Friday, 29 March 2013

My Biggest Lesson: Advocacy by Carly Pain





            After being in Ghana for almost two months now, it is difficult to say what my biggest lesson has been because there have been so many! Having to choose just one, I believe that my biggest lesson has been the importance of the nursing role of patient advocacy. There have been numerous times during my stay here where I have witnessed the need for a patient advocate or have been the advocate myself.

            As I am sure you can imagine, hospitals in Ghana are much different from hospitals in Canada. Saying this, I would like to stress that the differences are not all negative. In fact, there are many tips from Ghanaian hospitals that Canadian hospitals could pick up on, such as maternal and pediatric health information booklets.

One difference that has been prominent for me is the variation in family-centred care. For example, on multiple occasions I witnessed husbands being shooed away when they tried to accompany their partners to their postnatal appointments. Sometimes the husbands were simply yelled at by the nurses for attending. However this is not universal; family-centred care was promoted at one of the polyclinics that offered priority appointments to the babies who had both their mother and father present. We observed how beneficial it is for nurses to adjust their practice and effectively advocate for maternal patients. Not only does this advocacy involve the father in the pregnancy, but it also helps to form a bond between the mother and the baby.

            In other instances, I have had the opportunity to advocate for the patients. Primarily, this has been teaching staff members’ best practice techniques during patient care in a variety of settings. These settings include pediatric emergency, maternity, and the female outpatient department. One instance that stands out for me involved a one-month-old premature twin boy. He visited the neonatal intensive care unit (NICU) for a dressing change for a wound caused by an infected intravenous line. The neonate was still very small for his age and was still quite vulnerable to infection. The nurse informed me that she was going to leave the open wound uncovered to save on resources. Shocked, I told her that it would be best to cover the wound as leaving at open would only increase his risk for infection. This would subsequently lead to more resources being spent on treating the worsened infection. Much to my surprise, the nurse listened to what I had to say and covered up the wound. After reflecting on the day, I realized that one of the most important roles of my job as a nurse is to ensure that patients are receiving the best possible care and guaranteeing that the best practice is made known in unclear situations.

            In Canada I have had many opportunities to advocate for patients. One of the most important aspects of care in my daily nursing practice is focusing on precautions to prevent pressure ulcers. Patients often cannot move themselves or speak for themselves when they have remained in the same position for a long period of time. Consequently, there are high rates of pressure ulcers on the unit I work on. In order to prevent this, I make it part of my everyday nursing care to turn the patients minimum every two hours, apply pressure relief boots, and keep their skin dry. On a busy day, I often witness these preventative measures being overlooked and hear the phrase “it’s good enough for now” or “I’ll try and do it later.” Unfortunately the voices of patients in need are often not heard. It is our role as a nurse to advocate for them, to make their voices heard.

            I think that the importance of advocating for patients in Canada is often overlooked in part due to the availability of resources – we often place other aspects of care at higher priorities. After working in settings with an astonishing lack of resources, it became apparent that advocating for patients is something that must be practiced and enforced by nurses worldwide. 

Myths about Africa: Using Traditional Medicine in Ghana by Kelsey Klippenstein



 



            As our clinical time in Ghana is coming to a rapid close (only two weeks until we’re graduate nurses – time flies!), we have been visiting different facilities every day as part of our cultural experience. This week we are spending a day at each of the following facilities: the Osu Children’s Home, Princess Marie Louise Children’s Hospital, Korle Bu Teaching Hospital, and the Accra Psychiatric Facility. Last Thursday, we were all very excited – and maybe a little bit nervous – to visit a traditional healer! Now, when you read “traditional healer,” what was the first image that popped into your mind? I will not lie to you. I was expecting one of the makeshift lean-to’s we have seen on the road, claiming to have cures for everything from the common cold to gonorrhea and more, with Rafiki chanting behind it and mixing something in a squash. Pushing it? Maybe. However, after discussion with my peers it became clear that I was not the only one in the group who imagined something along the lines of a witch doctor, or a “quack doctor,” as they are fondly referred to in Ghana.

