ETCHE training 2

Submitted by Michaela Sholes

While I’ll be the first to acknowledge that training events are expensive and take a great deal of energy and effort, they are also hugely rewarding!

The second ETCHE training saw a total of 43 visitors attend, not including the 3 presenters, the AvTech girls, and our wonderful volunteers! Although we were a little disappointed that there were fewer community Queen Mothers present than at the first training, we were pleased to see that all 17 of the original communities as well as the 2 new communities were represented by their health volunteers or as in one case, a community-elected stand-in. It was wonderful to recognize familiar faces from the last training and put faces to names for the new communities.

In true Ghanaian fashion, we began roughly an hour later than expected, but the sessions themselves ran fairly smoothly. Audrey and Lydia facilitated a brilliant wound management session, with hands-down the most moving presentation as Lydia touched a personal chord with each individual as she shared with them the evident high cost of improper care for wounds. Prior to her talk, many in the audience had been unconvinced about the dangers of herbal treatments which Audrey had previously been discussing…but Lydia’s frank dialogue left no questions about the darker side of those herbs which are commonly used by many and the fact that her point hit home was clear. Afterward, Lydia employed the help of Mr. Kofi Wisdom (health rep from Asekesu Ada and dedicated teacher) to assist her in a demonstration of how to properly clean and dress a wound.

We were pleased to have with us Nurse Stella from GHS to help with the session on fracture management. She and Emmanuella did an excellent job discussing types of fractures, stabilization techniques, and evacuation options (i.e. backboards and local transportation). Nurse Stella provided a relevant frame of reference regarding locally available materials such as a clean headscarf in place of a splint-tie or sling. Manye Makutsu volunteered to help during the demonstration about how to stabilize a broken arm, getting more than a few chuckles out of the crowd with her exaggerated groans over her “injury”.

Juliet and I facilitated the last session regarding burn management and really enjoyed the discussion session with community members regarding their experiences with burns, prevention, and treatment. Mr. Prosper (the health volunteer from Akokoman Sisi) shared with the group about the time his wife had been holding their child while preparing the evening meal when she had accidentally spilled the pot all over herself and the child. Juliet did a great job walking the group through the way to cool and clean a burn as well as prevention behaviors.

We are so appreciative to Manye Esther, Manye Makutsu, and Manye Obukie for lending their support to the event and assisting with the coordination of catering for the trainees. Manye Makutsu provided translation for the first session as well as enthusiastic participation during the sessions. A big “Thank you” as well to the community members like Noah and Alexander who helped translate for us at different points of the day!

One of the things I enjoyed most about this particular training session was the ability to hold an evaluation-type of discussion with the group to gather feedback from them regarding successes and challenges they had experienced over the past 2 months of the program. Their honesty regarding what had or had not worked for them has really helped to frame our understanding of future directions, even when it means that on more than one occasion we’ve made mistakes. For example, although the SODIS demonstration was a huge hit at the last training, we came to understand that adoption among the communities was less than low…in fact, it hadn’t really been implemented at all. It’s not that individuals were opposed to it, but we realized afterwards that repeated demonstration and further explanation of the benefits would be needed to encourage adoption. On the flip side, communities reported not only widespread adoption of community sanitation practices and hand-washing, but also visible disease reduction in their homes!"

In order to change ....

Submitted by Rachelle Milam

I’m not sure who said it exactly, but someone once said, “To change, one must be sick and tired of being sick and tired”. Here in Ghana, we can definitely understand that! As with anywhere else in the world, people here will not change the way they treat community and family health if they do not see a need for it. If a man has a broken leg, he has two options - he can treat it, set it, try to help it get better, or he can leave it broken. If he does not know how to treat it or he does not think it serious, he may just leave it and say, “Oh well, I have another leg. I’ll be all right.” And he may live. He may never regain the use of that leg because it healed incorrectly, but he may live. He may struggle every day the rest of his life to compensate for the loss of that leg, but he may live. However, if he values his body and he understands that he does not have to leave it broken, he may decide to go to a doctor to get the leg treated properly, or maybe he or someone in his village might even know how to set it and care for it. All this to say, if people don’t understand or see a need for change, they aren’t going to change.

