A Day

the morning . . .

Watson is a 27 year old who, during the war in Liberia, had been seriously beaten in the head with the butts of rifles and had a number of other abuses done to him. As a result, he now has a lot of difficulty hearing. About 6 months ago we began the process of going to the audiologist for tests and to explore what could be done to help Watson in his situation. Just prior to my break in the beginning of August, we were finally preparing for his receiving hearing aids. However, the audiologist at Korle Bu (the teaching hospital in Accra) told us that he wouldn’t have any more solar powered ones available for a couple of months. So, Watson was prepared to wait for my return from break. (We had been referred to Korle Bu because they have behind the ear hearing aids, rather than the hearing aids we usually get which have cords going from the earpiece to a little pocket machine. We usually get these because they are more affordable and because the needs of the children in our school may change over time. And we wanted solar powered ones to avoid the ongoing expense of replacing the costly batteries.)

Upon my return from break, and after calling to find out that the solar powered hearing aid shipment had arrived, Watson and I left the camp early one morning so we could get to the audiologist in plenty of time, and we were fortunate since there was very little traffic. The solar powered hearing aids, however, made things louder for Watson, but not clearer. The audiologist tried a battery powered behind the ear aid which amplified things a little less and which he hoped would help to make things a little clearer – however, it was still not helpful for Watson. While the audiologist left the room to find another hearing aid to try out, Watson and I were left alone for awhile. We were talking and all of the sudden this guy, who’s always been hopeful and good-natured, broke down. He put his head down and just started sobbing. The tears were coming down his cheeks. He started sharing his concerns with me – how will he be able to go to school to advance any more in his field because he can’t make out what the teachers are saying; how will he ever support his family which is relying on him and now . . . what will he do?

I don’t often see such sincere heartbreak here – such a sincere sense of lost hope – such a sincere, sudden fear and acceptance of a limiting condition all realized at the same time. I’ve always liked Watson – he’s never come to me – as so many others do – expressing feelings of hopelessness, self-pity, neediness, etc. So when these emotions came out – when he shared this vulnerability with me – I was touched deeply.

We talked. After the audiologist came back and said maybe the ENT could recommend something more, but probably not, we went to check the ENT’s hours and decided when we’d come back to re-visit the ENT (Watson had been there before, but had been referred to the audiologist – so the cycle is coming around to completion). Then we went for lunch. We talked of all the possibilities still out there for him. We talked of ways for him to still further his education in his field of masonry (learning about drafting and plumbing so as to strengthen his skills and knowledge of building here) – of adaptations that could be made to the learning environment, etc.

Things like this are so hard here. When you are living and working here and you know of the possibilities that are out there – the medical interventions that could take place if only . . . if only . . . but don’t take place because of technological limitations here – it’s frustrating.

the afternoon . . .

Another angering and frustrating limitation is the care available for Abbie, who I’ve written about a number of times in the past (even pre-blog). The surgeon and the oncologist and the other caregivers all agree that her condition could be managed much better if she were somewhere “in the west.” How to get her “to the west”? is the question, though. And, if she gets there, then how will the costly chemotherapy and the other needs for the management of her condition be paid for? And if we can get the documentation from a doctor or clinic in the west saying they are ready to treat her, and further documentation showing that all the expenses will be covered – will we be able to get the VISA needed? If anyone has any suggestions on where to turn for answers to these questions, please feel free to give advice. Better yet, feel more than free to research it and come up with some answers – because I don’t know where to turn, and she’s breaking my heart.

After lunch, Watson and I went to pick up Abbie from the hospital where she had the tumors and also her breast removed. She was being discharged and I was helping her to get to a friend’s house where she’d stay while continuing to heal from the surgery. When I got to her room she was quiet and kept her head down. Her Aunty was in the room with her, and soon the friend she’d be staying with showed up with some food for her (patients in hospitals here need to supply their own food, so they always need a caregiver to stay with them). Abbie ate a little, but kept her head down, and occasional tears slipped out.

A couple of nights earlier when I’d visited, Abbie had been sitting outside, calm, at peace and enjoying the ‘cool’ evening air. This change in her demeanor was troubling. When her Aunty and friend left the room briefly she whispered to me that she had seen herself that morning when they changed the dressing. The sore was “so big . . . like raw meat.” It frightened her.

All through the previous year and a half of chemotherapy and radiation, Abbie (like Watson, who was waiting outside) had never slipped into self-pity, unlike so many others I see every day. We’ve gradually come to know each other. And, as with Watson earlier in the day, this sharing of raw emotion, this trust moved me deeply.

Abbie has a tremendous faith. She strongly believes she will be fine. Anytime I am with her prayer is involved – she finds her strength and peace in prayer during this time when she has no-where else to turn but to God. I’ve seen her more desperate and broken in the past couple of months than I remember seeing almost anyone in the past – yet her faith and trust in God has continued to remain strong. Abbie and her faith inspire me, and, as I said above, her courageous battle breaks my heart.

I haven’t taken many pictures of Abbie – I wanted to give her the privacy and respect. But a co-worker asked me recently “why haven’t you taken any pictures? You’ve always had the camera with you.” And some people who have been reading about her told me they wish I had included a picture of her. So, two days after I took her to her friend’s house, I was there for a visit and asked her if she wanted me to take some pictures of her. She had just returned from having her dressing changed, she was feeling calm (and I think maybe a little bit drugged to dull the pain from changing the dressing). The friend she was staying with had given her a wig to wear.