            Imagine our surprise when we pulled up to a very large, concrete building with a large sign indicating that we had arrived at the Centre for Scientific Research into Plant Medicine (CSRPM); this was definitely not the traditional healer that we were expecting! As it turns out, we were sorely mistaken in what we had imagined our adventure was to be that day, but we learned a lot about traditional healers and medicine. First and foremost, we learned that this practice of traditional healing does not involve crazy antics or quack doctors.

As a developing country with an average life expectancy of less than 60 years, Ghana has the need for “effective, appropriate and efficient means of meeting the health needs of its growing population” (Tabi, Powell & Hodnicki, 2006, p. 52). This approach blends aspects of both traditional and modern medicine due to the lack of medical resources, cultural traditions, and a belief that one must have a deep understanding of their health, life, and being (Tabi et al., 2006). Typically, the choice of an individual regarding choosing traditional or modern healing methods will depend on the illness and its perception by other relatives or friends; however, rural populations will more often seek the help of traditional healers as they are more affordable and accessible in such regions. Tabi et al. (2006) state that, “80% of the population in Africa uses traditional medicine for health care” (p. 53).

There are several different types of traditional healers in Ghana, including: traditional pharmacists, who use herbal medicines made from leaves, roots, or other animal and plant parts; plant drug peddlers, who travel selling herbal medicines; and, “the priest and priestess of deities and gods who use techniques and rituals in healing practices” (Tabi et al., 2006, p. 53), who use divination and rituals to cure what they believe to be spiritual diseases. During our tour of the CSRPM we also learned about herbalists: doctors who begin in medical school and choose to specialize in and work with traditional medicines. 

In Ghana many families and individuals do continue to use homemade remedies that have been passed on through generations, but that is not the image of traditional healing that the CSRPM projects. The centre has held World Health Organization Collaborating Centre status and continues research and development of herbal medicines with hopes of achieving their vision “to make herbal medicine a natural choice for all” (CSRPM, 2008).

When local individuals believe they have found a remedy from a natural source, it is brought in to the centre where it undergoes testing in a variety of departments: phytochemistry, pharmacology and toxicology, microbiology, production, plant development, and scientific information. After this, the CSRPM sends a report to the Ghanaian Food and Drug Administration (FDA) who then decides whether or not the product is safe for market. The CSRPM also runs an outpatient clinic where patients see the herbalists and can get traditional remedies – even visiting nursing students from Canada can purchase ointments for mysterious bug bites!

It is important for us as nurses, both internationally and at home in Canada, to recognize different cultural traditions and indigenous beliefs of our patients. Especially in Ghana, traditional and modern medicine will always be a large part of the healthcare system and it is important to acknowledge our role in helping patients recognize the positive elements of both (Tabi et al., 2006).

So while the vision and use of traditional medicine may not be as strange and extreme as we may have thought, the origins and current beliefs surrounding these practices are deeply rooted in the Ghanaian culture. Herbal remedies have been used for generations and hopefully, through the work of facilities such as the Centre for Scientific Research into Plant Medicine, they will be considered viable, scientifically accepted, resources for ailments all over the world.

References

Centre For Scientific Research Into Plant Medicine. (2008). Welcome to CSRPM. Retrieved from http://www.csrpm.org/index-2.html

Tabi, M., Powell, M., & Hodnicki, D. (2006). Use of traditional healers and modern medicine in Ghana. International Nursing Review, 53(1), 52-58.

Abayiwa’s Story by Rachel Gaudry


Explaining her vision for Obhema Child Care & Youth Development Centre


Ghana is a country supported by a large number of intelligent, accomplished and determined women. These women see the potential in their country, and are willingly to devote their entire self to bettering Ghana. Abayiwa is one such example. Although she stands only 5’4 tall, she is an absolute force of nature, commanding respect from all. She is also incredibly warm, humorous, and our informal guru in Ghana. I’ll spare you the details, but the woman knows how to get things done. Her sense of humour is evident in the fact that although she has another name, she prefers to be called Abayiwa or “young woman.” I want to share her story with you, as an example of how individual fortitude can be a catalyst for positive change.

