Tag: Africa

cynicism from a jaded summer

Development

I have been away from writing for a while and this is my attempt to convince myself that is it still important to share what I think. I have been doing a load of thinking since my summer travels. Upon returning from Ghana I started work back at my blue collar job full of racist, sexist, mostly ignorant co-workers, using the term ‘rednecks’ would be too clique, but I just did. At any rate they started off the extreme of the comments that I knew I would receive. Why would I go to Africa? Did I get a number of different diseases? Did I get AIDS? Many co-workers noted that they wouldn’t have even stepped foot off of the plane onto the African soil and I must be either very brave or stupid. These and other questions are starting to not even phase me. They still bother me, but not as much as they once did. The most common question with a hint of no interest behind it is, “How was Africa?” Well if I could easily sum it all up in the few short sentences that will hold your interest for more than two minutes, then I might try and let you know. Sadly the majority of people really do not know how Africa is or have the slightest inkling to discover. This is again not new territory for me and I am not surprised. This is what most worries me. Am I becoming jaded and cynical to a degree? I like to pride myself in working to not become jaded and to always be an optimist, however – people make that difficult, as much as they make it easy. There are just so many interesting things taking place on the African continent and so many thoughts and reflections that tag along that I cannot possibly focus an entry on just one instance – and that is the idea of this blog – to create a place for the contents of my mind that need to spill.

Since returning I have been doing a lot of work with my organization, S.C.O.U.T. B.A.N.A.N.A. We are launching our Year of Water Project in Michigan to fund community wells in 8 different African countries with an organization called Charity:Water. Chapter Action Boxes are being sent out to all 18 North American chapters. The ‘Handbook to Making a Difference’ is almost complete and now we are just waiting on the button order. I have found that applying myself in action has helped to combat the negativity of all the questions asked after returning from Ghana. I have stayed away from reading too much of the news of Africa, kept to the simple ways of a small city life, and have attempted to relax a bit. Now I can do so for no longer. There is too much happening on the African continent, there is too much to do here to raise awareness and there to save lives, there is too much to remain idle for too long. And so I am back at it. There is a wealth of issue I am set to cover, so there may be a large influx in entries over the next few days.

I didn’t have much time to do any great reading from my long ‘List of Good Books to Read,’ but there was one in particular that I enjoyed a lot. I would like add a brief review of a book that I finished this summer. The Power of One by Bryce Courtenay was a book that I had difficulty putting down. It is based in the time period before World War II (1939) and follows the life of a young british boy from his difficult days as a child at a Afrikaaner boarding school, to his climb to intellectual superiority in a new town, and later to his days as an accomplished teenager. All the while the boy is growing in his educational, spiritual, and professional capabilities – and working dedicatedly to one day becoming the boxing welterweight champion of the world. It is called a classic novel of South Africa and I think this tag fits because the book follows the development of South African society. The boy has no difficulty in accepting a person for who they are and often works diligently to assist the oppressed African people. The boy becomes respected by both Africans, for his language abilities and assistance, and white settler descendants, for his academic skills and athletic accomplishments, alike. Definitely a story that was spearheading for the future and one that gives an exciting story of adventure, accomplishment, and Africa.

Index of blog post series on Ghana.

the caramel apple of globalization

Development

Crunch, Mmm, the peanut chunks trapped in delicious caramel tastes oh so good. You bite and are rewarded with a mouthful of inticing caramel and nut flavors – all of a sudden that deliciousness is tainted by an odd sourish, crunchy, mushy apple flavor. What? Where did this apple come from, I like the outside best. This is the caramel apple of globalization – the outside is so delicious and appealing, but once you hit the apple and core, the fun has ended. Granted this all matters if you run with the majority and toss aside the age-old wives tale of eating an apple a day to keep the doctor away. Too many of us see this doctor everyday – there is no escaping this doctor because all too often globalization is used for ill, just to get the caramel and nuts, not the healthy fruit of the free market, fair trade, and multi-lateral agreements.

Globalization is seen as the harbringer of much ill in the world and the truth of this idea is undebatable. All one needs to do is visit a small community in a ‘developing’ country and the negative impact is obviously seen. Globalization, being a negative, can, if used properly, be a positive and can lift poverty from oppressed peoples. Some of the caramel of globalization’s apple I have seen firsthand in my travels of Uganda and Ghana. Trash, more specifically plastic, has created a scar on the beautiful African landscapes sought by all. This trash is piled, burned, and thrown anywhere. The great evolution of plastic was an amazing invention, but has created problems elsewhere. This goes along with the ‘quest for the west’. The Western pop culture permeates everywhere. This an odd development if you ask me because the cultures evident in African societies are so strong and have such beautiful histories and traditions. Maybe the youth in those societies do not think so, that must be a youthful commonality – rejection of old tradition. Terrible western hip hop is loved, most everyone is walking around campus with their earphones in and MP3 players out – you would almost mistake this for an American campus, but for the heat and the obvious difference in setting and language. The love of technology and having a piece of technology is great. Many places we visited, the youth asked us if we had headphones to give them. This interest in technology could also develop into a positive of globalization. There is also the adoption of the word term ‘fastfood’ at typical Ghanaian food stands. Let me tell you, at least in Ghana, there was no such thing as fast food.