When MoM did its first drops, they dropped to many communities along the river. As of right now, we are in contact with only about 20 of them. It is possible that some of those drops were never found, but it is also possible that some were found, and simply disregarded. The value wasn’t seen or understood. However, in the 20 or so communities that called back, there was a consensus that they were sick and tired of being sick and tired. They were also sick and tired of being forgotten or ignored. In a still developing country, community health is growing as an idea, but often aid is sent to only the largest and best equipped towns and districts. Often, the rural and remote villages we work with are not seen as worth the effort when it comes to outside aid. In the time since our first drops, we at MoM have done our best to make sure that these communities are receiving the correct information to bring about the changes that are so desperately desired and needed. The cooperation of a group of people working towards changing their world can radically change the course of the future. Who knows if because one person, one community saw the need to change the way they treated public health, one life might be saved? To us, that makes it all worth it. If just one life is changed because we were able to give them the tools to change their world, is it not worth it. To some, maybe not. But as we’re concerned, we too are sick and tired of seeing people sick and tired, and we’ll do what we can to help change it.

Working WITH the community.. the only way

Submitted by Rachelle Milam

In the early 1960’s, a young man named Bruce Olson decided that he wanted to work with the people of South America, and without the support of any agency, any money, or even any solid plans, he went. Through a series of events that spanned several years, he eventually ended up with the Motilone Indians in Columbia, a tribe that was, at the time, known only for their ability to kill anyone who came near their lands. Bruce, or “Bruchko” as the Indians named him, stayed with the Indians for many many years, and in his time he saw changes in the tribe that had never before been witnessed in a people so removed from “civilization”. They established agricultural centers, public health works, schools, newspapers, and many other amazing feats during the years that Olson worked with them. To many, this would seem just another story where a white man came in and saved the savages from themselves - however, this is not the case. The most impressive part of this story is the fact that the remarkable changes the tribe made were not through Olson’s coming in and taking charge of everything - it was through the Motilone Indians seeing a need for change and changing it themselves in their own way, with their own people.

My favorite part of his story is when he talks about how he first tried to introduce the idea of modern medicine to the Motilones during an outbreak of pinkeye. At the time, the tribe relied on a traditional healer to sing songs to the spirits and give out treatments of her own. After trying and failing to get the people to try the ointments that would heal the pinkeye, Olson got himself infected, then went to the healer and asked her to sing her spirit songs while rubbing the ointment in his eye. He was healed in just a few days. When the tribe saw that they did not have to change their whole way of doing things, but just implement new ideas and treatments, they were much more open to the idea of new medicines. That healer became a great help to Olson’s work, and he found that through education and allowing the people to learn from a healer they knew and trusted, community health was greatly improved.

Here at MoM, we could take the approach of riding (or flying) to acommunity and standing on a box in front of the whole village and telling them exactly what they’re doing wrong and why they must change. If we did things that way, I don’t imagine many people would want to listen to us. We have chosen, much like Bruce Olson did, to work in a different way. When the drops were first started, each community’s health representative or Queen Mother was asked to contact us. In the communities that had no health representative, the people were asked to get together and nominate someone that they trusted to be their health representative. Most of the contact we have with the communities is through these men and women, and it is they, not us, that communicate the information we give them for the betterment of their communities. This is so important because people are much more likely to believe someone they know and see regularly in their communities. If we were to go in and do it, people might nod their heads and pretend to listen, but likely we would not see any significant change. This way, the community can learn from people they respect, act together to change their environment, they can “own” their own health and the health of their families, and they have a much better chance of seeing the changes new health practices can bring.

