Meet Rafiqule Islam as he talks about his first volunteering project in Ghana

My experience of leading a group and organising my first volunteering project abroad in Ghana.

Before travelling to Ghana

During the Summer of 2022, I was given a last-minute opportunity to lead a group of eight optometry students from Cardiff University on an oversea volunteering project to Ghana. I always say when an amazing opportunity comes your way, no matter what, just go for it and don’t look back. I joined the team a few weeks before flying. During this period, I was working in practice full time whilst finishing my coursework for my independent prescribing module. I felt that I was under time pressure to plan and arrange the journey while submitting my coursework on time. It was not long left until we flew, hence it was becoming a stressful moment, but we managed to arrange vaccines, anti-malarial, transport, flights, and accommodation in time. As part of being a supervisor I needed to have a first aid qualification to meet the University’s requirements for the risk assessment. I contacted every single training centre in South Wales, but they were either fully booked or did not do any individual first aid training. I was almost close to giving up, but luckily there was a last-minute cancellation with St John ambulance a week before flying!

A Visa is needed to travel to Ghana, but we submitted our application quite late. Upon contacting the Ghana High Commission, I was advised there was a 10-15 day wait for the visa to be processed as there was a backlog due to COVID-19. However, we were flying in 15 days! As time went by some of the students did not receive their visa and I was getting quite worried. Nevertheless, after numerous calls, emails, and messages to the Ghana High Commission we all received our visa with one student having it a day before flying! Before departure, a range of frames, equipment, contact lenses, and sponsorships were provided by numerous companies including Cardiff University, Louis Stone, Heine, Specsavers and contact lens suppliers.

Travelling to Ghana

My first time meeting the students as a group was in Heathrow airport on the day of departure. Due to easing of COVID-19 travelling restrictions, the airport was much busier than normal. We waited in line for hours at customs and security and when it was our turn to be checked the staff at Heathrow went on strike. Typical! We were starting to get worried as there was only one hour left before we needed to board. After rushing, running and skipping the queues we just about made our flight. We left London at 11pm, landed in Cairo at 4am for a 5hr stop over and finally landed in the capital city of Ghana (Accra) at 1pm the following day. It was fair to say we were shattered and exhausted. I told myself it can’t get any worse than this.

Arriving at Accra Airport, my yellow fever certificate was declined (all students went through customs okay). Essentially that particular airport staff member was looking for a bribe. Cedi is the local currency but is not freely available outside Ghana and therefore I was not able to follow up on any bribes and thankfully the security staff just let us through. Although, the majority of the airport staff were very helpful unfortunately, one of the student’s baggage was lost in London and did not arrive in Ghana. That student did well in adapting to the situation as she rearranged herself a replacement anti-malarial. Thankfully, as all the students were girls, they improvised and were able to share clothes and other essentials. ​​​​​​​

Transport and Accommodation

From Accra, we travelled to our accommodation in the Cape Coast by minibus. We had a personal driver called Francis. Initially the driver had difficulty fitting in all our suitcases onto the minibus but eventually all our luggage just about managed to fit; there wouldn’t have been enough space for another suitcase so maybe that student’s missing suitcase was meant to be lost in London! It’s fair to say, we did not give Francis a good first impression with our tonnes of luggage. But I’m reliably told that with any volunteering project, an angry bus driver is compulsory. Needless to say, I absolutely loved Francis. On arrival in Cape Coast, we mainly stayed in university accommodation in small chalets. The rooms had all the fundamentals and all at a bargain cost of £25 per night. I had already been warned: when travelling always be ready for the unexpected! On our first night, at midnight one of the rooms boilers started to leak and was causing a flood. After a miserable attempt at trying to fix the boiler, I went out roaming the campus and thankfully (God must be looking after me) found a security guard that was able to fix the leak. We always seemed to be running into problems, but somehow, we always found a way to solve it. Our other accommodation was arranged by a Ghanaian travel agent, who covered the cost for me as I was having difficulty arranging payment back in the UK but advised to pay when I got there. Upon payment of full accommodation cost, I was told it was ‘cash only’ and the conversion rate was £1 to 10Cedis. This meant I had to withdraw significant amount of notes from the cash machine. I felt like I was in an action movie, due to conversion rates, my bag was filled with a substantial number of Ghanaian notes. I was told to meet in a random location with people that I have never met before to collect my Cedis. Even though this was not the safest nor the smartest decision to make, as I had no other way of getting cash, I trusted my instinct and soon learnt that local Ghanaians are pleasant, friendly, and just want to be helpful. Large payments can be difficult as a tourist in Ghana, but I learned to have trust and faith in the Ghanaians. Everything worked out in the end and I was able to pay for my hotel room in cash.

