« The secret isn’t counting the beans, its growing more beans »

Today started off with a little surprise. We had just arrived home from 37 military hospital and was getting ready to cut into a delicious mango. I was about half way through when I noticed a black spot in the middle, thinking nothing of it (as I’ve seen them before) I put my knife in to cut around and continue on. All of a sudden a huge bug starts to crawl out of the hole, I can see each and every one of its legs creeping out. Later on (after I run into the room, slip on the floor and fall against the door), we dig to see what else there is lurking in the pit of my mango and find a mini nest. All I could think of were « Mango Flies », they burrow under your skin and lay eggs, if you do not pop them out they eventually hatch and fly out of your skin….. I haven’t given up, mangos are still a huge part of my diet but I have opted for getting my mangos cut at the market from now on. Im aware Vince, once a suck always a suck.

I still put a lot of trust in the market food, especially at supper when you cant’ see a thing you are eating, if you bite into something hard (most likely a fish bone) you spit it out and keep on trucking. The amount of rice and fried plantanes I have been eating here would put Vincent to shame. You couldn’t hack it, guaranteed. My favorite so far is either red red (bean stew and fried plantaines) or Jolof rice with salad, plantanes, and lots of their spicy sauce. Some other Ghanaian dishes are fufu (mashed cassava and plantane thrown in different flavors of soup, you rip off a peice of dough, make it into a little scoop and throw it in your mouth along with the soup you manage to scoop up), Kenkay or Banku (fermented or not maize eaten with rice, sauce and spice), Yams and spicy sauce, more rice of course (fried, plan or watche)…. The 3rd day here my roommate and I tried out fufu. Not only was it dark, I couldn’t understand what was being offered so I pointed to a random pot of soup and asked for fish (I have heard when you ask for meat you can get full intestines and cow/pig or who knows what hide). I got a glimpse of a fish head and was mess by the end of it, I have learnt to stick to day light eating when trying something new…

FuFu, with chicken and groundnut soup. With the fish head incident long past me I decided to give it another go. Amazing! At each table they have a bucket full of water for you to wash your right (never eat with your left!) hand before and after.

We have 4 days left at the polyclinic and than its off to a village for our last week. The Mamprobi polyclinic is just on the outskirts of Accra, the west side. They do not call it a hospital, however it is similar to a small rural hospital back home. It has its own maternity ward, antenatal and postnatal clnics, STI clinic, psychiatric clinic, recovery room (small ER), outpatients department, and community health offices (child welfare, public health, school clinics)….. Last week I had the chance to be in the recovery ward, antenatal and post natal clincs. I’ve started getting used to the whole aspect of healthcare here and how things are run however I still find myself trying to collect my thoughts and not walk around with my mouth haning open for most of the day. One of the days in antenatal I was able to do HIV/AIDs testing (which is mandatory for all pregnant women each and every time), it takes about 5 minutes for the results and if they are positive they are referred for further testing (quick oral test) and counselling. It was heartbreaking to have to deliver the news of a positive result, made especially difficult with the language barrer. If you have the national health insurance (which was just implemented in the past couple years) most of antenatal and basic hospital care is covered for. However the funding can be sporadic and does not always make it to the hospital so there are times drugs are not available, or resources such as gloves or spirits (alcohol) which run out (almost everyday at 37 military hospital). Most patients have to wait until the family goes to buy their medication from the pharmacist (even in emerg) as well whenever a patient needs blood the family has to donate to either replace what was taken or so the patient can get it infused. After only experiencing our health care system it is the oddest thing to see money being exchanged for services right in front of me, and to see even emergent situations being put on hold because either the family is not there to pay or a lack of resources.


The antenatal/postnatal clinic is as efficient as it can be, they serve 100 – 200 women each day with only 6-7 midwives to see all those clients. Each morning I walked into a colorfull, hustle and bustle waiting room. These waiting areas are open to air with wooden benches, women sitting hip to hip either pregnat or with a baby tied to their back with material (I have never seen so many pregnant women in a room before in my life). Each women has a different colored/patterned dress and it makes the room look like joseph has spread his technicolored coat over the benches. (This picture is at the end of the day, when almost everyone had gone home). The day starts off with singing and praying for 10-20 minutes and moves to an educational talk (20-40minutes) by one of the midwives (safe motherhood, family planning, abuse, mental health…). Although these talks are in « Twi », sometimes it is impossible to miss the meaning of them with the demonstrations they have (especially with family planning  ). The women move on to weight and height, urinalysis, HIV/AIDs testing and than finally to see a midwife who assesses and educates them further. The nurses/midwives have amazing assessment skills however if their are complications, especially during birth and the women needs to be transfered to a major hospital for surgery it can be a problem. They have to find an ambulance, get ahold of the hospital (if possible) to get the OR ready (although they only have one OR room at the hospital close by because the other is under renevation), and if their are no other emergencies (chances of this are next to none) they can maybe get into the OR in an hour or 2, which by that time it could be too late. The maternal mortality is around 540 to 100 000 women, and in Canada it is about 8 to 100 000. However that doesn’t count all the deaths unaccounted for in rural areas…. Which could put it at double that.

