Greetings Earthlings

Turn your bike off the main road onto the dirt path that's engrained in the field. Riding towards the big tree ahead you see the teacher's table, and hundreds of children sprawled across the schoolyard for free period. You park your bike, inform the teachers why you are here, and follow an older student to the Director's office.

Every few feet there are children swinging makeshift ropes while their peers skip to the beat: thwack, hop, thwack, hop is the sound of the thick green vine ropes while the broken pieces of twine twisted together make a quieter, slapping sound. From the corner of your eye you think you see a few children jumping with a rope made of tied together plastic bags, but you aren't sure, and you're distracted by a child calling your name before you can decide.

"Smalle, smalle." Says a small voice from somewhere behind a block of classrooms. You smile and wave, and soon find yourself behind the classes and in front of the offices. The director isn't in, but when you call he promises he'll arrive shortly. As you pocket your cellphone you notice the commotion around you.

"Smalle, smalle." say many small, approaching, voices. You are completely surrounded by first graders. There must be 40 or 50 of them, all approaching in a uniform mob. They are bent forward, hands behind their backs, slowly hop-stepping towards you, whispering "smalle, smalle" tauntingly with every step. Once they are within a couple feet of you the group stops, and the voices quiet. A few brave children continue to call "smalle, smalle."  but most stare up at you expectingly.

You look to your colleague, and she mouths "What do we do?"  You have no idea what to do under such surveillance. The children continue to stare; you make a face at one. He smiles. You imitate another's facial expression; she quietly giggles and makes a new face at you. The rest of the students stare with saucer eyes.

You catch your colleague's eye and turn again to the students. Raising your right hand in the air you wave to the crowd, saying "Greetings, Earthlings." quietly enough that only she can hear. You both laugh. There's no other way to describe what is happening right now other than to say you feel like an alien who has just landed on earth.

There's more silence broken by brave voices shouting 'Smalle, smalle." You stand still, not looking at the children, pretending they aren't there. And then, all of a sudden, you rush towards them, shouting and flailing your arms. The children shriek and run away. It's official, you don't feel like an alien, just an ogre. You've scared them away.

And then the giggling starts. When the giggling ceases they all bend forward, arms behind their backs, bouncing towards you in a uniform step. The crowd buzzes with the words "smalle, smalle." Your ogre imitation appears to have been a hit, so you do it a few more times until the children don't react at all. When this happens you turn around to see what's caused their sudden disinterest, and see the director is standing behind you. There's a long moment of silence. He speaks some rapid fire Buli and the children run away.

And life in Sandema proves even 23 year olds can get in trouble on the playground. 

'There's Another': Meet Margaret

We weren't back in Sandema more than five minutes when a woman approached us at the bus station to tell us "There's another". And so, just after returning from Kumasi, we learned of a child with a cleft palate in the nearby village of Fumbisi.

Knowing we needed to return to Kumasi for the July 3rd clinic, and recognizing our fundraising had surpassed what we had budgeted we would need for Angelina, we immediately asked to meet the child to "see what we could do". We went into the meeting with the full-intention of asking the mother if we could take her child to Kumasi too, and this past Saturday the mother accepted our offer.

Allow me to introduce Margaret and her mother Lydia. 

Margaret is four months old and has a cleft lip & cleft palate. 

Lydia recently traveled to Accra where she had heard there was an assessment clinic for cleft palate children. There she was told the surgeons could operate but that the surgery would cost 250cedi-500cedi ($125 - $250). The cost of the surgery, as well costs associated with surgery (prescriptions, hospital fees, meals etc.), were too much for Margaret's family, especially after paying to travel all the way to Accra. Lydia was forced to bring Margaret home without the surgery.

We will travel with Lydia and Margaret to Kumasi next week to have Margaret assessed at the Kumasi Cleft Clinic. We will request a surgery date but have no idea when exactly we will be offered a surgery slot. Although we are dreaming of the possibility of July 4th there are many things that will need to fall into place for that to happen.

