The Daily Beacon

I’ve been given the opportunity to write an op ed column for The Daily Beacon, my university’s newspaper, this summer. It will be published every other Tuesday, and I will also be posting them here as well.

Obama in Ghana
“Obama is a hotcake,” a Ghanaian just told me. You better believe it. Last Wednesday all the local Ghana news papers were filled with stories of Obama’s victory over Clinton. On the streets, in taxis, in the media, all of Ghana is talking about Obama. Ghanaian music stars have concocted odes to Obama that beat from passing cars and roadside spot bars. “Obruni,” they ask me, “are you for Obama?.”

Although in the interest of time, I knew better than to ask a Ghanaian, “Why should I vote for Obama?” But because of the sheer insistence without any substance behind his democratic support, I couldn’t resist. Why? Unity. If America can elect a president with African descent, the whole world will realize we’re all one. It’s a step in the right direction, mate, but I’m afraid it’s not quite that simple.

Others have more honest, self-serving reasons why America should elect Obama as our next president. Our “hotcake” friend says an African president will draw attention to Africa. He would bring aid and support to the continent. An African as the president of a world superpower would be a great symbol to the world. Don’t forget Africa.

However, when I brought up the fact that the Bush administration, despite its flaws, has brought more medical aid to Africa by means of the President’s Emergency Plan for AIDS Relief (PEPFAR), than ever before in United States history, I was looking back onto a blank face. Although still barely making a dent in the African AIDS pandemic, PEPFAR has brought light and global support that is taking great steps in improving the state of health care in Africa. And that was by a white guy.

Increased African aid and a symbol of unity could potentially be nice side effects of Obama’s Presidency, but what about policy? I tried to explain to the Ghanaian preaching unity that, as citizens of the United States, we have a responsibility to consider the candidate’s platform. Will they support legislation that will improve our country? Are they strong enough to lead our nation? You cannot get these answers by looking at the color of one’s skin.

Although many Americans will try to argue that race is an issue of the 60s, this election has taken the awkward ugly step-sister out of the closet, given her a make-over, and thrown her a coming out party on CNN. No one can hide from the fact that race is playing a huge role in this election. The prospect of a black president has made Americans confront the fact that our nation never completely reconciled its prejudices and stereotypes. America just swept race under the rug along with the crumbs from the cookie mom told you not to have.

Africans shamelessly support a man because of the color of his skin. Is this true of Americans as well? I’d like to believe that more Americans vote based on policy than those who cast their ballot on appearance. I’d also like to be able to say that we as the voting population could focus on policy rather than on whether he’s black or white. However, whether the pundits are talking about it bluntly, or saying that we’ve progressed past the issue, the conversation still revolves around this election’s key word: race. Why don’t we just elect Michael Jackson? Then we’d have all our bases covered.

Wow. A lot has happened since I’ve blogged last. The main events that I’m going to try to hit on in this post are my experiences in the operating theatre, my first experience sitting down and talking with Liberian refugees, and my trip this past weekend to Boti Falls and Shai Hills Resource Reserve. And how badly I’m craving a Turkey Tom from Jimmy Johns…

It ended up being a little on the long side. It’s hard to limit what I want to tell everyone to a bearable length, but maybe you can grab a Turkey Tom and have a little lunchtime reading. Or you could forgo the awkward inspirational book on the back of the toilet this time and take my blog for a nice bathroom read. At least I’ve given you options!

The Operating Theatre

At my hospital, I have finally figured out that, outside of emergencies, they perform operations on Tuesday, Thursday, and Saturday. When I was in the surgical ward (pre-op surgical patients), we had a diabetic woman who needed her foot amputated. At the risk of sounding sadistic, I had been waiting to see the amputation for two weeks. It turns out they did it this past Saturday while I was out of town.

I am really glad I’ve had the opportunity to watch various surgeries in the States, because it has allowed me to make comparisons in surgical procedure here. I can’t decide whether it’s more similar or more different but I don’t think that distinction is really necessary. When I am in the OR, it is such a familiar feeling. Whether the surgeon is using decade old equipment and having to do invasive surgeries, or the surgeon is using the latest technology and doing a minimally invasive procedure, there is a commonality among it all. My favorite part about the whole experience is that we all look alike on the inside. Whether your skin is black or white, we all have the same pink organs.