One my preceptors from 37 military. Like most of the nurses from the military he goes all over Africa to work in the countries who have ongoing civil wars. He is leaving in 2 weeks for Liberia.

This past weekend a couple of us went to a town just an hour outside of of Accra called Aburi for the day. Once again getting on the Tro was almost a matter of life or death, after all that pushing, shoving and yelling you sit down and make friendly conversation with the person you almost (or did) elbow in the face. Everyone here has a story, whether they are from Nigeria, Chad, Ethiopida, Sierra Lione… most have been part of one there countries civil wars and have experienced more in their life than most people will ever experience. Back to Aburi, the town has beautiful gardens you can walk/bike around in and you can also walk around and experience the small town life. My roommate and I were looking for a bathroom and after walking through an alleyway with kids running up and down, we finally came to the « public » washroom. As many public washrooms in developing countries you have to pay for them, about 3 cents canadian. The lady who normally took the money was not there, we were about to leave the money on the counter when a Ghanaian walking around in his towel invited us to his families home to use his washroom. They handed me a a roll of toilet paper and led me to the facilities. I don’t expect much for bathrooms here, mainly as long as long as I’m not in an open area I’m good. This toilet ended up being the equivalent of an outhouse with 2 seats side by side. Afterwards they helped me wash my hands (pouring water over my hands from a bowl). We chatted with the family for a bit, said our thanks and went on our way. Once again I was surprised and continue to be by the friendliness and helpfulness of the Ghanaian people. I for one know I would not offer my bathroom to someone who was wandering aimlessly in Canada looking for one.

Later that weekend a couple of us made our way to a beach town called Kokrobite, and stayed the night at « Big Millies ». Bucket showers and washrooms, open aired rooftop sitting and Reggae every Saturday night. It was quite the vacation away from Accra.

Cutest little girl we hung out with all weekend called "Nifty"

Something I have discovered in the past month is a snack called « FanChoco », it is pretty much frozen chocolate milk in a large freezy tube. They have become a regular staple in my diet on the way to and from work, for 35 cents canadian why not? The easiest part about it is I do not even have to leave my seat on the Tro to get one, all I do is wave down someone carrying them on their head, give him 0.50 CDs and he passes one to me through the open window (hopefully before the Tro starts going again). We’ve been lucky, they will usually run after the Tro until it stops/slows down again and get it to us! Somehow in the +30-38 weather they are still frozen rock solid each time.

There is a new football stadium being built right on the outskirts of campus and when it is finished it will be the stadium all the higher end leagues will play at. We walk by each day and although it looks like the construction is at a standstill (a common site in Ghana) Ben and I finally decided to climb in and see what the inside looks like. Surprise surprise, a brand new track, surrounds the green soccer field in the middle! The next morning we wandered over, chatted with the guard, climbed over the stone wall and hop onto the track. This does not replace the football field we regularly exercise at while simultaneously watching a game on the field right beside it. The other day we were joined by a group of 4-6 kids whose brothers were playing in the field beside us. It was hilarious, they were sprinting with us and doing everything, the only difference was they were in flipflops /barefoot and were barely breaking a sweat while we were dripping. The premiere league teams actually practice on those fields as well so its amazing entertainment when we need a break.

With only 2 weeks left of nursing (woop woop!!!), it is time to start planning our travels to surrounding west african countries. We are thinking of hitting Burkina Faso, Togo and Benin. Time can be a factor, especially with the condition of roads, some times taking at least a day to travel a distance that would maybe take 5-6 hours in Canada. Mali (being the home of Timbukto) is slowly being ruled out for this reason…. Sorry Chris I won’t be able to visit and get a picture for you. Burkena Faso is one of the poorest countries in Sub saharan Africa, however is known to have some of the friendliest people, while Benin and Togo have long roots in Voodoo. We are heading up to the northern region of Ghana after the village to visit Mole Park, its Ghana most important reserve, you can either take a walking tour or hire a vehicle (in that case you will most likly see more wildlife like lions and leopards).

