Day 16-January 15, 2014

We began our final day at the Komfo Anokye Teaching Hospital in

Kumasi. As we walked inside, we were greeted by children and adults of

all ages who had come to see the talented Kumasi Cleft Palate Team for

pre and post-surgical consultation. The faces of tiny babies as young as

two- months stared back at us from colorful cocoons on their mothers' backs as we smiled and stroked their beautiful faces. Once in the clinic, we assessed the speech and language of children with repaired and non-repaired cleft lips and/or palates and provided recommendations. However, the highlight of the morning was the time we spent demonstrating safe feeding techniques to mothers of babies with non-repaired cleft palates.

While many of the mothers had figured out how to best feed their babies with cleft palates, some of the little ones were undernourished. An opening between the mouth and the nose makes it easy to swallow excess air. These babies also have difficulty creating enough suction to latch on to a nipple and lose nourishment through nasal regurgitation. We taught the mothers to hold their babies in an upright position, to burp them frequently and to keep them in an upright position for twenty to thirty minutes post feeding. The mothers caught on quickly to the feeding strategies, which were accompanied by beautifully drawn handouts illustrated by Tina. It was amazing to see the changes in both the mothers and the babies after a successful feeding and bonding session. One particularly tiny baby who began the session with a glazed-over look transformed into an alert little boy who gazed curiously at the faces around him. In addition to watching a mother learn how to successfully feed her child, it was incredible to witness the look of relief and thankfulness in the eyes of a mother after one compassionate smile or gentle touch of her child.

After a beautiful morning of therapy, we grabbed a quick local lunch before we returned to the hospital for a meeting with the world class Kumasi Cleft Palate Team. Dr. Peter Donkor, Head of the Cleft Palate Team and Dr. Solomon Obiri Yeboah, Specialist Oral and Maxillofacial Surgeon, were gracious enough to share their experiences performing cleft lip and palate surgeries in Ghana. Dr. Solomon explained that he had become the sponsor of a child whose cleft lip he had repaired. Not only does Dr. Solomon provide financial support to the child, but also includes the boy and mother in celebrations and gatherings as part of the family. For Dr. Donkor and Dr. Solomon, performing a cleft lip and/or palate surgery is only the first step of a life-long investment into the long-term investment into the well-being of these children.

We concluded an eventful day with a final shopping spree at the Kumasi Cultural Center for last-minute elephant paintings, beaded jewelry and other goodies. After packing our bags for the 7-hour morning bus ride to Accra we had our final class where George Odoi re-counted the past few weeks with a near-perfect memory. The night ended with a cheerful round of charades!

-Jenna

Day 15- January 14th, 2014

Today we spent the morning at Effiduase School, a unit school in which Belinda works. TC has been working with Belinda, a teacher of students with disabilities, for the past 7 years. Her class was comprised of 45 students ranging from age 3 to 22, all with a range of disabilities. We were all beaming as we walked into Belinda's classroom. All of the supplies that TC has donated over the years were seen throughout the classroom and was being utilized! The opportunity that we were given to co-teach with Belinda was an invigorating experience--the students remained engaged throughout the lessons, and were excited to learn. We were all in awe of Belinda's expertise as a teacher.  

 We also went to the local market with the students. There, they showed us how they use their AAC market cards to buy goods. It was amazing to see the market women recognize and engage with the students in an extremely friendly manner. 

After we left Effiduase, we added to our cultural experience by watching traditional kente cloth weaving, natural ink extraction, and wood carving. We also stumbled a upon a traditional Muslim funeral which we couldn't pass up. Funerals in Ghana tend to be a large celebration open to the public, and an all day event! We were warmly welcomed and included, and we were even asked to dance a traditional Ashanti dance in front of the everyone there.

Later in the evening, Belinda came and spoke to our class about the challenges she has faced while pursuing a career in special education in Ghana, and the process of starting a unit school in this community. Belinda's dedication to her students and to the field of special education has improved the the lives of  many despite the prevalent cultural taboos that still exist in Ghana.

---Katie

Day 14-January 13, 2014

We awoke bright and early this morning to our beautiful new digs in Kumasi. After breakfast, we boarded the bus to start our day at Komfo Anoyke hospital. It was a busy morning of introductions, and more assessments similar to those at Korle Bu. We saw kids with hearing loss, cerebral palsy, Waardenburg syndrome, and stuttering. For most of us, it was our first exposure to Waardenburg syndrome, which served as a particularly interesting case to assess and analyze.

Once our work at the hospital was complete, we grabbed a quick lunch to fuel ourselves for more market shopping. In the very back of the market was a painter who had no functional use of his arms and had to use his mouth to paint. He demonstrated his talent to us as we flipped through and purchased his pieces. Needless to say, they were all unbelievably stunning. However, that wasn't the only craft shop that stood out to most of us. There was a father and son who owned a woodworking shop with gorgeous handcrafted pieces. They even went so far as to carve it in front of you to make sure it's exactly what you want.

The night ended with a class discussion about the work we are doing and suggestions for next years trips.  

-Jenn

Special Post- Faruk's family

We all expected a simple happy story when we arrived in Larabanga to meet Faruk and his family. However, we witnessed the social and financial impact that cleft lip and palate has on families in developing nations all over the world. Faruk's father rejected him and his mother shortly after he his birth. The father, his family, and many members of the Larabanga community labeled Faruk and his mother as cursed.  Although the community gradually started to accept Faruk and his mother after the repair, they still were living off alms.