Globalization is defined as the sharing of ideas, technology, inventions, thoughts, education – it is an idea as old as the world itself, so why in recent years has it become such a harbringer of ill and a harsh word to the ears? Globalization brings in an international influence that can be seen as an extreme negative, but in some places international involvement is important to foster a strong economy. The idea is to make the right decision so that exploitation of people and resources does not happen. The economist, Joseph E. Stiglitz, attempted to write a book to explain this idea of ‘Making Globalization Work,’ I would recommend the book, but also look into other perspectives. Globalization can be used for as much good as it is used for ill. The important thing is to use the idea of globalization wisely, as with everything else at your disposal for power. I see the crises of black gold and other important resources in African countries ripping the people and governments apart. Globalization does not have to be the end, globalization is the means.

Index of blog post series on Ghana.

the land of culture; africa

Development

Culture is not very easily defined. Anthropologists give us a few attempts at definition and the real meaning must lie somewhere in there. In 1871, Tylor called culture, “That complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by a man as a member of society.” Keesing and Stathern stress the idea of culture in their definition, “systems of shared ideas, systems of concepts and rules and meanings that underlie and are expressed in the ways that human beings live.” We can at least gather that culture is a set of guidelines, whether written or unwritten, which are meant to direct a society. We think less about our cultures as being guidelines and can see culture as more of a means or way of seeing things from a perspective. In Culture, Health, and Illness, we can learn that there are different levels of culture: culture as a ‘facade to the world at large,’ culture as the assumptions known to a group, and culture where the rules are taken for granted and implicit, impossible for the average person to be aware.

Africa is often called the ‘land of culture.’ This I believe is an accurate title. From my studies and travels I have come to see that there is most definitely these three levels of culture and so it is easy to see why this title was given. There is the outside view, often ignorant view, of Africa as a vibrant land, etc. There is the level of culture within the people, depending on where you travel, which you can easily be a part. There is the level of culture where it is easy to see that there is no way that you as a traveler can ever hope to understand or take part. Culture exists at these three defined levels and so much more. Africa truly is a land of culture. But what more is there to culture that we miss when we travel or study a country, a group of people, or a society? Do we often miss the deep nature of culture?

Here is a glimpse of the culture of Ghana by way of drum and dance. I had the joy of seeing this display of culture in my travels of Ghana and in each region we visited.

An aspect of culture that I found very intersting to my work and studies is the idea of investing in death. On our travels of Ghana we visited a special business of coffin making. These were no ordinary coffins. They were in the shape of fish, cars, trucks, castles, coke bottles, artillery, and deer. The coffin is made to represent the life of the deceased person. However there is a greater issue in the coffin business. Often there is no money spent on healthcare or medicines, but when the person finally dies from that lack of healthcare they are given a funeral where expenses are relatively lavish and much is spent to celebrate the person’s life. No matter how easily they could have been saved from an investment in their life, instead of their funeral and death. For this reason funeral ceremonies and deaths constitute a large part of Ghanaian life. Yes, death is part of life, but in this case death is becoming life. The Medical Health Insurance Scheme being promoted and launched in Ghana, so there is hope that there will be a greater investment in health and life.

Index of blog post series on Ghana.

bombs bursting in air. . .

Activism

Independence Day, the 4th of July, let freedom ring – but are we ‘free at last?’ Today is a day that means a lot to Americans, or at least it should. In many other countries, especially African countries, independence days receive more than just one day and have celebrations that take over weeks. Here we celebrate with fireworks, family get togethers, remembering the troops, community events, and other random events set for just one day. Independence Day is something we have come to take for granted. We know that we are independent and ‘free,’ but we do not really understand what that means. We shoot off fireworks, blasting explosions in the sky, shaking our bodies – but what we do not realize is that ‘bombs bursting in air’ means something completely different to the rest of the world. Explosions, bursts of light do not represent independence in many places – these are signs of danger and create fear. A rocket’s red glare has a frightening consequence and that does not end often in freedom. I began really thinking about how people from other parts of the world would view our independence day when I attended the Seeds of Peace International Camp in Maine the summer of 2003.

The camp brought together teens from areas of conflict to learn dialogue and conflict resolution and more importantly learn that kids on the other side of the conflict were just like them. It was an amazing experience and helped to set my future path studying international relations. While I was there the 4th of July happened and there was a worry that the booms and explosions from the fireworks might frighten or panic some of the campers during the night. This is when I became aware of the fact that while we enjoy setting off fireworks for fun, independence is not so fun in other parts of the world and, sadly, independence is not for everyone to enjoy.