Although I have been here for almost 2 months I am still learning new things at every turn. Recently I found out when someone says « your invited? » it means sit down and have a handful of my food (literally) or take a seat and join me. I wish I would have known this earlier because my usual reply before I knew this was Yes… thank you?… and I would just stand there looking lost…. We are also learning the ways of travel…many times you can hop in a someones vehicle with them for free if they are going in the same direction as you. Football is almost as important as religion here. Every time there is a game on all the Ghanaians, Nigerians… gather in the TV room, right next door to our room, and above us, and for the next 1 – 3 hours do not expect to get anything done, there is yelling, cheering, dancing, and people running up and down the stairs screaming. Last but not least, being smelly is something you get used too, its unavoidable with the heat and humidity 

STF

Decision made, Friday after seminar we are going to the Volta region to swim and do some hiking. Although it is only 120 or so km it will take about 4-5 hours to get there. As always we are late getting started and figure because of rush hour we will miss the 3 oclock airconditioned spacious bus heading that way and instead will hop on a Tro Tro. Knowing this would be a tight ride, especially having to carry all of our lugguage on our laps, we are ready for the worst. Our taxi takes us to the Madina station and we get in line along with 30 + other Ghanaians. As the first Tro pulls up the line disappears and everyone starts pushing and struggling to get onto this bus, we are thinking we will never make it. Once again the Ghanaians pull through and one of them starts yelling at the other people, braces his arm against the door, blocking every from pushing us out of the way and gets us on the 3rd Tro. I manage to loose my sandel half way onto the Tro and see it tumbling into the muddy pile of dirt and garbage under the Van. Finally we settle into the back seats, I turn around to see some of the other girls but all I can see are bags and a couple wisps of their hair. Its going to be a long ride.

Personal space does not exist in Africa, espeically on these buses, so we get to know the ghanaians sitting beside us. One of the is from a village where we can hike a mountain and offers to help us get there (we have to change Tros a couple times) and get a room at the guest house. Thankful for the hospitality we agree, assuming the village he is from is the same village we are aiming for.... Halfway through the ride we stop for a public washroom break (consists of running to the field with the men to the left or and the women to the right) and the local peopl swarm our van selling food. One of our new friends has bought food and gives us some. Called "kenkey", it is mainly dough squished in between two large leafs and heated up. Along with the Kenkay he offors us what looks like some garnish, I agree thinking anything to spice up this dough would be nice, especially having not eaten since that morning. I look close up and they are tiny fish, you can see the eye balls and everything. When in rome....

We switch up Tros in Ho Hoy and head for the village we think is "Wlee". An hour long ride on a red dirt road with pot holes half the size of the van, swallowing us up. Travel on this road has to be impossible during the rainy season. Halfway through the ride our driver and "mate" realize a tire has gone flat. We all pile out for another public washroom break (thankfully it was dark by this time) and wait for them pull out a tire that was serving as my foot rest and switch out the flat tire. Finally arriving in the village just before midnight, our friend calls the guest house and we make our way over there. Making our arrangements to hike to the "falls" with a guide is underway and everything seems set, we get our mosquito net up, push the two single beds together and 3 of us pile on. A knock at the door lets us know our hike will start at 530am, after the long ride, the lack of food and sleep we agree and fall asleep.

The next morning after figuring out our hike is to climb the highest "mountain" in Ghana, Afadjato (mountain is overated, more like the highest hill), we realize we are in the wrong village... Oh well we are there and decide to do the hike and catch a Tro and head to Wlee falls that afternoon. We ended up hiking with 2 guys from France who have been teaching in Cote D'Ivoire for the past year and a half. After some picture taking and water breaks we head back down and hop on a Tro.

There are 2 falls in Wlee, lower and upper. The lower falls are busy and and easy 30-45 minute walk, the upper are almost completely secluded but a hard 2-3 hour hike to them. We hear the local kids will sometimes slingshot down bats at the lower falls and grill them up for you if your interested. After some breakfast we decide to hike to the upper falls. The hike consisted of intervals 15-20 minutes of hiking/climbing, 2 minutes of rest and wiping the sweat out of our eyes. Think of the volcano hike we did in Nicaragua but harder. An hour and a half in we make it to the falls, gorgeous, no one there but us. We intantly jump into the water and head for the falls.

We never seem to be getting enough sleep here, we try to take naps whenever we can... One of the best weekends so far.

The power has been going out twice a day at our hostel, most of the time while we are at the hospitals so its not bad. But than again, the power goes out at the hospital on a regular basis as well.

