Day 16 & 17: The End

On my last day, Tuesday, I followed my usual routine. In the morning meeting, Dr. Mahmud led a presentation on epidural steroid injections for back pain. He detailed their history, rationale for usage, and indications and contraindications (when to use them and when not to use them). The bulk of the discussion focused on comparing injection approaches and the importance of fluoroscopy and contrast to correctly guide the needle.

I spent the rest of the day my favorite way- teaching and playing with the children. Since it was my last day, Auntie Pat and I decided to break out the chalk so the kids could play hopscotch (modified for their backs), practice their writing, and draw. We led activities at both FOCOS and JB House so that all patients got to participate. At the end of the day I did my final walking traction with the children, as our friend Edmond told me that I was lying about leaving and even if I wasn't the plane would stop by to pick him up tomorrow too. As I hugged all of the children goodbye and promised them I would return, they were all so gracious and thanked me "so much" for coming. It felt funny having the patients thank me, when really I should be thanking them. The children I have met have opened my eyes by sharing their stories and showing their incredible resilience, passion, and gratitude. Saying goodbye to the staff, I thought about how lucky I was to have learned so much. Unlike other jobs and volunteer opportunities that have centered around pure observation or following a repetitive, set plan, my time at FOCOS allowed me to gain such valuable knowledge on everything from specific spinal terminology to how to run a non-profit organization.

During my travels home, I had a lot of time to reflect. What struck me the most about FOCOS and the unbelievable work they do was their complete implementation of sustainable development. At school I am a member of Global Medical Brigades, a wonderful organization that works in developing nations to provide healthcare, with other branches of Global Brigades working towards legal rights, housing, clean water, etc. This organization prides itself on its sustainable development model, which means that brigades go into villages not just to provide care, but also to teach the people there how to do the same. This system works so that eventually these places are able to provide for themselves, and although it takes time, it is the most effective form of aid. Last May I went on a trip with Global Medical Brigade to a village in Honduras, and the implementation of sustainable development was still very much in works; patients traveled hours in order to see our clinic, and most received the only healthcare they had and would have in a while. On the other hand, the FOCOS Hospital is a rare example of completely implemented sustainable development. The hospital has an abundant staff of healthcare workers and administrative professionals almost all from Ghana. Unlike the FOCOS medical trips years ago, the organization no longer utilizes outside resources. Everything the patients need is there, and on the off chance that a patient presents with an additional non-orthopedic problem requiring help beyond general medicine, the hospital has great relationships with specialists in the area. Prof has done a remarkable job educating the staff, especially the medical team, and the progression of this sustainability can be seen in the Ghanaian medical students and residents who learn at FOCOS.

In fact, old students of Prof and Hospital for Special Surgery medical professionals come to Accra to learn the intricacies of extreme spinal deformity from FOCOS. This is where the biggest misunderstanding lies. Foreigners may come to FOCOS as "volunteers" in the sense that they paid for their travels and living arrangements and are unpaid during their time there, but really they are students. I was not a volunteer, I was an intern. I did not make personal sacrifices to give to others, I was honored that others donated their time and resources to teach me. I was a student and I am forever grateful for all of the knowledge that my friends shared with me.

Thank you so much to my family and friends for their support during this journey, and even more thanks to the FOCOS team and patients for allowing me to be a part of their world. I'll be back soon!