Establishing Crucial Relationships and Learning More About Child Development in Ghana by Macy

A lot of our time in Ghana was dedicated to establishing critical relationships for future trips to Ghana.  We had the opportunity to visit a couple schools to form connections including the Volta School for the Deaf and the Autism school in Accra.  The Volta school for the Deaf was impressive because it was like a mini campus.  The children stay there throughout the year for 3 months at a time, and then go home to their families for a couple weeks between sessions.  At this school, they have a vocational area where the students make really cool crafts—we were able to see and buy these crafts at their store in the market called “Our Talking Hands”.  During our visit at the school, the children were out of session so it was difficult to see how we could be most helpful to them.  We talked about possibly focusing on ergonomics in the vocational area or tackling communication barriers between children and their families.  We learned that most children struggle when they go home because their parents do not know sign language and have no way of communicating with them.  It made me wonder why they have to be sent home if both the child and parent are not happy with the situation.  However, since this is a requirement of the school, I think that we could help with this communication barrier.

The Autism school was overwhelming for me.  As a former ABA therapist, I couldn’t help but notice how much these teachers could benefit from ABA training.  I think a major part of our role at this school could be through teacher education.  There was sensory overload from the time we walked in including a loud TV, drumming, and singing very loudly.  The teachers could benefit from an understanding of sensory integration because it was clear that some children had sensory processing difficulties.

We were lucky to have Yvonne (the daughter of mama from the orphanage) help us get in touch with the autism school.  She is a wealth of knowledge and I enjoyed having the opportunity to talk to her.  She and Bless, one of the older guys from the orphanage, have a lot of connections in Ghana, making it important for us to keep good relationships with them for future visits.

I enjoyed learning more about child development in Ghana by administering Denver II screenings and interviewing mothers in the local villages.  Bless was helpful in finding mothers to interview, and also helped with interpreting.  We conducted these interviews to get a better idea of typical child development in Ghana in hopes of eventually creating a screening tool for Ghanaian children.  A few of my observations included: people did not seem to think a child’s age was very important, children do not have access to toys or feeding utensils, and parents will seek medical attention mainly for children who are overheated.  I also thought that the animal identification list should be changed to include more common animals in Ghana (such as goats).

We were only able to administer Denver II screenings on a couple children from the orphanage.  I helped administer the screening on two young girls, but it was difficult to get a true idea of their skills because of the language barrier (they speak Ewe to them).  They were also feeling sick and were not comfortable with us, which might of also skewed our results.  We noticed that they did not move around much and had a flat affect, but this could have been due to the heat and/or their sickness.  Hopefully next year we can continue this research and get more Denver screenings in the Volta region.

Forming relationships is essential when traveling to a foreign country to provide services.  We were lucky to have pre-established relationships to assist us during our trip this time, and hopefully the relationships we formed this year will continue throughout the following years.  This trip was completely life changing and I am so blessed I had this opportunity. Not only did I learn about a completely different culture then my own, but I also realized how much we take for granted on a daily basis.  I feel very fortunate for all that we have here in the US and hope to someday have another opportunity to travel abroad again (maybe to go pick up Prosper :)).

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One of my favorite pictures from the trip 🙂

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How We Provided OT Services by Macy

As mentioned in a previous blog, I was assigned to co-lead handwriting and after school activities with the children at the orphanage.  I was most nervous about co-teaching handwriting because of my lack of experience in this area.  We were fortunate to use a curriculum called “handwriting without tears” which provided us with ideas for working with children at all stages of handwriting.  I spent a lot of time reading the teachers manuals, which were really helpful, but the uncertainty of how it would actually work in Ghana made it a bit more complicated.

The first day we spent at the orphanage, we introduced handwriting to the kids.  The lack of structure and table space made it difficult for the kids to pay attention.  However, after having each child take a quick handwriting assessment, we were able to split the kids up into reasonable groups by skill level.  Overall, the kids were decent at writing their letters, but there was a wide range of skill level.  Some of us worked on chalkboards, others with wooden blocks, and a few in workbooks.