This past weekend was their independance day (March 6th), we tried to make our way to the "Black Star' square, which is a huge open area overlooking the ocean with stands all around it. Odd thing is they only, only use it for their independance day bash, the rest of the year it sits empty collecting garbage. Thinking it would start like all other things do in Ghana (on Ghanaian time) we show up a "little" later and realize it had been over for an hour, there are still hundreds of people around, selling food and hanging out, so we take a seat in the shade of the stands. That evening on the university grounds there was a free outdoor concert, one of the singers was wearing a fishnet tank top in the colors of the Ghanaian flag. Don't worry vince i'm trying to find one like it so you can add it to your collection of fishnet tanks :)

Sunday, a bunch of us decided we needed some much needed rest and relaxation. We made our way to "La Palm" hotel/resort and after paying an entrance fee we set up camp arround the pool. La Palm is a very ritzy nice hotel. A couple of us had a little altercation with a cab driver trying to overcharge us and we were able to escape into the hotel with the security stopping the driver, he managed to get around them and find us by the pool, make a scene and than eventually left. One of the ritzy hotel guests decided we deserved a treat and sent us over a couple 30$ bottles of sparkling water and fresh fruit...oh life is difficult:)

This is our last week at the hospital, than we head to a polyclinc just on the outsquirts of Accra for 2 weeks and than a village for our last week. How time has flied! I am only at the hospital for 2 more days because I am going to an orphanage for the last bit of the week with another girl. I have finally started getting used to the Ghanaian ways at the hospital so I am sad to leave. We have an individual who was flown from sierra lion because they do not have a Neuro ward. The patients are amazing and love to chat (if they can), I have spent all my down time on the unit sitting and chatting with the patients. The patient are not allowed to leave the hospital before they have paid and this past week I saw this for the first time. I keep thinking in Canada if this were the case the patient would most likely just up and leave, however here they sit around in bed waiting for a family member to collect money and eventually come in and pay off the bill.

Mom I hope you dont' mind, I seem to be bringing home a bunch of the fellow nurses, they haven't given me a choice in the matter, saying "once we share food we are family". lol. Good thing we've got a couple empty rooms.... :)

I have been lacking on vegetable intake here, so we visited a local grocery store the other day..phil you think red peppers are expensive in Canada?... (1 CD = 90 cents canadian).

- #1 Daughter

Save water, Pee in the shower :

3 ½ weeks down. 6 to go. The heat is becoming somewhat bearable although I have discovered sweat in areas I didn’t think I could sweat. I have for the first time been able to catch drops of sweat from my upper lip when running. Rehydration at its finest I guess. I have mastered the art of sleeping without sheets or blankets, showering multiple times a day and doing laundry by hand (I’ll admit at times I will pay a couple CDs ($) if im’ feeling especially lazy). Bartering with cabs and flagging down Tros Tros (big vans that have been gutted and so far have a record of fitting 26 people) has also become part of my daily routine to get to and from the hospital. The traffic is so congested near the university some of the nurses I work with will leave two and a half hours early in order to get to work. It is about a 10 minute ride during down times and possible an hour-two from our place during rush hour. Unlike Canada (especially in Walmart parking lots) where pedestrians have the rightaway, crossing the street is at most a calculated run for your lives. There is no need to hit up the shopping mall to or from anywhere because almost everything is sold en route. Men, women and children walk up and down, and in between the roads with baskets on their heads full of movies, food, water, pencils, paper, bowls, mirrors, toys, toilet paper, candy, and even gifts for whatever upcoming holiday it is.


The biggest cultural element learnt in the first week was what we like to call “Ghanaian time”. When you are given a meeting time, do not expect people to even begin to show up until at least a half an hour later and for the meeting to start an hour later. Everything is at a slower pace here (except the traffic), this includes everything from getting the patients their medication to getting back to you with an email/phone call to getting your lock fixed on your door.


The main language in the south of Ghana is “Twi”. Although most everyone knows English it is not used as often as we would like. I find myself constantly asking the nurses, patients and doctors what they are talking about. Every once and a while I will hear the word “obruni”, which means white person, and since I am noticeably the only white person its safe to assume they are talking about me… I have started calling them bebini (black person), they seem to appreciate the humor.