Since I just returned from Ghana I can say that there were huge celebrations for Ghanaian independence, the first African country to gain independence from their European colonizers, Britiain. They had month long celebrations since it was their 50th anniversay of gaining independence and even while I was there three months after the celebrations, events to celebrate independence were still happening. Ghana is independent, but right after their independence not everyone was free. There was political, economic, and social troubles before Ghana reached its relatively stable situation today. I wonder if the US ever had this problem? Or have we even tackled this problem? We are independent from our ‘homeland,’ but does everyone have freedom. Is independence synonomous with freedom? We are free in the sense of George Washington and the founding fathers, but we are not free in the sense of Martin Luther King Jr. – the price of freedom is often talked about, but do we truly understand its full meaning? The price of freedom is at your doorstep and within your own self. What do you appreciate about being free?

when not in ghana

Development, Health

There is so much reflection and thought to write under this title, and the last. I will apologize now for the incohesive and random nature of my thought process and my failure of ability to express in words what you can only understand from experience.

I have been in Africa now for a month and a half – living, studying, and experiencing. Many people like to just leave it at that, but I like to be more specific. I was in the West African country of Ghana. A country with a relatively stable country and economy (some crises right now: electricity and fuel), full of culture and tradition, and even in its immense ‘development,’ Ghana remains with disparities like any other country – even the US. Africa is not a monolithic mass in the southern hemisphere of the world. So many people would rather chalk up the continent into one idea after reading, hearing, or experiencing a small aspect. Intellectuals, non-intellectuals, those who are from Africa, those who haven’t, and so many experts would rather clump the continent together. That just can’t be done. There is nothing about Africa as a whole that can sum up what it is. It is just like how in the US each state has its own special customs or accents or scenery – Africa as a continent is the same, but better. So many people would rather save time and refer to Africa as a monolithic mass. However, as I lived, traveled, and experienced Ghana the falsity of this idea was all too evident. Our MSU study abroad group was based in Accra, the capital city of Ghana and did much of our work at the University of Ghana. We took many field trips: Cape Coast, Volta Region, Kumasi, Villages near Danfa, and more. Every time that we would leave for a trip the Ghanaians that helped us would tell us that we would experience something so different from what we had seen before; something that we could only have seen in our dreams. They could not have prepared us more. Each region that we visited, each city, town, or village that we stayed in was completely different. We witnessed the many ethnic groups of Ghana, their music, traditions, and customs – the Akan of the Accra area, the Ewe of the Eastern Volta Region, the Asante of Ashanti Region. . . If there were so many differences and experiences in one of the smaller African countries, than what does that say for the massive continent itself?

One of the most obvious differences between Ghana and living in the US was the notion of time. In the States it is very hustle, bustle, go, go, go, exuding impatience – but in Ghana things will happen when they do. You can go for a meal order your drink, wait a bit, get your drink and order food, wait sometimes two hours (tops), get your food, and leave in about three hours from your dinner excursion. But its ok, what else were you going to do? Enjoy your food take your time, chat with your tablemates, tell jokes, enjoy the scenery, people watch – everything will happen in good time. I like that notion of time. I liked it so much that I stopped wearing my watch and often had to ask a Ghanaian with a cell phone for the time. I am not a rushed person, well at least not as rushed as most, and I like to take things as they come. Time should not be such a definitive aspect of your life. Time should work for you. One Ghanaian told me, “Here, we are manufacturers of time.” As opposed to we, in the States, who are the slave labourers to time. I return and time is back in my face again, cracking the whip. The ubiquitous tyrant of everyone’s lives will remain to be the arbitration of time.

Hurtling down the road at breakneck speed, I look over at the speedometer – hoping that we don’t nail a pedestrain or hawker – I see that the speedometer has been put out of commission, figures, they don’t want to know how fast they are going themselves. A mass of traffic appears and we, amazingly, stop in time to not die. The traffic lights have decided to work today. The car exhaust and black smoke flow into my front seat window as the hawkers walk by selling apples, ball floats, candy, posters, you name it. They are accompanied by those crippled by polio, beggars, and blind men walking with an aid. This is the taxi ride of Accra, you have not experienced Accra if you do not ride in the front seat of a taxi. Now back in the States I enjoy always smooth roads, no traffic backups (I don’t live in a very big city), and no death-defying driving skills. That is a fun little part of each day that I will miss.

