers; no one draws a wage for their countless hours of work, not a cent.  To be blunt we need help, physical and financial: to keep our aircraft in the air we need funds to fuel and repair them; to better service the people, we need a full time doctor and a nurse.  We need to build a treatment room and complete our other aircraft.  Even a couple of weeks of your time to assist with building, FOD (foreign object detail) walking, teaching, training, cooking, cleaning, painting, sewing, car maintenance, tractor work, welding - whatever your skill, there is something you can do here... and you would go away a much richer person for the event. That is a promise!

We will continue to do all that we can - but as you can surmise we are overloaded,  we work 24 hours a day, training, flying, building, repairing, deal with runaway girls, working on policy and regulatory change, and fighting everyday for our hard earned pay…. a simple smile that lets you know what you’ve done has made a difference.

Imagine the countless lives Amina can change with some basic first aid training. - she has two fantastically beautiful children - one toinght ran out between the cows - butt naked, smiling and happy... We have a lot to learn from them about happy lives, as we teach them how to live healthier lives. If you think you can help please contact us, we’d love to hear from you.

Update: July 10,2010

Update By Jonathan Porter

Update: Tonight Amina ran out to the car as we passed the Fulani camp - her smile bigger than ever all she could keep repeating was about how she had been able to sleep. It appears that the pain had been so bad she could no longer sleep. Her husband came up alongside her and we made him also promise 'no more leaves in cuts', he agreed. We will dress the wound again tomorrow.

Update: July 12,2010

Update By Mathew Porter

I spoke to Amina and her husband yesterday - both are keen to learn some basic first aid and hygiene. As I was there, I was discussing drugs for sheep and cows with Abdullah, her husband, and as we had all these veterinary bottles in front of us, I pointed out to him that he always uses pharmaceutical drugs for his livestock, as he knows that they are good, and strong, and do the job. But that he then goes out and picks herbs for himself and the family?

He looked down at the drugs, looked back up and chuckled sheepishly - I think he really saw the point. He even asked me to give him a list of basic products to buy to keep at the house to treat small cuts and wounds. I told him we would go together to one of the good and quite large pharmacies in the town to look at them. He then, very ironically, told me he knew the owner of the pharmacy - he used to watch their cattle a couple of years ago!

Update: July 14,2010

Update By Jonathan Porter

Update: Most of the swelling has gone and she is no longer in pain. Some small amount of infection still present - changed dressing amid the flies, cow pats and many children running around playing in the dirt. Here's the challenges. Today they had 'lost' the elastoplast tape because the children liked to play with it. I went back and got some more - but would not leave it with them this time. Second challenge; she has more tablets left than she should - it seems the concept of one, three time per day is translated as one, twiceish per day. Fortunately, she is responding to the antibiotics anyway, I guess a body weight below 50kgs is pretty light... and so it worked... this time... but we need solutions to these two issues in future...

Tried to get across the concept of using the antiseptic cream on every cut - BEFORE it becomes infected.... it was too way out to go anywhere today - but we will keep on the concept...

Only problem is, this really needs other people to do this bit - we are supposed to be the 'link' between need and solution, not the solution to the need directly... the only way we can continue to do this sort of thing is that we get our full time nurse.... so, if you are a nurse (or a practical Doctor) - why not volunteer a year with us, please!

Update: July 22,2010

Update By Mathew Porter

Update for today... we had agreed that today Amina's husband would dress her finger under some guidance, so I went over there. Sat them both down, and went through the process a little bit. Abdullah has seen it done a few times, but really they both needed some briefing on hygiene and keeping things sterile where needed.

Hygiene is something the western and more developed and educated countries and people take for granted. So when one has to go through it, it's a bit like explaining Halloween to a fisherman in a village. One has to be careful to explain everything - such as when saying to go and wash one's hands before doing anything, add "with soap".

He put a latex glove on one hand to handle the sore thumb, and of course had to be told not to touch the outside of the glove with his other hand, and things like that. They understand the basics of all this, but are a little surprised when I tell them that even after washing his hand, he still has to wear a glove!

Gloved up, Adbullah really looked the part though. I did imagine that under different circumstances he may have ended up in a very different job.