The hospital we are at for a total of 6 weeks is a military hospital, level 4 UN, called military 37. One of the old generals had brought a couple bats as pets when the hospital first opened, when he passed away they set his bats free and have multipled to around a million bats living in the trees and only in the trees on hopsital grounds. Every night at 6 o clock they leave Ghana to fly to Berkina Faso (country to the north of Ghana) to feed, and return every morning around 5 or 6. It used to only serve the Ghanaian Army and other peacekeeping armies who are in partnership with Ghana (such as Nigeria, Pakistan, Lebanon), but in the 90’s opened the doors to the public as well. However the soldiers have private outpatient departments, waiting rooms, and special surgical units (airconditioned, not having to share a room with 8 other patients and cleaner wards). They also have health care coverage (which covers “almost” everything), and extends to their family. Everyone else can apply for the health care insurance but does not cover everything. They patients families will wait around or come in the evening, get the prescriptions, go to the “chemist” (pharmacy) to buy the medications and finally we can give the patients what they need. Pain medication use is rare for the patients and if at all it is “mainly” Tylenol. At least half of the nurses are in the army and for once there is almost a 1:1 ratio of males to females  . The Ghanaian army is widely involved in peacekeeping in many countries, such as Darfur, Sierra Lionne, Cote D’ivoire, Lebanon, Liberia, Chad, Rwanda…..Some of the nurses I have had the chance to work with have been in the army for 10 -20 years and have been to almost all of those places for months. Ranking is huge, calling them by their rank such as “Left tenant”, or “WO1”… The actual hospital reminds me of a hospital from early 1900’s/ the tv show M.A.S.H. The pediatric emerg unit I was one for the first couple of weeks had bare necessities, one suction, one oxygen tank, and a sink that worked at best 2/7 days. The electricity and water are turned off around 8pm and do not come back on until 6am, however most days the water only runs for a couple hours. Buckets and buckets of water are filled up when it is running so we can wash our hands or whatever else needs cleaning. Running water is a commodity and I never realized how much we take it for granted! The other day we learnt peeing in the shower is encouraged because of how much water it saves.


I have finally graduated from drinking bottled water to bagged water. I can get 12 L for 1 CD which is about 70-80cents Canadian. So far so good.
Getting to know the Ghanaian ways has taught us getting a straight answer out of someone who is trying to sell you something is one of the hardest things to do. Answering a question with a question was most likely invented in Ghana. Repetition is key here, 4 seems to be the golden number.


So far on the weekends we have traveled throughout Accra and a bit of Ghana. Accra is a huge city with a population of over 2 million, it is busy, dirty, markets to random stands are on every corner and in between, kids and people running around and the majority of buildings are half built; but after you get to know it you realize it has its own beauty. A couple weekends ago we traveled to a small town called Busua, right on the coast, it was a whole different world. Goats and chickens walking free, hardly any cars, and you see a bit of everything. This town was paradise away from the city. We arrived late at night after touring Elmina castle, picked the cheapest hostel and woke to a beach in our front yard. There was even a monkey chained to a tree at our hostel, all I could think of was Kevin telling me monkeys throw their own feces at people, whether or not this is true I stayed far away. We met a friend who cooked us lobster dinner (the freshest lobster I have ever having bought it straight from the boats as they came in) who called himself “Daniel the Pancake man”. He set up chairs on his front porch, got his two boys to light candles for us and proceeded to cook us the best lobster dinner I have ever have.

Elmina castle, built by the portugese in the late 1400’s, is the oldest European building in Africa. At first a trading post for goods such as food and materials but after the Dutch took hold in the mid 1600s it became a trading post for slaves. We were able to visit the dungeons, holding cells and walk the walk a slave took before boarding a ship for America to work on sugar plantations. The history of slave trade is unbelievable, it is estimated for every 100 slaves who survived the crossing, another 50 -100 died while trekking across inland to the coast. From the gold coast alone (Ghana) they say around 1 million slaves were transported to Americas from 1600 to 1850.

A couple of us went to a football game the other weekend. First things first, bathroom and then our seats, we were only a little shocked seeing men in the womens washroom, thinking designated bathrooms may be something else ignored in Ghana. After we sat down and looked around I realized we were the only girls in the whole stadium, clearing up the whole washroom incident. Thank goodness for short hair, I didn’t stand out at all (the other day in the hospital one of the patients called me brother instead of sister…). Halfway through the game one of the players was knocked down unconscious and they instantly started CPR, within about 15 seconds the player jumped up and started crawling away from his “rescuers”. The game continued on.


We visited a vulnerable children and orphans institute one weekend to help give out Vitamin A enriched food (oil and rice) and to play with the kids. The majority of the kids (98%) were HIV positive, had lost their moms’ to HIV/AIDS or had died in childbirth. They come once a month to this institute for food (that will hopefully last a month), measurements of weight and height for all the kids, and education on prevention and staying healthy. We taught them the good old duck duck goose game and played it for hours on end.