We all take our health for granted. Everyone. In Ghana many of the students got sick, had diarreha, fever, something – back home we are rarely sick, we are rarely decommissioned for a day, we are rarely at odds with the world we live in as far as our health is concerned. I have the luck of owning an adaptable body and did not get sick in any regard. Thankfully whenever I travel nothing affects my internal health. The sun likes to affect my external health – my nose is still red with sunburn. We take our health for granted. Our professor who worked for over two years in the Peace Corps said she was always sick and while in Ghana I noticed this as well. Many people have fever, coughs, malaria, and who knows what. . . but, depending on location and class, they could not self medicate from the cabinet or see a doctor right away. They walk to get clean water, no faucet in the kitchen with clean water. We take our health for granted. I thought about this often when a group of us would go running. We would draw quite a crowd and get some cheers from school children. They must have all thought we were crazy – running miles in the hot sun at a fast pace, did we want to die? Well no, we Americans enjoy exercise, but for the Ghanaians we encountered and many Africans exercise is a way of life not a luxury to feel good. Will we ever stop taking our health for granted?

One of the sad reflections from Ghana is the idea of culture and tradition that is just not seen in the US. Ghanaians have a deep shared history and strong traditions rooted in their respective communities, which share much in common. There is a huge importance of family and the customs that are passed down. Many professions are passed from father to son, mother to daughter and the day to day of family life is passed down through traditions. In each of the villages we visited we were sure to make courtesy calls to all the local chiefs. The local chiefs still hold a great deal of power and we soon understood the protocol for visiting a chief. The importance of connections between people is huge. In some cases this cause corruption and nepotism, but there is an underlying good intention. Your connections with family are extremely important and you never lose that connection no matter what – if you decide to blow of family then you are looked down upon. You keep the family name, you name your children for past relatives, you visit often, and if you have a good paying job, you send support. This unknown emphasis on human connection is amazing. It goes beyond family to the people you meet in life. I couldn’t believe how many people could remember my name from a one time meeting. It must be the greeting ritual that makes it easier to remember. In Ghana you do not just wave and say, “Hi, how are you?” and receive the standard response, “Fine, thanks.” You stop talk, inquire about family, friends, and life. The nature of people in Ghana is just so much more cohesive and happy. I think it is because of the emphasis on people and getting to know them.

One of my favorite parts of Accra is that the grocery store is right at your vehicle window. While you are stuck in the mass of rush hour (sometimes it isn’t even rush hour) traffic, hawkers walk up and down the rows of cars, trucks, lorries, and taxis selling just about anything. Probably the oddest things I saw being sold were: a pair of puppies, toothpaste, a box of chickens, coffee mugs, umbrellas, the list goes on and on – pretty much anything that up might need is right outside your window. Besides the window side store and clubbing scene, I prefer to stay out of the big city. My best experiences on the etire trip were in the small villages of Otinibi and Danfa. The village life is so much more appealing and friendly. The village is a more closely knit community and is extremely welcoming.

Ghana was an amazing experience from all of the great classwork we did and, most of all, from the excursions we took as a group and adventures on our own. Meeting people was my favorite part and learning about their lives was most interesting. I don’t think I could have had a better experience in Ghana, unless maybe I spoke the language, but I am getting there. Ghana is an amazing place, an interesting beacon for the continent, and a force to be reconned with in the future of our global economy. I still have some very specific reflections from Ghana, so be sure to check back to learn about: investing in death, the discovery of oil in Ghana, and the confusion of the rastafaria movement.

Here are some random, artistic, super random pictures left over from Ghana:

Downtown Osu at night, Osu has many western style establishments that are run mostly by Lebanese.


An awesome tree at the Forex by the Center for Art and Culture.


The arc of Ghanaian independence just down the road from the presidential palace.


A fisherman’s association from the view of Cape Coast Castle.


A fisher and his boats taking a rest in the nook of Cape Coast Castle.


The canopy of Kakum National Forest, beautiful!


Don’t look down (from one of the canopy platforms.


Slightly frightening sign in Accra, just before we sped off. . .


This is the village area we stayed in, Shiashie, engulfed by the growing Accra.


The moon between palm trees at our hostel on Don’s 21st birthday.


A nice village scene in the Volta Region near Wli Falls, tallest in West Africa.


HIV/AIDS awareness and education.


Cool coke bottle shot, drink up.


At the University of Ghana.


One of our favorite restaurants to visit, off the beaten path, but well worth a good Ghanaian meal.


Me and Joseph, the most amazing hostel worker ever.

Index of blog post series on Ghana.

the longest driveway

Health, On the Ground, Research

On our way to the village of Danfa, where we were to conduct our community health diagnosis, it all became clear to me why the roads that we had driven on were being so developed. I learned from one of our interpreters that there was a new presidential palace being constructed on the top of the mountain past Mampong Regional Hospital. I learned that the roads before had been very precarious and dangerous, but nevertheless the entire route from the main road near our hostel in Accra-Shiashie all the way up to the mountain communities near the palace saw road development to the extreme. It was to be the president’s new driveway. The longest driveway that I know of, but when you get a police motorcade that clears the roads to take you home, why not have a smooth path in the name of development? This makes me wonder. . . will the surrounding communities benefit? Will they get development help and road improvements? I think not as evidenced by the poor side roads and lack of interest in rural communities (or so it seems). Is a long driveway really necessary (too much snow in Michigan)?

