Travel Blog: March 21 – March 23

The day started extra early for Christina. Due to some unforeseen difficulties at the visa offices in Ottawa and Washington DC, Ingrid’s passport had not arrived on the 20th as promised. She had already liaised with several of FedEx’s representatives and the first text she sent was to Ingrid, a picture of the passport finally in her hands. We all gave a collective sigh of relief.

Full of excitement and trepidation, we assembled at the check-in stand with huge bags of supplies in tow. We managed to wrangle everyone together and were about to check in when we were suddenly struck by nerves that all our belongings would go missing on the way to Ghana. A quick trip to buy luggage locks and we all felt much better.

We decided it would be funny to take pictures before and after all of our three flights and layovers to watch how we became more and more disheveled over the course of our 24 hour journey. We really really did.

We arrived in Ghana and made it through customs painlessly (thanks to Marj arranging for us to go through the business line), and to our delight, they had separated out our baggage so we didn’t have to wait with everyone else. There was one wrinkle, however, as it seemed a Reverend so-and-so had taken our bag (which looked exactly like one of our most important ones filled with educational materials and a printer) and left hers full of clothes and personal items. A guardian angel -airport employee made a call on his cell and soon we were able to make a trade.

Marj greeted us outside the gate with squeals of excitement, and we were quickly ushered into a large van. The driver had a few chuckles about the sheer number of bags, as we hastily informed him that we were not crazy high-maintenance people with tons of outfits packed but did in fact have mostly supplies in the huge duffles. We barely fit everything in the van (including ourselves) and headed to the B&B, owned by the Hesse’s who informed us that we are their very first guests. We were proud to be the first to sign their guestbook. After an amazing dinner of homemade pizzas and a quick chat about what is to come, we headed for some well-deserved sleep.

[Side note: if you have occasion to travel to Accra, we highly recommend this gorgeous B&B. The staff and owners are amazing and they have designed much of the beautiful wood detailing and furniture, made from local hardwood].

After a nice sleep-in in our own bedrooms and private bathrooms (we felt so spoiled!) and a hearty breakfast, we decided to stroll around the neighbourhood. It was a Sunday morning, and we were serenaded at every turn by songs, sermons, and live bands from churches of every denomination (it is 6 p.m. as I type this now and we can still hear a clear voice calling to a nearby mosque). Every person that we passed gave us a smile or a wave or called to us in words we did not understand but sounded like hello.

We were taken to a local arts market by our lovely driver Ebenezer, and were given fair warning by Marj on the procedures for bargaining. It was both a hilarious and exhausting experience, and we all left it loaded with treasures and funny stories. We were some of the only shoppers there and so we were sought after somewhat enthusiastically. The vendors could see that Andres was not in a shopping mood and so provided him with a chair and a chat while he laughed at the girls. At every turn, we were followed by a parade of vendors, each with a different style of sales pitch. Taryn and Natasha, attempting to purchase a cloth shoulder bag, first valued at $150 US (Coach bags aren’t that expensive!), managed to walk away three times, until “best price” was $10US. This was determined by a male-female team, who proceeded to argue and slap each other, until they took Natasha’s $10 and pinched her when she wouldn’t give them $2 more. But the highlight of the market visit was just at the end, when a gentleman ran through the alley up to Marj asking, “Do you remember me?” He had been her patient on a prior mission and wanted to thank her (and then of course showed us his wares).  Another man approached (not a vendor), and took Taryn’s hand with a “vanilla baby” and Natasha’s hand with a “chocolate baby” and a big smile.

On the way home, we were taken on a driving tour of the government buildings, the Korle-Bu teaching hospital and grounds, Jamestown, and the beach. Our camera trigger fingers were very busy. Once home, Marj and Christina immediately dove into work trying to organize hotels for us in Monrovia. Anders, Natasha, Taryn and Ingrid took a stroll up the street and sat with a cold drink on the sidewalk with some locals, listening to reggae music blaring from a large speaker set up right on the road. We were happy to sit and be part of the evening scene, with a favorite being watching the local children dance.

We are now waiting for a feast of Ghanaian dishes prepared by the staff of our B&B and a crash-course program designed to teach empathy in the medical field. We are to get up around 5 a.m. and pack up the car tomorrow. We have been invited to attend a joint board meeting with Mount Olives Hospital foundation at the Canadian High Commission, a memorandum of understanding will be signed at that event. From there, we fly to Monrovia, Liberia, and we’ll pick back up with you then. 

Marj Celebrates Danny Moe’s Manic Monday!

