Medaci, Ghana

I apologize for the extreme delay in posts! We’ve been very busy finishing up our research. There hasn’t been much to tell from the hospital. We’ve been conducting and overseeing interviews with women in the maternity ward. Our research is trying to gain perspective on what women know about newborn care and the education that is given by the nurses and midwives. With this, we may be able to identify the gaps in education, and implement more effective education for the future.

Most of my recent stories are about the traveling we’ve done on the weekends. Over the fourth of July, we went to the north to check out some wildlife and national parks. Just like the north in Michigan, the north in Ghana is gorgeous. It was a long 14-hour bus ride, but the scenery and the experience were well worth it. The north is mostly Islamic, so it was really interesting to see the God-loving signs and tributes displayed everywhere in the south change to the Allah-loving signs and tributes displayed everywhere in the north. The north is also decorated with small villages and mud/thatch huts. So the view from the bus window was awesome. But with time and internet limitations, the stories and pictures of the wildlife we encountered will have to wait until I return home. Which speaking of…

We’ve decided to bump up our departure date. We were scheduled to fly home on the 27^th-28^th. Instead, Ajab will leave for Senegal and Katie for the US on the 21^st, and I’ll head home the next evening. We’re working frantically to complete all of our data and data entry this week, which leaves us little to no time for data analysis. Plus, the additional hurdles of trying to access the software and commute back and forth from the University of Ghana are just too much. Ajab will still be in Africa for the next couple of weeks. But Katie and I feel that departing for the US early to give us the chance to start up data analysis in Michigan is the right decision. I’m also excited to be heading back early because I get to see Krystyna and Chris get married on Saturday and Maryum and Omar get married on Sunday! It will be a crazy busy weekend adjusting back to the US, but I think all of this is worth the earlier departure from Ghana.

One More Short Story, for the Road

Along this journey, I have experienced so many stories; some sad, some disappointing, some adventurous, some uplifting. I think this blog should appropriately end with the uplifting. And so I share this with you:

Patient 29 – the abandoned HIV+ baby in pediatrics (from the Children’s Ward entry) has found a happy home. We are unsure about what happened with Patient 15, and with ignorance-is-bliss in mind, I’m not really sure I want to know. I’d rather believe that he is safe, or that his last days were comfortable. But yes, I did say this would be an uplifting story.

One day we were finishing up in the public health office and we saw one of the social welfare counselors walk by with a baby in his arms; it was Patient 29, his name is Maxwell. The social worker shared with us that Maxwell would be going to the Missionaries of Charity supported by the Sisters of Mother Teresa. We had actually passed the convent earlier that day, and for some reason I had paid special attention to it. We’re told it’s one of the best orphanages and homes of care because of the nuns. Ah, the nuns, they sure know how it’s done! I’ll be thinking of Sister Regina, my godmothers and family (and of course my godmothers and godfathers from the Holy Cross/camping gang who maaaay have taught me different versions of pious appreciation but played a role in my Catholic upbringing nonetheless) when we go this Saturday to visit. We plan on donating our clothes and shoes that we don’t need and spending some quality time with Maxwell and the others at the convent.

Medaci, Ghana

Somewhere along the way, I came to understand the meaning of coming to Ghana. I’m sure I’ll have much to reflect on when I return to the States. But mostly, I came here to learn and I came to share stories. I think because of missionary and volunteer work and Western foreign aid, we have this idea that we are the heroes or that we’re going to make things better. But that’s not the case. We haven’t done anything out of the ordinary. We haven’t saved any lives. And we definitely haven’t had to make any critical decisions while our hands are tied with limited resources. Of course, we’ve contributed to small research projects that have potential to open the door to more valuable research. But overall, personally I’ve gained far more than I could ever give back. I have experienced the privilege of watching others do amazing work. And I’ve learned that even small changes can go a long way. When that small change is supported even by a small few, greater forward motion is possible, and many Ghanaians are doing just that. It’s not as if people here don’t appreciate help or people from abroad, there’s still much work to do, and constructive suggestions that are needed. But the people here want to build their own country. People always want to know what we think of the country and time and time again Ghanaians have told us that Ghana is the gateway to Africa- the place that represents the best of Africa.

I am sad to say goodbye. I have so much to be grateful for from this tremendous experience. I have many thanks to give.

I have to say special thanks to Dr. Deganus. Without her, none of this would have been possible at all. She has shared her work, her home, and her own personal journey with us. This woman is the word strength. If the purpose of me coming to Ghana had only been to meet her, then that would have been enough. She’s an amazing lady. She’s been our mentor and “mommy” here and I can’t wait to share with all of you more about her when I return.

I have encountered so many meaningful relationships, and it’s great to know I will always have friends in Ghana. We have felt so welcome. Here in Ghana, “Medaci” means “thank you”. And so I say medaci to Ghana!

World Cup in Africa, through an American’s Eyes

It came down to a shoot-out, and with much disappointment, we watched Ghana bow out of the World Cup. We were dually bummed. Not only were we in full support of the Black Starts at this point, but we were also looking for a win, so at least we could say that Team USA lost to the victors of the quarterfinals. We all gathered around a big screen tv at a bar & grill in Kumasi to watch the deadlock between Uruguay and the Black Stars. The heart-wrenching end to the second overtime was almost too much for the Ghanaians to handle. Uruguay player uses his hands to defend the ball while in the net?!? Red card!! Then a missed chance for a Ghana goal! Gyan doesn’t miss penalties! Sadly, the Black Stars just couldn’t get the lifts on the ball and shots on goal that were needed. Gyan redeemed himself, but with two misses and only one miss on the other side, Uruguay advanced. Ghana was broken hearted, but still proud of their Black Stars.

I’ve always had a love of soccer. Growing up, my Italian neighbors lived and breathed for soccer and the World Cup. I remember hearing the tirade of screams erupt from next door when Italy lost to Brazil in 1994. It was ultimately Andrea and Joey’s passion for the game that led me to start playing. That entire summer, we played pick-up games every night in our adjoining backyards with all the other neighborhood kids. Being in Ghana, I haven’t gone a day without seeing several pick-up games going on. Everybody here has passion for the game.

We were thrilled to be in Africa for the World Cup. When Ghana emerged as the only African team to make it to Round of 16, I bragged that clearly Ghana must be the best country in all of Africa. From the get-go, we hoped for a US-Ghana match. When we realized it could be a possibility after the US pulled forward to the number one spot of Group C with a goal by Donavan in the last minute of the match, we secretly hoped Ghana would lose to Germany to land the number two spot in Group D so they would play. Sure enough, the football gods allowed for the match-up.

So there we were at Basilissa, one of our favorite restaurants, bantering with the waitresses and other customers. They made us stand up and sing the national anthem. They attempted to sing their anthem, but didn’t know the words. Instead they adopted the phrase “Ghana, yes we can!” We heckled back “that’s OUR phrase, you can’t take that from USA!” I’ve mentioned Obama love in Ghana before, but honestly, so many people here think he belongs to them since his father is from Africa. I’ve seen Obama paintings, Obama t-shirts, Obama fabric and even Obama biscuits. I digress, though.

When Ghana scored the first goal, everyone jumped up, cheered and danced. One lady came and wrapped Katie and I in a Ghana flag. Although we reminded Ajab over and over that she was actually born in the US and should therefore be supporting team USA, she’s never felt the US was home and found herself celebrating for the team representing Africa. In the end, the US speed just wasn’t enough to get past the Black Stars. Prince Boateng and Gyan scored the two goals to advance them to the quarterfinals. Even though Katie and I wore our red, white and blue and supported our country, we were pretty excited for the Black Stars!