The first procedure I saw here was an emergency ectopic pregnancy. This where the egg is fertilized and starts to grow in the fallopian tube rather than making it all the way to the uterus. You might imagine how this could be problematic. When the fallopian tube bursts, the woman starts bleeding into her abdomen along with other complications. In this surgery the tube had already burst, so they opened her abdomen and repaired the tear.

There are tons of significant differences between operating room here and back home in the States. To list them all would take a while, but it is very interesting so if you would like to hear more about it, I can send you a separate email. Notably, all the drapes and gowns used are cloth and they are reused. Whereas we use several disposable paper drapes per procedure at home, here they use a single cloth drape with a hole to expose the operation site. The doors hang off the hinges leaving me thinking about all the germs floating in and out throughout the operation. Overall, it just seems like they are operating a decade or so behind the times. Certain staple tools used at home are absent from the theatres here. However, what impacted me most about my first time watching a procedure here is not all the technology or procedural differences. When they drape a patient at home, there is a large drape that clips to two poles by the patients head so that their face is hidden from view to essentially all but the anesthesia personnel. Here there is just one drape, so you can stand back and is one glance see the face of the woman and the incision revealing her organs all at once. This really made an impression on me because it is so easy to view the case as a body part and not an actual person with a life story. This image brought the humanity back to surgery.

Liberian Refugee Camp

First, a little background on the camp and why there are Liberian refugees in Ghana:
There were two civil wars in Liberia, the first from 1989-1996 and the second from 1999-2003. When the war in Liberia broke out many fled to Guinea and the neighboring Ivory Coast. Ivory Coast had its own war around 1995 (I have not verified the date here, but this is what I’m assuming based on my conversations with refugees) causing the refugees there to flee to Ghana, the next country to the east. The camp is 19 years old and they are currently trying to close it down.

At the beginning of the year, the UN was offering a repatriation package of $5 per person and they were allowed to take 20 kg (or 44 lbs) of their personal belongings. Obviously, even in Africa, $5 is not going to suffice even for a week. Rent is averaging $25/month in Liberia right now. Many of the women’s groups in the camp gathered to protest and demand more money. While asking for $1,000/person, the UN conceded to give $100/adult and $50/child, but still only 20 kg of belongings.

In Ghana, you are supposed to ask permission from the government to protest. The groups in the camp did not do this, so the government looked at the acts and decided the Liberians weren’t appreciative anymore and wanted them to leave Ghana. Also, Ghana has presidential elections coming up in December and they don’t want the refugees causing any problems.

Last week when I visited the camp, I just sat and talked to a number of refugees. In the short time that I was there, I uncovered some interesting trends. Most of the people who were older or had arrived more recently wanted to return to Liberia. The exception was a little boy named Michelle who came up to me when I first got there that day. He was wearing a Camp Wesley Woods T-shirt; I asked him if he knew where it was (fully knowing that he didn’t) and told him it was in Tennessee, where I’m from. I went to that camp in 5th grade! He told me that he and his mom were going back to Liberia soon. I asked him if he wanted to leave, and he said yes. He was 7 years old, had been born in the camp, and even speaks the local Ghanaian language Twi. I thought this was interesting that he wanted to go “home” to Liberia, a place he had never been and knew nothing about. I concluded that this must be largely his mother’s influence. It’s interesting how much you can tell about an adult from their young child’s opinions.
In another area of the camp, I sat with some people who were less willing to leave. Most of them either had been in the camp since the early 90s or were very young when they left Liberia. A few of them who were around my age were talking about how they don’t know anything about Liberia. They know Ghana’s history, not Liberia’s. They have friends here; they’ll know no one in Liberia.

Another common theme was the importance of education and a proper job. One of the women who wanted to go back to Liberia said, aside from going to Liberia, the one thing she would like the most is a loan so that she could start a business. She said she didn’t think she would have any problem paying it back. Another woman was 23 years old in business school when she had to leave. Nine years later, she is still determined to return to Liberia and finish her education. Her life has essentially been on hold for the past 9 years. All of the people I talked to are very capable people. They were living normal lives until they had to start over in Ghana with nothing. They knew another life and then had to flee that comfort and come to a foreign land with no one and nothing and completely start over.

