Screening Day #1in Ho

 I feel like this will be a long post so I am dividing it into "General Mission", "Humanitarian" and "Stuff I want to Remember" so you can pick & choose or read it all if you have time :)

GENERAL MISSION:   Another GREAT day in Ghana with one slight challenge...I got up at 6:30, got ready & had a call with Doug & headed to breakfast about 7:10 planning to eat & be on the bus at 7:30. SURPRISE!!! The bus left at 7 am???? There were still about 30 team members at breakfast to take the 2nd bus at 8:30 but nurses were supposed to be on the 1st bus...I was beside myself stressing out...in 20 missions I have never missed a bus...and the paper schedule said 7:30 & I thought that is what they said last night at the team mtg. but I guess it was 7 am. Unfortunately, I had the audio on my WhatsApp turned off (too many messages yesterday) otherwise I would've seen the message they were leaving at 7:15 instead of missing it. I know that getting set up for screening is ALOT of standing around but I still felt awful & asked if I could take a taxi but we are too far out & Princess (name of one of the coordinators) kept saying "don't worry its fine". So I took some deep breaths & reminded myself that I'm in Ghana and as we saw yesterday time is sort of relative but not usually on missions so not my finest moment...there were 24 of us on the 2nd bus including my trainee Abagail & Livingston another nurses, Clover my Anesthesia friend, and the Medical director of the mission - so I was in good company :) It was only about a 15 min drive to the Ho Teaching Hospital Campus down from the big hill where we are staying. Ho is fairly large but much smaller than Accra-less busy, less stands, (only a few open this morning), fewer people out walking, lots of churches 

I got their & they were set up for screening but were just starting patients. I was helping take Vital Signs & SOOOO MANY cute babies needing lip repairs were there with sweet mamas. I will post some photos on my social media. There were also quite a few palates & some older teens/adults. If we do 60% palates that could be 35 or 7 a day which could make for long nights - we will see!!! They do have a patient shelter here and some families have traveled 14 hours from the northern part of Ghana to be here. seeing transportation options, I am certain for many it was a difficult journey. With so many at the shelter a small bus would bring about 30 patients at a time & drop them all off with their parents where they would then start the screening process getting registered & going thru 12 stations that probably took them 3 hours minimum. Then about 2 hours later they brought a 2nd group. We stayed very busy from 9 am-2 pm between vital signs & getting a height & weight on each of them. There were a couple of sad cases an almost 2 year old with a tumor on her tailbone that of course Op Smile can't help but people hear there are free surgeries not know its a specific type & of course seek out help for their child :( We were able to give them a very solid referral for The Mercy Ship which will be here in early August.  

There were SO MANY things I had forgotten about Africa...the hospitals are a bunch of buildings with open windows, maybe fans for air circulation & all connected by outdoor walkways with outdoor grass & benches where family members sometimes wait. So I expect it may be a walk to get to the post op unit. I also forgot how humid & hot it is even in early June - I lasted about an hour before I put my hair in a ponytail. I also forgot that we are in a high Malaria region...they may have suggested prophylaxis but I may have ignored it because other than my 1st mission to Kenya I have never taken it but tonight Clover mentioned she needed to take her Malaria medicine because she forgot yesterday & I said "do we need it" to which she said "Absolutely" even though I haven't seen any mosquitos here. So little blessing for me Cherish got a prescription with 30 pills so she gave me 10 & I started taking them tonight. 

Two of the "Tribal Chiefs" from the area came by to see what we were doing as members of their tribes were here as potential patients. They were in tribal fabrics tied over one shoulder...very interesting - no photos taken the last thing I need is to make a tribal chief upset. They do have a local language "Twi" that many families spoke as do the local nurses. 

Mission lunches are always interesting - since I declined one yesterday Princess was insistent, I go get lunch today...3 choices a vegetarian, a spicy fish (head or tail still on) & chicken. Several others had eaten the chicken & the meals were in a nice container & a bag from a local restaurant with a handwipe & silverware, so it seemed legit. There was enough rice for a family of 4 & a chicken leg/thigh combo. I pulled off all the good chicken meat & ate a little rice to the satisfaction of others concerned about my eating & kept my peanut butter & bread in the bag for a sandwich tomorrow :) 

There was a lot of confusion over who should be trained for credentialing in PACU as one local educator canceled at the last-minute leaving Michael without a trainer & another local volunteer Sarah came & needs another credentialing shift. This was way over my decision making so I emailed Karina the Op Smile Academy Director letting her know what was happening & asking if I could train 2 people. She emailed back right away, put me in touch with Eddy the Program Coordinator on the ground here & long story short come to find out Abagail already had 2 successful trainings in her last 3 missions & should have been marked as "provisional credentials" only needing a skills check off that the Clinical Coordinator can do but her on line file was not up to date. Michael & Sarah both need 1:1 training & I can only do one at a time. So, I will train Michael & Sarah will have to be an "observer" which is heartbreaking as they are taking time away from work to be here. The missions here are 1-2 times a year so it can take a while to get credentialed. Had we not gone down this rabbit hole I would have been with Abigail who did not need another training mission & Michael would have been here planning to train without a trainer.  It all worked out as it should have :)

By 3:30 we were done screening 59 patients but 24 were still in the queue to finish some stations - since we were "Station #3" & done we packed up our stuff & came back on the 1st bus. Tomorrow we will actually leave at 7:30 (so up at 6:30) screen until 1:30 then come back to the hotel for the education session from 2-5 pm