I’m glad I was in Ghana the whole time to experience the football craziness. Ghana, after all, did represent Africa well! And not sure if the Shakira “Waka Waka” song played every two seconds like it did here, but all the African teams were joined together to support Africa. It’s a shame Ghana had to go out the way they did, but I’m so glad I was here to meet the essence of football in Africa.

Cape Coast- Canopy Tour and Elmina Castle

On Saturday morning, we woke up at 5am to start getting ready for our day trip to Cape Coast. The driver was set to arrive at 5:30, but instead arrived on AST (African Standard Time, not much different from Megan Standard Time) at 6:45. After a few complaints amongst ourselves here and there, we hopped into the van and headed to Accra. We picked up Kofi from his hotel, and the other Michigan girls from their hostel. The drive to Cape Coast was about three hours. I head-bob slept for a bit, but mostly stayed awake to look out at the changing scenery. West Ghana doesn’t present much of a difference as the east, but it’s always interesting to me to see style of housing and the goods people are selling on the side of the road. There’s always something going on. I think I’ll miss the people-watching the most when I return home.

We arrived at the Kakum National Park around 11:30am and set out on our climb to the canopy. Katie and I both got really excited at the feel of being in the woods and climbing. It was a small taste of the adventure we have planned at the end of our trip. We have about a week of travel time from when our internship ends to when we depart for the US. We had been throwing around all kinds of ideas of where we would travel. Initially we really wanted to fly to Eastern Africa, where several of our friends are doing their internships, or possibly to South Africa. We even thought Morocco would be an awesome adventure. But with the travel time and expenses required, we’ve decided our best trip will be right here in Ghana. We’ll head east and then north to explore the Volta region and climb the tallest mountain in Ghana. It will be a true backpacking adventure. We were happy to get a feel of the outdoors this weekend, though.

The canopy was absolutely gorgeous. Sometime within the last 10 or 15 years, a group of Canadians from Vancouver built a series of bridges in the canopy. There is no other canopy tour in all of Africa like this. I guess at times you can even see elephants down below and monkeys in the trees. We didn’t see any wildlife, but it was still a beautiful view nonetheless.

After the canopy tour, Kofi took us to some fancy resort nearby. I ate Red Red for lunch..sooo good! After lunch, we all piled into a room near the bar to watch the rest of the Ghana-Australia match. We were all hoping for a second goal from Ghana in the last ten minutes, as a win against Australia would have qualified Ghana for the next round. Now they need to hold their own against Germany. We’re sort of hoping for a Ghana-USA match up. In order for this to happen, Ghana has to be the #1 seed from their group and USA has to be #2 from their group. Or Ghana has to be #2 and USA has to be #1. Here’s hoping.

We headed to the Elmina Castle for the last part of our day trip. In 1482 the Portuguese arrived on the shores of Ghana in hopes to exchange spices and other goods for gold. They built this gorgeous white castle, which served as a trading post for many years. Unfortunately, it also served as a slave-trading post. It’s sort of ironic that this castle is so beautiful and lies upon a breath-taking coastline, yet inside the castle walls such atrocities took place.

We all felt an eerie presence walking through the castle. The guide showed us to the rooms where slaves were imprisoned. When we walked into the room where they kept the women, we all noticed a decaying smell. The guide explained that at any given time, up to 150 women were haled up in this one small room, with barely any air or light let alone space for them to move and find an area to urinate, defecate or menstruate. A stench from nearly 200 years ago still lingers. Once in a while, women were allowed to come out of the room and into the sunlight. Can you imagine this being your only view of freedom?

They were allowed to see sunlight for an hour in the day, and also bath from the rainwater reservoir that rested underneath the stone floor. During this time, the governor would come out from his bedroom (bigger than any of the rooms the slaves were kept in) and stand on the terrace over-looking the women. He would choose one lucky lady. She had two choices. She could either refuse and be chained to a cannon ball and beaten for the day – an example for the other ladies. Or she could choose to submit, climb up the ladder into the governor’s quarters, and be taken in the corner to be raped by the governor. She was never to stay in his bed.

On certain days, hundreds of women were lead down the small staircase within their cave-like holding room. This staircase led to an even smaller room. The room where men stayed also joined into this room. In chains and shackles, they all crammed together, and formed a single-file line into the tunnel at the opposite side of the room. It was in this room that sometimes husbands, wives, brothers and sisters would be reunited. As they shuffled through the tunnel, they were led into the room of no return. When entering, one can see a small opening with a view of the ocean. Hundreds of years ago, slaves entered through the opening and into the fresh air at last, but only to soon walk onto a ship to take them to the Caribbean or North America. The guide told us that the men and women shipped to North America would have been slaves in what is now New York, Florida and Texas. We learned that slaves that were healthy enough, according to the traders, were selected to board the ships. It’s just a theory, but health scientists have thought that slavery may play a part in one of the reasons why African Americans are more likely to experience heart disease, hypertension, etc. Only slaves that were plump enough after making it through days of starvation were chosen to be transported and only those that could retain enough salt and water to make it across the sea, survived. Interesting thought. Either way, being in this room, it was hard not to imagine the pain and suffering that people endured as they were taken away from their families away to strange worlds. Flowers and grave adornments now decorate this room. Visitors who have traced their ancestry back to Elmina have left the decorations.

After the tour, we had the chance to walk around on the top tier of the castle. The view was absolutely breathtaking. We also browsed through the gift shop which sold postcards, trinkets and many books about things like Ghana heritage, history of Elmina and oh yes, of course, Dreams of My Father and The Audacity of Hope. Let me tell you, the people of Ghana are VERY fond of Barack Obama. He’s on a billboard at least every 30 miles or so. Sometimes, when Ghanaians find out that we are American, they even call us “Obama people”. I’m sure the Republicans in my life are rolling their eyes at this point, but I’m only laying down the truth! Obama love is so very alive here in Ghana and we Michigan liberals are loving it, too. Ha! Anyway, after browsing the gift shop, and being harassed by the many sellers outside of the castle we made it safely to our van and headed back to Accra. We passed approximately four Obama billboards in transit. It was a great trip.

Adventures of Kate and Meg

**I’ve updated this post. I was in a rush to post it and only had the chance to read through it after I had posted. I tried to make things a little clearer and easier to read. I’ve also added more of my thoughts….

Katie and I have had lots of bonding time here in Africa. I love Ajab equally, but somehow when she’s around, we just don’t get into the same kind of situations. It’s most likely because almost everybody here thinks she is Ghanaian and so if she’s with us, they think we’re being taken care of. People are generally surprised when they find out she’s actually from Cameroon. So yeah, maybe it’s because Ajab is African and gets the way things work here better, or maybe it’s because Katie and I are a little bit of misfits and when it’s just us two, we always seem to find ourselves entangled in some sort of story. The last few days have been no exception.