Monday has been a full day for Danny, as he taught 80 care aide students Heart Power! Tonight he is speaking at the local church, the first of two nights teaching Heart Power!

I met with nurses and patients and had insightful discussions. One area that I observed we can improve is in hand washing. There is one sink at the end of a corridor between the patient ward rooms, and we need to place hand sanitizer pumps in strategic locations between every room to cut down on the potential for cross contamination of germs. The nursing staff is very eager to embrace each of the ideas presented.

Muffins! Faustina has a delightful store at the front of the hospital. 7,000 patients are processed through their hospital monthly and many find their way into her shop. So I got a bright idea! Why not sell come Canadian baking, like Marj’s muffins? All the staples needed for the muffins are right there in Techiman, especially cashews, which are indigenous to the region. So this week, one of my goals is to locate muffin tins and make batches of muffins for the staff. If they are enjoyed, then we are in business! We’ll start small and go from there. Next on that agenda will be quality loaves of bread, then unique cookies. . . if you would like to send a favorite recipe, pleased do and I’ll keep you posted!

Marj’s Talks About Mt. Olives Hospital

The Mt. Olives Hospital boasts two completed apartments and another bedroom / bathroom. So much effort is in evidence, as Faustina prepared our fully furnished apartment so comfortably. Everything is brand new. A housekeeper, Mary, has been specially chosen to serve our needs. We are already enjoying superb hospitality by our hosts and staff.

Our first Sunday in Techiman was spent at The Church of Pentecost in the city. Danny preached on Second Start / Second Chance, a new seminar of encouragement for those that may feel that life is passing them by. Each household was given a handout with 10 Commandments for Reigning in Life. The expert interpreter, Steve, a minister from another church, was a tremendous blessing as he spoke in the Ashanti dialect.

Our collaborative approach for the seminar week ahead was the evening focus. Many from the region have been invited to Mt. Olives for the upcoming Heart Power! Sessions, as well as Second Start / Second Chance and our Neuro — Stroke Days. Danny will be speaking three times a day. I just hope his voice holds out! He’s up for the challenge, requesting to be kept busy. So we took him at his word! We are trusting that this can be the beginning of culture transformation for Ghana. We have to begin somewhere, so why not the central region of the country?

Marj Shares Her Experiences In Ghana

Saturday morning saw the advent of our inaugural Mt. Olives Hospital Foundation and Korle-Bu Neuroscience Foundation Joint Board meeting. What an incredible morning. In the annals of time, it may prove to be one of the most transformative events in the future of neuroscience for the region. We are truly blessed that Rev. Prof. Seth Ayettey, a visionary par excellence, a Champion with Distinction, is Chairman of the Mt. Olives Board. Samuel Ampem-Asare is on both boards and serves Mt. Olives as Executive Secretary. Dr. Gladstone Kessie, Mt. Olives Medical Director, is the Executive Member. Other board members include Faustina Kessie, Director of the Hospital.

Mt. Olives aspires to be a leader in the region and nation. To this end, they are hosting the first Heart Power! and NEURO – Stroke Prevention and Care seminars for the community at large, including the Brong Ahafo region. Many from neighboring hospitals and clinics are joining us over the next 1 – 2 weeks. Our board discussions encompassed the vision for neuro rehabilitation and the critical need for neuro stroke, neurology and neurosurgery care for the people of Ghana and beyond. As well, a Memorandum of Understanding is being established between our two non-profit foundations.

Concluding our first joint board meeting one-and-a-half hours after our two hour projected meeting time, our bags were packed in Dr. Gladstone Kessie’s SUV and away we headed into the hills and mountain country on our seven hour journey to Techiman, north of Kumasi. We passed the President’s summer castle and the region where the early missionaries put down roots. The weather is much milder in this area and in fact, snow has been reported falling during the rainy season. We passed many Presbyterian and Methodist churches and schools in literally every village on our way north. Seth had informed us that the original Basal missionaries had served in the area without a convert for 50 years. However, in spite of many lives lost from disease, they persevered and today, I saw the results of that commitment.

We passed many stands selling cooking oil, bowls, fruits, vegetables, animals (both dead and alive), mushrooms with long roots, particularly at toll booths and check points. Ghanaian sellers were observed running quickly whenever there was the slightest indication that a traveler may like to purchase their wares. Such entrepreneurial spirits! What is astonishing is how many villagers sell seemingly the identical items. Danny commented how these sellers need to come up with uniqueness to their presentations and products to encourage purchasers.