HUMANITARIAN/CHURCH: I have continued to text Salam (Sis. Kassah) and Pres. Offari and about 2:30 during a lull and after the credentialing chaos Salam came to find me. she is a CRNA (nurse Anesthetist) at the hospital & said she that while she is not part of the mission, she will likely see me each day as she and I will be near one another in the operating & recovery areas so that was a fun surprise! We chatted about the needs they have discussed - several elderly in the community who need food support as well as some single mothers. I gave her examples of needs in other countries & told her to determine the needs & my "tribe of angels were ready to help". We will likely get together tomorrow night or Sunday. She may have the couple missionaries pick me up as I have no transportation options. I introduced her & Cherish & Cherish brough some water purifiers to give away & other items. AS we sat & talked I told her "I don't know what is needed here - that is for you & Pres. Offari to determine but of all the mission options I had this was the only one that worked & that I was selected for so I know I have traveled 7500 miles to Ghana for a reason- anxious to understand what that might be...

A local Op Smile employee Kofi Takorah from Accra came up to me and asked if I belonged to the LDs church & said he goes there too. As we talked, he mentioned growing up in an evangelical church talking to missionaries on the street and going to church with them & "feeling Jesus there". He knew the Bishop and wants to get baptized but part of his job is to travel to remote areas on the weekend to find children with clefts to come to missions for help & he has been busy preparing for this mission and not able to go to church but he will be going every week when he returns to Accra & will then be baptized. He was so nice & we talked a lot about Jesus.  

STUFF I WANT TO REMEMBER

A few Ghana "fun facts" 

After getting back to the hotel I was sweaty & desperate to shower - my room has a tub & then a shower handle that attaches to the wall pointing out of the shower. The "climb" up into the tub is honestly 2 feet high & there is no shower curtain. I had 1 bath towel & 1 hand towel, so I decided to sacrifice the hand towel to become a bathmat in order to not slip & fall or slip stepping 2 feet down on a wet tile floor out of the tub/shower. All was well.

In Ho there are not Ubers but they have the small Tuk Tuk motorized  carts that can carry 2 people that are in many 3rd world countries (here they are called Pragias?) After much deliberation several of us decided we could perhaps try to find a ride on one of those down the hill but were not confident we would get back up so we skipped that idea & ate dinner in at the hotel. 

Sadly, yesterday as we drove more thru the city of Accra as we stopped there were still the "street vendors" but also darling children smiling at us in the window & begging for money...it is typical in a 3rd world country I know but always so heartbreaking

Their version of "public transportation" in Accra is there are TONs of very old vans (normal size) with 5 rows of 3 seats across (including the driver's row) so 15 people & everyone with their big bags are squished in these vans. From what I was told they are at the side of the road & have a planned route depending on who gets in & then when they are completely full (I have not seen a van with less that all 15 seats full) they start their drive & drop people off - not sure if they add more riders along the way - it is wild & according to Ruben my hotel drive very inexpensive but miserable...I am sure it is better than walking though?

That's all for today - I feel & appreciate the prayers & good thoughts from 7500 miles away more than I could possibly articulate. So grateful for friends & family.

More Travel Than Expected - 8 hours we later Arrived in Ho, Ghana

 Happy Thursday from Ghana!!!

Despite the storm that was loud a good part of the night I really feel like I got some good rest last night which was very helpful! I had breakfast at the hotel and was grateful for eggs as most of the Ghana premade dishes were not ones I was ready to choose - so scrambled eggs & toast was perfect! An Op Smile Volunteer sat down & said hello Nancy? she apparently knew we were both at the hotel Her name is Clover from South Africa & she is the Anesthesia team leader - she was very nice & became my first team friend :) I also recognized a man in an Op Smile shirt & he came over - his name was Mark & he was from Cairo where we had been on a mission together & he is the dentist for this mission. Another friend! 

We were supposed to be ready in the lobby at 9:30 to leave and poor Elvis the bellboy was working again & got to help carry my bags down 6 flights of stairs :)  Clover & I had decided that we would be on Op Smile time & even thought it was a 3 hour drive it would probably take 4...we were fooled it took 8 hours! We started on time from our hotel in a small 24 passenger van/ & bus & 6 of us in it. We then began to pick up others on the way. The students Anisa from NJ & Elisa from MD & their sponsor Cherish from TX were at another hotel (more on Cherish later). There was quite a bit of traffic & we were on paved roads but the dirt roads were muddy from all the rain. We passed Black Star square & arch commemorating independence in 1957 - I'm going to have to read about that. As we got closer to downtown Accra there were larger government bldgs but still "stands" all along the road. There are LOTS of lil churches here & we also were on the coast of Ghana & saw the Atlantic Ocean. By 11ish we were 90 min into our travel time & had just arrived at Korle Bu hospital to pick up more team members & that's where we really got off schedule. We all moved over to a larger bus, but we weren't leaving...I may have dozed off a bit and when I woke up we were just getting ready to leave & it was 12:30..so 3 hours later we were still in Accra. We had been waiting for someone to finish making lunches for everyone's travel meal. That was my "mission reminder" that I am on Ghana time not USA time...and as always I just needed to "go with the Ghana flow". Lunch was rice, noodles & maybe chicken - I opted for a Trader Joes protein bar. We also picked up more locals at the Accra mall & then were finally on our way to Ho about 1 pm.

There was a big "traffic jam" of trucks & cars in this 2 lane paved road so our bus driver & lots of others just went "off roading" on the wet muddy dirt road next to the paved road -no big deal but then  both were congested & again the crazy driving!!! About 45 minutes later we found the cause..a broken down "commercial truck" just sitting in the lane...it stayed congested and we at times off roaded some more - even once in the median when we got to a divided road! At times when we had 2 lanes going in our direction there were actually 3 lanes of cars going in that direction with lots of horns honking - it was an experience.

