"What is you name?"

We both went to the orphanage today, partly so I could do some screening medical exams on some of the kids. The orphanage doesn't have enough money to keep the septic tank from draining through its courtyard, much less to regularly take the children in for medical care. Pastor Kofi wanted me to essentially triage who needed further evaluation.

We were greeted at the car with packs of children, each asking "What is your name?" and in turn telling us theirs. I promptly forgot most of the names, as it is tough to keep track of 100 children who are all in school uniforms. Pastor Kofi then gave us a tour of the orphanage, including the classrooms, the dorms (4 to a bunk bed), and the new bathrooms which they hope will have running water soon. We also saw the lovely septic tank, which has to be emptied every 2-3 months. They know it is full when the drainpipe starts leaking, which causes a small stream running down towards the classrooms. Pastor Kofi hopes they will soon have the 4 million cedis (about $430) to have the pipe extended away from the main buildings. We also saw the fish pond Pastor Kofi built to help feed the kids, and to use as a side business to raise money.

As I wanted to mainly see the kids who seemed sick, I asked Pastor Kofi which children he wanted me to see. He identified several from one class, and sat me down in front of the classroom had had me start examining them. A few children turned into a crowd after one of the teachers asked the kids, "Who else is sick?" Suddenly, everyone had a headache or abdominal pains.

Unburdened by charting or long discussions with parents, I was able to see about 30 patients in an hour and a half. The kids who were just looking for attention were easy to spot, but there was some interesting pathology. Only one child had to go to the hospital soon for an abscess under her fingernail. One teenager from Togo had a fever but was already taking antimalarials (she was also excited when Chris and Anne spoke French to her). A lot of the pathology was the usual well-child stuff: growing pains, plantar fasciitis (in one of the teachers), Osgood-Schlatter Syndrome in a 12 year-old boy who liked playing football. Sadly, there were a few children with conditions that would get prompt treatment in better circumstances, but there just isn't the money to pay for it. A teacher brought over one young girl who was hard of hearing, and she had bilateral chronic otitis media with effusion (In English: fluid behind the eardrum). I could only tell them to take her in to get evaluated at the hospital when the funds were available. I'm not even sure how oftern PE tubes are put in over here. Another boy complained of 2 years eye pain and sensitivity to light, and had very mild corneal clouding. Ideally I would have him see an opthalmologist to screen for cataracts, but again, that will have to wait. But for now, I could try the medicine of laughter, which I inadvertently gave after trying to say a few phrases in Twe to the kids.

All of the kids serenaded us with several songs before we left, and waved the bags of soap and toothbrushes that Chris and Diane had brought. And before everyone asks, this particular orphanage does not adopt out its residents, so Chris is not sneaking anyone back inside her trenchcoat.

Recent Good Local Food: Well, Funky's Pizza is not really local fare. But the pizza was baked in a woodfire over, and is an excellent dish to have with Club beer. Club is a local lager that is the closest thing to Budwiser in Ghana. Thus, I won't be trying it again.

Recent Bad Local Food: Meat pies, often purchased from street vendors and which sound good in theory. Mine had an overly buttery, crumbly pastry with a small dollop of sausage in the middle. The species of animal contained within the sausage is still a mystery.

Why Don't They Sell This in the U.S.?: Mango Fanta

Overly Religious Sign: "God Time is Good Gas and Metal"