My daughter Jackie (17) and I joined the mission with IHCV this summer and were amazed by the things this group of hardworking professionals was able to accomplish. As the first clinical psychologist to go on the mission I was unsure of how I could contribute as was my daughter, a youth volunteer, who had no previous experience working in a medical setting.

What we learned was that our services were needed indeed. I thought I would share two meaningful experiences we had during our time in Ghana:

On my first day touring the psychiatric wards I spotted a young boy watching a soccer game on television in an unlocked, adult male unit. The patients on this ward were mostly severely regressed, heavily sedated, psychotic men. I asked the nurse who the boy was, thinking that he must be a child of one of the patients. She told me that no, this boy was there for epilepsy and had already been on the unit for several months. "Why was he there?" I asked. She told me that she understood that epilepsy was a non-psychiatric medical disorder but there was nowhere else for him to go for treatment.

I immediately knew that I had to see what I could do to help find a more appropriate place for this boy to, preferably outpatient and at his home. I reviewed his chart and discovered that this 8 year old boy had a loving family who wanted him back but was overwhelmed by the sudden onset of his seizure disorder and had done the best it could to get him the help he needed.

The Ghanaian psychiatrist had wanted his seizures under better control with medications before discharge because in Ghanaian culture, seizures are often viewed as possession by demons and he didn't want the boy shamed. I called in our IHVC pediatrician who examined the boy and determined that discharge was indeed indicated if we could work out the psychosocial issues. We arranged to have a meeting consisting of the Ghanaian psychiatrist, the Ghanaian nurse, the American pediatrician, the American psychologist (i.e., me) and the boy's grandfather.

We discussed options for sending the boy home and provided education to the grandfather about what seizures are and how they are treated, making sure that the grandfather understood that seizures were not, in fact, a result of possession by demons. We reassured the grandfather that epilepsy was not a contagious condition and gave instructions for how to handle a seizure at home and what to tell people in the village should they witness one. The medication protocol was reviewed thoroughly by all parties.

The grandfather was deeply relieved and took the boy home with an ear to ear smile on his face. It was a very successful resolution that involved multicultural understanding and cooperation.

My daughter Jackie had several very meaningful experiences too. In spite of not being a "science" person she "ran" medical supplies both during surgeries and in the outpatient clinics. She felt a keen sense of responsibility and accomplishment for what she did. She was especially moved by the surgery, in which she participated, on an 11 year old girl who had a very large, fortunately not malignant as feared, ovarian cyst. What a difference this surgery made in this girl's life!

There were too many events to describe in this short note. The hard work and devotion of everyone on the mission was extremely impressive. My own experiences providing education about depression management in a local senior center, teaching in the psychiatric hospital, providing consultation in the outpatient clinics was very rewarding.

The teaching provided by the other medical professionals in surgical techniques, medication regimens, and management of complex cases was extremely valuable.

In some ways the teaching is the most important part of what we did because it insures that the work of the mission continues on. As goes the saying, "give a man a fish he eats for a day, teach him to fish he eats for a lifetime." The IHCV mission gives a metaphorical fish by providing much needed and complex medical care to a deserving population.

More important, it teaches the local medical professionals to "fish" by providing an intensive educational experience that can carry on into the future. The rewards of the mission were great for everyone involved and speaking for my daughter and I, we certainly hope we gave at least as much as we received from being participants in the 2008 mission.

- Dr. Elise Rossiter and Jackie Rossiter, Palo Alto, CA