On Thursday, Katie and I decided to go to the Accra Mall after work. We needed to get a power strip for our electronics. We came to Ghana with four wall plug-ins; three have short-circuited. We flagged a taxi down and asked if he could take us to the Tema Motor Roundabout so that we could catch a connecting tro-tro to the mall. This particular taxi driver proved again why we love the tro-tro so much more. First, he wanted to charge us three cedi. We’ve been here for 6 weeks now and we know how this works. A trip of the distance we were going should require only about 0.50 of a cedi (50 peswas). I said thank you but no thank you to the driver and walked away. He “tsked” us back to the taxi, a common way of getting someone’s attention here, and agreed to take us for two cedi; still pricey, but we accepted. Second issue: the taxi driver actually did not want to take us to the roundabout at all. Instead he dropped us off at the end of the on-ramp to an expressway heading in the opposite direction from Accra and told us to cross the five lanes of traffic to the other side in order to head in the right direction. We weren’t about to argue, and we didn’t have much time anyway because as soon as we stepped out of the taxi he began reversing back up the on-ramp. The kind taxi driver dropped us off at the point of the expressway where a tollbooth is located. Not too many people are hopping onto a tro-tro at this point. But, we crossed the five lanes of traffic anyway, and asked the street sellers the best way to catch some form of transportation to Accra. One of the guys flagged down not a tro-tro, but a giant 50 person plus transport bus. Katie and I hurriedly scampered across the traffic, got onto the bus, which was at a mere rolling stop at the booth, and made it to our seats. For 70 peswas we finally made it to Accra.

A day at the mall was much needed. We found out that we wouldn’t be able to get the power strip and step-down converter that day, though. The shady electronic shop guy had to go buy one from his guy at the market and wouldn’t have it in his hands until after the weekend. It was no big deal to us, as the real reason we wanted to go to the mall was to see Sex and the City. It was well worth the trip to enjoy a piece of American cinema and a bucket of popcorn. After the movie, which was super cheesy but well received by us given our cravings for New York City and dresses and high heels, we got some ice cream and called it a night… a great Obruni-American night.

The next day we went to the market in Tema to find our own guy with a step-down converter and power strip. This trip was successful. The assembly, however, of the step-down converter and charger done by yours truly – daughter of an electrician- was not so successful. I learned a very valuable lesson this day: Always read directions! After managing to blow up the step-down converter and my camera charger (which thank God Katie has the same one), slightly electrocute my hand and nearly cause a small fire, Katie decided I was no longer allowed to be near any sort of electronic devices or plugs. We found out in the end, that the converter is not completely necessary. Our electronics will take 220V, which means that the charger alone will work just fine for us. Thank God there were no major casualties.

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Sundays are generally slow days. Everybody is at church from like 7am until 2pm. Exhausted from the week of work, and a long day of travel to Cape Coast on Saturday, Katie and I decided that we could sleep in. It also down-poured this morning, which gave us perfect sleeping conditions. When we arose at noon, we knew we wouldn’t be able to find food for a while. After 2pm, we began wandering around Tema, thinking that we’d have to just resort to snacks for the day finding that nothing was open. We finally stumbled across some random Chinese restaurant, which looked a little bit like a warehouse, but we were so hungry at this point, we really didn’t care. They cooked us up some fried rice and spring rolls, which hit the spot. In walks this Ghanaian businessman who now lives in Beverly Hills, CA. He ended up paying for our entire meal. Sweet deal. We thanked him and said that was completely unnecessary. He told us that he knew we were students, and that God is good and that we should live knowing that and accept the free dinner. No arguments there!

Walking back in the direction of our place, we planned on stopping at the Internet café. We saw that the new restaurant located above the bank that is right next door to the café had finally opened. There’s been an “opening soon” sign up since we’ve arrived in Tema, so we were pretty excited to check it out. It such a cute place, and has great food for a reasonable price. I’m sure it will become a staple for our last month here in Ghana. The woman who owns the place so kindly added Tiramisu on the house to our order of Espressos. We’ve been really well cared for here. Katie and I shook our heads at how lucky we’ve been through all of our recent adventures. We love Ghana.

Things have slowed down a bit here, and life here has become semi-normal. We’re well past the adjustment period, and it almost seems as if this is our home now. We know though, that our time here is limited. Walking home from the Internet cafe after our Sunday together, we talked about all the things we will miss about Ghana. It’s funny, because Katie and I both went through a phase around our 2^nd or 3^rd week here where we completely questioned our decision to come here. Even last weekend, I was feeling a little homesick. Katie has been to Africa a few times now. She says that she goes through this every time. Now we are starting to approach that phase of questioning the way we’ll feel when we return to the US. Somehow, through all the resistance and questioning, the African way of life has woven itself into mine. I’ll explain it this way: Remember how I spent an entire chunk of a blog post complaining about the food here? Well, while I still crave food from the US, I’ve now been here long enough to have cravings for Ghanaian food as well. It’s the same with the way of life and I know returning back home will warrant some resistance and questioning as I pull away from my life here in Ghana.

It’s sort of like backpacking; something that Katie and I both love to do. We’ve talked about how backpacking actually is a pretty rough experience at times. You walk for miles in a day up and down loose terrain with 25 pounds or more on your back. When you arrive to a campsite, work is still required. You must quickly find wood or begin sawing at a dead tree in order to build a bug fire so that you can enjoy a meal out of a bag, or some sort of small snack. Sometimes it rains, and then everything is muddy and soggy. Sometimes you get really frustrated from the pain in your feet after walking for days. Sometimes you get really sick of being dirty and smelly. But somehow, when you make it out of the woods (and if you’re Jeff Knaus, head directly to Wendy’s for a Biggie #2), with time, you always want to go back. The beauty that you see in nature and the peace that you feel from the experience is well worth the struggle and pain. Our adventure in Africa has given us a similar experience, which is why I think it’s only appropriate that our last adventure here is a backpacking adventure. I wonder when I return home, how long it will take before the pull of another adventure abroad begins to call me back.

Will I ever smell African smells again? No matter how pungent they can be, at least they are honest and real. Will I ever be able to purchase a fresh pineapple sold on the street by a woman with her child tied to her back? It’s just not the same when it’s pre-sliced from a grocery store. Will I ever see kids playing a game of pick-up football in the field nearby through a tro-tro window? There’s something so special about the spontaneity of children and the game. It’s just not the same to see kids lined up in their blue and red jerseys on the manicured lawns of Firefighters Park from my air-conditioned car. Please don’t misunderstand me. It’s not that I don’t absolutely love the US or the people that live there. Believe me, I miss my family and friends more than I could ever explain in words. I also miss the clean air, summer in Michigan and my favorite t-shirt and pair of jeans more than you could know. But just as laughing with my friends and family, spending time in the woods and watching sunsets in Glen Arbor complete my life, spending time within another culture also fills a part of who I am. For now, I will enjoy each day left in Africa and take in this last month of experience and adventure, so that I will have many memories to keep with me until next time.

A Quarter Century in Ghana

Ghana was especially happy for my birthday! We were all pretty excited about the win. In general all Ghanaians support all the African teams. But since Ghana has been the only African team to pull off a win for their first match, I like to think I'm in the best country in Africa :) I'm sure there are some willing to debate me. We are told though that Ghana is the gateway to Africa.

I'm sure my family and friends all know by now through this blog and my emails that I'm having a great experience. It was a little strange turning 25 here, only because this is the first time I haven't had my family near to celebrate. However, my Ghana family has taken GREAT care of me! Katie, my roommate, bought me a hamburger and fries (yes they have those! but the taste is a littttlllee different). And then she got us a block of cheese (strange request, I know, but it's rare here) and a Snickers!!! I was a very happy girl. Our taste buds immediately flared up. It's weird how much our bodies miss American food. We also watched an episode of It's Always Sunny in Philadelphia just to make me feel more at home. At work on Monday, Dr. Deganus surprised me with a gift. This woman, honestly I could go on and on about how grateful I am to her. She bought me this beautiful fabric with my colors (purple, blue and green). She's taking me to the tailor on Friday to make an African dress for me. How cool is that?!? I am a lucky lucky girl.