17 June 2007
We arrived back in Danfa, as we had previously visited, and moved into our guest house near the community health clinic. The clinic was constructed back in 1969 with the help of the University of California (no one knows which one) and serves six local communities of over 60,000 people. Many medical students stay in the guest housing to conduct community health diagnoses. This is why ours was to be in the village of Otinibi, just down the road about two kilometers. We were to interview four individuals with pre-determined backgrounds to see how well the community was doing in regards to health. Here is where many students first saw a very rural village with not much development. However, here there was a fair degree of development due to the involvement of the University of California and other NGOs from the UK and Norway. This is where I felt most welcome and at ease. There is no rushing in the village, there are no hawkers, no one will lie to you for help, the scenery is beautiful – mountains in the background, heart wrenching picture opportunities of children, the freedom of the wilderness, there is just such a better atmosphere and disposition that it is very difficult to explain. It is because of villages like these that I fell in love with Africa. The guest house was a very nice place where we could all live, cook, clean, and work together. Everyone took turns cooking a meal and cleaning up, playing cards, singing songs, kicking a soccer ball around, and just having a good time. Hurrah for group bonding!

18 June 2007

The very next day we awoke early to cook (Team 3) oats, eggs, and cinnamon toast – believe me this is an amazing breakfast. After eating we met our interpreters for the day. They would assist us in interviewing community members about health practices. We split into groups and were assigned an interpreter. Elkanne, 18 years old and son of our coordinator, was our interpreter. He was a very nice kid and was very good at helping us understand the health of the community. We walked the two kilometers to Otinibi and began interviewing. The village is like many that we have seen here. In the early stages of ‘development,’ a hardworking chief, mud buildings, sheet metal roofs, no defined pathways, a borehole for water, coconut trees, and lots of ‘bush.’ The village is beautiful and I can’t get enough of it. We conducted our interviews, meeting a great array of people from a man who spoke for his wife, a not so enthusiastic bachelor, and an awesome grandmother who supposedly grows the best of the best peppers. We learned of many different aspects of community health and saw a great deal of the community to assess its health. We chatted with the chief as he passed by and attempted to climb coconut trees. Elkanne was much better than I was.


While we were heading back to our guest house in Danfa, after completing interviews, we passed by a kente cloth weaving ‘factory’ of sorts. We came across a young boy weaving so fast and with such skill, it was amazing. Later we found out that this was a place of child labour and that these children did not attend school, which is against the law. On leaving we informed the chief and he said that he was going to register all the children in the area who were supposed to be in school. He would then confront the man running the operation and extend some help for the children.

The Interpreters:

Our Findings
We identified four key areas that contributed to the community health of Otinibi: Nutrition, Sanitation, Water Source, and Health Service Use. Each of the four people we interviewed told us that they ate only kenkey (pounded maize) and fufu (pounded cassava), none of then had anything else to supplement their diets. No fruits, no proteins, no vegetables. We wondered what effect this had on the community health as much of the diet was composed of starch. We then asked about waste removal and everyone told us that they used the dump by the bush, only the grandmother told us that sometimes they burned it. For human waste they all went to the bush, which as you may guess is very unhygenic. The public toilets have been broken for some years (collapsed). This moved us into asking where the families got their water. There is a newly installed pipe tap which everyone said they used, but we were told that it cost 200 cedis per bucket. Is this really the primary source of water? I can’t imagine everyone paying for a bucket of water every time they need it. Before the tap, the community used the borehole (pump well) to get water. Everyone told us that they knew the water was safe to drink because they drank it and didn’t get sick. Or did they? This is where we wondered if the common ailments of headache and fever, which were diagnosed as malaria, were really due to the water. There was also a stagnant pond that some people used to get water for bathing.

As far as the decision of what medicine to use, we observed self-medication, use of orthodox and traditional medicines. In the community everyone told us that the Danfa Clinic was their number one choice of medical care. I contributed this to the construction of the Danfa Clinic and the subsequent outreach programs conducted in the surrounding communities. No one, except the grandmother, even touched on the use of traditional medicine. The grandmother did not like the orthodox medicine because the pills made her sick. When we visited she was cooking some leaves from the bush for her fever and she said that these worked very well. However, she did not see an herbalist and knew what to use herself. This use of traditional practice when the modern approach does not work was also seen at the bonesetter’s clinic. One man did not want metal inserted in his arm another could not get placed in a modern clinic. In this scientific age the traditional herbalists/bonesetters are using modern x-rays to do their work and it seems to be working well. We also visited the traditional birth attendant (TBA). The one we visited happened to be trained and served the larger community including Otinibi. She was trained in 1996 and before that she just used her experiences and teachings from elders to do her work. We learned that in many cases traditional medicine is reverted to for reasons of proximity, emergency, and convenience. The vast majority of the Otinibi community used the modern medicine and ‘knew’ that it was the best option. The father we interviewed even went to the chemist (pharmacy) to pick up headache medication for his wife. When I asked Elkanne what he thought about traditional medicine he quickly responded that he only used the Danfa Clinic, but why not? His father worked at the Clinic and the parental influence is very strong in Otinibi. The parents we interviewed would take their children first to the clinic before themselves.

