“Time to Say Good-Bye” January 11, 2010

Today is our last full day in Kpando. It is hard to believe that we have already been here for 13 days. We had hoped to do some more sightseeing in the Kpando region but we have been so busy working. We never made it to Fesi pottery or any church services. We did manage to make at least one big market day where fabric was bought and dresses were quickly sewn by the local tailors. We each have some Ghanaian clothing. I have had a Bu ‘Bu ( ? spelling) made. Essentially it is a large sack with armholes. It has a nice neck line and I have a matching piece of material to wrap my head in. I don’t know where I will wear this but it was something I had to wear. We have a meeting with the University of Ghana on the day we leave so I may wear it then.

We are expected in another Village today. It is Anfoega. We have been told that Lt. Col Mike Holly from the US embassy will be honored as a chief. We were hoping the ceremony was going to be today but details have not been fully arranged. Mike does meet us at Anfoega. He has traveled 3 long hours from Accra to meet us. This village is very smart. By making him an honorary chief they can assure themselves some visibility with the US and Ghanaian government. It is a big deal for Mike but the ceremony does not happen today. He is also joined by Jason Turner. Another US Army officer but I cannot recall his rank. Both men are very nice and from the Midwest. It is refreshing to hear American dialect.

We are impressed with the hospital at first glance. We had intended to do a repeat HIV education and testing program here but we find out that it is a Catholic hospital and that type of program is not really welcome here because part of our education focuses on safe sex and the use of condoms. There is a ceremony welcoming us. We are joined by some of the tribal chiefs and also the administrator and medical director. I am impressed with both of these people. The administrator is a young woman who seems to be personable and efficient and anxious to improve her hospital. The medical director is also a very impressive man. He is only 30 years old and he is the only physician at this facility of about 100 beds. He is on call 24/7. He does not have any mid-level providers working there( NP or Physician assistant) but he has established protocols for treatment and some of the more able nurses are able to manage a lot of the care that would normally fall on a physician. It some ways the nurses here have a lot of autonomy and in other ways I see them not fulfilling their potential due to lack of training and resources. I believe that some of the nurses have memorized some of the treatment protocols but may not understand the rationale or the physiology of their actions. It is hard for us to imagine working in these conditions.

We present our supplies to the staff and they anxiously inspect the ‘booty’. The tribal chiefs start to leave and I start taking BPs. A quick BP clinic is set up and we are swamped with mostly employees of the hospital and they are all looking for medications. This part of our efforts continues to bother me. There is a such a deep belief that pills are wonderful and if you are seen by a medical person you must receive pills. I am losing my restraint and start to go with the flow. Healthy men and women get some of the vitamins or Tylenol because this is all I have to offer. Sometimes we feel like the vultures are circling. I have experienced this type of frantic excitement for free items from all types of people here from the poorest of poor to the comfortable. Throughout our trip we are struck by the assumption of the people that we ( the students and myself) are rich Americans and our supplies must be endless. I think of the money it cost us to send these supplies and the hard work in obtaining donations and packing the 50 pound boxes and I wonder if our hard work has any impact if the non-vulnerable people want a ‘piece of the action’. It is something for me to discuss with the future groups that may travel to Africa. I do not want to be cynical but it seems like the same behavior is repeated where ever we go. There is so much need!

As I conduct the clinic with a few students a tour of the hospital is started. I cannot leave my position at the clinic. I am sad not to see the hospital and missed seeing the mortuary where the bodies were piled on shelves with no clothing and no plastic bags. I am told it is an eerie scene. We are treated to a lunch of typical Ghanaian food. We have become good at identifying the foods that we like( Jolloff rice, fried rice and chicken) and the foods that we do not like ( Banku, fish stew and baked WHOLE fish, with eyes intact). We are impressed with the generosity of our hosts and are very much impressed with this facility.

We return home to Kpando and begin our goodbyes to some of the people we have known to care for. We say goodbye to Eryram the young man who runs the internet caf’ and kept us connected to our loved ones, we say good bye to Pascalin who cooks for us at Cedes restaurant, we say good bye to Edith who must be the poorest but most appreciative woman we have met in Ghana and who gives us many blessings for our safe return to our home. We say goodbye to Shine who has been our dear host and friend last year and who remains my Ghanaian daughter. We say good bye to Patience our sometime cook and full time friend. We say good bye to Sam from the Friendly Spot who supplied us with our beverages after a long hot day. We say goodbye to the children of Kpando who are so poor but delight in getting a small sticker on their clothing and want to touch the ‘Yo Vo’s’ and have their picture taken. We say goodbye to Alfa, our young Ghanaian teenager who is on the cusp of becoming a man and needs so much but we encourage him to stay and excel in school. We say goodbye to a community that has welcomed us despite the color of our skin and our funny way of speaking. We are sad to leave but also realize that this part of our journey is over.