The will to live... better

Submitted by Rachelle Milam

Abraham Maslow once said, “All the evidence that we have indicates
that is reasonable to assume in practically every human being and certainly in almost every newborn baby, that there is an active will toward health, an impulse toward growth, or towards the actualization...” Can I just say that I LOVE this quote because it is SO true, especially here! Most people are not out to make themselves sick, nobody WANTS to be ill, disabled, and most people don’t want to be the same person in fifty years that they are now. Here in Ghana, most of the time, life is about survival. Life is about bringing in your crop or making enough so that you can feed your family for another day. When things like sickness or disability comes along, people usually react in one of two ways - they ignore it and continue to try to survive, or they essentially live as invalids. There isn’t a whole lot of in between. Granted, maybe that’s just how I’ve observed it. However, it’s amazing to me to watch the way some people persevere. When they come across something they think will help their way of life and it is attainable for them, they latch onto it with and enthusiasm that is amazing to me.

I see this enthusiasm in the communities we’ve come to know - They have a very decided will towards health, a desire to grow in knowledge and to see their children grow to be adults. When I hear about a community willing to implement new practices to try to avoid things like diarrhea or malaria, I see their will to live. They move beyond simply surviving, they begin to live. When they move towards better health, there is new hope for every baby gasping in its first breath of life.

I remember once hearing a man who worked in Israel say during his presentation, “When you see these pictures, you simply see faces from a distant land. But when I look at these pictures, I see friends. I see lives changed.” I’ve never forgotten what he said and it’s become even more relevant to me now. To our readers, I hope when you look at the pictures on this blog, you don’t simply see faces from a distant land. I hope you see the lives that are changed. They are not so different from us, and they too have an active will towards health, towards life, and and a fervent impulse to grow.

Burn care part two

Submitted by Michaela Sholes

When discussing general burn care with communities, we emphasize these actions as a first response to stabilize the wound and prevent infection prior to arrival at a health facility:

• Separate the person from the source of the burn if possible, without subjecting yourself to injury.
• Flood the burned area for at least 10 minutes with clean water which is cool/lukewarm in temperature. This cools the area to prevent further injury, removes burning chemicals (if present), and controls pain. Water which is warm or very cold may further damage tissue.
• Remove clothing, rings, watches, belts, shoes, etc., from the area surrounding the burn. Tissue will begin swelling soon after the injury, so these articles may become too tight for blood to flow properly.
• Keep the burn as clean as possible, applying a loose bandage until medical attention is received. Never remove items which are melted or stuck in the skin, as this can cause further damage, pain, and possible infections if not done properly by a health professional.
• Never squeeze or break blisters. When blisters are broken open, bacteria enter the skin. Warmth and moisture encourage the growth of bacteria, so infections can become serious in open blisters.
• Medical care should always be found for burns involving children, hands, feet, face, genital areas, or burns that go all the way around the arm or leg. Burns that go deeper than the first layer of skin or blisters over 5% of the body should also be immediately brought to the clinic or hospital.

In “The Calling”, there was an image of a little boy in the Fulani camp who had stepped on live coals while walking around the family’s courtyard. In the film, you can see his mother pouring cool water from a bucket over the burned bare little foot as Matthew waits, hands gloved, to apply a clean dressing to prevent infection until the family is able to get to the clinic.

Injuries like burns are common in many places, but are further complicated in rural areas due to the distance to the health center as well as a lack of sterile equipment and environment. These are their everyday challenges which can quickly get out of hand if infection control is not understood and applied quickly.

 

 

Burn care

Submitted by Michaela Sholes

One of the most common injuries in rural communities is a burn. Whether as a result of children being too close to the cooking pot/fire, acid being thrown at someone during a fight, or during dry season when there is a lot of brush fires, burns can quickly become life-threatening if not addressed quickly and effectively. As with wound management in general, there are a number of local or home remedies that are used when this happen, which can include anything from putting gel from the aloe plant (good for treatment, but only following proper cleaning and medical care for the burn) to putting sand (NOT a sterile or effective method) on the burn.

Just a few weeks ago, a friend of ours called me in a minor panic as a family member had just spilled boiling water all over her hands and needed information about how to properly manage her injury. Ironically enough, not 3 days later, her daughter was also burned by boiling water, but this time, because she had had the previous experience, she was able to handle it quickly and effectively.

