Sunday Fun-day in Kumasi

After a successful, yet exhausting Saturday, we were all thrilled to sleep in.  Many of us slept at least eight hours with perhaps a small interruption from a friendly neighborhood rooster in the early morning.  By 9:30am we began trickling into the dining room for breakfast.  As more arrived, we reflected on the past weeks events and excitedly discussed our new surroundings to explore on this beautiful Sunday in Kumasi.

Refreshed and well fed, we made our way out to the pool at our temporary accommodation and received our fill of vitamin D and story time.  Shortly after, we were off to settle in at the Engineering Guest House at KNUST (Kwame Nkrumah University of Science and Technology).  Those of us who had time quickly checked out our new hotel rooms and reported positive findings to the rest of the group.  At last, we were ready to enjoy a day off from all of our hard work!

Post scene photo with the actors

With a short drive, we found ourselves in a large artisan market with shops selling various goods from jewelry to woodwork.  George Odoi had explained to us that Joel Kwadwo Acheampong, one of the artists, was unable to use his legs and arms but was able to create his paintings by holding a paint brush with his mouth.  Unfortunately, Joel wasn't at the market today but we saw some of his paintings and made sure we would be able to meet him during our next few days in Kumasi.  Many other shops were closed and as we were preparing to move on to another market, we notice a few people filming something.  George made his way over and asked a few questions.  Next thing we knew, we were starring in a scene in a Ghanaian movie!  The movie told the story of a blind man who had been orphaned at a young age.  A handful of us had lines in the scene and the director helped us through our 15 minutes of Ghanaian fame.

After a brief water and snack break, it was back to our mystery adventures in Kumasi.  With some more luck and bargaining, we found ourselves at a festive music event where performers were sampling new music.  There were hundreds of Ghanaians in attendance including a chief from a small village in the North.  George had explained to us that people from the audience would be taken from their seats and brought up to the stage.  With persuasion from the host of the event, friends would then have to help "bail" them out with donations.  The donors would bring money to the stage and place it upon their head, which was seen as a sign of respect.  One of our own, Skye MacLeod performed clarinet on stage with one of the Ghanaian musicians and while he performed, we each went to the stage and placed money on Skye's head.

Skye MacLeod jamming on stage in Kumasi

Some Ghanaians joined in and helped support Skye.  However, stiff competition was yet to come as a small boy of about 7 years came to the stage.  The crowd went wild.  He sang two great songs (one including the alphabet!) and blew us away with his dance moves.  Needless to say, people were running to the stage to praise his performance with donations.

We spent a little while longer listening to performers and being entertained by the host's enthusiastic mannerisms and intonation, although we were uncertain of what he was saying since he was speaking a native language from Northern Ghana.  Before leaving, two students mustered up the courage to delve into the events a little bit further.  One student was taken from the crowd and earned her donations to be freed and rejoin the group, while another joined the musicians, embracing the music and engaging in traditional African dance.

On our trip home, George explained to us how tribes in Ghana often receive different markings to help identify their tribe.  Although this isn't as common today, some still practice it and a number of students had asked about the different types of markings that they had noticed.  Interestingly, being in "Ashanti land" (Kumasi), we discovered that Ashanti's have a great disdain for tribal markings because there is a rule that no royalty can have marks on their bodies.

At the end of this adventure packed first day in Kumasi, we enjoyed our typical dinner of rice and chicken or fish.  We learned our groups for our next three days in the Komfo Anokye Hospital and Effiduasi Methodist Primary School's "Unit School" and held a short review of the cleft palate course that many of us had taken this past summer.  Winding down, we each headed off to our new rooms to rest up for an exciting week two of clinical work in our new location.

-Dana Peterson

Professional Development Teachers Retreat (Program for AAC) Day

January 7th, 2012

Clement Ntim showing communication passports

The day started off as we woke up early in pitch black darkness, heading to Nkawkaw 5:00 in the morning. Today was a special and important day for all of us (including Ghanaian special education teachers) as the Professional Development Teachers Retreat (Program for ‘AAC’ Day) was held in Nkawkaw. The purpose of the professional development retreat was to share language skills and knowledge with the special education teachers and do collaborative work with the Ghanaian colleagues in order to enable students with special needs to learn at higher levels. All the TC SLP students spent the night before preparing educational materials (e.g. name tags, name tag holders, AAC cards) for this significant event. Due to lack of sleep and exhaustion, many felt tired and dozed off in the bus until we arrived at the Osankwa hotel at 10:00am. However, as we got closer to our destination, we became alert with alacrity as we noticed two figures standing and waiting in front of the hotel. They were Belinda Bukari (Head Master/Teacher at a Unit School) and Clement Ntim who also were in charge of leading the professional development retreat. They warmly greeted us when we arrived at the hotel. When entering the conference room, we noticed that the room was packed by eager Ghanaian teachers who came from unit schools of many regions.

