Day 3 ‘Americans in Ghana’

Today is our last day of sightseeing in Accra which is a good thing because I think we are all getting a bit anxious to start our work here in Ghana. We have never had this much time before our work started and although it is nice to see all the wonderful sights of Accra the students are anxious to get started.

We are due to see our American Embassy today and a few more sights in Accra. We leave the hotel around 11 but hit an enormous amount of traffic on the way into the city. The traffic here is like nothing you have ever seen.

Although the roads are paved and it appears that is should be atwo lane highway into the city it often resembles a large parking lot. I believe it is worse than even getting out of Fenwayor Gillette after a game. The roads are not lined and it can be like a giant game of chicken. There are many lanes of cars all trying to squeeze into a narrow road.

We are traveling in a larger bus but even the smallest of cars try to edge us out of our lane. There is lots of honking of horns and to complicate matters there are street vendors by the hundreds who are hawking their wares by the side of the vehicle. I cannot make eye contact with any of them or they will come over to the bus and tap on the window and offer their items. It seems cruel to avoid their gaze but it becomes necessary.

These people stand in the hot sun all day long trying to make a living. This type of occupation seems to be the largest employer in Ghana. There is an amazing abundance of hardworking people looking for employment and I am surprised that some of our US businesses who have outsourced their manufacturing to China or India have not considered Ghana.

Eventually we find out selves in at the Parliament Housewhere their legislators (Members of Parliament) are not in session. We are not permitted in the building but it is impressive. We are then taken to the Conference Center which is a huge building that is the home of large political and social gatherings. When President Obama came here to Ghana in 2009 he spoke from this building. We are given access to the VIP lounge where he awaited his time to speak. It is a large impressive room with many sitting areas . There is a large private office also where the Ghanaian president or other dignitaries can do some work. We are told that not many visitors get to see this area and we feel special.

Our appointed time is approaching and we must go to the US Embassy for our scheduled visit. It is quite the procedure to get into the building. All of our electronics (cameras, thumb drives, iPods, phones) needs to left at the counter as well as any liquids. We painstakingly go through the metal detector and bag scan. Only small groups at a time can enter into the Embassy and only with an official guide. We are joined byfive to six members of AFRICED so our entourage is large. As usual we are attracting lots of attention because it is not very often in Ghana that you seen a group of young white people like ours. The glances from the people of Ghana are never rude but rather inquisitive.

Upon entering the embassy we are directed to a large conference room. While we await the start of our program a young good looking US Marine comes into the room and starts to chat with us. He is a very personable young man who is excited to see a group of Americans and is anxious to invited us to a comedy night held at the embassy on Friday night. His name is Marcus and I wish we could spend more time with him because he is very humorous and gives us good insight into his life as an American in Ghana.

Our program begins with a welcome by Mary Drake Scholl who is the Public Affairs office. She gives us a wonderful description of what the US Embassy does in Ghana. I am amazed at the scope of their activities because I had always assumed there were in foreign countries just for American interests (security, passport problems, etc).

The US Embassy and their partners are involved with many initiatives like local and national health care, education and other activities that benefit the Ghanaians and American expatriates in Ghana. We then get a chance to talk to Susan Wright who is the deputy office chief of USAID/Ghana.

Susan is involved with many projects that are done to improve the health and welfare of the people of Ghana. She gives a great presentation on the prevalent health issues in Ghana (malaria being one of the biggest problems in this country) in addition to other social issues that are affected by the health of the people of Ghana. Her presentation dovetails wonderfully with the work the UML students have done in preparation for their community health implementation projects.

The students will be doing two projects, one is for malaria education and awareness for mothers of young children and the other is a nutrition education program for school aged children. They will be implementing their programs in a few days so all the information that Susan gives them validates their hard work and project purpose.

We then get to meet the heath care workers (a nurse and physician assistant) who are not government employees but rather are called ‘local hires.’ They work at the Embassy to provide health care to the embassy workers and their families and also have some responsibility for the other embassy posts in neighboring countries. It is interesting to hear their career stories.It seems that many people who end up in foreign jobs often begin their career with the Peace Corp. The working conditions that the PA endured in her previous job is incredible but it seems like her current job at the embassy is challenging but rewarding.

At the end of our program we are treated to a lively lecture by Dr. Fazle Khan who works with the CDC Director in Ghana at the Embassy. He has an interesting career story but it is his recall and insight into the health problems like AIDS and malaria that enthralls us. He is inspiring and has the utmost respect for nurses which is music to our ears. He gives some good career advice should any of the UML students desire to work in a foreign country like Ghana.

We are thankful for this interesting visit to our US Embassy which is a vast change from last year when our bus was bombarded by armed Ghanaian guards because some of the students took out cameras to take a picture.

We adjourn to a nearby restaurant for some cold drinks where we are met by a group of 10-12 people from AFRICED. We are presented with a souvenir t-shirt that says ‘University of Massachusetts Educational Tour ‘ Ghana 2011.’ The goal of our meeting is to spend some time with these hard working volunteers from AFRICED and to discuss their experience and concerns in addressing health issues in Ghana.

This exchange of ideas is strongly advocated by our coordinator Kwadwo. We need to learn from them and they need to learn from us. It is interesting to learn about the Ghanaian national insurance plan (costs a little more than $15 per person per year). It is financed by a tax. We have seen this tax on any item that we buy. Health care is available but there continues to be access issues such as proximity to a clinic or ability to afford even the $15 per year for health insurance (which is significantly less for children age 3 months -16 years). Pregnant woman and newborns are covered for free. This is to ensure improved health and maternal and neonatal outcomes which is a health care problem that is slowly improving but still a huge problem in a developing country like Ghana.