We passed a grass area where I did see 3 malnourished white cows & I have see chickens & goats off the roads. I did TOTALLY miss a photo op there were 2 Orangutaun monkeys walking on the side of a road - I do have other witnesses!!! The streets are lined with hundreds of these "stands" which may be lean-to on the dirt, just a cart, a table, or even a woman on a plastic stool with her basket of things to sell. A few back from the roads have roofs some flooring & I think are also where the people live, In the rural areas you can tell some live in the lean-to. Many are selling food - fruits, breads, grains - and some even stack the fruit for "presentation". I had to wonder are they there all day? who stops to buy and with all the stands selling the same stuff do they have "regulars" or how much do they hope to "earn" in a day $5 US. Moms with babies, men too. It's clearly the life they know but so hard it seems. There are also larger places selling, wood, wire, cement, and several selling caskets - which is also sad.

We stopped at the "famous" Adomi bridge to stretch our legs & also take a photo - it is a cool bridge & even some of the locals from Ghana had never seen it. On that stop I met Victoria - another student volunteer but she is local from Accra & had a cleft lip & palate herself. She was very quiet & sweet & since it was both of our first time over the Adomi bridge we took a photo together! There was a little boy probably 7 or 8 on the Adomi bridge who had caught fish all less than a foot long & was planning to go sell them. As we drove thru the towns kids were walking home from school - I don't know why but it made me happy to think that some of them are going to school -I don't know if it costs money or the specifics, but they were cute! ...At that point we were an hour or more away from Ho. 

As we drove to Ho it got more & more rural & there were hills & elevations. Less people, less cars, less stands and more people walking to wherever their destinations were, also all roundabouts no traffic signals. As we got closer to Ho there were some stands but not as congested as in the larger towns. As we drove by I saw on my side a sign for the "Church of Jesus Christ of Latter Day Saints" in front of a small building & later down the road a few missionaries were walking that direction :) That also made me happy. We continued to climb the hills here & got to our hotel - 8 hours after leaving the other hotel this morning. I am concerned now about my travel back for my 9 am flight (have to be there 2 hours ahead) but I will ask about that later in the week no need to borrow trouble now. 

This hotel appears to still be under construction in some areas. It is a typical mission hotel - same cooling as last night but no need for you room key it will stay on, 2 twin beds but having my own room mine are pushed together to be a king. There is one overhead light that might be 60 watts??? & a light in the bathroom same wattage & that's all - so the room was fairly dark since it was dusk when we arrived, I'm sure it's fine during the day - problem is I will never be here in the daytime :) You do have to turn on the water heater to get your water warm for the shower & there are only 2 outlets in the room both together & one outlet in the bathroom so I had to move a table around to maximize my plug options. I do look over the valley that we drove thru & it's a nice lil view. I was simply happy to be at the hotel - fully unpack & set myself up - stuff I take to the hospital each day in one place, my food area etc. and now I feel settled for the next 9 days.

We had dinner here at 6:30 & a team mtg at 7. I went into dinner & sat with Cherish the student sponsor since she wasn't with the students. She had been on an Op smile Mission as a high school student & went to Honduras & we talked about that as I had been on a mission there. Then she said "I also lived in Honduras for 2 years after that.....when I asked, "what brought you back there" she hesitated & said "I was doing missionary work" of course I asked "what church" and she said "The Church of Jesus Christ of LDS" a little sheepishly. I said, "That's MY Church" and she hugged me & said she was feeling a little lonely already. I said I was concerned myself & LOOK - God is in the details of our lives & sent us both here to be together - what a tender mercy!!! This is her first time as a student sponsor - she has 5 boys at home the oldest is 13 & her youngest are 4-year-old twins. She owns/runs a private Jr High/Highschool outside of Houston. I told her about my church leader contacts & she was so happy - I was too!!!

We had the standard team meeting - it was amazing to hear that this is their 4th mission in Ho & they have 3 other mission sites in Ghana. When they started missions here 12 years ago if you looked at the team photos it was 90% International volunteers & 10% Ghanaians being trained. Now this mission photo will be 90% Ghanaians & 10% internationals & they welcomed us here to continue the training. We then divided into groups so I got to meet Abigail who I will train - this is her 3rd & final training mission & it sounds like she has already had good experiences so my job should be easy. There was already a clear "Recovery Room Nurse Leader"...which also makes me happy - I just get to be a "worker/trainer nurse" and love on those babies & families. It is going to be a palate heavy mission - 60% palates & 40% lips (because they have been here & done so many lips on earlier missions) but with the volume lower on this training mission I hope there won't be too may late nights. 

I came back to my room to blog & get ready for bed & my phone rang - it was the front desk - Cherish wanted my room # & they called to ask my permission. She came in & said she was a lil lonely - that the teen students were chatting themselves & she hasn't had alot of experience with teenage girls & she ran out of data on her plan for the day & couldn't call home. We talked about how to engage the girls, she was worried because they knew nothing about the church & she thought her explanation was "bad" even though she had been a missionary  - I told he rot just love them & be their friend...this is day #1 & she will have great experiences with them the next 9 days & they will also have life changing experiences. We shared a prayer together & exchanged numbers & she went back to her room. While I was so excited to meet her at dinner & find our shard bond of faith...I also recognized that we seem to be here for each other & again...no coincidences -God is in the details :) Perhaps she is here for me & I am here for her...and we will all have a wonderful time serving the people of Ghana together. I also called the District President Sis Kassah - she will be working at the hospital tomorrow & will come find me at screening-I am very excited to meet her :) My water should be warm by now so ready to shower then go to bed & up at 6 am for 6:30 breakfast....let the Ho Ghana Mission begin & see what unfolds. Blessed to be here    

Travel Day - Made it to Accra -

 I am in Accra & right now it is majorly storming/raining so loud outside!!!