We've been pretty busy this last week. We're sort of taking a break from being in the rounds and getting our research in gear. Tomorrow we'll start interviews with translators. It's nice to be doing the public health end of things now. There's not much to update on, but we'll be traveling to Cape Coast this weekend to see the slave castles and take a canopy tour. So look for pics after the weekend!

Well, it's hard to believe my journey here is half over. We've been here for six weeks, and things are actually starting to feel normal here. I know my heart will miss this place. What a great way to bring in a new quarter century.

Life is Good in Ada

Ghana is such a beautiful country, I am eager to explore more. This past weekend we headed to Ada, the city where the Volta River meets the ocean. It’s located about 2 hours east of Tema, at least by tro-tro. In order to access our destination resort, we had to take a boat on the Volta. There were plenty of Obrunis to be seen upon arrival. It seems we all have the same idea: work/volunteer all week in the big cities, then head in any which direction away from those cities to enjoy the lush scenery that Ghana has to offer. We pulled up onto the sand and met with the keeper of the resort. She showed us to our hut.

We spent the day in the sun, and retreated for shade when needed. We laid out on the Volta River side of the beach, as opposed to the ocean. Unfortunately environmental regulations are not well developed here, which leads to a lot of pollution in the ocean. (Although, I guess back home we too are having our own struggles in the Gulf.) Nevertheless, we enjoyed our time in the sun. Katie and I were both pretty excited to sport our new Chelsea and Man U beach towels (football clubs). We caught the sunset at about 5:30pm. We were all amazed at the gorgeousness of this place.

After sunset we drank some beers, and enjoyed a bonfire. The boys caught some crabs then threw them on the fire -a tasty late-night snack. Before heading to bed, I hopped into a hammock and laid under a palm tree, looking up at the stars. Great choice. I’ve actually never seen so many stars all at once. I felt lucky, blessed to be there. I was feeling a bit homesick this weekend, so it was nice to be outside, looking up, and thinking about all my family and friends back home. I stayed out on the hammock as long as possible, unable to pull myself away from stargazing and searching through memories from home. I finally put myself to bed in our hut, although I considered sleeping outside. Once the Rastafarian man, who had been rastafarying all day long, had finally decided to shut off his blaring music that he and only he was dancing to, we were able to fall asleep to the waves. It sounds like a dream. I did come back with souvenir bed bug bites, so not 100% perfect, but picturesque for sure.

We enjoyed breakfast by the beach (banana pancakes wit sugar on top!!) and then took our boat ride back to land, back to the tro-tro. Such a great weekend! Ghana is beautiful and life is good.

Children's Ward

My heart is full. I just spent the last week in the children’s ward. I have been enjoying my days observing health care delivery in the maternity unit, and have felt connected in many ways to all that I have been learning in ANC and Labour and Delivery. But there is just something different about children. Women’s reproductive health is my area of educational interest, but children get my heart. I felt excited every day this past week to pop out of bed in the morning, take the tro-tro to the hospital, and join the doctors for rounds in the ward. I had sort of forgotten why I became so interested in international health and really, public health, in the first place. I studied abroad in Panama as an undergrad. My main interest and direction of research was on maternal and child malnutrition. Sometime during the trip, we visited an island off the coast of a major city in the mouth of the ocean called Son Cristobal. I remember pulling up to the dock, and stepping off the boat into a crowd of curious young faces; I was eager to learn about them, too. Most of the children had tattered clothing, pockmarks from parasites and decaying teeth. They had so many obtrusive health problems, but they were still kids. They played like kids, they laughed like kids, they were happy like kids. It’s the same at Camp Quality, too. So many of our kids are sick or have already endured so much, yet it seems at camp they have the time of their lives (as do we). If there’s one common theme about kids, near and far, it’s that they find time to enjoy the fun in life and certainly live life down to the very moment.

Most of the kids in the children’s ward are sick with malaria, diarrhea or suffer from malnourishment. There were a few HIV cases, but they were not in the majority. West Africa presents a very different picture from the Eastern and Southern regions of Africa. The prevalence of HIV/AIDS in Ghana is less than 4%. Certainly, HIV/AIDS is worthy of our attention, but thinking statistically, malaria and diarrhea in the child population are more outstanding health problems.

There are great things about Tema General Hospital, and I have to remember to focus on the good and not to get down about the gaps in the system. There’s a balance to be held, as we must also constructively critique areas of improvement. It seems that malaria is the glaring health problem especially for vulnerable pregnant women and children. Within three months at Tema GH, the children’s ward may see up to 6,000 cases. We asked the health professionals why they think this is the case. They told us that they educate, but nothing seems to stick. People know well enough that there are mosquitoes in this region and that they cause malaria, but still so many fail to take proper precautions. I wasn’t settled with that answer. There has to be more to it than that. Perhaps it’s that people feel that malaria is the norm and not a pressing health concern; sort of like chicken pox in the US. It’s true that a good portion of people living in areas of malaria contract it within their lifetime, but it can be dangerous, especially to children and pregnant women. Cerebral malaria can be fatal; it can also terminate a pregnancy. There are prevention measures against malaria in antenatal care. In fact, most of the women I saw were prescribed medication to prevent it. But with over 2,000 cases of children with malaria in one month, clearly something’s missing. I can’t settle with the idea that if there was education displaying the clear threat of malaria and if there was an affordable, accessible, and easy method to prevent this disease, that women wouldn’t adopt this method to protect their children. The latter is the ticket. Education alone is not enough to change behavior. This has been well understood in public health for some time now. You can throw education at a community all you want, but to really inspire behavior change, the social environment must also change. As a public health student, I see this disconnect as an opportunity. Malaria is preventable and with community education and accessibility to and availability of proper preventive measures, we can decrease the amount of people who get infected.

From my public health perspective, the population most vulnerable to malaria is the target. My clinical perspective, however, was concentrated elsewhere. We met Dr. Antwi for rounds on Monday morning. He is a young, handsome and charismatic pediatrician; not arrogant in anyway. He's definitely meant to be a doctor for children. I could tell by the way he examined his patients and joked around with them that he is well liked in the ward. He took the time to explain each case to us. When we approached patient 15’s bed, Dr. Antwi looked perplexed. He explained that the boy had come in with fever, vomiting, diarrhea, etc. He was also presenting signs of liver failure. With the combination of not being able to stabilize him quick enough and his family not having enough funds to afford basic labs and cultures, the boy ended up suffering several co-morbidities. He is now blind, deaf and possibly brain damaged. For an entire week, we watched his worried mother take care of his every need. When she wasn’t taking care of him, she was parked at his bedside, sometimes praying, sometimes with her head down just trying to catch a few minutes of sleep. When we met the boy on Monday, Dr. Antwi just sort of shook his head and said there wasn’t much they could do with their hands tied. We were all a bit unsettled at this. Katie and I spent a good portion of the evening discussing the need for palliative care if there weren’t any social services that could support this boy. We arrived the next morning, and headed straight for patient 29’s room, a baby we had all sort of adopted for the week. Katie scooped the five-month old into her arms, an action he was craving and needed. His mother brought him into the ward the Thursday before. She then admitted herself to the HIV/AIDS unit with chances looking slim that she would regain her strength. The father has abandoned them both, and soon the mother will pass. Instead of focusing on the questions of where this child will go, we focused on giving him the attention he needed most.