9G ZAF.. Upgrade time

Submitted by Capt Yaw

Work is under way to improve 9G ZAF, also known as 'the mission aircraft'. We are working on a number of improvement and hope to share with you very soon the new specifications of our lead aircraft for aerial supply work. As part of the upgrade we are installing many more sensors - however, not all sensors come with 'Africa in mind' and therefore specific protective solutions need to be developed. (This is just phase one of a number of planned improvement to our operational potential).

For the new pressure/temp sensor we are installing, we all felt that a 'cage' would be necessary to protect the 'business end' from insects and other critters (spiders are particularly troublesome with such sensors)! A few off the wall ideas were thrown around and then Patricia asked to be given a completely free hand to design and develop the sensor cage. We like to give people a free hand where practical and the ability to explore their potential, and gave her the go ahead. A couple of hours later she produced an excellent, functional and elegant solution. After inspection and appropriate testing it was permitted to be installed in the aircraft.
Well done Patricia!

Getting the point across... not as easy as you might think.

Submitted by Rachelle Milam

Lately I've been reading a book by Barbara Kingsolver about a family working in the Congo in the 1960's, and as I've been reading it, I've been reminded of one of the challenges that we face when we try to teach people in Ghana about health care. One of the problems the man faced when originally trying to reach out to the villagers was in his use of their language - one word that he used over and over in their language meant "beloved" or "wonderful"...however, the same word in a different tone meant "poisonwood tree", a tree that would make a person sick just by touching it. So instead of convincing the people that the changes he wanted to bring about were wonderful and good for them, he was telling them that these changes were like the poisonwood tree...a terrible mix-up to make when trying to gain the trust of the people you want to work with!

When I read this, I was reminded of some of the things we here at MoM have to consider when we're reaching out to people. It's not uncommon here to find that a parent has, in all good intentions and faith, slapped cow dung onto their child's wound and thought that was sufficient in treating it. To many of them, germs are a thing unheard of, so there's not reason why cow dung shouldn't work in healing if it covers up the wound. When trying to give new information to communities about sicknesses or wound treatment, the first and last thing that is considered is communication. Is what we're telling them very different from what they already do? Do we understand why they use the practices that they do? Has our information been communicated in such a way that those who may have a limited understanding of English might be able to understand? Has it been checked for cultural consideration? Before our last drop, when talking about nausea, we had used the phrase "sick to your stomach" at first. However, after showing it to some locals on the airfield, we discovered that this is not a phrase used in Ghana and might be misunderstood. Knowing that, we were able to reword it using terms and phrases that those in the communities could understand.

This is just one of the steps in reaching communities with information, but it is vital. If people cannot understand why we're telling them to do or not do certain things, and if they don't understand how we're telling them to change their practices, they might be less inclined to believe that what we've told them will really help them and their communities. If a person in a village has no concept of germs, what reason has he to believe that cleaning a wound and bandaging it properly will produce any different results than just slapping cow dung on it? This is why what MoM does is so important - many people in these communities simply don't know there are ways that they can improve the health of their families. They don't realize that it doesn't take a doctor to practice good health. This is why we do what we do. We're trying to change their ways of thinking about public health one community, one family, one person at a time.

Mavis Hyde .. an inspiration to us all

Submitted by Capt Yaw

Medicine on the Move is not an island, and we stand firmly with many other organisations with similar aims and objectives. One thing that MoM is able to do that many others are simply unable to achieve is to reach the infra-structurally isolated communities in new and innovative ways. Mavis Hyde is the founder of a small but essential charity called Disabled Equipment Sent Overseas (DESO). Mavis may be in her 70's, but she bounces like a kangaroo on Red Bull, her energy contagious to all around her.

