Home!

Godless Baboons and .PPT Presentations

I haven't had the cold or flu in about two years and I managed to catch one here in Ghana in the middle of July where the temperature rarely drops below 80 degrees or 90% humidity. Ugh.

Anyway, it's been another full week. The rest of the team showed up and the second half of the trip began, which entails public health field research. There are several teams studying things like infant mortality, elder health, micronutrient deficiencies, and oral history, among other projects.

I am on the "Research Dissemination" team, which entails going out every evening to different villages and presenting last year's findings to the community members. My teammates and I have worked for the past three months or so on the .ppt presentations as well as a leave-behind brochure that distills the main health messages from the research. It was a great exercise in really figuring out what matters most from the research and trying to communicate how the findings are relevant to the villagers. Most of the messages weren’t earth-shattering (wash your hands, water from boreholes is the cleanest, take your children to the clinic if you recognize these symptoms, etc) but reinforcing the education efforts already underway is an important part of preventative / public health.

I fast learned thought that no amount of flashy technology or good intentions replaces a motivated and passionate translator. Thankfully we have all of the above. Upon arrival, my teammates and I were told that we didn’t have a dedicated translator for our team and that the responsibility was going to be split between some people who already have quite a bit of other management responsibilities. I knew immediately that we needed to find someone else and thankfully I had met Daniel from the sex education presentation. He’s a community health nurse at one of the clinics where we did clinical hours a few weeks ago.

Daniel is the epitome of community health nursing and I’m lucky to have seen him in action. He’s passionate, knowledgeable and caring. He already does outreach clinics in many of the villages, so he knows the people and their questions. We’ve been asked some pretty tough questions (how should you do exclusive breastfeeding for the first six months if the mother dies in labor? Or is it safe to eat the vegetables in the market if they are known to be grown with fertilizers and pesticides?) and thankfully he’s right there to answer them in Twi (the local language) and translate them to us for our final report.

I’m hopefully going to borrow someone’s GoPro camera and film one of the evenings just to give everyone a sense of what I’m doing. It’s pretty good fun, lots of randomness and excitement and lots and lots of waiting around for some unknown person or reason. I quite enjoy it.

The other highlight from last week were the godless baboons in Mole (pronounced like the Mexican sauce), which is a big game reserve in the northern region of Ghana. It was created in the late 1950s after years of big game killing threatened to dramatically reduce their numbers. African sleeping sickness was rampant at that time, and people believed it was caused by the flies biting the animals and then biting people, so people went on a killing spree that decimated baboon, elephant, lion, and other large mammal species, according to our tour guide. The government created Mole as a reserve to save the animals and to provide a tourist attraction for the local economies. It’s a beautiful, rustic place with minimal amenities, which I’m into.

But the godless baboons, I am not into. These baboons have become so habituated to humans that they have no fear and will literally jump on your back to steal the bananas or mangos out of your hand. It’s one thing to have the small monkeys bare their teeth at me (which they did when I shooed one off the breakfast table) but it’s quite another to have a large baboon with big canine fangs jump on your back to steal a mango (which it did to a Danish girl who made the mistake of carrying the food between her room and the table). It was disconcerting during the “safari” orientation to be told that the baboons have learned to target women because we carry around food and only shriek when attacked instead of hitting or throwing stones at the baboons as the men do.

You probably won’t be surprised to learn that I armed myself with rocks and took it upon myself to chase the baboons away from all human-infested (sorry, inhabited) areas, yelling and waving my arms about their need to be a taught a lesson in feminism and manners. One of the other students commented that the baboons will probably talk for years about the feminine looking man with the crappy shot, but I don’t care. We pick our battles and that seemed appropriate for a weekend “safari.”

There’s plenty more to write and I suspect I’ll fill in gaps when I get back to a normal internet connections speed. As it is, I have a few things I need to upload back to the States to finish nursing classes, so I can’t spend too much time blogging. Know that I miss you and cheese very much. Look forward to seeing you soon.

Ghana advances to the All Africa Games and I teach 1000 high schoolers about sex

It's only been a little over a week but it feels like it could be a month with everything that we've done and seen. Since last writing, I spent another day at the hospital, shadowing a very inspiring doctor on the pediatric sickle cell ward, taught about 1000 high schools students about teenage pregnancy (and did I mention I hate public speaking and am horrible at it?), met the district chiefs and elders to explain our project, and then later gave my group's presentation to a small group (here that means about 60 people) in a village. We also went to the Ghana v. Nigeria under-23 football game that was to decide who went on to the All Africa Games. Ghana won, thankfully!