Not long after, a crew of doctors showed up for rounds. We again followed along. This time, Dr. “Boss” (I never got his name), the chief of Peds joined along. He walked in late, in the middle of another doctor’s presentation and took the lead from there. He is a small man, but his personality is big. I immediately equated him with Dr. D, the chief of Peds at Children’s Hospital in Detroit. Dr. “Boss” holds the same charisma, and scatter-brained intelligence.

Patient 15 was the last to be seen on rounds. We all crowded into his room, mostly somber knowing the situation. The doctors examined his vitals and checked for any progress. The three of us were wide-eyed, hoping for something positive. After standing around shaking our heads for about 5 full minutes, this speech from Dr. “Boss” emerged:

“So what should we do? Just wash our hands clean of this? This is a sad case, you know, a very sad case. The co-morbidities he’s suffering from, he’s so compromised, now. At the end of the day, is this our fault? Did we do this? His mother will now have to end up supporting him. And where’s the father? If there is a father, you know, before you know it there will be a divorce and the woman will be alone. She doesn’t have the money. Why does this always happen? It’s always the poor that are the sickest. What God would allow this? I guess when I get to the gate I have a few questions for God myself. So I’m asking, what should we do? We just walk away and go home? This is too sad, let’s just go have a beer and forget it. Come on. We have something to do with this, so doctors, what do we do?

Most of us stood with our hands tied behind our backs staring at the floor. Dr. Antwi, who is normally all smiles, stared off somberly, too. Finally, he lifted his head and spoke up.

“There’s a church group, you know. We could call a church group. There was one that brought in the boy, the HIV twin.”

The day before during rounds, we reviewed another abandoned HIV case. The boy, no more than a year of age, had been born to an HIV positive mother. He had a twin brother who was HIV negative. The sibling was clearly getting all of the mother’s nourishment through breastfeeding, which inevitably may result in another abandoned child with HIV. The twin brought in by the church group was near death from malnourishment. We found out on Wednesday that he hadn’t made it through the night.

Dr. Antwi’s suggestion jumpstarted the group from a moment of despair to thoughts of hope. Mumurs erupted through the group of doctors. Dr. “Boss” nodded along, but I could see by the look on his face, that he had a suggestion of his own.

“You know, there’s a Dutch organization, an NGO. Yeah, they’re doing great work. They have a sort of home for children with illnesses like this. If you go there, I promise, you’ll see every illness you’ve ever seen in your textbooks. Let’s connect his family with them, huh? I mean this is about quality of care right? We all know about palliative care. My mother, for example, she was diagnosed with cancer, two months to live. They put her on palliative care, she’s still cooking me meals. I mean, we can do this right? Let’s keep this boy comfortable; let’s let him have quality in his life. This is possible, and at least we’re giving some hope, right? I mean this is what it’s about. This boy is an example of the holes in our system, but let’s make this work, even if it’s just one case. We might not see things change in our lifetime, but if we can do something now and set things forward, it will happen one day. Hmm? I don’t know, maybe one day then we’ll be giving aid to the US.”

We all laughed. I was touched. I had lost sleep over this case the night before. I know better not to get too attached here, but I couldn’t shake the thoughts that this boy will not be supported because he now has disabilities that could have been prevented. I mean my Mom and sister make careers out of supporting children like this. So what does that mean then for children in Ghana? Where will this boy go? And what about his mother? I know that sad, unexplainable things happen all the time. But I too found myself questioning God’s role in all of this. What God would allow sickness and suffering with such limited solutions? It’s just hard to understand sometimes. Something in my soul needed this speech. I needed to feel chills; I needed to feel connected. It was the sermon that I needed to hear. It’s not that Dr. “Boss” said anything overly profound, but he gave us that small glimmer of hope. And if that’s all it was, then so be it. At least there’s hope at all! That small speech woke up a feeling in me that maybe sifting through all the crap in this world for the hope that within it there may be something good just might be worth it. In more literal terms, it means there are certainly health professionals here that get it, people that want to move things forward and make life better. It means there’s room for greater improvement in quality of care. It’s all very possible.

Pics- Life in Ghana

Pics- weekend at Mampong

Top 10 lessons learned so far

1. This is a God loving country. You will be asked what church you belong to and if you would like to go on Sunday within a 20-minute conversation. Note: agreeing to Catholic mass means waking up at 6am to attend a 2 or 3-hour mass; bring snacks.

2. Cabs are in greater supply than demand, and so they are costly and not our favorite form of transportation. Tro-tros, however, although not the best smelling or safest of vehicles, will take you anywhere and everywhere you want to go for less than a US dollar. We loooove the tro-tro.

3. If you search long enough, and talk to the right people, you’ll find delicious meals for super cheap and of sizable portions.

i. Adding a hard-boiled egg or fried egg to any form of rice, will instantly make it a tastier dish.

ii. If you tell the canteen staff you want Red Red for lunch, and then stop coming to the canteen on a regular basis because they don’t have it….you will find yourself eating piles of Red Red by the end of the week. Many thanks.

4. South African soap operas are the best form of television entertainment. But commercials inviting you to South Africa are played at every break and they are really enticing.

5. It’s perfectly acceptable for people to yell Obruni! (aka white-person!) anytime, anywhere. The inflection does vary.

6. There are goats EVERYWHERE just roaming around. The come in all different colors, shapes and sizes. They’re the equivalent of our squirrels.

7 . “Please, I’m coming” really means “Excuse me, I’m leaving.”

8. We already think it feels so much cooler outside if there’s a 2-degree temp drop.

9. Running water is not a given, therefore, showering every other day is perfectly acceptable.

10. Hand washing is the only form of washing clothes. It is best to push the time frame between washing to two weeks given the amount of time and labor that goes into this process. After your clothes have dried out on the line, it’s important to check them for any insects or critters. For example, one may find a giant ant in her underwear. Just saying.

Labor and Delivery

I have a whole new respect for mothers in this world. The images I have seen in the past few days have been ingrained into my memory. I’ve seen women give birth on tv in health classes, but it’s not real until you see it in person. Let me describe how it goes here.

Women show up and are admitted into the first stage labour room. They are closely monitored until it is showtime. And just about when the baby’s head is ready to break through, the woman walks herself (usually naked and moaning in pain with her own IV bag in her hand) to the second stage labour room. There are three beds in both second stage labour rooms, and each is lined up right next to each other. There is not much space between each bed and there’s certainly no such thing as a private room, or even a separating curtain. When it’s time to deliver, it’s time, and nobody cares if her body parts are open to the world. There’s also no such thing as an epidural during delivery. These women do it all natural, unless of course there is a complication and she is taken to surgery for a C-section.

It seems like women deliver in no time. Some of them barely make it to a cot before they are ready to start pushing. It’s amazing. After delivery, the nurse then shows the woman her baby, and the baby is taken away for Apgar score and washing. Next step, third stage labour, or delivery of the placenta. Women are injected with oxytocin, and the process begins. With some massaging and a few pulls of the cord, the placenta is out. There is more cleanup involved, but I won’t go into details about this. It’s graphic, and it looks pretty painful. I’ve seen more women scream during this process and the suturing that often follows after giving birth than when they are actually delivering. Finally after the woman is cleaned up and the baby is washed and oiled, they are united for breastfeeding. It’s truly an incredible process.

We do things very differently in the US, and some may even say we’ve medicalized childbirth, but it’s with good reason. There are women all over the world delivering completely natural, with no skilled birth attendant to assist. Those areas are also often accompanied with high maternal and infant mortality rates. Even here, the staff is skilled and well-trained, but there is just such limited staff, space and money, that it’s impossible for every woman to have her own room, with her own private physician and nursing staff, and machines monitoring every vital process. The reason there are no drugs/epidurals given is because they don’t have enough staff to monitor anesthetics. Also, the women here, depending on how busy the ward is that day, are out of the delivery room within an hour.

