The Beginning of Goodbyes

It’s Saturday, 8:12am Ghana time. It’s a cool 80 something degrees (I estimate), and raining. I have my cup of French press coffee. Delicious. Our roommate, Ruth, is sweeping. This place is different from the village. 2 weeks ago we moved here to the district capital, in medical village housing built for hospital staff and their families… so I guess we’re Ruth’s family for now. The place has a large living room with some borrowed furniture, and a mattress for guests propped up against the wall. There are 2 bedrooms, both have a large built in closet. There’s a kitchen WITH a kitchen sink and running water (when the guy who turns on the pump remembers to do his job). We have a shower room, a western-style toilet room, and a sink. Three rooms have ceiling fans, including our bedroom - my head lies directly under it, bliss! When electricity is off (more often than in the village) and the fans don’t turn, we still get a breeze through the huge windows. Just one of the windows in our new room is bigger than all of the windows in our village house combined.

Not only is the house different, the setting is too. We’re no longer in savannah terrain, we’re in semi-mountainous forest, which means it’s generally cooler here (!). The weather drastically changes when it rains, which this time of year is about every other day. Living in the medical village is a lot different from the village. Not everyone sees what time I woke up today, or when I went to the outdoor latrine. They don’t know that I tossed out a squishy half-rotten tomato (or try to take it and eat it). They don’t know my hair has been on the fritz and looks like a frizzy Chewbacca monster. People don’t come to my house to greet me, children don’t shout playfully “Ama, Ama, Ama” outside the courtyard wall. Instead, the food vendors smile back at me when I greet them when passing by to and from the hospital buildings. Nurses greet me in English: “Good morning.” The only Likpalnpaln I speak is when I walk around the hospital and try to find a patient or visitor (or occasional staff) to greet in Konkomba “Aa doon poah.”

“Change is hard,” I should probably trademark that quote before someone else goes and says it. Yesterday we went to Jumbo for a visit. Aside from having visited briefly to get some of our things out of the house, I hadn’t been there for 7 weeks. People were so excited to see me. My heart was warmed by their questions in Likpalnpaln of “Where have you been?” “Where from you?” “How is the road?” “Will you come back here to live or go again?” There were also a lot of “I’m happy to see you.” “God bless you.” And “How are your children?” (thrown in for mutual amusement). I was pleased that I knew what they were asking and could respond correctly, which received plenty of praise. The children ran up and offered to carry my limp purse containing little more than a handkerchief, today I regret declining their respectful offer. I had missed all of it. I had a tearful goodbye with Kwame, the boy we befriended so early in our time at Jumbo. He’s now in senior high school, and will miss our going away party. I told him we’d come back to visit after some years, once he’s working as a nurse at the district hospital in Kpassa, which doesn’t yet exist. I hope we can both hold true to that promise. Following the goodbye with Kwame, we greeted the chief, he looked happier than I’d ever seen him before while describing the party they are planning for us. This party will be our final goodbye to Jumbo. 

Kwame and the Rasmussens!

After greeting the chief, we made our way into Kpassa, our market town for the past 2 years, to say some goodbyes there. Our favorite chop (fast food) lady was delighted to see me, shaking my hand with both of hers. She changed her tone and asked when we would go finally. When we said 3 weeks she exclaimed, “Oh God!” as though her chop bar was on fire. I ate all of the joloff rice and salad she prepared for me, not only because I was hungry and her food is awesome, but to make her proud and happy. We then greeted our favorite carpenter, who wasn’t very happy that we were leaving. Once we reached mutual sadness he said, “when you’re in the US, flash me, and I’ll call you back.” Flash here means call, let your number “flash” on my phone’s screen, then hang up. I think I’ll take him up on the offer just to hear his booming laugh. Maybe he’ll continue to teach me Basaare over the phone. The old lady I bought vegetables from each market day doesn’t speak much English, but she understood when I was saying goodbye, her face told me she wasn’t happy about the idea. I took a picture of her selling and looking happy, which lifted her spirits. Her daughters joked that they’d come back with us, we joked that they should.