The hospital experience is worth writing about because Dr. Dominic was such an amazing human being let alone doctor. He is finishing his last few months of his house rotation, which I think is the equivalent to our doctors' residency. He works on the sickle cell ward, but has a variety of patients because of the overcrowding issue. He cared for patients with leukemia, G6PD deficiency, ortho/trauma injuries, severe malaria and sickle cell crises. There were between 2-3 patients per bed, which even though they know poses serious cross-infection risk, they do anyway because they don't turn away any patients. Where else would they go? KATH is the one of the only hospitals in the entire region, so turning away patients is not an option unlike in the US.

At one point Dominic was interviewing the mother of a very sick little girl through a translator because she was from the Cote d'Ivoire. He found out that she was fleeing the violence in her home country after her husband had been shot and killed. While waiting at a bus station in Kumasi (the city we are staying in) her baby fell very sick with severe malaria. Thankfully she somehow met a man who spoke both the native Ivorian and Ghanaian languages who took her to the hospital. The little girl was admitted and started on IV antibiotics, which saved her life. She was doing much better, though still quite sick, when we met her. Dominic had originally intended to discharge her home that day and have her come in a few days later for a follow-up appointment, but upon hearing that they were refugees with no where to go, he was going to keep them at the hospital. After a phone call to his chief resident (who wanted them discharged because of space considerations) and a conversation with the translator, they worked out a solution. The translator agreed to take the woman and her baby home with him for the weekend so they could recover further and he would bring them back next week for the appointment.

The depth of kindness displayed by both Dominic and the translator was deeply moving, in large part because we don't often see that in our culture between strangers. Here, it's part of the every day life. I think part of why I love coming here and learning about different African cultures is that there is so much good, so much kindness and generosity to be learned from, which is not often how Africa is portrayed in our media. All we see are refugees in the camps, starving children, and bloody machetes. It's reductionist and insulting once you've seen how much more is going on here. I could go on, but there's still the football match and teenage pregnancy talks...

Sunday morning was spent attending a boarding school church service followed by a sex education talk. My portion was about teenage pregnancy. I was sort of thrown into it at the last minute and thankfully my friend and trip member Adrienne was also giving a talk on STIs, so we tag-teamed the talk. We obviously had a translator who really did most of the speaking, but our presence lent both authority and the opportunity to talk in-depth about these topics in a way that the Ghanaian sex educators often can't because sex is uncomfortable to discuss. Sounds kinda like the US, eh?

I wasn't sure what Daniel, our translator and good friend, was saying given that I would say maybe two sentences and he would talk for about 2 minute after, but I figured he was elaborating and filling in my gaps. I decided to tell the students about a girl in my high school who got pregnant freshman year and dropped out. I talked about how difficult it had been for her, how she had to put off school and wasn't able to get a good job. Daniel took that story and ran with it, telling the students that it's a problem everywhere and that when it happens it's a challenge. Apparently the students were shocked (and a little happy) to learn that white people face the same problem in the US. I ended the talk by saying we all face the same problems of teenage pregnancy and STIs, but that if we used the ABCs (sex ed here focuses on Abstinence, Being faithful, wearing Condoms) and respected each other, we could lessen these problems.

The second talk was given by some other team members and they discussed the finer points of putting on a condom by demonstrating with a banana...I was proud of myself for not losing it and laughing out loud and was shocked the students didn't either. Apparently Daniel had told them though that we would get up and leave if they laughed! A little fear never hurt anyone I suppose...Overall it went really really well and the school administrator asked us to come back next year and give the talk again. I think having strangers come in to talk about it both lends credibility and allows for a more frank discussion.

This post is getting a big long, so I'll save the other stuff for later this week. Nothing really to report on the football match other than it was good fun and Ghana won! I love coming to matches here because they're so much livelier and entertaining, even when it's just the under-23 team and not the national team.

Apparently there's a misconception (probably founded by myself) that I don't get emails here. I do and quite enjoy hearing what's going on in the States, so please write. Hope your summers are lovely and relaxing.

Wherein I teach women how to breastfeed.

Internet is spotty at best, but is in Ghana! It’s been several days here and eventful. I was in a community clinic (think going to the doctor’s office, but in a rural Ghanaian village), shadowing the nurses for the first two days.

The first day was spent working with a Ghanaian nurse in the outpatient clinic where people from the surrounding towns and villages come to get medicine. For the most part, we saw lots of fevers (malaria) or abdominal pain (worms) and we prescribed antibiotics. (You’re wondering how he made the diagnosis: verbal symptoms and experience).

At one point the Ghanaian nurse and I were trying to figure out why a little old lady was peeing a lot, thirsty, with back pain and hypertension. It was cool because we were basically acting as doctors (some nurses have diagnostic and prescriptive powers over here, far out) and he took my input when I asked whether it could be the start of diabetes. We tested her blood sugar – normal - and decided that perhaps her kidneys were beginning to fail, but a good course of antibiotics never hurt anyone. Hopefully it was an infection that the antibiotics covered and she would not be back; if she returned within a few days the plan was to admit her for intravenous antibiotics.