Yesterday, I saw six births in row within a matter of 45 minutes. Two of the six were complicated. The nurses usually deliver, unless there is a complication. They do a commendable job, and the amount of training they go through to be obstetric nurses or midwives would really be like the equivalent of a nurse practitioner, physician’s assistant or a nurse trained in high-risk pregnancies. They know how to handle emergency situations, but there are still emergencies in childbirth that require the skills of a physician.

The first complicated birth was a breech birth, and so the doctor on staff was called in. The baby made it out with much pain to the mother, but unfortunately the cord had wrapped around the neck. The doctor immediately began resuscitating the baby. After suctioning and applying oxygen, the baby finally took his first few breaths and began to cry. All of the attention was solely on the baby. Every staff member and observer was crowded around the resuscitation table. But the mother was just left alone on the cot, and I could tell she was in-between feeling the need to just rest and feeling anxious trying to look over to see what was happening with her child. The second complication did not end well. It’s hard to tell what actually happened. Unfortunately, with the shortage of physicians, lack of constant monitoring (and machines to do this), lack of access to antenatal care, not being aware of the major warning signs of an arising complication, etc. the infant mortality remains at about 57 deaths/1000 births (or 5.7%).

On my last day spent in the labour ward, I went into surgery and observed a Cesarean section. That’s how I came into this world, and so I found myself in awe of the process. I paid close attention to the cutting and suturing involved. I had flipped sideways, transverse, and was an emergency situation. My mom was cut vertically, while most C-sections are a transverse cut. I had dissected portions of cadavers at MSU, and so I was aware of the amount of layers of tissue that have to be cut through before even reaching the uterine cavity. But still, this surgery was both intriguing to me as I watched the technical progression of cutting, removing the baby and the placenta, and suturing every layer, and also personal as I thought about the sacrifice and healing required from my mom’s body for my birth as her tissues were quickly cut across, intersecting the natural lay of the muscle lining. As I grow older, work within reproductive health and understand that probably within the next ten years I might be having my own children, I feel more connected to my mom. Women endure a lot to give birth.

Pics!

A few pics just to give you some visuals

Walking around in Tema.

The living accommodations and Katie in her

sleeping bag liner looking like a nerd with her

headlamp :) My sleeping bag is possibly my most

treasured possession now. It's been a great cushion!

It's hard to get a clear picture here of the true

essence of a tro-tro, but this is as close as I could

get to showing you.

Hand-washing the laundry

The coveted Red Red, soo delicious.

Akwaaba- You Are Welcome Here

I’ve had an amazing week. I know the last post indicated I was having some doubts, but I think it’s natural for there to be an adjustment period. I finished up my week in Antenatal Care, which was a really great experience. The nursing staff was very helpful in teaching and showing me around, and I gained a view of how health care is executed with limited resources. The staff is doing their best with what they have to work with, but there are definitely challenges. I wonder how counseling and comforting the patients works here. Being in health education, I want so badly to be able to ask these women so many questions about how they feel as a patient. I think maybe it comes down to time limitations. But it's hard for me to get a completely clear picture because of the language barrier. The nurses are great, but there is definitely a power dynamic between the nursing staff and the patients. Patients certainly do not act like consumers of health care. I was surprised at the style of support given when a woman would come in with a high-risk condition or had already had a miscarriage. In the US, pregnancy is such a special thing. Women for the most part are regarded with such care and delicacy when they are pregnant. Maybe it’s because pregnancy is so much more rare than it is here. There really isn’t a woman of reproductive age that doesn’t have a child. It’s still very special; as we’ve learned the inability to get pregnant here is probably the most devastating news a couple could receive. But, it’s strange because this is a very touchy-feely culture as far as personal space goes. One day I was at the market bargaining for some goods and the woman trying to sell me her jewelry touched the corner of my eye to remove some make-up without even asking me. She just stuck her finger in my eye. People openly give hugs too and everyone always smiles and says “you are welcome” or “akwaaba” in passing. It’s an extremely friendly culture. I love it. Yet, I get the impression with the women that came in to ANC, that they don’t need to be pampered in any way because they are pregnant. Pregnancy is completely normal, very common and completely expected.

I was really happy to be around these women. To me pregnancy is such a fascinating process. And it’s so interesting to see all the different shapes and sizes of their bellies – to see if they carry the pregnancy high or low, whether it’s her first and her abdominal wall is still firm or whether the baby is transverse or breech and you can actually palpitate the head. The one very rare event, however, is when the husband/boyfriend shows up with the woman to support her. On top of the fibroids research project we’re working on now, we’ll also be assessing attitudes of women on male involvement in antenatal care. When a man actually does show up with his woman, they get first priority. Literally, they go to the front of the line. And you should see the change in voice amongst the nursing staff when a couple walks in. I may not be able to speak Tri, but I can for sure pick that up.

Tomorrow I start my week in Labour and Delivery. I’m so excited to see a live birth, I’m really looking forward to the week. I’m sure I’ll be doing some clinical work and holding newborns again. Last week, when a woman at 39 weeks came into the clinic, the midwife took her in a separate room to check her cervix for dilation. Then she made me do it. Soooo, again, I’m thinking they think that we’re some kind of nurses or something back home. So with any luck, I’ll be catching babies this week!

For the weekend, we went to Mampong where a few of the others from Michigan are staying. It is absolutely gorgeous up there! We stayed in the botanical gardens. This weekend I'll be here in Tema, so I'll have some time to post the pics. It’s so much more lush and green; there are large rolling hills and mountains. It’s also much cooler. I was even able to go for a run this morning, which let me say, if you ever get the chance to run in Africa, be prepared to sweat buckets. But yeah, it was a real treat to stay there this weekend. Tema has it’s own charm, but it’s really hot and there’s not much of nature-y landscape. So the backpacker in me was super happy to escape north this weekend. Many adventures to come!

Adventures of the Obruni in Tema

Hi all,

I apologize for the delay in updates, I’ve been pretty busy here and I’m still trying to figure out the best means of communicating. There is an Internet café near the hostel that we are staying at, but it gets a little pricey and due to a heavy rain the other day, the internet was down for a few days. International calls are cheaper for me to make, but my minutes go fast, and as I learned talking to my parents this weekend, the connection is not great. I figure the best way to keep everybody posted is through this blog and emails (please update me too!). I may not be able to answer back right away, but I love hearing from everyone J Hoping all is well at home.

This is going to be a long post, so I’ve broken it up in sections.

The Adjustment

Well, I’m finally settling in here in Tema. It’s taken some time, though. When I stepped off the plane I could only feel pure excitement for this adventure. A few days after being in Accra, those feelings started fade and were partially replaced by my questioning thoughts. Let me preface by saying I’m truly grateful for this experience and Ghana is a beautiful country, but I think many people who go abroad for some time can empathize with the way I was feeling for the end of my first week. The cities are overcrowded, there is always traffic and the amount of pollution is just amazing. The smells are something I don’t think I’ll ever get used to. It’s really really hot, so you can imagine the amount of body odor going on; plus they have open sewage systems on the side of the roads. There are some covered sewers- one night walking in town in the dark, I nearly stepped in a pile of backed-up sewage that was seeping from a sewer with a closed cap. But mostly there are just deep ditches at the side of the road for garbage, waste, you name it, and especially on the hot sunny days, the sharp smell escaping from the ditches is overwhelming. A couple times walking to work, we’ve seen men urinating on the side of the road into the ditches. (My friends were a little alarmed, but thanks to my Uncle Charlie, I’m well conditioned to seeing public urination) The environmental health science alarms are definitely ringing loudly here. Ghana has made amazing progress, but it is still developing. So there are some things that will require an adjustment period. I know this is not supposed to be comfortable or easy and I’m glad, because I’d never learn anything if things were that way.