Abbie’s walking an emotional tightrope. She has strength, faith, hope, confidence. Yet, shortly after taking these pictures she was in tears.

Ibrahim

In the past I’ve talked a little of the group of people with disabilities with whom I work in the nearby town of Kasoa. At some point in the past year, the group observed that a number of its members were people with vision problems – so these members decided to branch off and form their own organization – the Kasoa Hope for Vision Society. I have been working with this group since its beginning, and we have been trying to acquire local support, things such as assistance towards vision screening expenses, towards an income generation project for the group, towards education related expenses for the younger members, etc. Just prior to leaving for my break in the middle of August, we were able to meet with the Special Education Division of the Ministry of Education. They were extremely helpful and supportive – encouraging us to pursue mainstreaming the children into local government schools. Currently, there’s one school in the country that is being mainstreamed (in regards to blind children), so this is an exciting step. The catch, however, is that, although the government can provide personnel to work with the school and its teachers in the mainstreaming process, it can’t assist with any of the tangible items needed – a Braille machine, Braille paper, etc. I tried to make some connections for these while on break in the U.S., but we’re still working on that. Meanwhile, Saka, the head of the group, made significant progress in working towards mainstreaming during my absence. In my first week back, the woman we had talked to at the Ministry of Education came to the school selected for the mainstreaming process so as to begin working with the school and the blind children. It was exciting to be there for this first visit, and to watch her lead around the school the one blind boy, Ibrahim, who had shown up that day (there are two more blind children who have been identified to join Ibrahim in the mainstreaming process). She introduced him in all the classrooms. She’ll be coming twice a week to instruct the children in Braille, and all the other days the children will be attending the regular classes.

Ibrahim (in white) during second week of being mainstreamed

It’s exciting – we’re actually making a societal change. Children who are ‘different’ are attending classes side by side with others. Some of the fear, the stigma, and the prejudice directed towards individuals who are ‘different’ will be reduced. When the seeing children are older they will remember Ibrahim sitting beside them in school, playing football with them during breaks, taking tests with them during class, and eating lunch with them daily.

The following week I was able to return to the school again, meeting again with the headmaster, the teachers in Ibrahim’s class and the woman from the Ministry – I call her Aunty. (When I arrived I found Aunty in another class instructing the students in some lesson. As she explained it, when she arrived and saw we weren’t yet there she began looking into other classrooms and was fascinated by the topic in this one and decided to see if she could contribute something.) We visited Ibrahim in his class and shortly afterwards he was sent to Aunty to begin learning Braille. It was fascinating to watch this learning process – I’ve never before been exposed to Braille.

Aunty took Ibrahim gradually through the steps for him to become acquainted with this writing and reading process he is about to undertake.

We are still looking for Braille machines, paper and other supplies to work towards successfully mainstreaming the children with vision problems into the local school, however, the process has begun and I look forward to watching it evolve, and to watching Ibrahim and the others begin having their potential tapped into.

Abbie update

Some of you have been reading about Abbie for over a year now. She’s had a rough time, as you’ve been reading. My first blog entry (and the only one until now) was about her. It’s only been a couple of weeks, and a lot has changed in her situation. Arrangements were made with the clinic on the refugee camp so that Abbie could go there regularly to have the dressing on her ‘sores’ changed. We were hoping this would help to reduce the terrible odor of rotten meat emanating from Abbie as well as just help to manage the sores in some way. During her second visit for the dressing change, she began bleeding from the sores and required a transfusion. Fortunately, the bleeding was controlled. However, this made the severity of her condition much more imminent to us. Abbie still felt strongly about having treatment done outside of Ghana, but the reality of this ever happening seemed less and less likely – I’m not sure if any airlines would agree to carry a passenger who might start bleeding while on the flight. So we began to discuss with Abbie and her family the need to have surgery as soon as possible and, after prayer and discussion, Abbie went from looking at me, crying, sobbing out that she didn’t want to do any further surgeries or treatments here in Ghana to looking me steadily in the eyes and stating “I know I need to have the surgery.” Prior to proceeding any further, however, her Aunty wanted us to contact the family in Liberia to have their permission to go ahead. (This is because if anything happens to Abbie, the family could then turn and hold it against the Aunty – family discussions, consensus and approval is powerful in Africa.)

To sum it all up, everyone came together and supported Abbie in her decision to go ahead with the surgery. This past Saturday she had the tumors removed from in front of her right armpit, and also her right breast removed. (If the family in Liberia hadn’t accepted the decision for surgery, no matter how strongly Abbie and her Aunty felt about it, the decision to go ahead may not have been made.)

She is still hoping (and the doctor is also encouraging) that the radiation and chemo and whatever other treatments necessary for her will take place outside of Ghana, but we’re no further along with any success in that direction.

Meanwhile, we continue to pray. And we continue to thank God for the gifts he has given us – life, knowledge, wisdom, skills, medical and technical advances to save lives. And we continue to pray that we have the trust in God and the gifts he has given us, and that, as with all gifts given to us from anyone we love, we put them to the use intended.