On arriving at the airfield in her old truck the other day, she came proudly with her friends - one gentleman, with severe polio from an early age, dropped from the vehicle and moved swiftly on his hands, swinging his withered legs beneath him and then gently raising himself onto a bench. Another chap wore leg braces and then there was her youngest member of the group, a lad without hearing nor speech, but with a smile and spirit that showed potential - energy to its fullest - possibly caught from being in the proximity of Mavis! Mavis and her entourage enjoyed a visit to the airfield and watching the aircraft, but that is not all. She brought gifts to go to the rural communities - valuable gifts at that!


Wheelchairs, walking sticks, walking frames and crutches - all donated from the UK for free and cleared from the port in Tema at a ridiculous price (which is why we no longer accept donated items). Emmanuella received the items with a smile and assured Mavis that good homes would be found for the items. We also discussed possibilities of constructing suitable low-cost aids locally - perhaps making it more attractive than shipping end-of life items here for short-term relief in the communities.

Some of these items will be distributed at the forthcoming meeting to be held at Kpong for the rural communities we have regular contact with.

Medicine on the Move is actively seeking further collaborative actions, with other like minded organisations, ensuring that we maximise the potential that we have developed to reach rural places in an efficient manner and making full use of our facilities at Kpong. Changing more and more lives. one flight at a time...

Wound management

Submitted by Michaela Sholes

When discussing general wound management with the communities, we encourage the following actions to prevent infection and promote healing in a wound:

· Control any bleeding through elevating the limb and apply direct pressure with your fingers. Wear gloves and use a sterile dressing if possible, or ask the victim to apply pressure himself.

· Clean around the wound with soap and clean water or disinfectant (e.g., alcohol, peroxide). Clean all skin within 2 inches (50 mm) of wound, starting at the edges and spiraling away from the wound. Note: these liquids shouldn’t be poured into the wound, but instead are used to clean the outside of the wound.

· Flush the wound with clean, drinkable water (bottled, boiled, or cleaned by SODIS method). Use a Pure Water sachet or a small clean plastic bottle with a hole in the cap to squeeze water through the hole to create gentle pressure. Use at least ½ liter of water, or more for larger wounds.

· Do not remove large objects that are firmly embedded.

· Cover the wound with sterile gauze and a clean dressing.

·Change the dressings at least once every day or whenever the bandage becomes wet or visibly dirty.

Many of these steps are easier said than done…it IS a challenge to get clean water and to find items like sterile gauze. But it WILL make a difference between spending a little money/time now and spending much more money/time at the clinic later once an infection has set in.

Many of these steps are easier said than done…it IS a challenge to get clean water and to find items like sterile gauze. But it WILL make a difference between spending a little money/time now and spending much more money/time at the clinic later once an infection has set in.

Effective wound management

Submitted by Michaela Sholes

Effective wound management is one of the main things we will be discussing in the coming ETCHE training session. Injuries happen everywhere in the world, but in the rural areas things can get complicated quickly due to a variety of factors. A small cut or insect bite can quickly turn into a raging infection, causing pain and additional challenges that could often have been avoided in the event that effective and maintained cleaning were present.

In addition to Lydia’s experience, we have seen the effects of these challenges time and time again. Last year in the Fulani camp, Asamau developed a severe infection which affected the nerves in her hand, all because a stick had punctured her small hand. Even though her family did take her to the hospital, she still faced challenges related to environment and health literacy.


It is for this reason that we feel it is necessary to provide our community volunteers with training in basic first aid, to be able to quickly and effectively manage and stabilize injuries when they occur.

First aid lessons

Submitted by Michaela Sholes

The girls and I spent our time during the MoM class reviewing their demonstrations for the training and fine-tuning their presentation of the material. I know this blog will seem similar to those who read the blog from last week, but I did want to share just just how well they are doing in their understanding and applications of first aid skills. Before, Lydia understood the importance of cleaning a wound properly, but now she can go into detail about not drowning a wound in alcohol, the meaning of the word "topical" and using tweezers and a piece of gauze or cotton to clean from the edge of a wound going outwards. Before, Emmanuella knew that it was important to keep an injured or fractured arm still, but now she knows that you should stabilize both the joint above the break and the joint below and can describe why it is important to keep checking CSM's. At the end of our class, we watched some videos of "professionals" performing the demonstrations we had just reviewed and Juliet was simply outraged that a paramedic was cleaning a burn and handling sterile materials without gloves! I had to smile..."