When the teachers retreat began, Clement initially acknowledged Cate Crowley and Miriam Baigorri’s endeavors and great efforts as he referred them as the “brain[s] behind this whole wonderful event” and showed deep appreciation of their hard work to make an educational and social change in Ghana. An introduction of the Communication Passport regarding its term, use, purpose, and needs for target populations was presented by Clement Ntim. His transparent explanation and passion for the aids that can be provided to children with nonverbal or limited verbal communication was impressive and straight to the point. He emphasized the value of the passport and the significant impact it will bring upon students who use it. The other teachers expressed deep interest and eagerness to learn about this communication system as they nodded their heads frequently while taking notes or pictures. Afterwards, the teachers and students broke into small groups to create a Communication Passport with collaborative work. The teachers were specifically instructed to select an appropriate candidate of Communication Passport from their class in advance to the retreat. Each group presented their Communication Passport with refreshing ideas and thorough details that amazed not only the TC students but the clincial directors and supervisor. 

Belinda introduced name tags with symbols and provided literacy and language activities that can be used and taught the teachers a simple song that can be used during attendance. The TC SLP graduate students also shared additional activities that could be applied monthly during attendance or classes for other subjects. Afterwards, AAC market cards were distributed to the teachers with information on how the AAC can be effectively used in practical settings. Toward the end of the teachers retreat, all teachers that participated in this professional development received a certificate to honor their work in Ghana and also their achievement in acquiring educational knowledge and skills. Thanks to the Wyncote Foundation, we were also able to purchase educational resources and books and distribute them to the teachers along with the certificate. The teachers retreat was a huge success. 
Here is a 3 minute video on the day
http://www.youtube.com/watch?v=ocJMBbD6r0g&feature=youtu.be

African sunset

We then continued on our journey for the final destination of the day, Kumasi. The plan was to stay at the KNUST School of Engineering Guest House. Unfortunately, when we arrived at the guest house, the manager made a mistake of reserving our rooms for the following day. Having no choice, we needed to seek another hotel accommodation for the night. The closest place was called King’s Tower, but running out of luck, we could not be able to get ourselves rooms. One colleague was witty enough to quote at that moment, ““All this in and out, back and forth, is worse than being in a relationship”. While heading toward another hotel, we were fortunate to see a beautiful African sunset. The red sun hung low in the sky, looking as if it was nested comfortably above the lush forests with beautiful tropical trees, creating a magnificent view. The African sun put a nice, pleasant smile on our faces making us forget about our worries for a moment. But then, back to reality, we kept on searching for another hotel the hope to have a place to rest. Our final stop was the Treasure Land Hotel, a place where Cate had mentioned to us a funny story about a Peeping Tom (or a Peeping Kwami) at this hotel. Hopefully, nobody will have the thrilling experience of meeting this mysterious figure.

It was a long day but nonetheless a memorable day that we won’t forget. We are looking forward to another adventurous day at Kumasi tomorrow.


Binna Lee

Day 4 at Korle-Bu Hospital

After breakfast, we left the hotel to Korle Bu Hospital like the past three days.  Students separated into their groups and started working with patients.  Each group saw approprixately 2-3 clients with different types of communication disorders.  Similar to the past few days, we conducted parent interview, assessed the patients, and made recommendations.  Today was less busy because George informed us that people in Ghana prefer to rest on the weekend including Friday.  Hence, there were less patients today.

Three students were assigned to the audiology clinic, where they performed hearing screenings.  Seven students visited the Reconstructive Plastic Surgery & Burn Center, where they read books to children, who had surgery.  These students visited the 5 months old baby, who had his cleft palate repaired on Wednesday.  It was observed that his grandma was feeding the child in an improper posture.  Subsequently, one student recommended and educated the grandma the proper feeding position (i.e., upright position) and food consistency (i.e., thicker liquid).  It was imperative to discuss the anatomy briefly because milk and water were coming out of the child’s nostrils.  It was reported that the child also has an opening in the secondary palate.  Therefore, the student explained how everything is connected.