Traffic in Kumasi was often at a stand still. While creeping along, rain began and a lightening shower ensued. Traffic on the highways, whether two lanes or four, often boggled the mind. I’m convinced that African drivers must have talents that we in North America could only dream of, otherwise many more people would be dead. Watching drivers climbing a hill on the wrong side of the road when a vehicle can be coming over the crest, is breathtaking. Many vehicles were seen abandoned along the side of the road and in fact, a lone truck had been disabled and was parked in the middle of the highway, at the bottom of a hill. We learned from Gladstone that during the night, these abandoned vehicles can lead to many losses of life.

Thankfully, we approached Techiman, and were thrilled to arrive safe and sound to a lovely meal at the Kessie’s home.

Marj’s Latest Update

Friday morning saw the advent of our journey to Tema Port to rescue a container destined to Mt. Olives Hospital in Techiman, a city in the Brong Ahafo region. That is pretty well smack-dab geographically in the middle of the country.

This is the second container to make its way to Mt. Olives courtesy of KBNF and our shipping partners, Compassionate Warehouse. Unfortunately, through a series of unforeseen events, the container has remained in port since the spring of 2013! Mammoth effort has been made to get its release, including authorization from the Minister and Ministry of Health and Finance and visits to port by members of our KBNF Board and Mt. Olives.  However, the demurrage and rent charges of this container being held so long had reached boundaries exceeding Mt. Olives’ ability to pay.

So Sammy Ampem-Asare, Gladstone Kessie and I were on a mission of mercy, so see how we could extract this container once and for all. Gladstone has driven down from Techiman and Sammy took a portion of the day from his busy schedule, albeit, he was working via the internet and phone throughout the day. As he said to me, this commitment was necessary, “it is God’s work.” Dave Gonyea, a faithful KBNF member from Victoria, has been intervening on behalf of this container for many weeks, burning up the phone lines to Ghana, Belgium, Scandinavia and Nigeria. He now knows many in various echelons of Maersk and Safmarine’s administration on a first name basis, to say the least. So Dave joined us by conference call at 5 a.m. in the morning Victoria time! His impact, I believe, truly turned the tide.

You would think that after 21 container shipments, these kinds of challenges would not occur any more. Unfortunately, not one container seems to have an easy transition through port. Each seems to have its own unique issues. Knowing the goodwill and the extraordinary effort required to transport quality and new hospital equipment and supplies to Africa, it is so disheartening to experience the entrapment of containers, held hostage to high fees. It is a situation that we feel is void of ethics and morals. Efforts to help the poorest people are thwarted by greed. These containers should be freely received to help build the health of the nation. We just shake our heads.

We began to negotiate what we perceived was an acceptable price, and thankfully, after hours of fervent discussion, we were able to complete the process. We must express our appreciation to Jenkins and Nicholas, Safmarine agents/manager that worked tirelessly with us through much of the day to ensure we brought this situation to a positive conclusion. Nicholas is committed to joining KBNF and encouraging his sister and family to also join!

We all agree that any further containers will be managed through their efforts directly, well in advance of departure, and along with the Minister of Health’s intervention, we now feel that we just may be able to see the light of day to actually send more containers when required. Otherwise, shipping overseas would become a thing of the past.

The container was located just as we were leaving their offices and will be released Monday morning. Danny and I should be here for the unloading! What a gift!

Needless to say, the entire day was devoted to this cause and we returned to Accra exhilarated and exhausted. The Hesse’s had a lovely meal ready for us of fish and vegetables and we devoured it.

An Update From Marj Ratel

Hello everyone!

We made it! Our flights were blessedly uneventful. Transferring from our Air Canada flight to our British Airways flight with one-and-a-half hours to spare was an adventure all of its own! Olympian sized hallways to walk, two bus trips, customs, security, elevators and numerous escalators. We just managed to make it to the third and final bus, packed in like sardines (honest!), before heading onto the tarmac and plane. If you weren’t a fast walker, you couldn’t have made it–and two passengers didn’t!

Thankfully, the flight was smooth for most of the next six hours. Seeing Africa from the night sky is special. The villages light up in clusters. Flying high over Accra at 8:30 at night, we watched the heavy traffic moving steadily along the George W. Bush Causeway: a city fully engaged in life!

Arriving at the airport customs, it was a lesson in patience, as the business / diplomatic line moved at a snail’s pace. And we were their last customers! However, as expected, our luggage had yet to come. We were warmly greeted by Sammy Ampem-Asare, one of our KBNF Board of Directors, and the Chief Inspector of the airport. Always given priority care and attention, our bags were retrieved and we were whisked off to our transport in short order. What a blessing!