And then we heard Cynthia's story. Cynthia is Faruk's older sister, and she was living with her father's family in Damango.  However, her father disowned her after she brought water to Faruk and their mother when he was getting his surgery in July of this year.  Her voice broke and she fought back tears as she recanted her story, and spoke about her determination to take care of her mother and brother if she had the chance to finish school. Our hearts ached as we listened to this young girl's plea. 

The group decided to collect money to finance Cynthia through the remainder of her junior year; to help sustain Faruk and his mother; and to provide capital for the mother to start a business. We were happy to help this family temporarily; however, Cynthia still has to finish school.  We set up a committee to raise funds for this family, so please keep an eye up for future updates.

Day 13-January 12, 2014

On Sunday morning, we went back to Larabanga to see Faruk and his family.  We were excited to tell them that we had raised enough money to finance Cynthia's schooling for the next year so she could go back to her old school in Damango.  This school is much better than the one in her village and would give her a better chance at getting into a government high school.  We brought Cynthia to Damango with us where we were able to speak with the headmaster of her school and inquire about her returning to the school.  The headmaster gave his assent for her to start classes again so we happily began helping Cynthia buy supplies and material for a new uniform so she would be ready.  Since Cynthia would not be able to travel from her village to the school every day, we helped set up room and board with a family member who lives in Damango.  We also visited the Catholic Church where some of the women played traditional music for us and Cynthia was reunited with her school friends.  It was incredibly emotional and we are hopeful she will keep in touch by using her new cell phone.

After Larabanga, it was back on the bus for another "African massage" and many, many hours traveling south to Kumasi where we will be working for the next three days.  To pass the long hours, we laid down some tracks for the TC beats.  Get excited to hear them at home!

-Galadriel

Day 12-January 11, 2014

Today we drove from Tamale to Mole on the bus while enjoying an "African massage" from the unpaved, bumpy roads. Along the way we stopped to see a traditional village. The village consisted of several families living in mud huts. Unlike cities such as Accra where it's more common to have fewer children, men in this area would have multiple wives, and up to 20 children.  We met the elders of the village, and were introduced to a chief from the surrounding village who's daughter had a physical disability. The chief explained that the family treats the child just like all their other children,  and Jenna spoke on behalf of the group to agree with this approach, and to share how we try to accept such children in the US.

After this beautiful exchange, we made our way to Larabanga to visit Faruk and his mother. We were so excited to see how Faruk's surgery had gone. Faruk was a baby that the previous TC group encountered in May when they heard of a baby that was born with a cleft lip, and the rejection from the community forced the mother to keep him indoors since his birth.  The group pooled money together to help fund his surgery.  We were all so happy to see that Faruk's surgery had gone well! However, we quickly realized that this family still faced so many challenges. Since this story deserves its own posting, we will leave the details out for now. The group left the family with a promise to return the next day with a plan to help them.

The village interpreter lead the group to the oldest mosque in subsaharan Africa. It was fascinating to see the construction of the structure, and how there were multiple entrances for different groups (men, older women post menopause, the Imam).

We ended our day with a safari at Mole National Park.  The park rangers told us that we would be really lucky to see one elephant considering the time of our arrival. We climbed up on the roof of jeeps and prepared ourselves for a thrilling and dusty ride.  We were extremely lucky, and saw baboons, warthogs, bushbucks---as well as over ten elephants!!!

--Marissa

Day 10-January 9, 2014

Today was our final day at Korle Bu Teaching Hospital. We spent the morning providing outpatient speech and language therapy to patients who ranged in age and diagnosis, from adult stroke patients to young children with hearing loss, and everything in between! We are grateful to have had the opportunity to work with and learn from the Speech and Language Therapy team at Korle Bu, especially Dr. Albert Osei-Bagyina (the first Speech Language Therapist in Ghana), Josephine, Nana Akua, and Clement.

After thanking the Korle Bu SLT team for their clinical support, translating services, and cultural insight, we headed over to the Cleft Palate Clinic in the Korle Bu Reconstructive Plastic Surgery Centre. We saw over a dozen children with repaired and non-repaired cleft lips and/or palates. We made recommendations (for speech therapy, surgery, or other services) based on our parent interviews, speech and language assessments and an examination of each child's speech mechanism.

One 9-year old boy we saw was particularly interesting. He had multiple surgeries to repair his cleft lip, palate and fistula; however, the fistula had re-opened, resulting in hypernasal speech. The boy told us he was afraid to undergo further surgery, but after our SLP students counseled him on the importance of repairing his fistula (an opening along the stitched seam in the repaired palate), he agreed to have his fistula repaired. Yay!

Next, we presented our findings to the Cleft Palate Team. The team included surgeons, audiologists, Ear Nose and Throat (ENT) doctors, dentists, orthodontists, and medical doctors. Together, we met with each patient and his/her family to discuss the patient's condition and make recommendations for future care. It was a privilege to collaborate with such a remarkable and compassionate group of healthcare providers.

Before saying farewell to Korle Bu, we visited the boy whose cleft palate repair surgery we observed yesterday. He looked happy and well :) We are hopeful for a smooth recovery.

Tonight, we went to dinner in Osu (a neighborhood in Accra) - "Little London" - at Oxford Mall. We toasted to a successful few days! We're going to bed early tonight to catch a 6:00am flight to Tamale!

-Amanda and Jenna