After placement, we went to the Dean’s Guest House for lunch.  Our clinicial director, Miriam Baigorri, asked us to reflect on the first day and the last day, share what we learned, and what do we want to improve.  Many students thought about the questions while enjoying their lunch.  One student stated, “I learned a lot because I haven’t had a placement.  It’s so different compared to the clinic at home because we’re assigned to work with the same client throughout the semester.”  Another student replied, “I think my clinical judgment has improved significantly within the four days.”  She elaborated by saying how she exhibited difficulty identifying individuals with a disability initially.  Collectively, all students felt they have improved in making clinical judgments, conducting parent interviews, assessing the patients, and providing appropriate recommendations.  

We returned to the hotel around 3pm to pack for our next destination, Kumasi.  We all got together at 5pm to discuss tomorrow’s schedule and to prepare for the Professional Development Retreat.  Most people went to bed early because we have to wake up at 4:30am.  We are looking forward to our placements in Kumasi!!

-Yuk Lan Peng

Third Day at Korle-Bu

Our day started with extra excitement and alertness, anxious to keep up with the schedule for today without any delay. As excited as we were to see the new patients waiting for us at Korle-Bu Hospital, we also had another big event of the day in the back of our minds; it was the meeting with the Minister of Health of Ghana, Hon. Joseph Yieleh Chireh. We were blessed with the amazing opportunity through one of our colleagues, Christin Chambers, who was able to arrange the meeting with the Minister of Health through her fortuitous acquaintance. So all of us were packed and ready for the hospital earlier than usual to make sure that we had time to see all of the patients by noon, for which was when our meeting was scheduled.

When we arrived at the hospital, we were divided up into four groups with our three supervisors and with one group joining the Audiology clinic to participate in the hearing test procedures. It was evident that the student clinicians have increasingly become more confident and effective in treating a variety of patients at the hospital, even through the pressure added by the cameras and reporters from TV-3 channel that had gotten there early before our meeting with the Minister of Health. One of the most memorable patients today was a 19-year-old male who has stuttered his whole life before coming into the Korle-Bu speech and language therapy clinic for the first time today. He demonstrated with a severe stutter during his initial assessment for speaking and reading. However, with the use of the techniques introduced by the student clinicians, such as the easy onset and Melodic Intonation Therapy, the patient was able to produce sentences and read with perfect fluency. During the interview with TV-3 right after he came out of the therapy room, he commented that he “feel[s] a lot more confident now," and that he was "glad that [he] was here."

Our meeting with Ghana's Minister of Health

With another day of adventures and excitements at the hospital behind us, we moved to the place where the meeting with the Minister of Health was held. Veronica Adjei kindly arranged this meeting for us. First, a warm word of Akwaaba (welcome) was given by the Minister of Health as well as a few other board members of the Ministry of Health that were able to join us in our meeting. Then, Dr. Crowley and a few members of our team spoke briefly about our past few years of experiences in Ghana, some of our current goals and accomplishments, and about some future, long-term goals regarding the speech and language services in Ghana, such as the establishment of the Speech and Language Pathologist training programs in Ghana as well as a possible pilot program for providing speech and language services from the United States to patients in Ghana through the use of Skype. The constructive and positive responses from the Ministry of Health throughout the meeting has unveiled a vast amount of opportunities and potential for further development of independence and sustainability for the speech and language services in Ghana.

Sowah Tetefio, Celestine Sappor, Amy Erickson,
 Pres. Victor Asante, Sheila Zotorvie, Dr. Cate Crowley,
and Dr. Emmanuel Kitcher

However, meeting with the Minister of Health was not the last crucial event of the day. Thanks to another colleague of ours, Amy Erickson, our team had been invited to have a meeting with a member of the Rotary International club in Ghana by the pool-side at a four-star hotel. We were able to discuss with them about the current and following collaborative projects regarding the Audiology department at Korle-Bu Hospital as well as the new SLP training program in Ghana.

With all the exciting events and meetings aside, famished students were happy to end the day by shopping for some groceries of our individual preferences at reasonable prices (unlike the drinks and salads at the four-star hotel...) at the Accra Mall. We will surely have enough food and snacks to sustain us through another adventurous day at the hospital!

-Jinyee Kim

Day Two at Korle Bu!

We arrived eager for our second day at Korle Bu hospital (the 3rd largest hospital in Africa, with around 2,000 beds!) having an idea of what we would experience, with heightened confidence and enthusiasm. Upon entering the hospital, we were greeted by the stroke victim that some of the students had evaluated the previous day. He suffered a stroke 2 years ago, leaving him unable to express his thoughts through speech; however, through assessment, the students found his strengths lie in his comprehension and compensatory communicative abilities, using a variety of gestures, pointing, and intonation of vocalizations. Although he was able to get some wants and needs met, he lacked a more productive communication system that would allow him to communicate socially. After our strenuous day of therapy at the hospital, the students, motivated by this man's story, strengths, and deficits, stayed up late constructing a personalized booklet for the purpose of alternative and augmentative communication (AAC). They used many of his interests, such as football (that's soccer for those Americans out there reading this), favorite foods such as fufu (a traditional Ghanaian dish, not a bunny rabbit), and family members, to create various pages for his book.

