3 August, 6:00pm GMT - Osu, Accra

Today was our first real outreach. We spent the morning sorting donated reading glasses by prescription, then headed to a church to set up our clinic. It looked as if word had spread to avoid the clinic (perhaps someone had had a bad experience the last time the clinic visited here), for as we drove around the village announcing the outreach visit, the villagers just stared and didn't follow us. The village coordinator, a local responsible for raising awareness for the event and arranging the facilities, couldn't give us a straight answer for why this was. In the end, we saw 46 patients, which was a mediocre but not terrible turnout.

On each outreach, there is normally a preliminary health talk to explain the purpose of the outreach, common eye diseases and their symptoms and causes, potential treatments, and how to use glasses and eye drops. This is followed by patients rotating through five stations: registration, where their explain their symptoms; visual acuity, where we measure distance vision; exam, where an ophthalmologist measures near vision and examines the lens and retina for problems; research, where any volunteers doing research ask patients survey questions with their consent; and distribution, where we give out glasses and medication, schedule surgeries, and type up the final diagnosis and treatment in a spreadsheet to send back to Unite for Sight. At this outreach, there was no talk, so the patients didn't understand what they were receiving treatment for nor how to administer eye drops. Somehow also, nearly every single patient was diagnosed with refractive error, even if their problem was actually vitamin deficiency or allergies. Nearly everyone was prescribed reading glasses and either eye drops or vitamins, but most only took the eyeglasses since there were GHC1 whereas all medication was GHC7. These are nominal fees charged to give the treatment some value so that patients will treat it with care, use it properly, and not feel as if they are receiving a handout; all the proceeds go towards paying for gas and the salary of the staff so that these outreaches can continue to happen and become somewhat self-sustaining. At the end of the outreach, there was no record of how many glasses or drops had been distributed nor of the amount of money collected, which was worrisome.

The outreach was dominated by older patients, mostly male. There were no children, and Lianna's research, which looks at caretaker's perception of eye health care for their children, revealed that this outreach had mostly grandmothers rather than mothers, and that they for the most part saw no reason to take their children in for eye exams. Of the few women we saw, most of them looked very upset by the experience, and nearly all of them had to leave to get money for their treatment. None of us spoke the language yet, and we received minimal translation help from the staff. I'm not surprised that they were distressed by being treated by foreigners speaking a language they didn't know examining and treating them for problems they didn't understand. Overall, I felt this overnight outreach was pretty ineffective, but hopefully the others will be better organized.

On the plus side, after we returned to the Telecentre, the veteran volunteers who have been here nearly all summer took us out for dinner. They are Brandon, Carrie, Sara, Hussain, and Diana, and they are all leaving before we get back from Kumasi, which is really too bad because they are an awesome crew. Ghanaian culture has shaped them so that everything comes naturally, and so that our clean clothes and our US-made snacks seem foreign and unnatural. I imagine we'll feel the same way after two more weeks here.

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