Travel went well the 3 am drive to LAX was easy & my gate was close so I had just over an hour before boarding. The flight to JFK was uneventful...I took a lil nap & fortunately I was 8 gates away from where I landed to my next gate - but it seemed longer? (I guess everything is bigger in NYC). The flight to Accra wasn't bad - I was in the center section of 4 seats & it was only me on the aisle & a guy on the other aisle so essentially, we each had 2 seats. I did end get a few hours of sleep among the 10 hour flight & we landed at 6:30 am. I presented my "on arrival visa" and all was well. I found out that an Op Smile rep Ruth was going to meet me which was great because me actually finding a shuttle would have been a disaster-hundreds of taxi drivers & others trying to convince you they can help - I simply said "my friend is coming" and after Ruth & I connected the hotel driver Ruben met us there & Ruben my driver became my first friend in Ghana. All my "knowledge about Africa" came rushing back to my mind - CRAZY drivers - minimal traffic lights, lots of roundabouts, crazy people on scooters, women (mostly) in the streets balancing gian baskets on their heads - some full of 30+ water/soda bottles! or trying to sell you fruits, bread, dried nuts, even soccer balls & rags. With the drivers here you always feel like you are playing a game of chicken with the other drivers to see who is the most gutsy!!! Not my favorite pastime. Also lots of stands and people walking on the streets, kids in uniforms walking to school people sitting on the curbs

I had exchanged $50 at the airport but was told to go the a "charter bank" Ruben said there was not one nearby, so he took me to a "money changer" (which friends had told me about) but they didn't open unit 8:30 so we went to the hotel & I checked in...at the "Crystal Palms Hotel" it's not as nice as the name but not bad...however I am on the 6th floor with no elevators. I was so proud that I packed only in a carry on & a "personal duffle bag" but they each were likely 40 lbs & the young bellman Elvis who weighted all of 100 lbs himself would not let me carry one. The room was really warm so Elvis also setup my AC (really a fan on the wall) I changed clothes & could feel it starting to cool a bit and didn't want to take my room key out & stop the "fan" so I did what any wise person would do & left my AAA card in so the room would stay at its "cool 72 degrees" & not heat up when I was away. It is also very humid here so I am hoping for pore cleansing with all my sweating! I went back down so Ruben could take me back to the "money changer". It seemed a lil shady but was legit - receipt & all!!!

I told Ruben I wanted to go see the Accra temple from my church & could I pay him to drive me there - he said that was up to the hotel & they needed him for errands so I took an Uber. It was a 20 min drive & about $5 US. Raymond ws my driver but here most people don't own cars not even Ruben) so the ones who do have cars will  "rent them to Uber drivers" & then take 25% of what the driver earns. I am not sure if Uber takes money too :( So my ride was 54 Cedi ($5) & if he is busy  & drives 12 hour a day he can earn 1000 Cedi a day & keeps 750 or about $65 so he earns $5-$6/hr. It was later morning & we passed SO MANY food street vendors - none of which I would ever go near!

It was so peaceful to walk around the temple grounds. The local Missionary Training Center & Accra Church offices were on the same property so there were alot of people around & they were all so kind. After being outside for maybe an hour I decided to just go into the lobby of the temple even though I was in sweats & sweaty!!! The sweet woman at the desk said "sister if you have your recommend we would welcome you in" and since its digital I did have it, went in borrowed white clothing & got to spend a little time inside. It was such a special opportunity that I will never forget. I felt so much peach there & it is built EXACTLY like the Newport Beach temple so felt a lil familiar. 

After that I got an Uber back to the hotel. ON this drive back we went by "the circle" which was a really crazy marketplace that is open 7 days a week - it was chaotic even just driving by! By the time I got back to the hotel the jetlag was kicking in so I took a 90 min nap in my cool room. Just as I got up my hotel room phone rang & it was the front desk saying Ruben had finished his shift & thought I wanted to talk to him. When I returned after the temple, I had asked the young girl who was a "hotel security guard" about where I could get some diet coke. she said I would need to go to a market & it was a bit far. I casually said "maybe Ruben could take me" & she told him & he called me. Unfortunately, he couldn't drive me as the car belonged to the hotel & he doesn't have a car. So he said we would get a taxi...but several taxis didn't want to go "that way?" I suggested we Uber but he said we could start walking & then get one. We went about 3/4 of a mile then got in a "taxi" and I use that word VERY LOOSELY...it was maybe a 1980s Chevy Spark - windows & door locks didn't work. We did get there but even Ruben agreed I could get an Uber back which was less $ than what the taxi guy gouged us for because I was a tourist!!! We did accomplish my mission though &b I got 12 bottles of Coke Zero - one per day!

I finally showered, better organized put all the food in my luggage with my drinks an extra bag I packed, showered off the dirt & sweat of a travel day & decided to stay in & eat stuff I brought rather than go downstairs. Then the hour long rainstorm started & I did my blog :) Its 8:30 Ghana time so I think I can sleep & sort of be in the right time zone. Tomorrow breakfast is at 8 & we load the bus at 9:30 to drive to Ho. I haven't met or seen any team members at the hotel yet & the locals arrive in the area tomorrow I think. Ruth said there are some students from the USA plus students from Ghana & I always enjoy when they are in the recovery room so that will be nice! 