The afternoon was spent administering the antibiotics, which are painful injections deep into the “buttocks” as it’s spelled here. It’s the rainy season and malaria is rampant, but I’m not sure how much so because we didn’t do blood tests. According to Integrated Management of Childhood Illnesses (IMCI) protocols from the WHO, if a child has a high enough fever during the rainy season in a malarial endemic area, it’s diagnostic for malaria and should be treated with antibiotics even without a blood test confirmation. I don’t know if the same holds true for adults, but that seemed to be the operating assumption at the clinic. I wondered though what treating every fever with quinine does/would eventually do to the local malarial strain’s resistance to it, especially because it’s reserved for severe malaria. Food for thought..

The next day I taught a group of women about breastfeeding because, you know, I have so much experience with that. Ha. But it went really well. There's a bunch of literature from the WHO for health care providers and the Ghana health ministry about it, so I basically reinforced messages they’ve already heard: exclusively breastfeed for the first six months, proper positioning and signs/symptoms to come to the clinic for. There was lots of laughter, weighing of babies, vaccinations and “abroni” (Twi for “white person”) songs.

Today was my first day at the Komfo Anokye Teaching Hospital (KATH) and it was something I’ll never forget. We weren’t sure if students would be allowed to shadow nurses on the labor and delivery floor, but it came through today and lucky me, I was one of the first ones. It took lots of introductions and explaining who we were, what we were doing, and that we were here to learn, but we eventually had a wonderful tour of all the maternal wards followed by several hours watching births. I saw a spontaneous vaginal birth (ouch) and a c-section (double ouch) and was beyond impressed. The nurses and doctors asked me several times how it compared to the US and I honestly said that other than supplies and volume of patients, it was the same. Actually, the Ghanaian surgeon was much faster at the c-section and he seemed pleased when I told him as he left to do another in the next operating theater.

After a very full morning, we took a tour of the new hospital built two years ago. Again, beyond impressive. I wish I had been able to take photos, but patient privacy is more important than my crappy blog, so no photos. Hopefully tomorrow I’ll take some audio snippets interviewing the doctor and nurse I’m shadowing.

Starting Anew

Blogging into the future...

Ken Sands, the blogger guru at the Spokesman-Review, said it's harder to teach journalists to be bloggers than bloggers to be journalists. In other words, blogging is particularly suited to a certain type of journalism, one where the journalist is present in the narrative and offers his or her opinions and comments on the subject. Many non-editorial journalists are unfamiliar with the 1st person style of journalism because we are taught in J-schools across the country to be "objective, accurate and fair" in how we gather and present information. But what Journalism classes often don't discuss is how the information left out or how the ordering of information is a subtle, but still subjective way of influencing how readers understand information.

Readers are showing their acceptance of blogging as a new and legitimate development in journalism. Apparently, my fear that people will confuse journalism with blogging is unfounded, said Sands in a phone conversation with my journalism class. Readers know that blogging, at least the blogging done by actual reporters, is more like a sneak behind the Wizard's curtain not a directive from in front of it. It's a way to see and hear information not typically present in news stories, for example, comments on the actual reporting. Reporters can discuss how they tried to get this piece of information, or how this source said a bunch of thing illuminating the issue, but that couldn't fit in the actual printed news story because of space considerations.

Sands' best point was that its too early to tell what blogging's effect on mainstream journalism will be, but that doesn't mean that we should resist it. Instead, journalists need to embrace the potential of internet technology and take advantage of the opportunity to combine print, video and audio journalism in one place online. He's beyond worrying about the survival of print journalism because he doesn't see them as in competition, which is another good point. There's attributes of newspapers that blogs don't have, i.e. established credibility, paper that a reader can hold, and a process of production. Blogs have immediacy and subjectivity as their main defining features. The two, if taken together, could take us that much closer to accurately reflecting the human condition.

This I believe

I believe in having a journalist's mission. This is mine:

As a journalist, I will strive to give voice to people and perspectives not typically covered in mainstream journalism. As much as possible, I will try to do so using their words in their context.

As a journalist, writer and human, I will treat others with the respect, love, compassion and dignity I would like to be treated with. If I fail or am treated with less than this, I will apologize and admit my failing or will gently but firmly point out this poor treatment.

My personal and career mission statements are guided by these same principles: respect, love, justice, humility, kindness, compassion, generosity, consciousness and hope. I will accept nothing less from myself and therefore from my friends, co-workers, bosses and partners.

I don't believe in much, but if the values of respect, integrity, honesty and love were universalized, I think the world would be a much better place. We spend so much time debating society's laws and rules without questioning the ones we internally live by, if we do at all. I think its important to begin within before working on the external. This I believe.