The next day we were able to teach handwriting in school which was a little better since each child had a desk, and we had access to the blackboard.  I was really glad to provide each child with their own workbook with the letters in the correct teaching order (based on difficulty level and groupings of letters).  While working with the kids, we noticed that they had difficulty making the connection between letters and their sounds.  They could usually tell you what the letter was, but most could not tell you the name of something that started with the letter.  Based on this observation, it seems like the teachers are more concerned with memorization of the letters alone versus usage of letters in words.  Maybe this could be something to look into in the future, followed by providing feedback to the teachers.  Overall, I thought the handwriting went pretty well.  Most of the kids benefited from learning the correct way of writing letters, which will help them in the future when they learn to write words.  I would have liked to have more time for handwriting so we could of worked on lower-case and cursive letters (for the more advanced kids).  We did leave some materials and the curriculum for the teacher, so hopefully he will take advantage of that information.  Writing is a critical skill that will benefit these children for the rest of their lives and I was happy to take part in the learning process.

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The biggest success for after school activities was making the rainbow loom bracelets.  The kids had never seen them before so they were very interested.   When we brought out the rubber bands, the kids all swarmed around to learn how to make them.  We taught them how to make them on their fingers since they wouldn’t have access to a “loom” (which most kids in the US use to make them).  I was impressed with how quickly they caught on—even the younger ones. They even asked for us to send them more rubber bands so they could sell bracelets at the market!  The friendship bracelets out of string did not interest the kids as much, but some of them really liked it.  They were able to tie the string to their toe to make these—improvising at its finest!

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During our last day, we had the opportunity to meet with the University of Ghana OT students.  I really enjoyed working through case studies and learning more about them and their program.  The students we met are the first OT class and they are in their second year of undergraduate studies.  They haven’t had much exposure to OT yet and have taken mainly general education courses.  They will only need a four-year degree to practice as an OT in Ghana, but we are not sure how it will work since there are only a couple OT’s in Ghana.  However, working through case studies was a cool experience because we were able to help them begin to think like OT’s.  This experience made me realize that I know more than I think.  I think that our pediatric course this past semester helped prepare me for working through the case studies.  It made me feel good that I could help them with their critical reasoning skills and helped me see that I am starting to think more like an OT!

I also enjoyed providing transfer training to the teachers of New Horizon’s and The University of Ghana students.  I was glad we were able to do this because so many people get hurt while trying to transfer others.  I hope we at least helped them understand the safety concerns for both people during transfers to help reduce injury in each person.

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What I learned most during these OT related projects was that most learning usually comes from uncomfortable situations. Before each of these activities, I did not feel competent since I am not yet an OT.  However, I learned so much from each of these experiences, and realized that I knew more than I thought!

What Was Different in Ghana by Macy

While in Ghana, there were certain parts of the culture and environment that took some getting used to.  People in Ghana are so friendly and almost every person that saw us would tell us “you are welcome”.  I am not used to people being so welcoming and it was a nice change!  The part of Ghana that I had the hardest time with was the heat and humidity.  I had never been so sweaty and dirty in my life, so it was a hard adjustment for me—I even sweat through my “sweat proof” pants!  Another difficult adjustment was waiting such a long time for meals—in the US, we are spoiled and food is prepared quickly, and all food is served at the same time.  In Ghana, everyone gets his or her meals at different times and it could take a couple hours for it to be ready.  Also, there are not nearly as many choices as we have in the US.  While in Ghana, someone asked me what kind of food we have in the US and the only answer I could come up with is “everything!”  It can get overwhelming with the amount of choices we have here, but it is better then having only a few of the same choices at every restaurant. Another part of meals that was different was that most people eat meals with their hands instead of utensils.  Before a meal, the server would bring out a bowl of water and soap to wash your right hand with before eating a meal. Here is a Ghanaian dish called “Banku” that we tried which was actually pretty good (although I was a little freaked out by the fish in the soup), Melodee washing her hands in a bowl, and Prosper eating his lunch with his hands:

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The older boys from the orphanage informed us that some people in Ghana eat cats and dogs—this news was a bit disturbing and steered me away from eating meat the rest of the trip.  They also found it very amusing that people in the US have cats and dogs as pets and take them to the doctor—it is kind of ridiculous if you think about it. It is so common in the US that I never really thought about it that way.  People in Ghana hardly have access to medical professionals and we are taking our pets to a doctor!

Something that I found interesting that I have never really experienced before is sometimes babies were afraid of us—I hadn’t really thought about the fact that some babies there may have never seen a white person before!  This would happen mostly in the villages while we were doing interviews with families.  At the orphanage, most of the kids were used to white people because volunteers visit the orphanage throughout the year.  I also noticed that at the orphanage, the kids clothing and shoes were not gender specific.  The kids were just happy to have something to wear— in the US, this would probably be shamed upon.  But is it really that big of a deal? Here is a picture of one of the outfits Prosper wore while we were there:

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I did not enjoy hand washing my clothes in the sink—I felt that I could not get them clean enough and we did not have a stopper for the sink which made it extra difficult!  I respect the people in Ghana (like the older girls at the orphanage) who hand wash clothes on a daily basis—it is not fun and hard work!