Although we felt accomplished and excited to share our patient's new book with him, we were apprehensive about whether or not his family would see the value of it as a significant means of communication since we learned in our classes here in Ghana that the Ghanaian culture holds eloquent speech in high esteem. Our fears were put to rest immediately upon witnessing the reactions of the patient and his brother to the page depicting football pictures (i.e. foul, team names, good game/bad game, etc.). Those smiles were truly worth the trip to Africa. Not only was the patient excited to explore these new avenues of communication, but his family began to recognize him as a viable communication partner once again. We recognized even moreso that this would truly be a sustainable system when we suggested that the family add items to the book that they thought would be useful, and his brother without hesitation named several more favorite foods and mentioned that he knew someone who could draw them on the extra pages of the book. One student guided the patient through using this new communicative system and how it can progress over time, and worked with the family to model its use. Another student dispelled the previous notions that the family held that his symtpoms were caused by a disease, by explaining the incident that occured in his brain, and what he can expect in his recovery.

Imagine that this was only our first case of the day! Next we split into three groups with our supervisors to see the remaining patients seeking our help. One group ventured off for a tour of the facility and to meet with other rehab specialists, such as physical therapists and audiologists. In an unexpected yet exciting turn of events, a few of the students were offered the opportunity to view a cleft palate surgery, and quickly scrubbed in. While the students jumped at the chance to see this live surgery after learning about it in our cleft palate class back at TC, our documentary film maker, Skye, agreed in the spirit of filmmaking while the color drained from his face.

Meeting with the Chief Executive of Korle Bu Hospital

When given the option to rest at the hotel after all our hard work or to meet with the Chief of the hospital, we all mustered up the energy and decided, "when in Ghana...!". At the meeting, we applied all the rules we had learned about Ghanaian etiquette. Dr. Crowley scared us enough in our first meeting for us to remember NOT to cross our legs! Fortunately we remembered this tip, among others, such as the way a group is always greeted by counterclockwise handshakes with the right hand. Stay tuned tomorrow for more details on this and what's to come... hint: you may want to ask your cable providers for access to Ghana's TV-3 to see the TC students in action with a surprise guest!

-Alana Krieger

Our First Day of Clinical Work in Ghana!

Ready for our first patient!

The day we have all been waiting for has finally come.  After breakfast at the hotel we briefly discussed our plan for the day before heading on our bus.  We drove only a few minutes to Korle Bu Hospital, where we met Albert Osei Bagyina, who for decades was one of the very few practicing speech language therapist in Ghana. (nb: in the past several years a new Ghanaian SLT qualified in England and is practicing in Ghana, a U.S.-Trained SLP moved to Ghana approximately 6 months ago, and 3 Ghanaians who were sent to England to qualify by the University of Ghana have recently returned to Ghana and are waiting to begin work.) Albert was very welcoming and informative, explaining his role at the hospital and his plan for us while we are here!

We then began to see patients who have come to the hospital to see our therapist team.  Although we broke our big group into 3 smaller groups for the majority of the time, we began by evaluating 2 patients together.  The first, a toddler who arrived with his mother said few words, such as 'yeah' and 'bye' and pointed to objects he wanted without sounds, was assessed as having a language delay.  After discussing his development with members of our team, the mother was given recommendations to expand his speech by modeling 'bi' for 'biscuit' and waiting for him to respond.  The more he does this, as well as other techniques, the more he will connect saying a certain sound, and eventually a word, for a specific item.

The second, a school age boy who has had hearing aids for 2 weeks had problems articulating /s/ /k/ /r/ /z/ and /t/.  The team worked with him by isolating the trouble sound in a word, such as 'seal', by running his finger along his arm while saying the /s/ sound for tactile stimulation.  As the parents were very attuned to his speech abilities, they were able to give detailed information about his school life as well as progress since he has had his hearing aids.

While in 3 smaller groups, there were a variety of cases we were able to assess and evaluate, including individuals with Cerebral Palsy, Aphasia due to a Stroke, Expressive and Receptive language delay as well as many other communication disorders.  This gave us all the unique experience of working with different patients of different ages in the course of just a few hours.  We all came away from our first day of clinical work in Ghana with a sense of accomplishment that we were able to help parents and family members communicate better to their loved one, as well as more ways their loved ones can communicate with them!

