"Obruni!...Ginger Snaps?"

I’ll start off with a humorous observation:

Being around my two British roommates, I have begun to think in a British accent, but not talk in one. Therefore, it is quite strange when what I think in a British accent comes out in an American accent. (I wondered why I did not think in a Ghanaian accent, but then realized that I’m still having trouble understanding it all the time. To not be able to understand your own thoughts would probably be a disadvantage.)


Saturday, May 17

Today was my first venture into town! We went into Osu, the area of Accra that is more touristy and also the location of the internet café I use most. We ate lunch in Osu at Tip Top Chinese Restaurant. “Chinese?” you ask? Why, yes! Apparently, Chinese and Lebanese food is very popular here. For those who know me better and question simply the fact that I ate Chinese—I was in a rather indifferent mood and that was the choice of the other two guys I was with.
While we’re on the subject of food, the food here is very good. Since I left Knoxville Tuesday, I had not had much of an appetite. I’m not sure why—this was very strange for me! But, thank goodness, my appetite returned to me on Saturday and I can properly enjoy the Ghanaian cuisine (or Chinese). My host mom—and her house helpers—cooks very well. She said she doesn’t put any peppers or hot spices in our food, for which I am very grateful! Today as well, I got to fry plantains with Abena. (Abena is one of the house helpers and is very sweet. I would guess her to be around 13 or 14. There is also a younger girl, who looks to be about 10.) Abena is a master cook—I think she was amused with my clumsy culinary effort. Mrs. Obiri told me if I wanted to prepare one of my American meals, to let her know and she would get the ingredients. I had to inform her that I was not the best cook….perhaps I’ll let Abena teach me a bit!

Sunday, May 18

I can tell I’m getting more comfortable here, because in four short days I was able to get back to my horrid habit of sleeping through alarms. I might have to revive my old phone to utilize its three alarms. Unlike when I would sleep half the day back home, oversleeping here was 9:00. I am usually up between 6:00 and 6:30. Where life is slower here, it is definitely earlier too. Last night I was in bed before 9:00. I don’t think that has happened since my parents gave me a “bed time”.
Today I learned that one of my housemate, Naomi, who was supposed to be staying another 2 ½ weeks will be going home tomorrow. Ellie leaves on Friday and the next girl does not arrive until a week later. Tonight we went out to have a last dinner with Naomi. It started raining just as we were leaving to go. The place that they wanted to go was closed so the only other option, while avoiding the pounding rain, was the food court next door. It was very Western—they sold pizza, burgers, chicken, “chips” (fries), ice cream, and a variety of other foods that one might see in a Western food court. It was strange to see something that looked so familiar in the midst of the unfamiliar.
I hate to change the mood quite suddenly, but the most poignant aspect of my day was my visit to the orphanage. We went to visit the infants. Upon entrance to the building where they stayed, I was surprised with the number of babies just lying on the floor. To walk down the hall, I was stepping over children. We helped to feed and bathe them. Well, I didn’t do any bathing—except for myself after a boy threw up all over me. I felt bad because there were so many children, (with just a quick glance in around my immediate area I counted close to 30) and I knew that the ladies working there simply could not give them all the love that they need. One child’s face will be etched in my memory forever.
The infant looked like an old man. He was so emaciated that his cheeks sunk in and the skin on his face was stretched tight against his skull. The skin on his arms and legs hung loose like an elephants. I could see where his tibia met his femur at the knee joint, and his hands looked grossly disproportionate to his body. He lied there, not crying along with the other children. Every so often, he would just roll on his side, reach his tiny, bony arm up and stare at the tiny baby girl lying diagonal from him. In addition to his malnutrition, he was sick, with vomiting and diarrhea. Looking down at the child, I felt as if he knew he had no hope.

Tuesday, May 20

I have completed two full days at Poly Clinic now. Here are the highlights of my thoughts while spending time there:

Privacy. Or lack there of.
Coming from working in a U. S. hospital where HIPAA (Health Insurance Portability and Accountability Act) is jammed down our throats from day one, it is quite different here. I have not found out specifics about whether or not there is a similar privacy act here, but I have not heard of such. The patient information is just left out on the table and I have heard no cautions against using descriptive information when telling others about certain cases.
Privacy is also negligible in other cases. The “Emergency Room” is a single small room in the middle of the waiting area. However, when emergencies come in—usually consisting of patients who are severely ill—they are treated in the open area. There is a rolling curtain that they use to try and conceal the patient to a point, but until they get that in place everyone in the waiting room (I’d estimate up to 100 people) is sitting there watching the proceedings. Also, where we check the vitals (temperature, weight, and blood pressure), there is a patient at each end of the 4 foot wide table and plenty others around to hear the vitals being reported. For instance if the patient is going to the AIDS clinic, they tell us at that point, and therefore anyone in the vicinity knows that individual has HIV/AIDS. Maybe it’s a culture difference, but I still feel individuals should be able to have privacy concerning possibly stigmatizing information.