Arriving at our friends the Hesse’s bed and breakfast, a transformer had blown somewhere in the community and the power was out. The Electric Company will be working through the night to repair it. With a lovely meal on board, we are managing fine with battery powered lights and a gentle warm humid waft of air is filtering in through mosquito protected windows.

A new day approaches . . . I’ll keep you posted!

Exciting News on the Jackson Doe Hospital

KNBF is thrilled to be a part of an innovative project that is envisioned to be a component of a multi-year program to assist the Jackson Doe Hospital, and Liberia at large, in making advancements in education, training, quality, and healthcare access.  The areas targeted areas focus on where there is appropriate non-profit and volunteer support and those areas that the Jackson Doe Hospital has determined to be vital to its mission of service in Liberia.

The project will be facilitated by three integrated collaborating teams:

Johns Hopkins Save a Life resuscitation team, estimated team size: 8

This team is a collaboration between members of the Johns Hopkins departments of anesthesia and critical care medicine and the Doctors for United Medical Missions, Inc. Because Jackson Doe Regional Referral Hospital is a new hospital, having opened in 2011, the facility has not yet developed a resuscitation system for the many adults, children and pregnant women who receive much needed care. Therefore, the John Hopkins team will prove invaluable.

Tappita specific missions will include:

  1. educational survey on aspects related to their education objectives
  2. education objectives to teach a customized sampling of BLS, ACLS, ATLS, PALs all targeted to the level of diagnostic/therapeutic capabilities of the hospital site.
  3. train staff on proper utilization of defibrillators, ventilators and other related equipment, prepare a patient care team for the post-operative management of the KBNF team
  4. direct the post-operative management of the KBNF patients


Humanity First Team Inguinal Hernia Surgery team

Objectives of the course are to train invited surgical staff on techniques for efficient inguinal hernia surgery with a significantly lower recurrence rate.  They will also provide educational support to surgeons, nurse anesthetists and nurses on selected topics to be determined by the Jackson Doe Hospital. John Doe will specifically benefit from Humanity First Team’s help as inguinal hernia surgery is the number one most frequently performed surgical procedure in Africa, but has a relatively high recurrence rate.


Korle Bu Neuroscience Foundation Team

The team taught a neuroscience educational program at JFK Hospital in 2012 and this would be a follow-up project for interested healthcare providers from throughout Liberia. KBNF’s help is essential because there are currently no neurosurgeons working in Liberia and up until this year there have been no anesthesia physicians working in the public service in Liberia.  In pursuit of its mission to provide quality care the Jackson Doe Hospital has now obtained the services of an anesthesiologist, expanded its physician workforce, has secured the only CT-scanner in Liberia and has taken on a number of medical interns as well.

KBNF’s Objectives include:

–   Selected presentations

–   Intra-operative management of selected neurosurgical patients

–   Discussion with stakeholders about referral/patient transfer options to Korle bu Teaching Hospital or University of Benin Teaching Hospital.

–   Assessment and recommendations related to the potential to develop future neurosurgical capabilities in Liberia and at the Jackson-Doe Hospital.

Neuro-Simulator Introductory Week: Part Three

Tuesday was a very special morning when the simulator was unveiled and demonstrations were conducted. Furthermore, a full introduction of the research study was provided. Alfred tells me that the event was well attended and the Canadian High Commissioner, Christopher Thornley, was present. Patrick and Harry (KBTH neurosurgeons) had invited neurosurgeons from far and wide, and I had invited guests including the MOH, UoG past and present administrators, KBTH past and present administrators, KBNF Board and the media. Fred Addai promoted the event at their Anatomy Staff meeting and encouraged his staff and students to attend. Many of these individuals are studying neuroscience at the moment, so Fred felt this was excellent timing.

I had completely forgotten that refreshments are always expected at these events. Thankfully, when it was realized that this had not been organized, Patrick stepped up to the plate and arranged caterers to handle these details. I engaged the CEO’s involvement in ensuring a suitable room was provided with tables and bottled water.

The remainder of the week is signing up participants, trialing them on the simulator and getting things moving for the next three months of research. Thankfully, Patrick and Harry have been fully engaged in ensuring this is a success. On our part, I have encouraged that medical students interested in neuro be given an opportunity to engage in this study. Fred and his Anatomy Dept have taken this to heart and have been doing their part to ensure participation.

Tomorrow morning is a coffee reception at the Canadian High Commissioner’s official residence. Official invitations (requiring RSVP) have been going out from the HC since Monday morning and the media is also invited to attend. There is actually significant enthusiasm for this event and Nichole, the executive assistant tells me things are progressing very well.  I am so very grateful to the HC for his enthusiasm and commitment to our project work. I is just so rewarding to me personally, having his full engagement from the commencement of his term.