The idea of returning to Kumasi again, with another child, is much more daunting than the first trip. Now that I know what we're getting into it is easy to have a lot more worries. However, there are also a lot of factors that work in our favour. Now that we have gone through this process once, we can better anticipate what is needed of us and can better navigate the challenges of the hospital system. Lydia speaks English, and is more familiar with travel, which will take many stresses off the trip. And I'm confident it is not a coincidence that we have encountered Margaret in this timing. There is a plan that is bigger than us, and I know what we need will be provided just as it was for Angelina.

In addition, at this time we anticipate Margaret's initial trip to Kumasi can be fully funded from the donations initially received for Angelina's surgery! Thank you for your generosity that has made it possible for us to assist not one but TWO beautiful little girls from the Builsa District. 

Please join with me in praying for our trip to the July 3rd travel clinic. Pray for Angelina's cleft lip follow-up appointment, and eye assessment, praying specifically that any special needs would be identified. Please pray for Margaret's trip, for her mother that is traveling with her, and for a timely surgery date to be assigned. 

Gifts

Picture taken on Angelina's return home after Kumasi 
L:R Angelina's Uncle, Angelina with her Mother's Sister Wife,  Angelina's Mother 

This past week we received a visit from Angelina's father. He had been tending the fields on the day we brought Angelina home from the hospital and wanted to come to personally thank us for all we had done to arrange Angelina's medical care. Through a translator he spoke to us of the impact we had made on his family, and about how grateful he was that we cared for his child. 

"I didn't even know this was something that doctors could treat," he said "but now we will think of you and what you have done for Angelina everyday for the rest of our lives." 

He spoke about how there was nothing he could do to thank us appropriately, because what we had done was so very big. Wanting to offer us something he brought each of us a guineafowl. Guineafowl is a very traditional gift here in West Africa and it's quite special for me to be a recipient of such a gift; it was surely a sacrifice for Angelina's family.

I hope that even oceans away you will consider yourself a recipient of these two birds too. Through monetary gifts and/or prayers you have played an integral role in Angelina's medical care. Though Angelina's family will never know your names or faces, your impact is very real. And I can now say, this impact directly extends beyond just Angelina (see here!).

[If you're wondering what became of this gift, we weren't able to integrate these guineafowl into the flock on our farm. So this weekend with the assistance of our host sisters we cooked our birds, learned to prepare a traditional recipe (rice balls & peanut soup), and invited friends for a lovely evening.]

Immunity

As I write this my home city of Calgary, and surrounding areas, sit partly underwater. Heavy rains and spring run off have combined to create the worst flooding the city has experienced in living memory. 75 000 people have been evacuated, main roads turned to rivers, and countless homes have been destroyed.

Today, Sandema feels like a safe-haven from the craziness that comes with a city in the state of emergency. And yet too, I have watched my News Feed fill with offers to help others, and I have been reminded of the se way in which Calgary is capable of rallying around its own, and the sense of community that is present in our city, especially in times of challenge. I am always proud to be Calgarian, but today especially. 

Ironically, Sandema is in the midst of fears of draught as the rains have been far less than usually occur by this time, and certainly less than the farmers need to care for their crops. On my way to work I ride past fields that haven't been planted, and others than have been planted on faith that the rains will come. And I recognize, yet again, that no place is immune to hardship. 

My thoughts and prayers to my family, friends, and neighbours, in Alberta.  

There's Nothing Funny About This Post

It's true. There's nothing funny about this post. Except, in a weird way, everything is funny. Because life in Ghana is glamorous.

That's really all there is to say. I've recently picked up a heavy dose of Norwalk Virus & acquired a case of pink eye. All fingers point to the time I spent in the hospital last week as being the source of this new adventure.

I'd like everyone who still has misconceptions about Africa being a magical, wonderful land, to discard those now. Africa is a wonderful place, with challenges like any other. And horrible moments like throwing up all over your friend's lawn, biking home, and vomiting all over your own lawn, happen here just like any other place. Except they probably happen here more. And probably in any other place you wouldn't be hiding behind a tree, expelling any last traces of food from your system, while your host sisters, whom you haven't seen in a week, return home and stare at you with shocked faces.