Breast Feeding.
This stems from the privacy idea. I was surprised to glance over at one of the benches in the waiting area on see a woman sitting there breast feeding without covering herself. My first (American) reaction is that they should be able to do this in private. Then, on second thought, I decided that this was a very good thing. It encourages breast feeding, making it convenient, and normalizes the natural act. This is very good because breast milk is the best nourishment for the baby and such acceptance encourages the practice.

Efficiency.
I hate to venture into the subject since I am sure the hospital workers know much more about the hospital practices that I do. However, with 3-4 staff nurses at a time operating patient screening and the emergency area, it seems slightly inefficient for the entire staff to leave the screening desk to go tend to the emergency. Thus far, emergencies have not been anything dramatic such as someone coding, they are severely sick and weak people. The nurses just start an IV and take the person’s vitals and wait for the doctor to come see the patient. Meanwhile, the whole screening process which every patient has to go through before they can see a doctor is at a standstill. Again, I hate to comment on their procedures since I’m sure they have reasons for the way they do things, but I’m not sure where the line is. I don’t know if I’m being culturally naïve, or if there really is room for improvement.

People Watching.
A great past time—even better in a modernizing third world capital city.
I love to sit and look at the variety of people and attire in the wandering and sitting in the waiting area. There are people of all ages and all different classes. People are dressed in everything from very traditional attire to Dolce and Gabbana jeans. I like the women in traditional dress with Dior or Burberry scarves on their heads. We spoke of the effects of globalization in my Life Happens seminar with Dr. Rita Geier this past semester, and it’s very interesting to actually see it. I see women in business dress the equivalent of what you would see in the US, with a baby strapped to their backs in the traditional Ghanaian fashion. There are businessmen, traders, school children in their uniforms, young mothers, old mothers…the diversity is so interesting to take in!
I love to catch the eye of a small child or a baby. Many times they will just stare at me. Today there was a little boy who was looking at me, and whenever I looked at him he would “hide” but find another angle from which to look at me. Any time I caught him he would laugh.

Semi-Notable moments/ thoughts:

There is a spot on my journey home where the road narrows from two lanes to one. Of course, this backs up and slows traffic—to a halt during rush hour. Along this stretch of the beach road, vendors carrying everything from pure water and fried plantains, to mentos and toilet paper walk between the cars. Some of the vendors will notice me sitting in the window and stare me down trying to sell me something. “Obruni!... Ginger Snaps?”

On Monday I made my first successful solo trip from home to La Poly Clinic. Then I got a little courageous and even ventured to Osu to visit the internet café after work. Afterwards I made my way home, thus completing my first successful round trip by myself.

Noticing how much I stand out here made me think about the diversity in America. Everyone I pass knows I’m “not from ‘round here”. In America, however, we would never notice a foreigner simply because of their skin color. Culture and diversity are such interesting subjects. Here there is diversity yet such a strong shared culture. In America, the same exists, but in such a different way.

One thing I have learned about myself is that I am interested in the political aspect of medicine more than I previously realized. I am so used to having constant internet access back in the US and keeping up to date on international and local policy happenings, it is strange not having my daily perusal through the New York Times and CNN web pages. I was previously considering studying at Gulu University in Northern Uganda in the spring, but now I am thinking I might try for an internship in Washington D.C. I feel this would put me in contact with a variety of people and provide a more diverse experience concerning subject matter.

Fried plantains are amazing. I love the food here. It’s such a refreshing break from all the processed food back home. Especially since my diet was mirroring my mental crash near the end of the semester, consisting of mainly Cheesy Gordita Crunches and Micky D’s Sweet Tea. (My last “American” meal in the Detroit airport, as well, haha.) Fruit is so easily available! I went from never eating breakfast to having oranges or pineapples, banana, and bread every morning. Last night we bought a pineapple for 40 pesewa (about $0.40) and an orange for 10! For lunch today I had some form of a meat pie, fried plantains, and a Fanta—all for 70 pesewa!