The finger was looking good and dry, no pain or sign of infection, but the old skin is still there (calloused and hard from working), and her flexibility of it is still a bit low. All together he (they - Amina was co-operative) did a good job. They are very adept manually, and both understand the importance of keeping the dirt out for a bit longer. So now they are both getting used to this and understanding the importance of hygiene and dealing with small cuts they are to start telling the other ladies and men in the camp not to be using herbs on cuts, and instead cleaning them well (with soap!) and using antiseptic and even dressings if needed. I hope that a few more sessions with them and a bit more education, then next time one of the children from their own or another family hurts themselves they can be the ones to deal with it properly and save pain, money, time and hassle. They both have buckets of common sense, and with some guidance, should be able to know their limits and what they can do, but also expand their limits and their knowledge too!

WE FINALLY LAND- and what a success!

Mission report filed by Audrey Biney

Yesterday (Thursday, 1st July), our second attempt in a week to land in Battorkope was finally successful, and what an experience! Being my first landing on water, it was hard to hide my excitement and this was topped by the huge number of the villagers who had gathered to meet us with their usual big smiles, huge welcome and such enthusiasm. I was treated like royalty, they refused to let me walk through the water to get to the shore, and insisted on getting me a canoe for the final 10 step journey. After the welcome, Captain Yaw and I were led to their Church Hall where the Chiefs and elders and other members of the community gathered for our discussions.

 It was very interactive and in our opinion, very productive. We gave them the opportunity to tell us what their main health issues/concerns were, and to explore how we could best help them. These were some of our findings:

--The main problem stems from the fact that their nearest health facility is some 18 miles away and they have no Doctors or Nurses in the village to attend to any health problems, emergency or otherwise.

--The first concern was voiced by the headmaster of their school, who is often confronted with sick/injured pupils at school who need immediate treatment.We suggested perhaps if we could get several individuals from the community trained as first aiders, they could be the first point of call in an emergency. Captain Yaw requested they selected suitable members for this post, who we could assess for suitability and have trained for the future.

Similarly, and following concerns about their pregnant ladies, again individuals could be trained to address these needs pre and post natal and during labour.

--It was also clear the children were not growing at the normal rate for their age, and nutrition clearly plays a big part in this. So the way forward could be to conduct some health education programmes on proper nutrition, focussing on the importance of a balanced diet and eating 5-a-day fruit/veg etc. Also they could grow moringa seeds, rich in vitamins, to add to their diet. Matthew offered to help with this project. Of course they could also grow their own fruit and veg on the vast land they live on. In addition, James, their current health educator and teacher has been tasked with getting together a growth chart - height and weight, of all the children, which would need to be updated regularly to monitor their growth.

Other concerns were the high number of Hernia/ Fever/ Diarhhoea/ Bilharzia and TB cases. These illnesses are preventable and could be addressed with education on proper hygiene care, starting with their source of drinking water. At the moment they have 5 bore holes from which they draw water, but this water has a high salt content and the boreholes need to be better cleaned/maintained. They could benefit generally from a teaching session on better cleanliness/ hygiene care.and safety measures. Also some advise from the water treatment company regarding the mineral level could be sought. We could also in future organise a session on correct lifting techniques.

--We enquired about vaccination and it appears there has been a programme in the past. We will need to look at their vaccination records to see if the children in particular, are up to date with their immunisations, and if not see how we can address this to prevent future illnesses.

--They also identified they have 24 patients with eye problems, so we are exploring how we can get someone over to properly diagnose them and look at future options for treatment.

--The final concern brought up was how they were struggling to keep their pupils in school past primary level. Again we need to educate them and more importantly their parents on the importance of education...a session we hope to run soon with them.

Ideally this community would love to have a doctor within the community at all times but this is not possible. What was clear from our visit was that we cannot achieve or resolve all their issues at once, it'll take time, but what is certain is that we can make a difference and will be able to help this community with hard work, perseverance and committment, and Captain Yaw explained this to them well with some fantastic analogies.

Finally Captain Yaw invited them to the event on the 12th November with the promise of a special area designated for them, and of course we couldn't leave without a few gifts for the children to keep them occupied.

They were all ecstatic and after a brief visit to their airstrip which they are working very hard to complete, we had a lovely farewell from them and embarked on our journey back to Kpong airfield. I must admit the take off was a little scary with Captain Yaw battling the choppy waters, but this all added to the excitement and I didn't even need my change of clothes!

We're looking forward to Mission 004 when we can go back with some solutions.