In any other place you may not need your boss to drive you to the hospital because, 8km bike ride aside, he is your only means of transportation. On the way you may not be required to listen to him lecture you on the dangers of eating "wayward food" and the necessity of eating only at "reputable restaurants". He might also not accompany you to see the optometrist and speak rapidly in Buli to her, occasionally injecting the words "wayward food" into their conversation. Either way, this lecture on where to dine will feel derogatory, especially because the only other time you have had food poisoning in the past month is when he took you to eat at his favourite 'reputable' restaurant. Of course, this is something to keep to yourself. It's a losing battle to try to argue, and you're too tired to anyways.

That said anywhere else your boss wouldn't be able to call the hospital and get your name first in the queue so you don't have to wait in the overcrowded waiting room to see the specialist. And anywhere else your host sisters wouldn't come to check on you in the night, and then hand wash all the clothes you were wearing while you were getting sick all over their lawn. Your fellow interns might not bike into town just to buy you popsicles, or dare to check on you while you're laying on the bathroom floor at midnight. And certainly, these same interns might not be calling home to explain to everyone how hysterical it is that their colleague threw-up all over the place, and then stood and laughed with them about how ridiculous the display was. No, this is unique.

Africa isn't all that bad. It's just a place like any other, with flaws just like any other. And sometimes those flaws include puking your guts out. That's just life right? But it's only, sort of, kind of funny. Just like the sarcasm of your subconscious and having "Glamorous" by Fergie stuck in your head the whole time you are sick, is only sort of, kind of, funny.
_____
UPDATE: I am doing much better! I'm happy to be feeling healthy again, and be back at work. 

Homeward Bound!

Saturday afternoon, less than 48 hours after her surgery, Angelina was discharged from the Komfo Anokye Teaching Hospital in Kumasi. Though her lip is still swollen, it's evident the surgery has been incredibly successful! 

I'm so very grateful for the kind & talented surgeons who stayed after hours to operate on Angelina so she could have her surgery on Thursday. And I will forever be amazed at the dedication of her mother in caring for her over this week: a task that required her 24 hour-a-day presence at the hospital. One thing is for certain, Angelina is a well-loved little youngster. 

We spent most of the day traveling from Kumasi to Bolgatanga, and look forward to a short 2 hour bus ride to Sandema tomorrow. Our three day trip (A three day trip…quote Gilligan's Island) turned week-long adventure has been wonderful, tiring, and nothing short of a roller coaster. It all still feels very surreal. 

We will return to Kumasi for the July 3rd Cleft Clinic for a follow-up with the surgeons. Until then, Angelina and her mother will return to the village and I will return to work with CBR in Sandema. Katie and I will also begin the process of learning what the next steps are in an assessment for Angelina's eyes, and what the process is for getting her care for her vision needs. 

Angelina & her Mama outside KATH less than 48 hours after Angelina's surgery. 

Angelina post-surgery (still swollen, but SO beautiful!)

A kind of thanks...

I'm not sure I have proper words at this time to express to you how grateful I am for the outpouring of love and support I've been privy to witness this past week. Through your words of encouragement, prayers, and faithful giving, I have felt supported in my role in advocating for Angelina and I am personally, so very grateful. Most importantly, the way in which you have supported Angelina, a child whom none of you have ever met, has touched me immensely. Without the combined contributions of many of you from across the country, Angelina never would have made it to Kumasi, let alone had this surgery. Maybe someday I will find the words to express this thankfulness. Until then, I will simply say thank you.  

The P Word

For a complete update on Angelina & her surgery see my post here. For some of my thoughts on this experience keep reading. 

I never dreamt this is the kind of adventure my internship would hold. Many times throughout this week I've caught myself think "Is this reality? Is this really happening?" It has been such an exciting, exhausting, wonderful week.