Things have been a little busy, and I realize I have to back up a bit here in order to stay in my chronological order. I think I left off at the weekend before we headed to Tema. A lot has happened since then, but I’ll rewind…

Last Saturday evening, we met up with my friend John. He’s in the HMP department at School of Public Health and is from Ghana. He and his buddy Kwaku (Kweh-ku) took us out for dinner and drinks. It was kind of interesting because at this point Ajab, Katie and I all wanted to try out the Ghanaian food. But John and Kwaku wanted to take us to hangouts spots with a younger crowd. And so we had pizza. This bring me to my sidenote about food:

There are about four staple Ghanaian meals: Banku, Fufu, Jollof rice and fried rice. Sometimes we come across Wache (beans and rice) and Kenke. Banku, Fufu and Kenke are all made from a combination of cassava and corn dough. They differ by consistency. Fufu is doughier, kind of like raw bread dough and kenke is much thicker, corn-based. All three are rolled into oval-shaped balls and served with some kind of spicy tomato-like soup and either chicken, goat or fish. Ajab loves Fufu and Banku, but Katie and I usually stick to fried rice, plain white rice or jollof rice (fried rice in a tomato-based sauce). I was really excited for the Ghanaian diet initially because the first meal I ate, Red Red, was soooo good. It’s basically black-eyed peas served in a red sauce with fried plantains on the side. But we have sadly found out that Red Red is rare. I don’t mind some of the other dishes that I listed, but they are generally pretty spicy and oily. I’ve actually been sick for most of this week (which could be due to so many things) but I figure I’m just building my immunity for many global trips to come J

Departure to Tema

Last Monday morning (May 10^th), we woke up early and prepared ourselves for the first day of work. Kofi is the name of the man that will be watching out for us here. He’s Ghanaian, but has lived in the states for some time and works for UM. He’s the man. So Kofi took us to the Tema General Hospital hospitality center where we will be living for the next couple of months until we move in with Dr. Deganus or whoever will host us in July. The stay here in Tema is pretty nice. Katie and I are in a room together. We each have a twin bed and we have a bathroom and shower (that works most of the time), which is really great. I know some of the others studying here are bucket showering on a regular basis, so we are grateful for running water! Ajab is in the room across the hall. The people that work here are so friendly and have been extremely kind to us. We got lucky!

After dropping off our stuff at the hospitality center, we headed to Tema General Hospital to meet with Dr. Deganus. She warned us that the first day would be rough. Mondays are postnatal days and the busiest of the week. I had described in the previous post that at least fifty women were waiting for care in the maternity ward. That was on a Thursday. Hundreds of women were waiting on Monday, some had been lined up since 5am. It was 10am when we started our day.

I was placed in the Reproductive and Child Health unit. There is a little bit of a misunderstanding of what public health is here in Ghana. In order to be in public health you have to either be a nurse or doctor. So they don’t quite understand at first when we tell them we’re strictly public health. Also, the nurses are so overwhelmed that they’ll take any help they can get. When I walked into the room, the nurse was running things on an assembly line system. About ten women would walk in with their infants; she’d give her five-minute speech about the importance of vaccinations and protecting from infectious disease. Then each baby would get vaccinated one after another. After the first round of women and infants came in, she looked at me, pointed at the needle in her hand and motioned for me to come help her. I’ve given shots before to patients, but I felt in no way comfortable vaccinating six-week-old newborns. So instead, I mixed and prepared all of the vaccines for the nurse. I’m sure by the end of my internship I’ll be vaccinating children.

After my first day of work at Tema General Hospital, I definitely had to take some deep breaths. First breathe of air: We found out we actually don’t speak the language-something I wasn’t expecting. I was thinking we’d be able to provide all of this health education. But most of the women can’t understand us. English is the predominant language in Ghana, but people from most parts of Greater Accra (especially where we are) prefer to speak Tri (chwee). So because we can’t speak the language, we have learned we’ll have to help in other ways. Second breathe of air: There are serious overcrowding issues. The amount of women just waiting to get some kind of care for themselves and their infants was shocking, and it was daunting to us that many had to be turned away. The health workers all understand that there is major lack of space, lack of resources, etc. Dr. Deganus has literally pulled the administrators out of their air-conditioned spacious offices, shown them the madness, and begged for better solutions. I hope we can make constructive recommendations to help her, the rest of the staff, and the patients with comfort.

So after a few exhausting days, Dr. Deganus sat down with us. I truly admire this woman, by the way. She asked us how we were feeling about everything. We were of course polite, but she could see in our eyes some of our obvious concerns. She explained that there are days that she has to remind herself that Ghana is a developing country, and we all have to be prepared that things aren’t going to be perfect. But if we can focus on the glass being half full, then we can start to see the good things about the hospital system. She also tapped into that over idealism that I previously mentioned that public health students (and generally westerners) bring to developing countries. We have to remember that at this point, even a simple small suggestion can go a long way. That talk with her took away any of the anxiety I was feeling. We are truly lucky to be working with this woman. She gets it.

Working in Tema

After the craziness of Monday, we were place in Adolescent Health for the rest of the week. Auntie Monica runs the show there. In the morning we go on rounds searching for young women under the age of 25 that are either pregnant, or voluntarily would like some sort of counseling. They especially focus on the younger adolescents. The first day, we sat in on a session with a 14 year old that was pregnant for the second time. She aborted the first pregnancy at 13, but decided to keep this one. Auntie Monica (a public health nurse) did a fantastic job talking through all of the key points that we learn in classes like motivational interviewing and behavior change counseling. The staff here in general is great. They know that they have limited resources and education to work with, but the amazing work that they do-especially in reproductive health- is promising.

The third day brought an even sadder story in my opinion. We counseled another 14 year old who had aborted her pregnancy by drinking some sort of poisonous concoction, which unfortunately severely damaged her insides and probably her chances of ever getting pregnant again. She was explaining that her partner did not want to use a condom during sex, and that she really had no choice. When she became pregnant, he “hated her for the pregnancy” and so she took drastic measures to abort. We all felt for this young girl. It’s so easy to get attached to cases here, and we know we have to maintain professional relationships. But we took her out to lunch to let her know that she has support here at the hospital.

I’m sure some people are reading this and thinking things are slightly depressing here. Again, there is great work being done, and we get to be a part of that too. Plus, we make time for relaxing and fun. After our first week of work we headed to the beach with the others from Michigan and enjoyed a nice weekend away. I’ll post pictures of everything soon I promise!

The second week at the hospital, we all split off into different units. I have been in Antenatal Care for the entire week. I was more prepared for Monday, knowing that there would be a large crowd. Luckily, I was in an air-conditioned room, and got to examine babies all day! I checked the plates in their heads, skin for any infections, and the shape of their spines. I also got to hold them J They call me Obruni here, it means “white person.” So Auntie Kate, the nurse in Antenatal kept laughing at the skin color differences between me the Obruni and all the little Obibini babies (black babies). For the remainder of the week, I’ve been doing a lot of clinic work, helping the nurses examine the women coming in for check-ups and giving HIV tests. I’ve had a great time this week, I’m enjoying myself in Antenatal.