Surprise!!!

Submitted by Michaela Sholes

You know those surprise moments that catch you off guard and you're so excited that you just want to hug the person, even though it would be completely inappropriate? That's how I feel about health education and the moments when you actually see it changing behaviors and having an impact. Ben and I stopped by the Fulani camp earlier today to catch up with Alai for a moment. We were sitting under the tree in their front yard talking when, mid-sentence, I noticed something... There was a fresh mosquito net hung over an area on the front porch of Alai's house!

I should explain why this makes me so happy: a few weeks ago, I wrote a blog about working with Alai and Amina in order to take some pictures for the malaria poster. During that photo session, we took pictures of the net Amina has hung over her bed which she shares with the children. We learned during this session that Alai actually sleeps outside on the front porch every night in order to keep an eye on the cows, and that, although he makes sure his family sleeps under a bednet, he himself did not! We took a picture that day as an example of a behavior that individuals should try to avoid in order to prevent malaria. This was particularly poignant because at the time, his daughter was battling a rather severe case of malaria and spent about a week going back and forth to the hospital to manage it. So, at some point between then and today, he has taken the initiative and has hung a net over his sleeping area of the house too!

The Ghanaian perspective

Submitted by Michaela Sholes

We are so appreciative of the local partners who work with us to help us do what we do, who give us insights into the Ghanaian perspective in general and the Krobo perspective in particular, and advise us on how to create partnerships/avoid missteps. After her travels overseas during the last few weeks, I was glad for the opportunity to visit Manye Esther in order to check up on her health and discuss some logistics with her regarding the upcoming training. Although she has had some challenges to her health recently, she was in good spirits and we shared a productive discussion. We look forward to having her representatives join us to help with translation for next week's session and hope Manye's health allows her to join us. Local collaboration, in our opinion, is the only way for efforts to be both effective and sustainable.

SODIS .. it's working

Submitted by Michaele

An interesting discussion was held during the women's session at the Fulani Camp yesterday. We had finished the literacy session and were discussing some of the health education topics and demonstrations that have been held, when Audrey was curious about actual use of the information. She asked if any of the ladies had tried the SODIS method for water disinfection or could provide a little bit of feedback. At first we were a little disappointed as it seems that Amina and Alai's family are the only ones to have tried it thus far, but when Amina shared her experiences with SODIS and the difference it had made for her family, we couldn't help but be reminded that things are changed one life at a time. Amina explained that they like the taste of the SODIS water so much that they use it for cooking as well, and since they've been drinking it, their family has seen a marked decrease in tummy troubles like diarrhea! Some of the other ladies in class had been absent for the SODIS demonstration and followed the conversation by asking her to show them later how to do it for their families as well. We are so glad to be able to have provided an option that helps improve the quality of life for even just one family, but it is extra encouraging when you see how that one family begins to share their successes and inspire others!

A penny saved is a penny earned...

Submitted by Ben Sholes

Three weeks ago, we distributed a rough budget template sheet to the Fulani men in an effort to help them understand how they were spending their money. Despite the sheet only have two categories (transport and phone credit), the results were pretty clear: they learned that they didn't realize how much money was going toward those two items. Goal number one accomplished!!

Riding that wave of realization, we continued to talk about what that fact means. We discussed about how to look at trends in their week to week spending, how much the total cost of each item compares to their total revenue, and if the items that they are tracking are actually money makers for them. After sufficiently blowing their minds, the universal question that was asked was, "Are we spending too much money on these items?" And, like a smart group, they answered their own question: more categories needed to be tracked! Goal number two accomplished!!

Next week we'll continue with more about money management as well as get into wound management.

It's a Girl!