Our Recommendations
We observed a number of open pits and stagnant water sources. There was an old open well that had accumulated a disgusting degree of trash, fecal matter, and god knows what else. We recommended that these holes be filled in to reduce injury risk and mosquito breeding. Our next recommendation was for a separation of trash and regular removal. We also saw a positive in starting a composting project. This could help with the community’s subsistence farming. Since it was the rainy season many homes had closed windows and poor ventilation. For this we recommended screens or mosquito nets on the windows to keep out pests and provide ventilation. For nutrition we recommended maybe introducing beans to be grown and eaten as a source of protein. We also recommended that the people eat what they grow. A number of those interviewed grew vegetables and other foods, but only to sell. Eating the local fruits would also help the nutrition of the community. These were just the small ways that we saw to improve the community health. I would say that the community was for the most part healthy and just needed to act on some simple measures to ensure a greater wellbeing. I also noticed that there was a great lack of emergency transportation. There was none except for the local vehicles. I saw people hurriedly carrying sick people into the clinic, the TBA talked of childbirth emergencies with no transport, I have seen and heard this before – investing in an ambulance may help.

While in Danfa/ Otinibi we had number of delicious Ghanaian dishes:

Palava Sauce (spinachy) and Boiled Cassava

Groundnut Soup with Chicken and Rice Balls

We saw a scorpion! In Ghana they are seen as very evil creatures and are the evil-doers of witches. This one was caught in the gutter and after we all took our pictures and left was probably smashed to a pulp. Scorpions are hated with the passion of a million fires in Ghana.

Index of blog post series on Ghana.

a mixture of black, white, red

Development, On the Ground

14 June 2007
Our third visit to the Volta Region.
We visited the Akosombo Dam, creator of the largest man-made lake in all the world. This dam was constructed in a brief three years by Italian engineers. The Lake is formed from the Black, White, and Red Volta Rivers coming from Togo, Benin, and Cote d’Ivoire. Volta in the local language means ‘rapids,’ now there is just a giant dam. The dam was built to be used for electricity and to create a source for fishing. The dam was huge and presented a great mark on the landscape of Ghana’s lush forests near the Volta Region. The dam provides all the power for Ghana, but currently there is an energy crisis. We have experienced this crisis with frequent black outs and power outages al across Ghana. We discovered why this is happening by viewing the extremely low water levels for the operation of the dam. Our guide told us that they are waiting for the rainy season to get into full swing to fill the Lake Volta and increase the power.
No pictures were allowed of the operational side of the dam, but here they are. After learning all about the dealings and history of the dam and how it works we walked back across the bridgeway and I noticed that there were less power lines heading to the north of Ghana and a great number headed to the Accra city center and southern Ghana. This seemed to be an all too common theme and yet again more evidence of the disparitites between North and South in Ghana. Kyle noted correctly that this was a great scar of development. The dam stopped up the rivers that now create the Lake Volta which covers one fourth of the country. It harnesses the water for electricity and development. It sits high and heavy on the once beautiful landscape on Ghana and screams of a continued practice of harmful ‘development.’

Seeing Lake Volta for the first time reminded me of an article that our professor showed to us about child labour in the fishing industry on lake Volta. The article was from the New York Times and followed the stories of families that could not eat and sold their children into labour for money with the promise of seeing their child once a year and being sent more money. Those promises rarely hold up and often the children are beaten, overworked, and never return home. The article covered the story of a young boy who worked on Lake Volta, fishing in the potentially dangerous waters with little sleep or rest, and a lot of work. Child labour is not beyond the ‘most developed’ country in Africa. It happens here, in the very eyes of development.


We headed over to the Volta Lake Hotel to have lunch. The hotel was a great Western hub catering to Obrunis (this is the correct spelling) and providing one of the most delicious meals yet. I forgot to take a picture before the meal, but here is the after picture of my ravaged plate. I was quite hungry by this time and the fillet of perch with a cocktail fruit drink and fresh fruit hit the spot.
Our bus driver was very tired this day since the day before the bus needed repair and there was trouble finding the part, he had been up since 5 am that day. He took a little nap.

Index of blog post series on Ghana.

snapshot of health in ghana

Health, On the Ground

We are now a week into our second course of out study abroad program, studying the disparities of the Ghanaian healthcare system. These disparitites range from Ghana to the US, urban to rural, and ever North to South. We have seen and learned about a number of different healthcare situations in Ghana. Since my interest is in access to basic healthcare I have been watching health clinics as we traveled around for the first 4 weeks and I have been trying to understand how the healthcare system worked, now all that I have observed is making more sense.