Maura and I share a lively conversation with Sherry (who also works on land disputes issues during the day and is going to school for her degree in business administration), Simon (who is a laboratory technician at the large Korlebu Hospital here in Accra) and Mustapha (who works in hospital accounts at Korlebu). Thesethree people maintain their full time jobs but also devote time to the social problems in Ghana such as child slavery/orphans and financially assisting families with many children to keep the families intact and functioning and not to sell their children into slavery to help the family finances. There are many other projects that AFRICED is involved with and they will be joining us intermittently this week to help us with our clinics and distribution of supplies.

After our debriefing on the bus (where the students are asked about the observations of the day), we then sit in traffic for nearly 3 hours to get back to our hotel. This is torture for us and I long for the rural roads of the Volta region where we have to dodge goats and not cars. Upon our return to the hotel we have a birthday celebration for one of the students (Kim), with Little Debbie brownies that have stashed in a suitcase. Chocolate is like gold to us now.

We spend about an hour organizing our supplies for the next day and counting pills. I have purchased some medications and the Nursing Students Without Borders club also purchased some OTC meds like Tylenol and multivitamins. My goal this year is to try not to make our trip about handing out pills but rather addressing some health education needs of the people of Ghana. If we teach someone about how to manage their hypertension that is much more sustainable than giving them 10 pills.

The students are anxious for our first clinic tomorrow.After a long day I retire to my room to discover that there is no water left to bathe.Some of the students have already showeredand used up all the water. I think we need to start a shower rotation schedule because I will be pretty smelly if I don’t shower for a few days. After a quick wet wipe cleanup we are in bed for some rest before tomorrow.

As I prepare for bed at 1 a.m.the rooster starts to crow again’ Does anyone have a muzzle?

Day Two : ‘Bugs, Buses and Beliefs’ By Valerie King

Today was a good day. I started with a cold shower but the toilet flushes and the AC worked all night. Some of the students lost their AC in the night and woke up to a hot room. The heat did not keep the lizards and bugs away but I am pleased to tell you that my most bug-phobic student is making great strides in conquering her fear. I told her it was well worth spending all this money to cure her bug fears!!

We had a day of touring the capital city of Accra. It is a very busy city with much traffic and congestion. It can be an interesting range of sites. We can be passing a shanty type community and 1/2 mile up the road pass by affluent gated compounds. The disparities in wealth are incredibly sad.

The UML students are amazed at the number of street vendors who sell anything by the side of the road. We see little children with large bowls of water bags on their heads who have likely been selling at the busy intersections since early in the day. No school for them. They are probably being used to sell items to help the family finances. The UML students payfive times what they need to pay for a small bag of water. The little girl does not know what to do with the extra money even when urged to keep the extra money to herself. It is sad to see how children are exploited in some situations and this child may never finish grade school because she is more valuable as a street hawker.

There are all kinds of merchandise on sale. Cheap toys, candy, fried chips, water, maps, jewelry. They are there just trying to make enough money to live another day. I worry about the small children by the side of the road and realize how easily a predator could scoop them up and drive off. The UML students seem subdued when they see these sights.

We were supposed to meet with the Minister of Education today but after waiting for him for about an hour we were told his schedule did not permit a meeting. We then proceeded to do some touring of the city and we ended up at Frankies which is a local restaurant that features American food. This is a treat I usually save until the end of the trip. We haven’t experienced any real hunger yet and here we were today at this restaurant eating American sandwiches and French fries. It is a welcome respite for the students because we are now approaching our busy time.

We hope to meet the Minister tomorrow and I will have to come up with some greetings on behalf of UML and the nursing students. I was asked if I had a ‘gift’ for the minister. As is customary, people often bring gifts when they meet the minister and last year I gave him some bottles of OTC medicine because that is all I had to give. That bothered me tremendously because those medications can be easily purchased by any person working in these government jobs and I felt it was depriving a needy patient of much needed medications.

This year we did not bring as many bottles of medication due to shipping costs so I had nothing to share. I told our coordinators that the Minister of Education was going to have to settle for the ‘present ‘ our of ‘presence’ in his country. That was kind of a snarky response but I have a real issue with inequities in health resources (in any country) and I am not going to promote those inequities because of the ‘custom’ of giving gifts. At some point in time a person has to stand up for their beliefs and this was in important issue for me. I know that I risk offending a very important politician but I think it is better to stay true to one’s own beliefs.

Tonight we returned home to our hotel and had our first debriefing session. This is such an important part of the day where everyone gets a chance to voice their observations, concerns or questions. I am proud to hear the comments from the UML nurses. They are absorbing so much and I can already see that this experience has begun to change their perception of social and health problems in a developing nation. UMass Lowell has taught them well.

Maura and I have a few glasses of wine and some peanut butter crackers and cookies for supper (we need to have some food to take our malaria medicine with). The wine is relaxing and I play a few rounds of a fun and crazy card game with some of the students while the other group is busy in their hotel room revising one of their assignments that is due for Community Project. Everyone is getting along well.

The marriage proposal count is at one. I told the students I will keep track of their marriage proposals and oneof the students was proposed to today by a Ghanaian military guard. I predict our marriage proposal count will go much higher when we get to Kpando. I will give updates on the proposals.

It is about 12:30 and time to go to bed. The rooster just crowed outside my window. He needs to have his circadian clock fixed. He woke me up at 3:30 this morning also. Tomorrow will be an interesting day as we have been invited to our American Embassy in Ghana to meet our Ambassador. Last year we almost got arrested for taking pictures and this year we are invited guests. Funny, how a year can make all the difference in the world.

Good night to all and come back to read some student blogging. I have been keeping them busy but hope they will start blogging soon.