In front of the 3-classroom school that Abayiwa is building

Abayiwa has an extremely successful career, with a completed degree in Nursing, her Masters in Philosophy, and a soon to be completed Master of Arts in Theology. What are most impressive, however, is how she came to achieve all of these things, and what goals have direct her life. Abayiwa’s story begins at age five. She was living with her Grandmother in Anagyi in the western region of Ghana, when an American volunteer visited her school. This woman spoke of the value of completing a full education, always working towards self-improvement, and the importance of seeing the world. As her school was a unique mix of children from many different Ghanaian tribes, she had already developed a strong sense of unity and tolerance for others. These new concepts, however, resonated deeply. Throughout her childhood, Abayiwa suffered from a variety of illnesses, including a life-threatening bout of Guinea Worm and two occasions of Polio. Thankfully her Grandmother, who was a traditional birth attendant, was able to nurse her back to health. These challenges, as well as the strength of her Grandmother, affirmed her decision to pursue nursing as a career, and to one day found an institution in which others in similar situations could be cared for.



Although her health improved after childhood, she faced a new set of challenges throughout her high school years. Without any financial support from her family, and living alone in the city, she was barely surviving. When she passed out from exhaustion and hunger in class one day, her concerned teachers proposed Nursing School as a possible solution to her predicament, as she would be fully taken care of. Again, her struggle through her teenage years made her question, “how many others are in my situation, and what can I do to help?”Abayiwa was very strong academically, and upon completing her 3-year diploma, decided to pursue midwifery. Her career continued to develop when she travelled to Nigeria on a scholarship to complete further education. Impressively, she returned home as the first Ghanaian woman to obtain a nursing degree. Unfortunately her credentials made her overqualified for most nursing positions available. She was eventually posted in the Brong-Ahafo region pioneering in a new field - family planning. Investing herself completely in her responsibilities, she rode her bicycle from one inaccessible hamlet to the next. Her deep love of cultural perseverance and community values emerged when she established a gathering place, central to all of the hamlets, for families to come together to hear her health talks, receive immunizations, antenatal care, and dance.  There is no doubt in my mind that she was a well-loved and respected presence when she explained that all of the young children would bathe in preparation for her arrival. What is perhaps most admirable was that she worked directly in the field, below her high credentials, in an extremely rural and challenging environment. She understood the importance of community development, and endeavored to unite and support all of those she encountered.

The reception area with Mango trees in the background

Eventually, the Minister of Health took notice of her outstanding efforts, and requested her skills in another position. A number of years have now passed since her “bike and hamlet” days, in conjunction with a number of successful promotions and accomplishments in her career. One thing that has not changed, however, is her commitment to caring for others, especially vulnerable populations. In fact, her 5-year-old vision, dreamt so many years ago, has finally come to fruition. Obhema Child Care & Youth Development Foundation, her own personal NGO, is up and running. With the land already purchased, her main focus is constructing the necessary buildings, and fixing up the present ones. Her complete and total commitment to her project was evident when she spoke of the children developing their talent and potential, the elderly coming to partake in events, and how green the grass will be for everyone to enjoy. Her vision is that this will serve as a community center, fully equipped with a school, living quarters for orphans, a recreational facility, and of course, a cultural hub.

When I asked Abayiwa what she thought some of the strengths of the Ghanaian people are, she immediately responded with a well-known Ghanaian slogan, “the Spirit of Community.” No one can possibly question what she is passionate about, or what she values. When asked what she believes to be the most important lesson that we, the 11 Canadians visiting, should take away from this experience in Ghana, she expanded the “Spirit of Community” to apply at a global level. She wants us to value cultural competence, learn from each other, and build on each of our different strengths. When “we are one,” we create the potential for change. Abayiwa is a leader, someone with ideas and ambition. This is only her individual story, but it serves to give voice to the countless other stories of passionate and visionary Ghanaians striving to build their country from the bottom up. 