Day #1 done (or really 2 days it seems!) Feeling SO SO GRATEFUL to be "back on a mission"

Nurse Nancy

Here today & tomorrow off to GHANA - Operation Smile Mission #20

 

I cannot believe it has been 2 years since my last mission. I had received numerous emails with mission  opportunities and each time I was SO DISAPPOINTED I couldn't reply & say - "pick me-pick me!" There have  been many things going on at CHOC that kept me tied there (opening the new CVICU 1 year ago, supporting a  leader on a one year medical leave etc) and really important family plans that didn't match with the mission  dates I was offered. 

Back up 4 months to to January 2026 when I received an email from the Operation Smile Volunteer office with 4 upcoming needs for Recovery Room Educator Credentialed Nurses. The first 3 I had conflicts for & the last one - Ghana in June was one that could work. I immediately emailed back saying I was only available for the Ghana mission and would love to be considered. The international volunteer coordinator said she would forward my "interest" to the Ghana headquarters & see what they said....and 2 weeks later they offered me a role on the team :)  I am so excited to get back to this work that fills my heart and spirit and helps children and families. This time I am doing it FAR AWAY....Ho Ghana to be specific 7500 miles from home according to Google.

I will have a VERY early start tomorrow morning - 2:30 wake up alarm & at 3 am Doug will drive me to LAX to arrive about 4 am for my 6:20. While the travel is long - A TOTAL OF 16 hours flying-I do have a pretty direct route- LAX to JFK (5 1/2 hour flight) 2 hour layover at JFK then JFK to Accra Ghana (10 1/2 hour flight). I will arrive in Accra at 7 am on June 3rd - then find my way to the shuttle to take me to the "Crystal Palm Hotel". I will stay overnight there with other volunteers and then on Wed June 4th we will travel 175 km (about 3 hours) to Ho Ghana the site of the mission.  

This is ALL POSSIBLE today because my VISA from the OSI leaders in Ghana just arrived THIS MORNING!!!! There was a lil underlying concern over the weekend but it was in my email when I woke up this morning. Talk about lots of last minute prayers answered! 

I am serving on this education focused mission & my role as a recovery room nurse will be more of a “trainer” for local Ghanian nurses. Getting the details has been slower this time & I just received the "Team Packet" last Friday...I always look to see if there are any other volunteers on the team list that I may know from past missions with but this time I was surprised to see I am the only USA volunteer...the majority of volunteers are from Ghana or other parts of Africa (DRC, Ethiopia, & 2 from Egypt) and ME!!! All the trainees are from Ghana & I along with a credentialed nurse from Ghana will train 4 new Recovery Room nurses. At times like this I always wonder...for what purpose (aside from the mission) am I going to Ghana? I always feel that I end up going where I am supposed to be on these missions and there are no coincidences 😊

As I always do I did reach out to the local church leaders there letting them know I was coming & that I hoped to connect with them & help church members & others in their area. There are small branches of the church in Ho & the District Women's Society President Sister Quaye replied a few days after I sent my email & said that she was aware of the mission and works at that hospital the mission is being held at - my heart felt immediately comforted that perhaps I would have a "friend" at the hospital - which meant even more after I found out I was the only USA volunteer.  Just a few days ago the District President Benjamin Ofori emailed and he is a Public Health Officer with Ghana Armed Forces Medical Services at the Artillery Unit Hospital in Ho. (I am unsure if that is the hospital we will be at?) He also told me they were "ready to receive me and would stay in touch" I think I will phone then once I arrive in Accra. I have friends who have served two church missions there so they have given me some help as I prepared.  I have done 6 other missions in Africa - Ethiopia x3 (East Africa), Kenya (East Africa)- my very first mission 15 years ago, and Morocco x 2 (North Africa)  This time I will be in "West Africa" & there is a 7 hour time difference 

The "Wikipedia" information I have on the area of Ho is that it is in the Volta Region  with a population of 180K and is supposed to be one of the cleanest cities in West Africa - so that's a plus! It has a tropical savanna climate (translation the weather app says it will rain a part of every day). The primary ethnic group there and language is the Ewe...more to learn once I get there...

As always my blog is “my journal” I share with you on these trips so it may be a bit boring 😊 but I will update while I am there & 14 years later I have not yet figured out how to fix the way it posts on Facebook??? I really need Tech Support!!!! As you can see I had an issue with this first entry...no idea about the formatting that is showing.

I would be immensely grateful for your prayers & positive thoughts as I begin my travel on June 2nd and the throughout the time I am in Ghana until I return late in the night on June 13th. A mission trip  always brings some uncertainly that I acknowledge - and I can be BRAVE - but I have to admit I am a bit more insecure thinking I am the only USA volunteer. I know it will also be a wonderful opportunity to make MANY new friends from Ghana. 

Lots of Love,  Nurse Nancy

 

Monday 4-8-2024 A day in Porto Velho post mission

I have an hour before we leave for the airport, so I decided to try & complete this blog post now as when I get back I have work and travel to Utah next week. While it is fresh in my mind I wanted to finish up. Yumi & I slept in until 8:40  -it was glorious! We went to breakfast at 9 am & for the first time I notices a “Panini maker” that they use to make toast – and they serve ham & cheese in addition to ALL the Brazilian fare that I did not eat. So, I decided to make a panini breakfast sandwich & mix it up a bit 😊 We saw the team who was still here for the day & who all fly out tonight. Different people were making plans for the day. Yumi headed out to go shopping with a group . I made my 2^nd trip across the street to get some Coke Zero & get Yumi a Moster as she manages her travel tonight. I was happy to come back to the room, put on some music and catch up on my blog and begin packing.

