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!