I’m running out of time on the internet, and I fear this post is getting to be waaaaay too long for anyone to want to read. So I’ll quit here. This weekend, we’ll meet up with the other Michiganders again and go enjoy some scenery a bit north of where we are. We plan on catching a futball match at some point this weekend too! I look forward to hearing from all of you too, hoping everyone is well. Talk to you soon, and pics are coming soon too!

Welcome to Ghana

Hey guys,

I've made it here safely...it's been a long couple of days. I left Detroit Metro around 10am on Tuesday, flew in to DC. My friend Katie from my program traveled with me. Since we had about a 7 hour layover, we decided to hop on a bus to downtown DC. We walked around, and to all my public health friends, the first building we came across was the the Department of Health and Human Services..ha. It was a beautiful day in DC. We sat outside at a little tavern and ate gigantic burgers and fries-a great American meal before departure. We did some more sightseeing and said hi to Obama at the White House...we thought it was necessary we should let him know we were leaving the country. Made it back to the airport with plenty of time, then flew overnight to Frankfurt. I've never been on a plane for more than 5 hours, so I when I wasn't trying to sleep (aka head bobbing) I was getting pretty antsy. The flight to Accra, Ghana departed pretty soon after touching down in Germany. I luckily had a window seat, and sat next to a man from Ghana. So we chatted a bit, and I was able to see a great view while landing.

I was absolutely shocked at the heat when we stepped off the plane. I was expecting it to be hot, but not this hot. And I'm told it gets hotter. Ghana is in the beginning of their rainy season so the average temp is anywhere from 85-95 degrees. Anyway, we were picked up at the airport and taken to a really nice hotel to get settled in. The third member of our team, Ajab, arrived around 8pm. We took showers, got settled in a bit, talked with our professor about our project and then got some much needed sleep. Thursday was a super long day. Not only were we jetlagged, but the heat was making us a bit woozy too. We took about a forty minute drive to Tema, and met with the hospital director and the doctor we'll be working with. Tema is a pretty busy city, and I'm told it's actually more middle class, while the surrounding nearby areas are lacking in resources. However, the doctor to patient ratio (because of the size of the pop) is the reason there are so many challenges.

It looks like we'll be doing 3 week rotations in prenatal care, labor and delivery, postnatal or maybe pediatrics for me. We may also get the chance to do some work with their PMTCT (prevention of mother to child transmission of HIV) team. We have this next week to figure out the details, and narrow in on a research project. Everybody is really nice and friendly here, and Dr. Deganus knows exactly what we're looking for as public health students...so I'm pretty excited about the experience.

We had the chance to take a tour and check out each ward. I probably won't be able to take pictures, so I'll try to describe it as best as I can here. It's not a hospital like you or I have been to, but it's not exactly a health clinic either. It's really more like several small health clinics clumped together in one area. Each building is sort of an indoor/outdoor set up with air flowing through. The patients mostly wait outside on the walkways, or on benches. The maternity ward waiting room is outdoors and has basically rows of pews for the women. The maternity ward was so overcrowded, I don't think I've ever seen so many pregnant women at a given time...there were easily 50 women, probably more, waiting either for prenatal check-ups or to get prepped for delivery. We saw a few women actually in the process of labor. I mean I know I didn't grow up in this heat, and probably the women here are used to it, but I cannot imagine giving birth in this heat with just a small fan blowing on me. Also, the smell of whatever sterile solutions are being used definitely wasn't pleasant either. But the staff are really encouraging and accommodating, so they make it work. I hope that we can help alleviate them, as they are overworked, in some way. We'll find out our main tasks sometime this next week.

Other than checking out the hospital, we've just been getting settled in. We went grocery shopping, got phones, settled into University housing for the weekend. We've met a bunch of students from England and from other areas of Ghana studying here. Also, the group of UM students that will be here for the summer showed up yesterday. So we had lunch/dinner with them, walked around a bit. The boys with us played a pick-up game of soccer with some of the guys in the neighborhood...it was intense. We hung around a bit afterward in the dorms and stayed up late chatting and playing UNO (thanks mom, that came in handy). Today we might explore some more. It's kind of strange, there is so much traffic here and people move quickly, but at the same time, it's so slow. Not much to do but walk around, read, sleep. Most of us don't even want to eat much because of the heat. One big meal in the day is enough and granola bars, bread and cheese, fruit...small things for other meals.

I won't be able to upload pictures until I get to an internet cafe with higher speed. But I'll try to get those up as soon as possible.

I can already tell this is going to be an amazing experience. I'm pretty excited for these next few months. I hope everyone at home is well. Miss you guys. Talk soon.


OH the one thing I left out here....everywhere you look, there is something World Cup related...can't wait to get into the craziness of it! See ya!

Into the Mystic

I'm ready to go. My bags are packed. I've shared meals and beers and hugs and kisses with my family and friends. I've got my itinerary in my pocket, DEET by the pound, visa secured, and a backpack full of all the essentials for the next three months. I also have a pretty amazing playlist, might I add, to serve as a soundtrack for this journey. I'm ready to go. I'm on my way to the airport, ticket in hand. I'm ready.

Realizing the great need for health education and outreach in the United States-and in Detroit- some people have fairly questioned, why Ghana? I can only explain it as simply as this: I have to go. I tried to bargain with myself in the beginning of my internship search, asking the same questions: why global health, why not domestic? In truth I probably could have been happy interning in Detroit or New York or DC or even Seattle. But every part of me whole-heartedly knows that I have to experience this. It may sound whimsical and mystic, but to me, at least for now, I feel it’s where I’m supposed to be…

Public health tends to attract the idealistic. But my experience in this program so far has only procured my ideals to incorporate sustainability and practicality. We are trained to understand that community empowerment is necessary in the process of change. We must offer the tools we have as public health professionals, while working in partnership with the community to build upon the existing framework. Change can only happen with the help of the community.

In one of my classes this past semester, the professor that is directing my project said something that resonated. She said to truly understand the challenges faced as a health educator/program coordinator in community building, you should live in an impoverished area for some time, where infrastructures are anything but stable. I know some of my friends in the field already can attest to this.

This summer I’ll be working in Tema, a city on the ocean, located about 40 miles from Accra. Tema is mostly a fishing/shipping town, but lacks resources. Women, in particular, endure many reproductive health problems due to lack of access to appropriate services. Many do not seek prenatal care, and the majority delivers at home, which consequently results in major pregnancy complications and maternal and infant death. The goal of our project is to provide education and outreach to the women of Tema, while supporting the one and only OB/GYN in the area, working to build a sustainable health education program/campaign to reduce maternal mortality.

Interning in Ghana isn’t just an opportunity to gain experience in health education within a resource-poor community; I could easily build that skill-set in Detroit. Rather, this is a chance to remove myself from what is familiar and go outside of my comfort zone. I have the opportunity to not only learn a great deal about a community in a foreign land, but to grow as an individual and truly test my capabilities away from home, away from luxury, away from comfort. I’m going to Ghana because it’s a chance to travel and see my world from a different point of view. I'm going because I believe in cultural collaboration. I'm going because I do believe in sustainability and community change, no matter how long it takes. But most importantly, it’s because I believe in this.

So if at very least all I get is a glimpse of global challenges, then I hope to realize the fortunes I have. If it’s a new community experience that I gain, then I hope to be able to draw comparisons to my own. And if it's a view of the inequalities and struggles that women face abroad everyday, then I hope to appreciate the freedoms and opportunities I have. A summer in Ghana is an experience worthwhile, and it's exactly the experience my heart is searching for.