Submitted by Michaela Sholes

Working with the rural communities has been such a special privilege. We at MoM have often talked about the way we want them to feel supported and cared for by flying over them even though we are not always able to visit in person. Through answering their calls after a drop, calling them in between drops, and meeting them face to face at trainings, we have gotten to know them in such a unique way. In the same way, hearing from them as they call just to say hello, or when they celebrate community successes and joys, means so much as it indicates that they are also thinking of us. Noah, the health volunteer from Dawa-Kpersebi called this morning to celebrate with us that his wife had delivered a baby girl! Mother and child are doing well, he says, and they are looking forward to having the naming ceremony for the little one.

What does this have to do with health? People are what matter about health...health is personal. Whether it is discussing health behaviors or actions towards treatment, and certainly when celebrating a new life, each aspect of that is dependent upon the people. I am so honored to be able to share that joy with them!

DESO

Submitted by Michaela Sholes

I was encouraged in such a special way today, when we had some staff and children from an NGO in Tema come to visit today. Disabled Equipment Sent Overseas (DESO) is an organization that works to provide specialized equipment for the many Ghanaian men, women, and children who are affected by physical disabilities. Their energetic group (which included a little boy who is mute, a teacher whose legs were crippled by polio, and a gentleman who also utilizes a metal brace to stabilize his leg) was so inspiring to me for a number of reasons, not the least of which being the non-verbal communication of the grinning little boy as he pointed to the planes flying their circuits, completely mesmerized. It made his day later on when one of our flying students let him try on a headset! I loved hearing from the teacher about how he is heading this school for other disabled children and how he doesn't consider himself to be disabled at all because of his mindset which focuses on what he CAN do, rather than what he can't.

Although the Ghanaian national campaign against polio has seen great successes against the disease, there are still a great many around Ghana who suffer from the challenges of physical disabilities as well as the stigma associated with it. Unfortunately, many times a deformity or abnormality may be called "witchcraft" or something to that effect, limiting that person's access to support structures and other resources. While disabilities anywhere present a unique set of challenges for the individual, there are especially few resources available to them here in Ghana which can leave them particularly vulnerable in terms of education and future possibilities. Health education is about more than just increasing awareness about disease prevention and treatment, but should also include advocacy to encourage integration in place of segregation

Hands on Demonstration

Submitted by Michaela Sholes

The AvTech girls practiced their demonstrations for the upcoming training and I am so excited to have their help!  Each girl spent time reviewing the layout of each of their sections and enjoyed a hands-on review of the material.  Juliet had some excellent ideas about how to effectively explain the various levels of burns to the communities, while Emmanuella really enjoyed creating make-shift sling/swathe arm splints and traction splint using locally available items.  I thoroughly enjoyed my conversation with Lydia regarding her desire to educate others about proper wound management and the high costs of doing otherwise...in her words, "a dream coming true.

The Next Training session

Submitted by Michaela Sholes

One of the things we’ll be sharing with the communities in the upcoming training session is the concept of effective wound management. There are a number of perspectives around the world about the best ways to clean a wound and keep away infections. Some of these perspectives are driven by scientific proof (i.e. using clean water to irrigate a wound will help avoid infections as it will clear the vulnerable wound of foreign bacteria) and others are driven by tradition/home remedies (i.e. putting cow dung or brake fluid on a wound as treatment - which are clearly not appropriate treatments and need addressed).

Now, we should specify that we are not condemning the use of all herbal/alternative medicines any more than we want to portray modern medicine as the only thing that will ever work…they must work hand in hand, with those that employ their uses being educated about what is valid to use, what might in fact end up doing more harm than good, and how to best utilize the local clinics. A big part of effective wound management is keeping the wound clean and free of potential infections by ensuring that hands and bandages are kept clean AND introducing the concept of using low cost, readily available anti-septic creams/liquids. Controlling bleeding, fully irrigating/cleaning a wound, applying clean bandages for stabilization, and avoiding the introduction of any foreign contaminant on the wound before bringing a person to the clinic increases their chances of avoiding infection.

No ops in the rain .....