The Statistics
– one third of the 138 districts have no hospital
– high maternal mortality rate (hemorrage & infection)
– beyond the capital the road system is poor
– 40% of population is covered by the national insurance
– life expectancy is 57 (this has fallen with the emergence of HIV/AIDS)
– healthcare is geographically, financially, and culturally inaccessable

The key problem in Ghana is figuring out where the divide should be joined between traditional and western medicine. What is more interesting is the integration of traditional medicine into the very western Ghanaian health system. I noticed from my pre-healthcare course observations that there is a large number of missionary clinics, government hospitals, pharmacies, and other private health service centers in the Accra area. As we traveled from Cape Coast, Volta Region, and Kumasi I noticed that there was a lesser degree of healthcare services advertised or offered. Why was there such a change from the urban to rural was my first question. Even more so why was there such a disparity between the other regions and the Volta Region of Ewe people?

7 June 2007

Our first visit of the health systems in Ghana was to a health clinic and research center that was solely focused on using traditional medicines and herbs for cures of ailments. It was very interesting to observe the research being conducted and see that they were also running a full health clinic with their findings. The center claimed to have WHO (World Health Organization) funding, but I am not sure if that is true anymore. While there we met some students from the US who were interning at the center for the summer. This is a direct linkage between the traditional and western methods of medicine. This also brings up the issue of intellectual property rights – do the communities that the center learns from benefit from its revenue? Sure the health clinic, but otherwise? This is a reason that the center’s director gave for not partnering with large pharmaceutical companies – to not lose IP rights.


From there we went to the Mampong district outside of Accra to view the structure of the health systems and network of regional health services. We first visited the regional administration offices and talked with the head nurses. They gave us a very well run and organizaed outlook on healthcare in Ghana. At the offices there was also a counseling and testing clinic for HIV/AIDS and a peer educator class taking place. Here we learned that USAID (United States Agency for International Development) provided food rations for new mothers and mothers with malnourished children. I asked if this was true at all regional districts. The answer was yes, but I wonder if all the regions are as well established as Mampong. We then went to visit the regional hospital. It was a large, modern building, not very dissimilar from what you would find in America or Europe. But, there were obvious differences in the developed nature of the hospital. It was a nice hospital, but not one that I would want to stay in. We were given a tour of the entire premises and had a near-death experience in the elevator. Twenty plus people in an old hospital elevator in Ghana makes for exciting times. The elevator descended with the help of our weight and gravity – there was a loud bang as we hit the safety catch – there were still three floors to fall. The head nurse was not very keen on what to do next, but eventually we all climbed out from the gap left between the two floors to the wondering faces of what seemed like the entire hospital staff. Its the stairs from now on.
There seems to be a very good system of healthcare in the relatively developed areas of Ghana, but as for the villages I cannot say. It seems that we have visited mostly well put together centers and clinics. This made me think of the situation in Uganda, where it is the private and mission clinics that have all the supplies and the government run centers have absolutely nothing – very different.

At the Mampong regional administrative offices we learned that in many villages where there is no clinic or government hospital there is a nurse that lives in the community and is charged with the health of that community. However, I cannot speak to the degree of training or equipment that these community nurses have. This speaks to the obvious disparity between the urban and rural environments. There is not as much access to healthcare in the rural areas and so I wonder how much access there is in much of the rural North of Ghana? How many people do not have access?

11-13 June 2007
Some of the issues brought up in our classroom lectures about the health systems in Ghana relate to money. Not everything is covered and so some people cannot pay for access to services. There is bribery in medicine, we have not experienced this, but I do not doubt it. The basic insurance policy in Ghana costs about 72,000 cedis a year, this may not seem like a lot to ‘developed’ countries, but to a Ghanaian this could mean a great deal. In its health development, Ghana is still working on eradicating polio and guinea worm – even in metropolitian areas. Sanitation is a big problem. “The world is my toilet,” has become a joking phrase among the males in our group. If you are a male you can urinate just about anywhere, except where it says, “do not urinate here!” However, you still see people urinate by those signs. Sewage drains have stangant water and often do not drain anywhere. Trash is not collected and is often burned by the roadside. This reminded of Uganda where trash is just thrown out the window. In Kampala you cannot get away from the smell of burning trash, and there are not even drainage ditches.

Another issue brought up was that of ‘assembly line medicine.’ In Ghana there is such a high number of out patients (40% due to malaria) that the health workers often diagnos based on perception, not based on evidence. The issue of traditional and modern medicine is also a hotly contested topic. The health worker crisis in Africa seems to have been circumvented slightly in Ghana. Ghana has included traditional birth attendants in their health system and has just set up a new council for traditonal medical healers to have their say. The most fatal health issue in Ghana now is maternal motrality. Why? Good question, Ghana is ery developed in its understanding of health practices and so it makes no sense whatsoever that a mother should die due to complications of childbirth.