Our thankfulness for Abayiwa’s hospitality and support are beyond words. Her extraordinary character and cultural insights have indisputably enriched our experience in Ghana. We are eternally grateful. 

Grandma Abigail: A Picture of a Ghanaian Midwife by Stephanie Duval



Part of what makes Ghanaian culture rich and unique is the value placed on friendship and respect.  From the very first day I arrived in Accra, I have had the pleasure of meeting some remarkable individuals, including professionals and patients at 37 Military Hospital, new friends at the International Student Hostel (ISH), and extraordinary characters that are part of my daily experiences.   I am delighted to have the opportunity to blog about one of the most influential individuals I have met in my clinical practice to date.  I am hoping that the following will enable the reader to imagine this “larger than life” personality and do our Grandma Abigail the justice she deserves. 

Annabella Ablah Anderson-Agbolosoo (a.k.a. Grandma Abigail), was born on May 3rd, 1955, in the small rural community of Damongo in northern Ghana.  She is the 7th child of ten (three boys and seven girls) born to Class I Warrant Officer Charles Ackummey Anderson-Agbolosoo and Patience Adzo Afatsawoo.  Her father was a well-respected military man who retired after his service in the Gold Coast Regiment.  Her mother was an influential “Jill-of-all-trades” who worked primarily as an independent wholesale vendor with some of Ghana’s largest companies (GB Olivant).  Grandma Abigail describes her upbringing as “lovely” and “normal” albeit strict.  Her parents raised their children to value the importance of formal education as the gateway to bigger, brighter futures.  During her infancy, Grandma Abigail moved to Tamale with her family where she completed her schooling.  Her father eventually joined the civil service and transferred to the Volta region into the ministry of health – a decision that later influenced four of the Agbolosoo girls.    

           

The hard work and emphasis on education in the Agbolosoo household ultimately proved a major advantage.  Four of the ten children (all girls) moved on to post-secondary education and became successful registered nurses—nurses of extremely high-standing I might add!  However, nursing was not always in the cards for Grandma Abigail.  Her original career plan was to become an air stewardess.   “Unfortunately for me, my father was strongly against it, and forced me to go to nursing school (Midwifery)” Grandma Abigail writes, “His reason was that, compared to being an air stewardess where I ran the risk of dying in an air crash, nursing (Midwifery) was a very respectable and important job which would place me among the top hierarchy of important people in the district.”  Grandma Abigail explains that the conflict that ensued with her father created a very “unpleasant period.”  Both parties adhered to a stonewall silence and avoidance in hopes that the other would concede.  Grandma Abigail’s determination and will was so strong that in order to get her to nursing school, her uncle had to forcibly pack her into a car, in tears, and coax her to stay. 

Admittedly, she fell in love with the nursing profession as she advanced in her training.  “I discovered that I loved being involved in the entire process of caring for others and nursing them to good health.  Most importantly I was and still am fascinated by the miracle of childbirth.  I derive a whole lot of satisfaction and happiness from helping women and their families as a whole… and preparing them for that special moment – when the mother and baby see each other for the first time.” 

The road to becoming a registered nurse and midwife was not without its challenges.  It was a delight to listen to a nurse with 35 years’ experience regale me with her stories as a nursing student.  Need I tell you that despite the cultural differences, Ghanaian and Canadian nursing students have a lot in common from sisterly love and camaraderie, minor tiffs with tutors and work colleagues, and at least one really good embarrassing story. 