Submitted by Michaela Sholes

Rainy season is in full swing, bringing with it the need to adjust activities when a storm system blows in. Our plans for the weekly session in the Fulani camp had to be rescheduled as the roads both on the airfield and at the camp are essentially undriveable. The last time we tried to drive in to visit the camp right after a storm, we spent nearly 30 minutes trying to drive the quarter of a mile on dirt road from the junction to the camp because the mud was so thick. We will attempt to reschedule for Wednesday or Thursday if possible. 

This week’s session is scheduled to review the budget sheet Ben introduced to the men’s group 2 weeks ago, as well as the SODIS demonstration and literacy lessons with the women’s group. We have been reviewing basic phonics with the ladies, but will be increasing the pace soon. Based on the different working levels of the women, we may look into splitting the group into those who need more foundational work and those who are ready to work on word building. Real life applications will be incorporated where appropriate so they can practice letter/sound recognition in their everyday lives, whether that be medicine bottles, health posters, or their children’s workbooks from school. Audrey, Ben, Rachelle, and I look forward to continuing to work with the group to support their efforts, help address challenges, and cheer on their successes!"

Sourcing local first aid supplies

Submitted by Michaela Sholes

The MoM team worked on a plan for identifying locally available and cost-effective items to be included in a community first aid kit. Some things were easier than others to identify: for example, clean white cloth for slings/swathes/bandages are readily available in the local market, while sterile tweezers, gauze, and scissors are somewhat more difficult to locate at a cost-friendly rate! Although gauze is available fairly cheaply, it is not in sterile packaging. While visiting a local pharmacy, we discovered all kinds of things that were presented to us as "appropriate for putting on wounds," not all of which were actually useful. It's not as simple either, as the temptation to jump to judgement of the pharmacies and medicine sellers. If sterile gauze is hard for the seller to access, then that translates into a higher cost for those wanting to buy it. In relation to medication, the danger lays not necessarily in WHAT is sold, but HOW it is sold. I went in asking for a cream to keep my wound clean and was handed (without instructions regarding the differences of each) one described for burns, one for skin fungus, and one triple antibiotic ointment.

In more Westernized areas, these things tend to be much simpler and we don't think much about it. If you get a scratch or small wound, you put some neosporin on it and be about your business. If it's a larger wound, you make a quick trip perhaps to the 24-hour emergency room and get yourself fixed up. But I've realized through exploring these avenues, that many of us are perhaps more dependent than we think on our "band-aids and neosporin". If we found ourselves without our two easy fixes and no emergency room in reach, would we know what to do? How many of us know how to keep a wound clean without alcohol and antibacterial creams available?

Well done Patricia!!

Patricia Mawuli on CCTV.... "Faces of Africa"
Good work Patricia You've worked hard to earn your stripes!!!

Link to the video if the player fails to load Patricia Mawuli

Community participation

Submitted by Michaela Sholes

One of the things I love most about working with the communities is how different they all are and the various personalities we interact with. I had another encouraging call from a community today, this time from the community’s chief or “dademantse” (phonetically it is “DAH-day-MAHN-chay”). This fellow has been highly supportive of our efforts from the very start and we at MoM believe that is crucial to success. This time, he called to let me know (very enthusiastically!) that they had received the last ETCHE drop, had arranged the next community meeting to share the malaria information, and that the community would come together to help sponsor their Queen Mother and Health Volunteer to attend the upcoming training. It makes all the hardships worthwhile when you hear something like that, to know that they value this and want to do what they can to make the most of it.

The road side infomercial

Submitted by Michaela Sholes

Every part of the world has various angles from which to portray health issues, including the "infomercial" perspective on health. In the US, you'll see the latest vitamin trend which promises to regrow hair, give you "super energy" and various other promises which are tailored to appeal to what is important to us as a culture. It's no different in Ghana, as you can see from this advertisement located on a busy intersection, where the ailments range from spiritual in form (i.e. witchcraft), to cultural (sexual weakness), to actual health issues (Bilharzia, stroke, etc...) that may also go by local names. This is part of the challenge in health education as we want to be respectful to culture and perspectives that are not our own, but also to address these ideas that are very real to many.