We next traveled to Ashesi University, a private, liberal arts university in Ghana (the most liberal in all of Africa, supposedly). Here we met a Fulbright fellow and a former fellow who is a profesor at Eastern Michigan University. Here we talked about the ‘brain drain’ and new ideas for Ghana’s health system. Currently a physician is in charge of managing the health center, but this means that often the physician has no idea how to manage and makes the staff unhappy and then does not practice medicine because he or she is too busy managing the center. The professor from EMU was working on publishing a study to help change this and introduce education for health managers. The incentives for staying in the country to work are minimal, but inticing. If you work in the Ministry of Health (MOH), then you can be sponsored to increase education and degree. The professor also talked of how Africa, “gets under your skin, you keep coming back.” It really made sense to me and I really don’t want to leave.

13 June 2007

Today we visited the Korle Bu hospital, the best government hospital in all of Ghana. We were not able to tour the main clinic becuase we arrived late, but we did get a quick tour of the Department of Child Health. It was a very nice center, as you can tell from the pictures. This was again an amazing compund that constituted a village in itself. It was obvious that this center must receive a large amount of the government funding for health. There were a number of different center, housing for doctors and nurses, a bank, pharmacy, and a teaching hospital for the University of Ghana. Hopefully we can return later and get a tour of the main clinic to see how things are run there.

The recommended health center for the MSU program students, if they are to fall ill on the trip is Nyaho Clinic. It is a private center tucked away in a random area of Accra. We have had a few students go there, but I have not seen for myself the interior. I have heard it is very nice and Ghanaians in the health profession know it as a nice and expensive clinic.

So far most of the health systems we have seen are very well established and well run and seem to be in great condition. We have not seen the failings of the Ghanaian health systems and the picture for now seems very rosy. I have seen the many mission, private, and government hospitals and clinics in the fairly ‘developed’ regions of Ghana. What I have not seen is the lack of healthcare like I saw so vividly in Uganda. The EMU professor at Ashesi University told us stories of his experiences with health in Ghana. He told stories of overrun rural clinics, a family’s inability to pay for lifesaving medication, the long distances traveled wo receive attention when it is too late, the sheer numbers of people who just do not have access to basic healthcare. This is where I feel we should be, this is where it would make sense to me, this is where we can make a difference. We will now be leaving for the village of Otibini near Danfa to do a community health assessment. I think here is where we will get to feel the village life and true health crisis.

Index of blog post series on Ghana.

the chinese influence

Development, On the Ground

The Chinese influence in Africa is a topic that I have been researching for a few years now. I have conducted most of my research by way of news sites and journals in the States and with the help of the internet, but now I have the opportunity to see firsthand the impact of the Chinese influence in an African country. This entry will follow my experiences and insights on how China is involved in Ghana.

The first thing that someone traveling in Ghana will notice is that there are so many Chinese restaurants. They are just about everywhere. Chinese food is almost as prevalent as Ghanaian food. Sadly, the Chinese food is not at all what you would find in America or for that matter China. The menus are often 15 pages long and with only minimally Chinese named dishes. Nevertheless, Chinese restaurants are everywhere. Also in the service industry there are a number Chinese themed hotels that host a number of Chinese tourists and business people. On our walks down East Legon we see them buying bread and other food stuffs at the market.

As some of you may know, China is currently one of the highest (maybe the number one) foreign aid provider. This is often called ‘rogue’ aid because it is not administered through an aid institution without any restrictions on aid usage. This aid is evident in Ghana with a number of projects sponsored by the Chinese government. One day on a tour of Accra, near the Kwame Nkrumah moselium a police escorted motorcade shot through the traffic with a handful of Chinese officials. The wonders of Chinese aid is prominently displayed in the construction of the National Theatre, it was completely funded by the Chinese government. I wonder if there is any linkage between Kwame Nkrumah’s administration and the remaining Chinese connection. During his rule Nkrumah often hosted Chinese officials and received help from China.

The people, the aid, the food, the history is all here. There is a deep worry, that I often agree with, China is seeking to gain natural resources from African countries. They make a number of aid packages for ‘development’ and sign bilateral trade agreements, but what does it all mean? Is China’s motive in Ghana to reach a growing market economy? Is it to cash in on the mineral wealth of Ghana? It cannot be just to build a National Theatre and assist the Ghanaian government with ‘development.’ I really wonder what the specific trade-off for China is.

China is not the only big aider that I have noticed while in Ghana. Iran is sponsoring a number of projects and many of the government ambulances are donated by the Republic of Iran. I will touch more on this in ‘A Snapshot of Health in Ghana.’

Index of blog post series on Ghana.