Here’s Grandma Abigail’s embarrassing moment:  During her first observation of a live birth, Grandma Abigail and two of her nursing colleagues collapsed and missed the entire process!  To make matters worse, the three fainters spent the rest of the day crying in fear that they would be dismissed from the nursing program.  The house mother had to console them all night.  Grandma Abigail pinpoints this moment as the one in which she finally embraced nursing as her true vocation. She hasn’t looked back since and is a proud Officer of Midwifery today (graduated in 1978).   


    
A glimpse of Grandma Abigail, beauty pagent contestant, mother, professional nurse and more.

Aside from her professional accomplishments, Grandma Abigail’s personal life and struggle is also extremely noteworthy.  She married a young military officer (retired a Major) in 1980 and together they produced three beautiful children (Rosetta, Patricia-Lois, and Mona-Lisa).  Grandma Abigail describes her marriage as unstable and unsupportive.   The union was severed in 1986 when Grandma Abigail received permission from her mother and uncle to divorce.  Her tenacity and determination was then channeled into raising and educating her three lovely daughters  (she later conceived a fourth daughter with her 2nd husband whom currently lives in the United States).  

Grandma Abigail states that her uniqueness stems from having to combine the busy schedule of a midwife and single-handedly raising four beautiful, highly responsible and inspiring women.  “I have had to play the part of both a father and a mother simultaneously, overcoming many great obstacles along the way and enduring many frustrations and harrassment from family, society, and working colleagues for being a single parent.  Most times in tears.”  The financial stress of raising four children on a single income often proved overwhelming.  As a result of “God’s grace,” hardwork, and several selfless individuals, Grandma Abigail was able to overcome the financial strain and pay private education fees and post secondary studies for all four girls.  “May I also give special thanks to my mother (who is 93 years old).  My mother is an angel.”    



To this day, Grandma Abigail continues to be a source of encouragement and inspiration to other single mothers who have been victims of ridicule and discrimination.  Her message to these woman is to never give up–empowerment is key.  This informs her nursing philosophy that women derive a source of power from their natural ability to carry and bear children.  The choice to maintain a healthy pregnancy, in large part, is up to the mother.  Grandma Abigail’s role is to uphold this belief and provide expectant mothers with the education and support required.  In turn, unnecessary medical interventions and maternal mortality will be reduced. 

Daily obstacles in the life of a Ghanain nurse are many.  Poor and unsanitary working conditions and restricted access to essential equipment are at the top of the list.  Regardless, Grandma Abigail takes extraordinary pride in her profession and feels that society recognizes the special role midwifes play in the lives of women.  “Nursing above all is a progressive calling.  Nursing is a calling to honour humanity.  Nursing is a noble profession.”  Funnily enough, Grandma Abigail inadvertently quotes one of my ultimate favorite bands.  “All you need is love” she tells me.  Well that’s exactly what I have for Grandma Abigail despite the fact that she threatened to cane me for touching her radio…jokingly I might add!  Thank you Grandma Abigail for sharing a part of your story with me.  God bless.  



   


Wednesday, 27 March 2013

Myths about Africa: Traditional Medicine in Ghana by Kelsey Klippenstien







             














           As our clinical time in Ghana is coming to a rapid close (only two weeks until we’re graduate nurses – time flies!), we have been visiting different facilities every day as part of our cultural experience. This week we are spending a day at each of the following facilities: the Osu Children’s Home, Princess Marie Louise Children’s Hospital, Korle Bu Teaching Hospital, and the Accra Psychiatric Facility. Last Thursday, we were all very excited – and maybe a little bit nervous – to visit a traditional healer! Now, when you read “traditional healer,” what was the first image that popped into your mind? I will not lie to you. I was expecting one of the makeshift lean-to’s we have seen on the road, claiming to have cures for everything from the common cold to gonorrhea and more, with Rafiki chanting behind it and mixing something in a squash. Pushing it? Maybe. However, after discussion with my peers it became clear that I was not the only one in the group who imagined something along the lines of a witch doctor, or a “quack doctor,” as they are fondly referred to in Ghana.