And though I have at times felt completely unqualified to be getting medical care for a child I've just met, in a country I've just arrived in, I have seen time and time again that everything we need to be able to care for Angelina has been provided. I recognize my qualifications don't come in the form of medical knowledge, or Ghanaian language skills, but that I am here to serve as an advocate for a child who simply needs someone with a voice. I am capable of fighting through the system to ensure Angelina gets cared for, and I have experienced enough of life in West Africa to know a little about how to do that.

Navigating the hospital system has been an incredible challenge. If I wasn't overcome with a deep sense of focus and drive I know I could easily throw my hands in the air, scream, or cry. Doctor to patient communication here is poor, and the communication between staff is not any better. We hear different answers to the same question every time we ask, and wrong answers have catastrophic effects for Angelina's care. Before the surgery we were sent away from the hospital on more than one occasion by nurses, and every time when we pushed for answers and sought out doctors we were told not to go anywhere and that the surgery was still going ahead. We were given different prescriptions from different doctors, told Angelina shouldn't eat after 6pm/4am/6am/10am before surgery, and were never told Angelina would need special feeding formulas after her surgery (so we rushed out to get them for our starving child who hand't eaten in 24 hours).

Constantly asking questions, searching out second opinions, and spending time waiting for information that never comes has been our past two and a half days. And though it has only been two days the constant toggling between long waits and rushing to care for urgent needs has been exhausting. I can't imagine navigating this system alone like some of the mothers here are. And I know Angelina's mother could not have managed this on her own: with her beautiful meekness and quiet voice, I wonder if she ever would have made it past the waiting room.

This fight through the system comes with a personal struggle too.  And though I find joy and excitement in serving as an advocate or the "Strong One", as a bus driver on the trip down here called me, there is an uncomfortable element in it all too.  I have struggled with navigating my own privilege in such a complicated system.

My white skin brings me advantages most days in West Africa (along with my fair share of teasing, and occasionally a lack of respect) but never before have I confronted my privilege so much in a single day as I have at the Komfo Anokye Teaching Hospital. And yet there is no "proper" way to communicate this privilege either. How do you grapple with the fact that you being a foreigner, specifically a white foreigner, brings advantages that others here don't receive? I accept it because of how it has helped Angelina, but I have not come to terms with it. The knowledge that my presence here has lead to a different kind of care for Angelina is both a relief (I could be here to do that!) and sickening (Why is that I need to be here? What of the children that don't have a Brittany or a Katie?).

I feel the weight of this discussion on me every time I walk through the Visitors Gate at the hospital. The strict visiting hours (6am-7am, 3:30pm-5:30pm) mean family members who arrive at the hospital late come up against a locked and guarded gate that bars them from entering the hospital. Occasionally I have seen family members discuss urgent needs with the guards and be let past, but I have also seen guards physically restraining family members so they couldn't pass. And yet as I approach the gates they are opened, and I am ushered through with barely a hello. I can go back and forth in the evenings, doing multiple errands, passing through through military check stops and the 'Visitors Gate', while some cannot get past even once. I accept it because it means I can bring the mother food, or the child milk and bananas, but I still don't think it is okay. It just is.

Yesterday I walked past a woman outside the children's emergency department crying the cry of a mother who has lost a child: the kind of deep, wretched, wail that I never want to hear again. There is a little boy across from Angelina's bed in the ward who has an oozing tumour the size of his head, growing from his neck. His small frame is so malnourished he looks extraterrestrial: an oversized head balanced on a thin skeleton, it's impossible to tell his age. And when I see his mother caring for him during visiting hours her malnourished limbs and large smile make my heart ache. This isn't how it should be, I think. It just is.

And in all of this I know I look on with a visitor's attitude. I can, at any time, choose the best my system has to offer. I am educated and able to understand complex medical issues, I have preventative medical care and emergency medical care, and I have the means to access them at any time. Wherever I am in the world I am privileged because of who I am and where I am from; I can witness the medical system here with the full knowledge that the best this system has to offer, this reality, will never be thrust on me.