I am on GOL Airlines for my return flight & go from PVH to BSB (Brasilia where I have a 4 hour layover them from BSB to Orlando where I have about 2 hours to get thru customs & catch my flight to LAX returning there at 10 pm tomorrow night. GOL has a bad reputation in airflight, poor reviews and are trying to file for Chapter 11 – not too encouraging. Last night I was able to find my reservation & see that I have assigned seats but it was too early to check in. Today I get to the same place & then they cannot locate my reservation & I can’t check in. It is the same for the majority of people flying on GOL…and I have tried multiple times today so I am counting on it all being fine when I get to the airport. Several others are on my same flight to BSB & 3 or 4 others are on my next flight to Orlando so I will be nice to have company as I travel.

At 1 pm Sister Rosemary picked me up on her lunch break. She works very close to the hotel & is in finance for car companies? After she got me we picked up the sister missionaries & then drove about 20 min out of town to a grocery store that she said had good prices. Sis. Gabriella & her 16 year old son met us there & we ended up buying 200 1Liter boxes of milk so that each food basket will get 4 liters. I asked if there was anything else & they said: “the children love chocolate” so we ended up buying 50 containers of “chocolate” to go in the milk – like Nestle Quik. The 16 year old was the muscle to load the car - we took a few photos said our good byes. Sister Rosemary dropped me at the hotel – we took a few more photos & hugs & then she was taking the sisters back & going back to work. She text me later “Again sister please share our deep gratitude for everything you and your wonderful friends are doing for the families of Porto Velho -Rodonia -Brazil”. They plan to put all the baskets together this Saturday & deliver them over the next week :) I had an hour to finish packing before we needed to meet in the lobby for our boat ride on the Rio Madre de Dios – River of the Mother of God. The river was pretty brown & I am sad to say there were exactly zero pink dolphins spotted. It was a nice lil cruise though with music and a snack bar & visiting. The captain even let me drive for at least 2 minutes – for a photo op at his insistence! There was a beautiful sunset over the river as we docked.

After the cruise we went to a place called Barto for hamburgers-they were actually quite good! And I visited with Carlos a plastic surgeon who I have probably been on 4 or 5 South American missions with. He is a nice man. We just got back to the hotel  -showered to be fresh & clean for our flights & are finishing things up (like my blog) before we leave for the airport.

It was a lot of travel & I have just as much in front of me but even with all the travel if asked I would do it all over again. The ability to meet faithful members of the church & see them volunteer with the  same “Helping Hands” vests that we wear at home helping our friends and neighbors was touching, the miracle of the 50 food baskets and the generosity of my friends is something I will never forget. The sweet children and their families reminds me why I became a nurse & the opportunity I am given to use my talents for good. My connecting with the 10 missionaries in this zone reminded me there are AMAZING young people in the church willing to serve & parent who have prepared them (I forgot to mention that the one elder from Spain was a professional soccer player there & made a decision to give that up & come  on his mission) He was great & would find me every day & say “Sister Nancy are you okay”. Understanding the commitment of and feeling the love that these stake leaders have for all people who are in their boundaries was touching & recognizing the environment that they serve in is so challenging – reminded me how grateful I am for all who serve in church callings.  Meeting people like Yumi I also know was also not happenstance…I was scheduled to be with a different person but the debacle of the room assignment when I arrived turned out to be something wonderful. Doug & my family support of these endeavors is so important to my ability to make these trips & my team at work who know that these trips fill my bucket & touch my core. So as the mission comes to an end I am simply GRATEFUL for the uncountable blessings that have come my way over the past 8 days. I am so blessed. Ready to head home first flight in 4 hours at 1:15 am. Praying the travel angels accompany me!

Surgery Day 2 – All Lips – Cute Babies to Snuggle but an unexpected end to the day!

 Since we (the PACU team was at the hospital so late they told us we could leave at 8 am instead of 7:40; basically the time for the bus to go to the hospital & come back. I stepped out of the hotel at 8 am exactly only to see the bus drive away…typically buses are sort of on time but this was a first???        No problem I am resourceful so I called an Uber & for $1.50 American I got there at about the same time as the bus.

We were doing all lips today so I assumed the day would go faster & the patients would come back sooner – it sort of went that way…we had a 2^nd translator in the PACU in addition to Sis Wright – her name was Amanda & she is 24 & a schoolteacher at an Portuguese/English private school. She is one of the “LDS Church Helping Hands Volunteers”. Her sister in law is Carlos’ daughter & Carlos was asking for all members who spoke English to help and Carlos daughter planned to come but was unwell so Amanda came in her place & was so sweet. She shared lots of cultural information about Brazil. She has lived in PV for a year & moved from the center of the country where there was more crime. The other Sister Missionary Sis Rueda  has been the full time translator for the Psychologist from Honduras who speaks Spanish as Sis Rueda speaks Spanish, English & Portuguese, Sis Rueda has the most amazing countenance – she is 28, is so gracious and kind and has a calming sense of maturity and life experiences. I am certain she brings so much to her missionary service. She taught English in Mexico prior to deciding to come on a mission.