            Imagine our surprise when we pulled up to a very large, concrete building with a large sign indicating that we had arrived at the Centre for Scientific Research into Plant Medicine (CSRPM); this was definitely not the traditional healer that we were expecting! As it turns out, we were sorely mistaken in what we had imagined our adventure was to be that day, but we learned a lot about traditional healers and medicine. First and foremost, we learned that this practice of traditional healing does not involve crazy antics or quack doctors.

As a developing country with an average life expectancy of less than 60 years, Ghana has the need for “effective, appropriate and efficient means of meeting the health needs of its growing population” (Tabi, Powell & Hodnicki, 2006, p. 52). This approach blends aspects of both traditional and modern medicine due to the lack of medical resources, cultural traditions, and a belief that one must have a deep understanding of their health, life, and being (Tabi et al., 2006). Typically, the choice of an individual regarding choosing traditional or modern healing methods will depend on the illness and its perception by other relatives or friends; however, rural populations will more often seek the help of traditional healers as they are more affordable and accessible in such regions. Tabi et al. (2006) state that, “80% of the population in Africa uses traditional medicine for health care” (p. 53).

There are several different types of traditional healers in Ghana, including: traditional pharmacists, who use herbal medicines made from leaves, roots, or other animal and plant parts; plant drug peddlers, who travel selling herbal medicines; and, “the priest and priestess of deities and gods who use techniques and rituals in healing practices” (Tabi et al., 2006, p. 53), who use divination and rituals to cure what they believe to be spiritual diseases. During our tour of the CSRPM we also learned about herbalistsdoctors who begin in medical school and choose to specialize in and work with traditional medicines. 

In Ghana many families and individuals do continue to use homemade remedies that have been passed on through generations, but that is not the image of traditional healing that the CSRPM projects. The centre has held World Health Organization Collaborating Centre status and continues research and development of herbal medicines with hopes of achieving their vision “to make herbal medicine a natural choice for all” (CSRPM, 2008).

When local individuals believe they have found a remedy from a natural source, it is brought in to the centre where it undergoes testing in a variety of departments: phytochemistry, pharmacology and toxicology, microbiology, production, plant development, and scientific information. After this, the CSRPM sends a report to the Ghanaian Food and Drug Administration (FDA) who then decides whether or not the product is safe for market. The CSRPM also runs an outpatient clinic where patients see the herbalists and can get traditional remedies – even visiting nursing students from Canada can purchase ointments for mysterious bug bites!

It is important for us as nurses, both internationally and at home in Canada, to recognize different cultural traditions and indigenous beliefs of our patients. Especially in Ghana, traditional and modern medicine will always be a large part of the healthcare system and it is important to acknowledge our role in helping patients recognize the positive elements of both (Tabi et al., 2006).

So while the vision and use of traditional medicine may not be as strange and extreme as we may have thought, the origins and current beliefs surrounding these practices are deeply rooted in the Ghanaian culture. Herbal remedies have been used for generations and hopefully, through the work of facilities such as the Centre for Scientific Research into Plant Medicine, they will be considered viable, scientifically accepted, resources for ailments all over the world.

References

Centre For Scientific Research Into Plant Medicine. (2008). Welcome to CSRPM. Retrieved from http://www.csrpm.org/index-2.html

Tabi, M., Powell, M., & Hodnicki, D. (2006). Use of traditional healers and modern medicine in Ghana. International Nursing Review, 53(1), 52-58.

Tuesday, 26 March 2013

My Biggest Lessons by Kirsten Ziegenhagel




Since I first stepped off the plane in Ghana every single day has been a life lesson for me.  Firstly, I have gained a greater appreciation for my own country and a realization of how fortunate I am.  Secondly, I have learned a lot about what kind of a person I want to be and have redefined my values.  Lastly, I have discovered the importance of humility in my personal life as well as in my nursing career.