The ugly truth is that there are multiple realities in this world; as a visitor I can waltz between them, visiting when I want, and leaving just as quickly, while walking past mothers and fathers and children who have only this reality. It's that's why the visitors gates bother me so much. It's not the fact that I can visit Angelina whenever she needs someone, it's that the visitors gates are a physical representation of my privilege and consequently a representation of the injustices of this world.

Walking through the visitors gates is a momentary insight to the ugly parts of our world and to the brokenness that cannot be repaired by man alone. Development work will never do away with the multiple realities, the power and the privilege, that divide us. This is something that requires something bigger than us. For now all I know is that this isn't how it should be. And yet it is. And somehow, I am responsible to take what I have and to use it to serve. And that itself is a scary, and wonderful, thought. 

___________________________________________________

Update: I wrote this post in the morning of June 14th before returning to the hospital for another visit. When I returned  I passed by the small boy's bed, this time partitioned off from the rest of the room. Through a break in the partition I could see the small boy's frail body draped from head to toe in a sheet. I refused to think about it. Maybe he is sleeping I told myself. In the afternoon when I returned again to visit I couldn't pretend any longer: I knew what I'd seen. All evidence of the child had disappeared: his things were tidied up, his bed was being prepared for another patient, and his mother who so diligently came for every visiting hour was nowhere in sight. This is the reality that shreds your heart. This is the reality that shouldn't be. 

Angelina Update

Komfo Anokye Teaching Hospital, June 12th.
(Last pre-surgery photo!) 

What a whirlwind the past few days have been! Many times over the past days Katie and I have commented about how surreal this experience is and continues to be. A week and a half ago we met Angelina, one week ago we decided to go to Kumasi to get an assessment, and today we visited her in the ward to see how her recovery from a life changing surgery is going. 

Yesterday we arrived at the hospital before 6:30am, ready to see the doctor for his 7am visit, and have Angelina brought in for surgery not long after. Instead, around 8am we were brought to the operating theatre with Angelina and her mom, and 3 other cleft babies and their mothers. There we joined several others waiting for surgery. The nurse called everyone's names and checked them off on a sheet, but did not call Angelina. When the nurse looked up and saw her there she got angry, asked for her name, and told Angelina and her mother to leave. "They can't do her surgery today, they'll never finish by 4:00" she said. We were met by silence.

Katie and I grabbed her files, and rushed across the hospital campus, to the cleft clinic. The doctors aren't in they told us, so we should wait. And just then Dr. Henry, the same doctor that rescued the day before when the nurse told us to leave the hospital, walked in. He personally escorted us back to the operating theatre, spoke to the staff, and started detailed records for everyone. "The surgery is going ahead." he assured us.

After he left the staff informed us Angelina was still missing an aneosthesiology assessment, and the doctor responsible for assessments would not be in that day. Another of Angelina's surgeons showed up, and put in a phone call, and another doctor came in early to make her assessment.

And then we settled in for a long wait. All of the mothers and children were seated in a  small room, with metal benches. As we sat in the waiting room we watched each mother surrender her child to the nurses, and then watched again as each mother got the call to meet the ambulance and travel with her child back to the hospital ward. And finally, just after 3, after Angelina had fasted for nearly 23 hours (all of the babies were refused food after 6pm the day before because of a nurse's misunderstanding) she was taken back to the recovery room and given an IV to rehydrate her before surgery. And around 3:30pm she was finally taken into surgery.

Would you believe it that the doctor that took Angelina back for surgery was a native Buli speaker? From a native speaker population of less than 10 000 people, to find a native speaker in Kumasi, and have him serve as her nurse, was simply a divine appointment.

The wait while Angelina was in surgery was much harder than the hours of wait before the surgery - and I know I experience only a fragment of what our mother was experiencing. I sat across from her for a while, as her eyes stayed glued to the door the surgeons would come through to tell us the surgery was done, as she wiped her eyes and pretended not be upset, and wrung her hands. And I sat beside her for a while, wanting to offer comfort and knowing there was nothing I could say, other than to tell her Angelina was in good hands. I asked the translator to remind her about all the babies we saw yesterday who were back for their follow-up visits, and about how perfect their little smiles were. Angelina would be okay, we said. Her mother listened and nodded, and continued to watch the door.