We have a total of 16 patients again & 3 age deviations meaning we are doing lip repairs on 3 babies <6 months old (which is the OSI criteria) but we can do younger if they are well nourished & meet other criteria. They are all on Yumi’s table so I told her to look for me when she brings them to to the PACU. I went into the patient holding area & saw the cutest lil 9 year old Greciane who has had an “unrepaired primary lip” her entire life. She is Autistic and they have not been able to have it repaired. She had a play stethoscope in her ears & a pretend microphone & was singing her little heart out 😊

I really thought we would have the first round of lip patients out sooner but I guess they were doing a lot of teaching? The first baby came in at 11:15 & the next 3 within 15 minutes so it got a bit busy in our area. My fist patient was Giovnna & she was a sweet little girl that took awhile to wake up. I snuggled her for quite some time & later in the day the Op smile photographer sent me a photo of us that he took. It encapsulates so much of my love for these babies & this  work. I had to pass her off to a volunteer when the 4^th patient came in as Norina & Allyson were also busy with patients.

My next patient was Petyro and he was a bit more fussy & harder to calm but settled if I was standing him rocking him..like all babies. The team dentist Flor came in & wanted to hold him & she sang some Brazilian songs & did some dancing with him in her arms & he loved that! I guess I didn’t have the right moves or language 😊 After that it got loud with 4 moms & 4 patients crying & my friend Greciane came back & literally was screaming for at least 30 min – I cannot imagine coming out of anesthesia not knowing what is happening. It was rough but I am so glad she got her lip repaired – the mom said because of both eh autism & her lip she has been ostracized most all her life ☹

I got “shamed” into trying the local lunch which today for the Brazilians was a plate of rice, beans on top of the rice, lasagna on top of that & shoestring fried potatoes on top of that for texture (they really seem to care a lot about texture?). I opted to try the lasagna only 0 it had both diced ham & ground beef in it – wasn’t bad…

My next to last patient had a crazy backstory the entire surgical team was surprised about.  Her name was Kabatchogue & she was one of the babies from the indigenous tribes in the area. She was 9 months old & 6 mos ago came to a local mission in another area. She had a large bilateral cleft lip plus a palate. The chief in their town believed she would bring a bad spirit to their tribe & banished the mom & baby. At 4 mos of age Op Smile did not feel they could repair the full lip but were concerned for her safety so they repaired one side of the lip. AT this point the story gets a bit unclear because I don’t know if she was able to go back to her tribe or has stayed away the past 5 months? On this mission she came & we repaired the other part of her cleft lip & I believe she will return to her tribe now? The baby will still need palate surgery. Mom & baby were accompanied by an aide worker who could translate her dialect to Portuguese – such  sweet person.  

Mid-day we got a text that there would be a tam dinner at a “Pizza-Pasta Buffet” with buses leaving at 7:30. Sounded fine to n=me but my last patient REALLY needed the extended stay at the end of his time in the PACU & I then became doubtful if our team would attend (but don’t worry we did!). Anyway my lil guy was only 4 months old & had both a nose & lip deformity. They did a 3 ½ hour surgery ti repair the lip & tried to do some reconstruction on the nose. He came to the PACU with a clear tube coming out of each side of his nose – & had a bit of oozing around it but nothing too concerning aside from the fact that the surgeon expected it to stay in for 14 days & the mom would clean it each day??? News Flash she lives in a rural part of Brazil. He really was doing ok in PACU. I syringe fed him some juice when he was awake & he settled ok for me & mom. Mom was uncomfortable though as she only breastfed & was engorged & the baby could not latch on…so the local PACU RN & I “played McGyver” & made abreast pump from a 50 cc syringe. We cut off the syringe tip, I covered the raw edge with tape stripes  & we put it on her breast using the syringe phalange to pull the breast milk out – WaaaLaaa it worked & once the baby was crying the milk flowed freely into the big syringe & I fed him from a small syringe. It’s all about innovation at the smallest level! Our PACU MD is on the nutrition council for Op Smile & took photos of our “creation” haha. Unfortunately about 30 min later – not certain of the reason his oozing of blood around that tube increased. I applied pressure which made him more upset & ooze more, so Teresa the PACU Dr sedated him & we applied more pressure & ice. Since he was the last patient the majority of the team had left – I was literally ready for him to go to the post op ward when this started. We out him on some oxygen continues to control the oozing & called the surgeon on call who came about 30 min later. In the PACU we all believed the tube was irritating his nose, causing more swelling & more oozing – we were right. The on call surgeon came in, removed the sutures keeping the tubes in place, I applied more pressure while the surgeon created nasal packing with Vaseline & gauze, Packed the side of the nose that was bleeding &  then we put on a moustache dressing – it was now 7 pm & he looked okay but they wanted to watch him for 30 more minutes. The local Dr had to stay & Allyson offered to stay so I got an Uber for Norina & me& we go to the hotel at 7:25 truly did a 5 min change & made it on the bus to the dinner.

There was some VERY INTERESTING pizza combinations – dry beef & cheese, carrot & cheese, banana & meat, shrimp, chicken & corn, one with lots of meats  & fortunately marinara & pepperoni which I ate. They were also serving all sorts of pastas I passed on & french fries? Then they had dessert pizzas that still had a base of crust & cheese on them plus either lots of chocolate & chocolate sprinkles, chocolate & strawberries, one with flan on top & lots of caramel & another with all sort of m&m’s sprinkles & a scoop of ice cream & chocolate syrup. We got one of each at our table & all tried a bite. Very sweet!