My appreciation for Canada has grown tremendously over the last month and a half.  Before leaving Canada, I would frequently complain of trivial issues such as the annoyance of being stuck in traffic on the Anthony Henday or that the coffee shop was no longer selling my favourite drink.  In terms of our health care system I would complain about issues such as the staff to patient ratio and emergency wait times.  Although these are issues that our healthcare is faced with, I can now see that other places in the world are dealing with much bigger problems and disparities. 

In Ghana, the healthcare system is completely overwhelmed.  The nurses have to battle with decisions on who can receive care for based on the resources that are available to themAn example would be that if two patients were in need of a ventilator, the hospital may only have one and the staff would have to make an executive decision on who gets the ventilator.  This is a problem that Canadians will likely never have to face.  The lack of resources and healthcare providers is a huge problem in Ghana. The nurse to patient ratio can be as high as sixty patients to three nurses, making it extremely difficult to provide adequate care for all patients.  These types of healthcare issues, as well as the disparity I see while driving to the hospital has allowed me to appreciate the resources and support we have in Canada.

Secondly, I have been able to reflect upon myself and my own values.  I feel empowered to do more not only for the rest of the world, but for the people within my community.  I have had the opportunity to meet some amazing Ghanaians that are making a huge difference within their community.  This past weekend, we were fortunate to go to a small village and see firsthand how an individual in the area was making a difference.  This person had developed his own NGO and had been actively involved in ensuring that the children of his community could go to school. His actions have empowered me to become more involved not only by donating money or resources when I can, but by volunteering my time and advocating for NGO’s that I know are putting their money and resources directly into the people they are helping.  I have learned that there is a lot I can do to make a small difference in someone’s life.

 I have also been able to evaluate what is important in my own life.  I realize now more than ever that my family is the most important aspect of my life.  While nursing in Ghana, I have been able to see just how precious life really is.  People are dying needlessly from illnesses that may have been prevented or treated in Canada, and I have seen several individuals pass away before they should have.  Seeing a one year old girl pass away opened up my eyes to how life can slip away in a moment.  I plan on spending more time with my loved ones when I get home and really cherishing them.  I plan to put aside all of the squabbles we may have had before I left and focus on enjoying my moments with them.  This has been a huge revelation for me, and I do not think I would have been able to grasp just how precious life is without my experiences in Ghana.

Lastly, I feel incredibly humbled by the experiences I have had so far.  Cultural humility “requires embracing the belief that one’s own culture is not the only or best culture” (Byrd et al., 2012).  I myself did not have this belief, however I had no idea what to expect from Ghanaian culture.  I have been able to embrace it and learn a lot about my own culture and beliefs through watching the way the Ghanaians interact and go about with their daily activities.  I have also been humbled by the disparity that I have witnessed in Ghana. The issues that people face here are much greater than I could ever have imagined. Their strength to continue never ceases to amaze me, and I feel grounded by what I have seen. While walking through a small village recently, almost all of the people lived in shacks and many children appeared malnourished due to their swollen bellies.  I had never experienced poverty like that before, and it sickens me that I had complained so much about trivial issues at home. 

This experience has taught me that the rest of the world has so much to offer and I can learn so much from people of other cultures.  In my nursing career there is a lot of focus surrounding “cultural awareness, knowledge, attitudes, and skills” (Chang et al., 2012).   Having this experience in Ghana, I can now fully appreciate the necessity of being culturally competent in my career as a nurse.  I feel extremely blessed to have been able to experience Ghana and the lessons I have learned during my time here.

References

Byrd L, Schuessler J, & Wilder B (2012). Reflective Journaling and Development of CULTURAL HUMILITY IN STUDENTS. Nursing Education Perspectives, p. 96-99. Retrieved March 17th, 2013 from: EBSCOhost.

Chang ES, Dong X & Simon M (2012). Integrating cultural humility into health care professional education and training. Advances in Health Sciences Education, p. 269-278. Retrieved March 17th, 2013 from: EBSCOhost.