My Ghanaian Grandma

Sorry for the intermission! The internet here can be unreliable. But I'm back!

When I last left, I was going to go to a match the next day. Kofi and I went early to get good seats. Baba Yara Stadium, the main stadium of Kumasi and FC Asante Kotoko, is painted in Ghanaian colors, and from the VIP seating you can see the complete flag. That night, I saw Dwight Yorke, Alex Song, Emile Heskey, Edgar Davids, and Sol Campbell*. I thought I missed my chance to see a real live Heskey goal in my youth, and lo and behold he slots one in during the first half. 

This World XI played Asante Kotoko, the local team with a riotous fan base. They were quite a force during the game, and won 4-1. The only disappointing part of the day was not seeing John Mahama. While we were waiting for seats, we saw a coach bus pull in. 40 bodybuilders came out in a single file line (I honestly don't know how they fit through the bus doors) and loitered in the parking lot. I thought it was a good omen at the time, but alas Mahama has evaded me. This isn't over Mr. President.

For the past two weeks, I've been volunteering for the Ghana Health Service and the Sickle Cell Foundation of Ghana. The Foundation works in conjunction with the GHS to provide free newborn screening for sickle cell disease, and acts as a source of valuable information for caregivers. Sickle cell disease (SCD) is a lifelong condition, which affects every part of the body. Early on in a sufferer's life, if left untreated, SCD can damage the spleen. This results in a severely immuno-compromised state that leaves a child open to attack from opportunistic infections. 

Therefore, SCD sufferers are prescribed prophylactic penicillin. Although this protects the child, SCD will continue to damage the body, and requires careful and continual examination by a medical professional. In spite of these issues, treatment of SCD has advanced to the point where it can be managed throughout a person's life. However, these advancements have been quicker than changes in the social and cultural stigma of SCD (more on that later).

First, I headed to Suntreso Gov't Hospital, where I trained and observed Wilhemina, a charge nurse and screener for SCD. She performs a simple heel prick to every infant born in the hospital and collects the blood and information. After a day of this, I tried my hand at it. At first, it was difficult to get perfectly round red spots on the collection sheet. This is very important to avoid false positives/negatives after the lab sends back results. By the end of the day, I was pricking like a champ: I was so good, my last baby slept through it.

Wilhemina was a great teacher and we talked about her relatives in Ghana and the United States. When I told her my age, she told me she was old enough to be my grandmother. Little did I know this would come handy later...

After I wrapped up my last day at Suntreso, I headed out the door and right into a marriage proposal. A nurse was asking me to marry her and her friends surrounded me like a pack of lions. In Ghanaian culture, family has a lot of say when it comes to marriage. I saw my grandmother and told the pack that she would be the one to choose my wife. Luckily for me, she said none of them were good enough and got me out of there. Who knew my Ghanaian grandma would save my life?

Next up, I headed back to KATH to learn about the next process of screening: results and counseling. This part is difficult and at times, emotionally draining. Many believe that SCD is a death sentence, and that their child will be dead before 20. This leads many families to forego paying the cost of educating their children with SCD, leaving them illiterate when they do make it to adulthood. Educating families requires a collaborative effort from the healthcare system to dispel these misconceptions. 

The first day I learned about the program, how to navigate the database, how to ship results to the lab, and how to counsel parents with supervision. When a mother would walk in with her records, I would search for her child in the database and wait for the result to pop up. If the child was FA (F refers to fetal hemoglobin and is ubiquitous among the newborn, A is normal hemoglobin), then all was good. If the mother spoke English well I would inform her that everything was alright and she would continue about her day.

However, there were times the result would be FS. It's hard to imagine how two letters on a screen can change a family forever. A genetic counselor and I would sit down with the parents, and the counselor would walk the parents through everything. Correct information at this stage is crucial: not only can it protect the child, but it also protects the mother. We work to show how inheritance works and how each of them contributed a trait to their child. If we forego this, mothers are often blamed for the child's status. After a thorough explanation, I would fill out some paperwork to refer them to the sickle cell clinic. This experience taught me how important it is to connect with people, and to remain a bastion of stability and trust in an incredibly tumultuous time.

Today, I went to Bantama, an area near Kumasi, in order to find an unreachable mother with a son diagnosed with SCD. After 2 hours of walking and searching, talking to many different people and eventually finding her workplace, the community nurse and I admitted defeat--for the day. We resolved to come back later in the week. Although some slip through the cracks, it's incredibly important that SCD is caught early.

Tomorrow, I will head out bright and early to area hospitals to help out with a field research study called TransMAL. The goal of this study is to analyze the vulnerability of the population infected with schistosomiasis to malaria, and how co-infection affects the body. Schisto is a neglected tropical disease: although it affects tens of thousands of lives, not much research is done to help this population. This study is meant to shed light on how schisto sufferers can be better managed by the healthcare system in Ghana and other countries where it is endemic. 

I will update soon. So long, friends. 

*Judas--COYS