One of the biggest differences I noticed in the children at the orphanage versus children in the US is their independence level.  The kids in Ghana have to learn from a young age to look after themselves versus kids in the US who are “babied” for a good portion of their childhood.  It was hard for me to accept this because I just wanted to make sure the kids were okay! For example, when we took the kids to the waterfall, I was scared about the younger kids running ahead on the trail.  The “US caretaker” in me was thinking I didn’t want them to get lost or taken.  However, I realized quickly that they knew their limits and I had to just let them go!

My favorite difference about Ghana was the true happiness expressed in the people there.  I feel like here in the US we don’t even know what true happiness is because we are always looking for happiness through “things”.  In Ghana, they don’t have much, but seem to be happier with the little they do have.  They seem much more appreciative for what they have and rely on their tremendous faith each day.  I only hope to one day be as spiritually sound as the people in Ghana.  One of the major things I learned on this trip is that less really is more because without all the materialistic things is where to find true happiness.

Akwaaba Ghana!

We made it! And just in time for a magnificent thundestorm. Eric, the head of the Grace International School, met us set the airport and we crammed into vans to head into the city. The whole group is hanging out in Accra tonight and tomorrow the Volta group will head east while the Accra group heads to the Grace International School (I think).

It’s humid but not too hot and everyone is excited to be here and no longer on planes!

It’s a beautiful day in London by Caitlyn

We made it! We’re at the Heathrow airport. The flight was great! Free food, music, tv, movies, and alcohol. I think we all got a little sleep. We’ll be at the airport for a couple hours before boarding our flight to Ghana. Almost there!

Here’s a picture of the little bit of a view of Europe from the terminal. Remember, this is my first time on international soil!

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Bye for now!

Last Minute Prep by Macy

It seems unreal that the time is already here—this week has been a hectic one to say the least! Finishing up the first year of OT school with finals in each class, moving out of my place in Richmond and back home to Northern VA, and now leaving tomorrow for a life-changing trip—I thought this day would never come!  Tonight is about organizing and determining if I need to pick anything up tomorrow.  As much as I like to be prepared, I know I will get there and have forgotten something—at least there are other women on the trip and between all of us, we should have everything we need!

Today I went to Wal-Mart and have spent the last couple days picking up stuff here and there, collecting last minute things (including a spontaneous, costly trip to Eddie Baur, a store I never really knew about but fell in love with for Ghana attire).  When I went to check out at Wal-Mart, my mom started talking to the cashier, telling her about my trip and how nervous she was.  It turns out, this nice lady is actually from the Volta region in Ghana (in a town called Ho), and moved to the US only 3 years ago!  It made me happy because she eased my moms mind about the trip, and made me even more excited to have the opportunity to go there!

I met with my co-leaders this week regarding our projects—I will be co-leading handwriting and after-school activities at the Eugemot orphanage.  I am nervous about handwriting since I have never taught it before, but I am looking forward to learning a lot and challenging myself to think on the fly.  It will be good to have some background in handwriting when we learn more about it next fall.  After school activities should be fun as we are planning to teach how to make friendship and rainbow loom bracelets, and play active games such as red rover.  We are hoping to find a ball at the market when we get there so we can play other games such as four square and kickball.  I am lucky to be traveling with such an awesome group and I know that we will work well together to get everything accomplished and have a lot of fun, too!

I am mostly looking forward to getting to know the children and the culture in Ghana, and providing to them in any way that I can in the short time we are there.  I should be able to call a few times on our group phone, so I will call either my mom or my boyfriend, Marcus, and they will update others to let them know I am OK!  I am so fortunate for this incredible opportunity and I am grateful for the many people who supported me through my fundraising page.  Because of all my awesome friends and family, I will not need to pay much out of pocket which is such a blessing to me!  I will be blogging throughout the trip if we have access, but if not, I will after the trip.  Thanks for all the support and I cannot wait to share my amazing experiences!