Although my emphasis is health care, that seemed like mute point here. There is an equipped clinic on the grounds. Anyone who needs treatment can go there—providing they have the money. They aren’t treated until they pay. It seemed obvious what the obstacle to health care here is: poverty.

As I familiarize myself with situations like these all over Africa, poverty is the common theme. It’s a vicious circle, and one single aspect such as health care cannot be isolated. We have to work together to build the infrastructure at once. If you lift a table from one corner at a time, everything is going to fall off. If you work together to lift all four corners at once, everything will stay in its place. You can’t fix the problem of poor health until you fix poverty.

Boti Falls and Shai Hills

This past weekend 11 others and I went to explore the amazing nature that Ghana boasts. The trip was interesting from the start since we had 12 people. We thought we’d never find one trotro with space for us all. It turns out 12 is the perfect number—we fill an entire tro! When drivers noticed this, they would allow us to essentially charter their tro to take us where we wanted to go. The only problem is that they saw the cedi signs in their eyes and paid no attention to the fact that they had no clue where exactly it was that we were going. However, Ghanaian men aren’t too proud to ask directions, unlike their American counterparts.

On Saturday, we went to Boti Falls. First, we hiked to Umbrella Rock. For most hikes in Ghana, you have to have a guide. The only problem is that these guides, in my experiences, have their speed set at turbo, so you’re rushing to keep up with them and not being able to enjoy the scenery. I enjoyed the hikes here more than back in the Smokies because they’re not as worn down from so many hikers. My favorite parts are climbing over roots and rocks. It did, surprisingly, remind me a lot of the Smokies though. All it was missing was a picnic by the river with my family and a turkey sandwich, Lays, and double stuffed Oreos.

Once we got to the rock, I noticed there was a scanty little ladder leaning up to the top of the rock. Our guide said for 20 pesawa ($0.20) we could go onto of the rock. Seeing a way to be adventurous and put my life in danger at the same time, of course I had to go up. You could see 360 degrees of the mountains—the first amazing view of the weekend. After Umbrella Rock, we went down to the falls. They are twin falls, and pretty big. When we were in the clearing by the pool of water, mist from the force of the falls hitting the water cooled us off nicely after our hike.

Saturday night we took another it-should-have-taken-one-hour-but-took-three-instead tro rides to Shai Hills Resort to ready ourselves for our early 5:30am rise to see monkeys. Sam, one of the other volunteers, is amazing at bargaining and was able to persuade the driver of a facility truck to drive us around the reserve for 35 cedi. We did two hikes in the reserve: one to a point 290 meters above the ground and another to the bat cave. (I ran into Alfred there. He said Bruce was out of town, but he let me take a spin in the Bat Mobile.) The first view, from the high point, was incredible! It is, hands down, the most beautiful view I have ever seen in my life. The land was so flat you could see for miles. I know at least 300 km because we could see the town of Tema in the distance. You could see small mountains come up out of the ground and then still see past them. It reminded me of looking out onto the ocean, how the horizon gently curves as it passes out of view.

The bat cave was interesting because a tribe used to live there and you could see where they fortified the area and put up traps to stop enemies. Other than that, I ended up way too close for comfort to a room full of bats I could only hear and not see.

On another note, my roommate, a couple friends, and I are making American pancakes for dinner tonight. I am extremely excited. Even more than a hot shower, I miss certain foods…What does that say about me?

It's "Ghana" Get Interesting

Sorry, I had to use that pun at some point. It's done now.

Sunday, June 1

Preface

I have been making references to what I am studying in my past blogs, but I have never explicitly said what I am studying or why I am here, in Ghana.

At school, I was just accepted into the College Scholars major. This is an honors program designed for "highly motivated and academically talented students who have clear goals for their undergraduate education, and who cannot attain those goals within the traditional requirements structure of the College." Essentially, it offers a student the opportunity to design their own course of study, working closely with a faculty mentor, and culminating their studies in a senior thesis project.