By 5:20pm Angelina was out of surgery and her mother was taken back to the recovery room with her. Before 6pm Katie and I met Angelina and her mother on the road, as her mom carried her back to the hospital ward. We could sense the mother's relief the moment we saw her, and through the translator she told us how happy she was now. Angelina's mouth, although swollen, looks beautiful. Her lips meet and align perfectly, where there was a gap before there is now jaw, and where there were teeth coming her lip before there is just lip. And for a little girl that spends most of her time laughing, I think there's nothing better in the world than to have a complete smile. 

We visited Angelina several times today, and she and her mother are doing well. This morning Angelina was sleeping peacefully, and this afternoon she was sitting in bed, playing with her mom, laughing. She has some recovery to do still, but her big surgery is done. She may be released from the hospital as early as tomorrow, in which case we would start the trek home on Sunday.

Thank you again for your support in making this possible.

~Until the next update

Angelina in Kumasi

14 hours on a bus and 10 hours in a hospital has never been so very worth it. 

Imagine for a moment that you have grown up in a rural farming community. You never attended school and you speak only the local language, a few key words in Twi, and even fewer words in English. You are in your early 20s but the furthest you have traveled is a few hours away from your community, and never to a large city.

Now imagine you are told you will travel with two people you've only just met, who speak only English, and a few choice words in your language, to a city 14 hours away. Not only a city, but the second largest city in the country. Instead of pre-savannah you will enter the tropics, where the people eat different foods and speak different languages, and where you will see a large city for the first time in your life: overpasses on the roads, buildings taller than you've ever seen them, and a hospital with hundreds of doctors (the hospital in your home district has only one doctor). When you arrive at this hospital you will spend hours waiting to see a doctor, and when you finally do they will tell you that they need to operate on your daughter. And that they will do it tomorrow.

If you can imagine this you have a fraction of an understanding of what our young mother has experienced in the past 40 hours. She has taken this all in stride, but every once and a while we catch a look of fear and see how completely overwhelming this experience is for her. Even still, Angelina's mom tells us (through our translator) that she is very grateful for what we are doing.

This has been a learning experience for me also. I have never needed to navigate travel for a mother and child before, argue with a bus driver to get a refund on our 'non-refundable' tickets because he lied to us about the departure time, or hold a grown woman's hand as we wove our way through traffic in the night because she was terrified of the city. I have never had to figure out a foreign medical system, let alone learn my way around one of the biggest teaching hospitals in Ghana.

And yet in all of this I have seen us be provided for again and again:

• I stumbled upon a bus leaving for Kumasi just when we needed to go, allowing us to refund our tickets and get on our way to Kumasi, saving us hours of travel time. 
• Our friend found us a translator in Kumasi who was able to translate from Twi to Buli, so our mom knew what was happening at all times during our 10 hour day at the hospital, something we couldn't have dreamed of having on hand (before that our translator was still a phone call away).
• When we arrived too early for the cleft clinic we were able to sort out all the paperwork and pre-assessments that might have held Angelina up at the clinic, and managed to get 'our baby' first in the queue. This also gave us a chance to see all of the babies coming in for their post-surgery follow-ups and see the beautiful success stories coming out of this clinic. 
• When we finally saw the team of specialists they were amazed we had traveled all the way from Sandema to have Angelina cared for. I could hardly hold the excitement back when I heard the surgeons begin to discuss their operating schedule for the next day, and hearing them negotiate with each other. They offered to operate on her tomorrow! Not only that, but Angelina's surgery will be covered by her health insurance.  
• Once it was determined the operation would be this week rushed medical and lab tests - and with the support of the doctors were able to push the results through the system. When we arrived back with the results we were told we'd missed all the doctors and we would have to come back tomorrow, but one doctor saw us and stayed behind to make arrangements for Angelina to get into pre-op so her surgery could go ahead. By 4:30pm Angelina was checked into the pre-op ward, getting ready for her surgery tomorrow. 