The research team concludes their stay Saturday evening, so Saturday is wrap-up and to be a tourist and shopping day.

I expect that this research study will become significant news in the scientific community internationally, as things progress. It’s a milestone moment for KBNF and Ghana and Canada. If this proves successful and results in transforming neurosurgery training in remote areas, it could lead to breakthroughs in how surgeons are trained in all areas of the developing world. And the next step could be mentoring surgeons during live surgeries. Really, the sky’s the limit!

If it is not a success then our Canadian researchers can return to the drawing board, more knowledgeable but with an aim to refine their program and to engage in further study, until success is realized. All in all, this is a win/win situation for potential surgery developments in the 21st century.

Neuro-Simulator Introductory Week: Part Two

The neuro-simulator was shipped by air and after significant effort released from the airport and delivered to KBTH courtesy of intervention by Nii Otu Nartey, Seth, and Harry Akoto (a KBTH neurosurgeon). One of the challenges we encountered was that Seth and Nii determined just last week that they would prefer to be in the background to avoid any potential for negative exposure. Seth and Nii did not want to encroach upon the current Acting Chief Administrator’s role or his authority, thereby putting any kind of damper on these events. Consequently, we had to quickly realign our actions to fully engage in the PRO office and administrator’s office. The PRO had assured us that they would make this a priority with the CEO and letters were sent out through them (Seth edited the official letters for me to ensure they were suitable). Nevertheless, the Administrator did not appear to be aware of the activities when Patrick Banka (KBTH neurosurgeon) went to meet with Rev. Alfred Botchway to update him. Consequently, when I learned that there was a disconnect, I called him. After considerable trials by fire, including difficulties in securing a line that we could actually talk on, Rev. Botchway proved to be very accommodating and promised that full support from his office and staff would be in full swing immediately. We have since corresponded by phone texts or emails and appear to have a positive rapport developing. One of the requests he has made is for our foundation and KBTH to establish an MOU, so he can present this to their Board and to whomever asks about our collaborations. I have promised him that we will draft an MOU.

The week’s activities were orchestrated by myself and Melissa. Monday was set up day but a critical cable was missed in the packing of the simulator. On Monday afternoon, we were seriously challenged in finding a replacement. So after discussions with Anders Engstrom, our biomedical engineer, and then Sammy literally coming to the rescue by getting a replicate cable from his own office early in the morning and delivering it in time, the team was able to get the simulator operating. This was fortuitous as Sammy had been planning to be out of town that week on work related business. However, at the last minute, his company had to cancel the trip and he was home to make sure things weren’t stalled.

Alfred has been another godsend, ensuring that things are progressing and that between him and Sammy, KBNF representation has been well taken care of throughout, including being available to address the media. Thanks to Alfred, he travelled across Accra’s busy morning traffic to get to the Tuesday event, then had to travel back across the city to attend to his patients. Alfred even took the ladies out to dinner last night.

Neuro-Simulator Introductory Week: Part One

The Neuro-Simulator Introductory Week is progressing well, thanks to an incredible team effort. This event is a first, as you all know, and has engaged everyone from KBNF, not just from Ghana and Vancouver but also: the University of Toronto team; the Canadian High Commissioner and his team; the Foreign Affairs Dept in Ottawa (they have been engaged in ensuring that the website coverage is acceptable); the Research Council in Montreal; KBTH (both the administration and neurosurgery department and the Anatomy Department which is superbly led by Fred Addai); two Ghanaian television stations (TV 3 + Ghana Broadcasting Corp); and individuals hat include the Hesse’s and Seth and Nii Otu.

John Sampson (DrUMM) helped immeasurably in finding Gloria Peprah, Broadcaster for GBC. She in turn ensured that I located Joel (broadcaster for TV3) and both arranged media coverage of the week’s events. Jocelyne and I had Gloria and Joel stay with us here in Vancouver during the Vancouver Olympics, and now consider them like family.

Dr. Adriana Lopez, Neuro-Simulator Team Neurosurgeon / Mentor and Melissa Cunningham, Researcher, arrived Sunday evening and were met at the airport by Sammy. Dr. Lopez and Melissa have been staying at the Hesse’s new rental apartment (adjacent to their own apartment) during their stay. With its three bedrooms wand private bathrooms, a full kitchen and living room, the pair love it. Dr. Lopez and Melissa have a designated driver for the week. The drive across the city is substantial each day but these ladies, having never travelled to Africa before, feel safer staying close to trustworthy and supportive KBNF family members.