After a busy morning at the hospital, our team, along with Albert, enjoyed a wonderful lunch while outdoors, learning more from Albert as well as discussing our plans for tomorrow.

Proverbial Coffin at Artists Alliance

The rest of the day was enjoyed by all, going to the W.E.B. duBois Memorial for Pan African Culture, visiting where the African American leader lived and was buried with his wife.  We then drove to Umanye House where there were many beautiful paintings, beadwork, items of clothing and carvings for sale by a local artist alliance. The most intriguing pieces of art, however, were the coffins, which are called Proverbial Coffins.  These amazing coffins are made into shapes very specific to the deceased lifestyle, or a symbol of their clan or tribe.  Coffins on display at the alliance included a Coke bottle, Nike sneaker and tiger!  It would not be unusual in Ghana for someone to be buried in a Nike sneaker coffin if they were a well known basketball player.  Aside from being functional, the amount craftsmanship and artistry displayed through these coffins is truly unparalleled.

We ended the day by going to a local market where fabric, shoes and food (as well as many other items) were sold before heading back to our hotel for dinner and discussion about the day. Tomorrow is sure to bring more rewarding experiences!

- Shemaiah Villani

Our Cultural Competence Continues...

Sunday, January 2nd

     After waking up ocean side in the huts of Coconut Grove Beach Resort, we enjoyed breakfast to the sounds of the waves of the Atlantic crashing behind us. After breakfast, we gathered our things and packed ourselves back on the bus. George started the ride by exercising our brains with a couple of riddles. Give them a try...''I am greater than God, I am more evil than the devil, and if you eat me you will die.'' and ''Every room has two and every corner has one. What am I?''

     As the answers were revealed, we arrived to St. George's Castle in the town of Elmina, the oldest and largest slave castle in Africa. Similar to yesterday's experience at the Cape Coast Castle, our tour guide, Kofi, led us through the male and female dungeons and the Door of No Return. Built in 1482 by the Portuguese, the castle was captured by the Dutch in 1637, purchased by the British in 1872, and finally taken over by the Ghanaians in 1957. The beautiful backdrop of the ocean was again overshadowed by the horrifying statistics of the castle's history: Throughout the 400 years of slave trade at St. George's, 3 million people were captured, of which two-thirds of them died. Despite all of the appalling information Kofi revealed, we ended our tour with a very appreciative "maydasay'' (thank you).

    Next, we traveled a short distance to a small fishing village in Elmina and were greeted by a local fisherman named Lionus. The overwhelming smell of fish and smoke accompanied the sight of women and children hard at work in their daily routine. While several children loaded and carried long, wooden pallets of fish to be cooked and smoked, women packed the smoked fish for delivery to the market. As Lionus led us though the village describing the process of catching and preparing fish, we were greeted by many young children of the village. We shared our names and high fives with the children and a few students learned the cultural art of balancing a baby on their back with a wrap. The hard, skilled workers fish everyday except Tuesday, which is the day of rest for the workers (and the fish)!!!

     The three and a half hour trip back to Accra left time for George to further engulf our minds with the culture and history of Ghana. He discussed various stages in a Ghanaian's life focusing on the rituals surrounding birth, marriage, and death. Guess which of the following is true: 1) You can go to a stranger's wedding whenever you want (bring a bag of rice of course). 2) It takes anywhere from one month to one year for a Ghanaian to be buried after he/she dies. 3) In the past, the birth of twins was seen as a curse. You guessed it! They are all true! Can you believe it?

     We survived the "bottle neck" (traffic jam of Ghana) with the help of a local woman selling plantain chips in the street. She briefly joined us on the traveling bus, where she sold more plantain chips than she had sold all day! This served as an appealing appetizer before preparing for dinner at Asanka, the local chop bar. The daring ones amongst us ate the traditional Ghanaian dishes of Banku and Fufu with their right hand, as it is disrespectful to eat with the left. As dinner winded down, we gathered in a circle to learn the modern Ghanaian dance, Azonto. Although a few of us had difficulty coordinating our foot tapping with simultaneous hand and hip movements, we all shared laughter and singing until we closed the restaurant.

     This weekend's experiences have provided us with significant insight to Ghanaian culture, which is crucial for our upcoming clinical work. Our  increased knowledge and understanding of the culture will allow us to be more sensitive and competent clinicians when working with our first patients tomorrow. As we anxiously and eagerly await our first day of clinical work, we drift off to sleep with the rhythm of African music in our minds...

-Brenna Zielinski