There will still be a lot of bills for Angelina, although we don't know yet what all they will be. We will have to pay for her stay in hospital, and for all the medications she will need,  pay for a longer stay in Kumasi and 2 day a trip home (in lieu of the stressful 1 day trip). But it's overwhelmingly clear that Angelina is being cared for and provided for. If you feel so prompted you can still donate to cover the expenses of all this week (and the future follow-up visits) will entail.

Thank you for playing a role in supporting Angelina through your contributions and through your prayers. Without both of these this trip to Kumasi, and the opportunity to give Angelina a new smile, would not be possible. 

I'm overwhelming grateful for the opportunity to be a part of this. And giddy when I think about how beautifully it has come together. It's nothing short of divine provision. 

Angelina

Top: Angelina
Bottom Left: Angelina's Father, Mother, Angelina, Uncle
Bottom right: Angelina with her mother 

This past week I was introduced to Angelina: a bubbly 18-month-old baby girl with a cleft lip, and possible cleft palate. As she squirmed and giggled from her perch on her mama's lap I realized this could not be my only encounter with her. 

Angelina's family is from a small village in the Builsa District in Ghana's Upper East and her family cannot afford the cost of a trip to the Cleft Palate Clinic in Kumasi (~500km), let alone begin to afford the cost of her medical treatment. This is why she has just turned 18 months old and has not yet received medical care for her condition, the extent of which is still unknown. 

There is also very little information readily available about medical care for cleft palate patients in Ghana, although I am told the cost of treatment for her condition will not be covered by her National Health Insurance policy. I also know cleft lip/palate repair is best done between 0 and 18 months of age, but that Angelina can still see successful outcomes.

In my short time in Ghana, and during my previous experiences in West Africa, I have seen how difficult life here can be for persons with disabilities; disability is not widely understood here, nor is it well accepted. Health-implications of an untreated cleft lip/palate aside, Angelina will have an extraordinarily difficult life if she doesn't receive surgery. 

Living here I come face-to-face with need frequently, but great need like Angelina's case is not a daily occurrence. I simply can't turn a blind eye to her case, but I also am unable to bear the brunt of the cost of her medical attention alone. 

I'm asking for you to help me, and my colleague Katie, to be able to ensure Angelina receives the medical care she needs & deserves. We have put together a fund-raising call through Fundrazr. 

Because we know so little about Angelina's medical condition, and due to the lack of information available about the cost of her surgery, we are unable to appropriately estimate the full costs of Angelina's medical care. On our fundraising page you will find a more detailed outline about our anticipated cost of the initial trip to Kumasi for the Cleft Clinic, and our commitment to financial accountability to you. Any funds raised for this 'Stage 1' of treatment that are not used will go directly into the fundraising pool for Angelina's Stage 2 & Stage 3+ medical care. 

Matthew 25:40. Whether or not you are able to make a financial contribution to Angelina's case I urge you to keep Angelina and her family in your prayers. Please pray specifically for the journey ahead to Kumasi, for the medical professionals we will encounter there, and for successful medical appointments. Pray Angelina will be able to receive the medical care that she so deeply needs. Please also pray for her family: this trip to Kumasi will not be an easy journey, and much of it will be scary for both mother and child. 

Katie and I will travel with Angelina and her mother to the Cleft Clinic in Kumasi on June 12th. I look forward to updating you as our time with Angelina progresses. 

With you in grace and love, 

Brittany  

Click here to see our fundraising page. 

I'm happy to answer your questions or provide you with detailed financial information as we progress through Angelina's care. Just send me an email. 

The Night You Don't Sleep Tight

Two Weeks Before

During your first days in Sandema your roommate points out a strange rash on her feet and asks you what you think it is. You hold back for a moment, and blurt, "It looks like bed bugs…" You both dismiss this as reactionary, and not plausible, concluding self-diagnosing in Africa could always end in some strange disease. 

One Week Before

You notice you have many bug bits arounds your ankles, on your arms, and hands. You dismiss this as mosquito bites, brought on by the fact that your house is open-air style and bugs are free to roam. You fail to consider the fact that it has been years since you have developed any sort of allergic reaction to mosquito bites, or that you haven't actually seen any mosquitos, and instead choose to be grateful for your anti-malarials. 