They showed the traditional video – highlighting that this is the 10^th mission in PV & they have now done 400 surgeries here so I don’t think they have ever done a big 90 patient mission here. Christina the Local Executive Director Volunteer has been a part of the entire 10 year history. It is always nice to se the mission from our 1^st gathering thru the training days screening, surgeries, recovery & post op. It encapsulates the entire experience so well.  I was in the video with one of my sweet babies from today 😊 The event finished at 10 pm & we were back at the hotel at 10:30 & some people were leaving for the airport at 11:30.As much as I typically am ready to head home right after the mission I am actually grateful that I am not leaving tonight; for a few reasons. I am tired & looking forward to a good nights sleep with no alarm to be set so maybe I will come home rested – perhaps jet lagged a bit but rested. Tomorrow I will get to make some other need purchases with Sis Rosemary the Relief Society President. Also for those of us here all day tomorrow Nipson is arranging a 2 hour boat trip on the local river (not the Amazon River) to hopefully see the “Pink dolphins” that are unique to this area of the world?

I am writing this post Monday morning so happy to report a good nights sleep – Yumi & I slept in until 8:30 & it was wonderful! I will make my last blog post likely after I return. If you have been following along – THANK YOU for the love support & prayers during these missions. I am so blessed & grateful to be able to use my skills for good all over the world with Operation Smile & have these opportunities & I believe I have been where I was meant to be this week in PV Brazil

Teaser – Ambra came to me yesterday asking If I knew some of the plastic surgeons at CHOC who I do (Dr Jaffurs & Dr Elyas) as their group & CHOC? would like to sponsor a mission in the DRC in about a year & she wondered if I would be interested…

Day #1 of Surgery 16 Palates!!!

It was a “typical first day mission morning 😊, UP at 6:30, breakfast at 7, team mtg at 7:20, bus leaves at 7:45. Last night they gave us Op Smile Brazil scrubs that they wanted everyone to wear today once we get to the hospital but they are made of really heavy materiel & oddly sized so I was going to wear the Op Smile Scrub top & my own pants only to see about 25% of the team didn’t wear them?!?!  But by then I was not going to change clothes. While viral season in the US just ended & we lifted our masking requirements for RSV etc, the seasons are opposite here so it is just starting & they just began masking at the hospital.

Also a normal morning at the hospital to start the mission. We finished setting up the PACU & our supplies remain sparse. We checked the crash box, had the mock code and then we wait….our PACU intensivist is Teresa a native of Brazil, who is fluent in English & has done numerous missions. Allisson (male) is the local nurse who has worked with Teresa on many missions so he is our leader in the PACU. We do not have anyone we are training so there are just 3 experienced PACU RN’s Norina is on her 5^th mission from Canada. I guess that PACU RN’s or PICU R’s functioning on a mission as a PACU RN are hard to find??? IN this country there is usually only 1 RN and then the rest are “technicians” caring for the patients and PICU’s are limited & PICU nurses rare. Since this is my 2^nd “Champion Mission” w/o any “trainees”.

Today we have 4 operating table & each table will do 4 palate surgeries so I am anticipating a LONG day 😊 Since we have only 2 days of surgery it is the opposite of what is “typical”. On most missions the 1^st day’s schedule is filled with lips & then they start on palates. We got our first patient at 12:10 so I used the morning to type up my blog on a word doc so I could post it last night.

Davi was my 1^st patient & came in at 12:30 – he was such a sweet boy & I remembered him from screening but he came in to the PACU a little wild & we needed to give him some Nubain to help him go back to sleep. That provided him with the 3 hour “extended stay” in the PACU and when he woke up like a little angel. He had chubby thighs & a sweet mom and his palate repair was great. By about 2 pm the 2^nd round of cases were on the table & the 4^th & last round were started at about 6 pm so I knew then it would be a late night.

A few “oddities” about this mission – it is the first one that they have not had water bottles at the hospital – they had large water coolers in 2 areas with little 4 oz cups so I was not hydrating well at all & will bring my water bottle tomorrow. Lunch had a slight variety today it was self serve on a hot plate – rice, beef in a sauce & a root vegetable of some sort. I was completely happy with my PB sandwich, and a protein bar and snacks! Another odd thing is that the pre/post op ward is “on this street” but ½ mile away so the patients go from the PACU to the post op area via ambulance – never had that before. So no visiting the Pre/Post area for me. It does seem like an added risk to be an ambulance ride away if there was a problem but fortunately that will likely not be an issue. One nice thing here is that they let the parents go into the operating room for their child initial induction to sleep before the surgery & they also bring them in to the PACU once we have them settled.

My VERY LAST patient Andre was 2 years old & his cute mom was 6 months pregnant and so grateful & tearful when she came in to see him in PACU. He had his lip surgery about a 16 month ago & had been waiting for another mission to have the palate repair & traveled 36 hours from the southern part of the country. Thru the translator she said she was so grateful I came to her country and that her mothers heart was swelling with love for having surgery for her little boy because it will change his life. I replied that “I know a mother’s heart with my own children & grandchildren and am happy I was here with this team to help” We shared a long HUG!!! He was another that got Nubain on arrival to make him comfortable & had the “extended stay”. After about an hour I did a little face wash to see if he would wake up a bit & he did but was fussy. His mom held him & sang him lullabies until he calmed down it was so precious to observe. He was finally sent to the post op area at about 9:45 & we closed up the PACU at 10 pm & I was back at the hotel at 10:20 to shower & get ready for bed. Yumi & I shared our days, I called Doug & went to bed at 11:15. Unfortunately, for some reason I was awake until about 12:30 – just could not “turn off my brain” even though I was tired. Tomorrow is he same schedule but all lip patients so it should be a shorter day * about half of the team leaves tomorrow night & the other half (like me) Monday night