The program I have designed is entitled ‘Exploring the Relationship Between Conflict Zones and Health Care Delivery’. It focuses the consequences of war on access to health care, and looks at access before, during, and after violent conflict. It also focuses on African studies. I want to work as a surgeon in areas of armed conflict, predominantly Africa. It is imperative in providing optimal health care to understand the culture and society within which you are working.

To list all the reasons I wanted to come to Ghana this summer would take to long—perhaps a conversation best held in person. Primarily, I wanted to immerse myself in the culture and work in a medical context to be able to compare the practice of medicine here and to that in the U.S. I am also working at the Buduburam Refugee Camp in order to do research regarding my university studies. Talking to refugees and hearing their stories is a great way to learn about the effects of war.

Buduburam Refugee Camp

Last Wednesday I visited the refugee camp. The day went as most of my time here has been: One step back, two steps forward. I mentioned that I had met the director of PAC (Pan African Center for Peace) and arranged to meet with him at the camp. It turns out the organization is not yet a registered NGO but is a CBO (Community Based Organization). They focus on education and hold workshops in the areas of NGO management, Peace Education, Private Education (on how to teach), and Community Health. They had the Millennium Development Goals (MDG) hanging on their wall and when I asked, they said all their programs are aimed at fulfilling the MDGs.

They were excited that I was studying conflict and health care. What PAC had in mind for my involvement was for me to design and lead a workshop either in Peace Education or Community Health. I felt I was not qualified to lead such a workshop (especially not in peace education; I’m just starting to learn about that myself!), but I agreed to help inform PAC more about community health since they know essentially nothing. While talking to them, it was difficult to find a happy medium not letting them overestimate me, but without underestimating myself.

I was able to talk to some medical assistants and the head doctor at the camp clinic, which I believe is run by UNICEF. I was trying to figure out the health situation in the camp (i.e. - what the biggest problems/ diseases are) just to have a starting point. I was able to speak to the head doctor in the end. While trying to be polite to John of PAC, what I believe he was trying to tell me is that Pac is a CBO that doesn’t know anything about health care and it would be a much better opportunity and experience for me to piggyback on the campaigns that the clinic already ahs running in the camp. I’ll admit, this was a relief to me since this is more the type of opportunity I was looking for. I did not feel comfortable with the responsibility PAC was trying to give me.

I hope to gain insight to the health care situation in the camp and to have time to sit and talk to refugees; to hear their stories.

I don’t know if I’ll be able to go twice a week as I had hoped simply because it is quite a journey by tro tro to get there.

Friday, May 30

Medical outreach was cancelled today. I tried to sleep in since it was the first day I’ve had free since I’ve been here. I was awake by 7:00. I finally had an opportunity to meet with a friend of Dr. Hackett’s, Kwesi. He and his family were very nice. He is the Chief of his village and showed me the video of his installation as Chief. I wish I had time to watch it in its entirety; it was very interesting!

Saturday, May 31

Today was the end of the month beach party with Projects Abroad. It’s an all day party at Akwaaba Guest House on Coco Beach near where I live. Volunteers from all the different regions PA has placements come down for the day. There is food, drinks, games, drummers, dancers, etc. We played tug of war between the different regions (our Accra guys won!). We also had football (soccer) matches and I played with the girls. It was a punch in the face reminding me how out of shape I am!

There was a cultural group there with African drums and dancers. I love watching African dancing. Everyone always looks so happy. Not to mention that they can move in ways I didn’t think humanly possible! After dinner, they moved the drums down to the beach around a bon fire. But the festivities didn’t last long.

There was a group of four from another region that went swimming. The current here is very strong and the waves are really big. They got too far out and had to start swimming in. Two made it in on their own, and two of our guys were able to pull a third guy in, who was taken to the hospital. The fourth girl was still missing. It gets dark very quickly here so there was no way to see her. There are not effective emergency services here either, so there was essentially nothing we could do except walk the beach looking for her and wait. A little over an hour she came up on the shore right in front of where we were. She was still alive and taken to the hospital.

I just heard this afternoon that she did not make it. Please keep her family and friends as well as the other volunteer that was taken to the hospital in your thoughts and prayers.