The Day of

You are in town hanging out when your American friend sees the bites on your arm and asks what they are. You admit you're not sure & that you've been passing it off as mosquito bites. Now that she asks though, you are reconsidering the assessment. You add in that your initial reaction was bed bugs. She hesitates and then says categorically, "that's exactly what I think it is." Resign yourself to the fact that you are not crazy, and that maybe this needs to be investigated. 

The Evening Of

8:00pm Try to remember everything you have ever heard about bed bugs. You know they are nocturnal and best investigated in the night. Pretend to watch Sister Act with your African Sisters while really just dreading the possible discovery you are about to make. 

9:00pm It's been dark for several hours: you can finally begin your investigation. Pull off the sheets in one big swoop and shine your flashlight across the mattress. Heave a sigh of relief when you see no bugs scrambling to move away from the light. Maybe, you are all wrong, and there are no bed bugs. 

9:05pm You are about to give up on the hunt when you see a bug scrambling across your mattress. Panic. Look again. It moves like an ant. It can't be…Look closer. Shine a light on it. It's a strange, translucent looking thing with funny legs and antennae, and weird dark stripes across its back. It's not an ant. Panic again. Hit it with your shoe. Look at it's shrivelled corpse. Immediately regret killing it before taking a photo. 

9:10pm Start googling bed bugs. Your internet connection continuously cuts out and loads slower than dial-up. Persist. Find photos. Read articles. Refuse to accept what you are seeing come across your screen. 

11:00pm Congratulations! It's 11pm and you have just confirmed the bed bug infestation. It's now time for sleep. Your roommate asks about your conclusion. Start to tell her you are convinced…backtrack. Tell her you're not sure. She laughs and tells you she hopes you can sleep after all of this. Laugh, sort of. Wish her a goodnight. 

The Night 

11:15pm Take your new mat from the hall and put it on your bed. Toss your sheet over the mat and curl up. Mutter "Goodnight, sleep tight, don't let the bedbugs bite" to the empty room. Say this both with an air of sarcasm, and a slight hint of sadness. Despite your new-found knowledge you have no trouble falling asleep. 

3:30am Wake up extremely confused. There is HipLife music blasting through your window. The 70 year old man living across the courtyard from you is DJing a one-man late night music party. Heave a deep sigh and roll over. 

4:00am Silently curse the music for keeping you awake and for bringing about a state of fatigue-induced-craziness that makes you think you are covered in bed bugs even when you know you can't possibly be. Decide you've lived 2 weeks with the little guys, and you can survive another night. Fall asleep swatting imaginary bugs off your itchy skin. 

The Next Day 

Admit to your roommate that you do, in fact, strongly believe it's a bed bug infestation. She agrees. You spend the morning being grossed out together. 

Ask your colleagues what they know about bed bugs. Watch them squirm and laugh. Tell them it's not funny. Admit it is actually, really very funny. Laugh with them. Deep down you know if you can't laugh you might just cry. 

Begin googling how to exterminate bed bugs. Talk to your host family. They know all about bed bugs, and are embarrassed you have encountered them. Decide on a fumigation plan.

Talk to some other locals. They tell you it is not an issue, until you explain again what kind of bug it is. Once they realize you don't just have a bug infestation, but have bed bugs, they will exclaim "Those are very hard to get rid of!" Resign yourself to the fact that there is no quick fix. 

There is a saying for this kind of day that is both a complaint and an admission of defeat: West Africa Wins Again. It's the kind of thing us foreigners say when the little idiosyncrasies of life here in Africa become all too much. It's a kind of 'straw that broke the camels back' statement that acknowledges life here is just harder than life at home. WAWA, we say, WAWA. 

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UPDATE: We've now just completed the fumigation process & can move back into our rooms tonight. The whole thing is an inconvenience, but also very manageable. There has been much laughter about the whole ordeal and we're in good spirits. This is life :)