Outreach Experience

For our outreach days, transport was arranged by the University of Cape Coast. However, I would normally only get a message 30 minutes before pick-up time which meant we never knew when to be ready. With the short notice, it felt like we were part of “The Apprentice” getting ready to meet Lord Sugar. It was fair to say we were late the majority of times and our bus driver, Francis, hated us. But we loved Francis.

The pioneering team of optometry students performed over 400 sight tests in relentless heat and humidity. They performed retinoscopy and ophthalmoscope in daylight with patients that had dense cataracts and small pupils which can be challenging even for the most experienced practitioners. Almost all patients that were examined were unable to speak English and therefore students had to suddenly adapt by altering their routine and communication to safely perform the examination.

Through the outreach, we supplied free spectacles and artificial eye drops for those in need. The most common ocular pathology that we came across was advance glaucoma, macular degeneration, and cataracts.  In some unfortunate cases, spectacles could not provide any significant improvement to vision, but the students rose to the challenge and provided counselling services and discussed other ways to make the most out of their vision (including any non-optical low vision techniques for example, eccentric viewing, increasing lighting and contrast).

As a newly qualified optometrist myself, there were some pathologies that I had never dealt with in the past such as uveitis in a child. In these cases we referred those patients to the university eye department for further investigation and treatment. Throughout the five days of outreach work in Cape Coast, I saw the students all improve their clinical techniques, communication and decision making exponentially. I believe they took in and learnt so much from the outreach clinics which provided them with additional support to supplement a lifelong career of examining, treating, and managing patients.

University of Cape Coast Optometry School and the Hospital Eye clinic

In addition to our Outreach work in Cape Coast, we also spent two days in the University Eye Clinic and the local Hospital eye department working alongside Ghanaian optometry students and qualified optometrists. The departments had limited equipment, but I was inspired by the way the Ghanaians used what they had to their advantage. I was amazed by the Ghanaian knowledge, clinical practice, and work ethic. I learnt that once Ghanaian optometry students graduate from University, they can prescribe drugs within their competence and are able to manage and treat a range of ocular conditions such as glaucoma. Currently, in the UK, optometrists are not able to do this without additional qualifications. To me this indicates the importance of upskilling for current qualified Optometrist and necessary changes that, in my opinion, are needed to the UK optometry degree programme.

​​​​​​​In addition to clinical work, the Cardiff optometry students also participated in educational program and aided me in delivering workshops and lectures to the Ghanaian students.  Another group of academics joined later in the project who delivered numerous workshop and lectures on OCT, keratoconus, glaucoma, visual fields, indirect ophthalmoscopy and gonioscopy.

Culture, Activities and Food

Our Ghanaian hosts provided us with the upmost hospitality. They looked after us and kept us safe for two weeks. The University, the village chiefs and the locals provided us with food and recommended us places to go. The food was rich in flavour, full of spices and very fulfilling. Some of my favourite traditional Ghanaian dishes that I would recommend is the tilapia fish, Red-Red stew and the jollof rice with chicken.

We were fortunate to take in some of the cultural and historic sites of Cape Coast. We visited Cape Coast Castle in Elmina, also known as one of the forty slave castles built on the Gold Coast of West Africa by European traders. This was one of the scariest, evilest, and horrible places I have experienced. It is part of Ghana’s history and a popular historic tourist attraction for many. For over 300 years, men, women and children were kept in captivity in the castles’ chambers before being shipped off for slavery. Today, Elmina is a lively, bustling, and friendly town, but the castle is a reminder of its dark past.

We attended a local festival in Elmina and had a true taste of Ghana’s culture. It was colourful, energetic and was one of the highlights of the trip.  The other places we explored were Kakum National Park, Ghana National Mosque and several beaches in Cape Coast.

One Last Hiccup!

It’s not a true volunteering trip if it does not end with a challenge. Upon travelling back to the UK, we landed in Cairo at 10pm with a 10hr stop over. The Egyptian staff took our passport and forced us into overnight stay. After several hours and a few bus trips later, we finally got to the accommodation at 1am. However, the rooms were not due to be cleaned until 3am. The staff advised me the bus would pick us up at 6am to take us back to the airport and therefore to be up by 5.30am. It was the best but the riskiest 2hr sleep I had in a very long time. Thankfully we were all up on time and made it back home safely.

I really enjoyed my time volunteering as a supervisor in Ghana and learnt so much. I realised with any volunteering projects there will always be challenges and not everything will go to plan, but it is all about how the team work together to overcome it. I hope, the University of Cardiff can take another group of students next year so that the collaborations with the University of Cape Coast can continue. I am very proud of the team and wish them the very best for their future endeavours.

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