The State of Rehab in Ghana by Lily

          Since I’m a little late to the blog posting game, I was struggling to find something to write about that hadn’t already been covered by one of my classmates. Then I remembered this video (http://www.youtube.com/watch?v=pnQl9VYtSB8) found by a doctoral student travelling with us that I had yet to watch. The video, made by the International Rehabilitation Forum, discusses the state of rehab services in Ghana and follows Tom Haig as he travels through the country using his wheelchair. During the course of our Tuesday lunch meetings during the spring semester, we have learned about the various disabilities we will encounter in Ghana as well as the culture and support for disabilities there, however this video was very helpful in tying everything together and helping me understand what to expect.

          The current rehab situation in Ghana is generally not good, but is still better than what many developing countries are working with. Throughout the video, Mr. Haig visits several hospitals and medical schools across Ghana. Most of these hospitals have a physical therapist, but occupational therapy is not mentioned and does not seem to be well integrated into the healthcare system. Because of these limited medical resources, Ghana has implemented a community based rehabilitation program (CBR). The major goals of the CBR program are to promote rights of people with disabilities by raising awareness and mobilizing resources, to establish links between health care providers and the community, and to strengthen the associations for people with disabilities.

          A huge attribute of CBR is the network it has created between people with disabilities. Ghana now has one of the strongest disability advocacy groups of all developing countries. In 2007, the group had a major role in getting the Ghanaian Disability Act passed. The act includes provisions on basic human rights, employment, education, transportation, healthcare facilities, and inclusion in national activities. Although the new laws may sound good on paper, Ghana is still having trouble putting them into action. This is evident when cameras follow Mr. Haig as he navigates through Ghana. A recap of some of the problems he encounters:

  • Only the main streets are paved and all the rest are bumpy dirt roads. During the rainy seasons, this means that people using wheelchairs may be blocked off from the rest of the community for hours or even days.
  • Trenches carrying drainage and waste run alongside the length of many roads with sometimes only a few boards laid to cross over, creating more obstacles for people using wheelchairs.
  • In the capital city of Accra, Mr. Haig discovers that able-bodied people are able to catch vans into the center of the city for what is about the equivalent of one US dollar. Unfortunately, these vans won’t stop for people with disabilities, forcing them to pay up to the equivalent of $25 for a taxi ride. For some Ghanaians, it could take weeks to make that much money.
  • The vast majority of old buildings do not have ramps or elevators

           While CBR is a good idea in theory and has brought a significant amount of change to Ghana since the time it was implemented, there is still a problem of the medical aspect of rehabilitation being ignored as soon as the family, community, and advocacy groups step in to assist a person with a disability. One rehab expert has compared community-based rehabilitation in Ghana to community-based neurosurgery. Often times, once a person is released from the hospital, they return home to their family who is unable to pay for medical equipment and supplies or modifications to their home like widened doorways for wheelchairs. When this happens, many people simply end up being left at home with no way to interact with community or live a normal life. Lack of proper medical equipment is also an enormous issue and forces many Ghanaians to construct their own makeshift devices (scroll to the 13:05 mark of the video to see a wheel chair made out of a white plastic lawn chair).

            Now I’ll try to end on a positive note. Many of the problems Ghana faces in regards to the medical aspects of rehabilitation can be addressed by occupational therapists. Our group will be working on some of these issues, including wheelchair positioning and modification and modification of toys and tools to allow children and adults with disabilities to play and work in their natural environments. We will also be educating staff at centers for people with disabilities on proper positioning and modification of wheelchairs. Near the end of the IRF video, a Ghanaian neuroscience professor offers her view on the state of rehab in the country today. She says that Ghana is very close to attaining a self-sustainable rehab culture, but still needs a little push in the right direction. I think I can speak for all of my classmates when I say that we are very excited to be a little part of that little push.

Welcome!

We are a few members of a 15 person team traveling to Ghana this summer from Virginia Commonwealth University (VCU). We are all first year Masters of Occupational Therapy students who have decided to take this opportunity to explore the world and apply skills we’ve learned in our studies to provide education and services to Ghanaian people. A special focus will be placed on children with disabilities and children who are disadvantaged by their family situation (e.g. orphans, street children). Our group will be splitting into two upon our arrival and heading to both Accra and the Volta region.

Part of our trip experience is sharing what we learn with others. A few of us have decided to to blog collaboratively about our experiences before, during and after the trip to share our varied experiences in one place. Our goal is for this blog to serve as a place for us to reflect on our learning prior to our trip, to share our personal and group goals for our time in Ghana, and to provide information about our experiences with others interested in working in Ghana or other developing countries.