We got one last mineral (soda) in a spot (bar), then headed back to our latest new home in the district capital. We rode in a Peugeot wagon with the usual 9 passengers, the driver, and 3 chickens. Maybe I won’t miss that. We stopped in a small village to load 2 heavy, feed-sack bags filled with charcoal on the top of the car. Again, I will not miss that. By the time we arrived back in Nkwanta, it was 5pm and dusk was approaching. We picked up our bicycles and rode out to the medical village. We arrived very dusty (won’t miss that grime). We showered, and once squeaky clean we rested from our busy day.

Again, change is hard™. But change is necessary. We’ve done our time, so to speak, living in a village for almost two years. Now I am helping the nutrition department do outreach for a few weeks, making a recipe book for fortifying local recipes and conducting surveys for the district in remote villages. A new PCV has come to live in the village, and is ready for her own village experience, sure to make her own impact along the way. The village is ready to work with her. We must move forward as well - it’s time - we’re moving on, back to the US where change will be waiting for us. Until then, we’ll cherish our last few weeks in Ghana, in our “neck of the woods,” our home for the past 2 years.

**Side note: my editor (Kris) says I need to say something about how I feel about this…truthfully, I don’t know yet. I’m excited to be going home, while nervous about the responsibility of it all. I’m sad about leaving my home for the past two years, knowing that there’s a good chance I’ll never visit (while making promises that I will). Even if we do come back for a visit, some of my friends and (Ghanaian) family may no longer be around, this makes me want to cry. I also feel proud of the work I’ve done here, and anxious to see its long-term impact/sustainability. In a word: basket case. I guess that’s two words. I’m sure once I’ve had a bit more time to process this huge change in my life, I’ll be more eloquent, until then, I’m coming…

Malaria, Malaria, Go AWAY!!

Peace Corps isn’t just about holding babies. *gasp* I know sometimes that impression is made. Peace Corps has three goals, to provide technical assistance, to help the host country nationals understand America, and to help Americans understand the culture of the host country. The second goal can be quite tricky when you have to combat popular TV shows and movies like Desperate Housewives, Prison Break, Survivor, and all of the Chuck Norris films and shows. Ghanaian’s are shocked when I describe the homeless, healthcare system, and politicians in America. “No, I don’t know President Obama, but the next time I see him, I’ll have him invite you to the U.S.” You may think that goal three would be easy, but American’s are sometimes close-minded about the rest of the world. Contrary to what some folks think, Africa’s a continent, not a country. It’s 3 times bigger than America in population and size. The languages are not all “clickey” languages. Unfortunately (or fortunately), I don’t have elephants living in my backyard. The whole continent isn’t hot. A lot of African’s DO have access to electricity, running water, internet, and medicine. Today is World Malaria Day. I’m going to focus on goal 3, and share with you about a disease that negatively affects Ghana every day of the year.

In November 2010 I got malaria. It was miserable, but I survived (much to my mother’s relief!). How’d I get malaria? Simple! I was bitten by a mosquito of the genus Anopheles gambiae carrying the protozoa of the genus Plasmodium. The mosquito picked up the protozoa from biting a human whom had the protozoa already in their system (a person who already had malaria). Once the infected mosquito pierced my skin to feast on my blood, the sporozoites in the mosquito’s saliva (yuck!) entered my bloodstream and traveled to my liver. My immune system didn’t catch it early. By the time my immune system did see it and started to make antibodies against it, the parasite changed into a protein that made it very difficult for it to catch up to the replication of the disease. I was sick, a fever of 104, shaking chills, vomiting, headache, and severe body aches. The disease can kill you within 24 hours. Luckily I noticed the symptoms right away and took Coartem, a medication used to treat malaria. You can read more about my experience here:

(http://krisandtriciapc.blogspot.com/2010/11/on-coartem-24-pills-in-3-days.html)

Every hour, over 340 cases of malaria are reported in Ghana, which adds up to a staggering 3,000,000 cases a year. In 2010, 3,000 people in Ghana were reported to have died from malaria; I have reason to believe it’s higher. An article was published in February 2012 by Richard Knox of NPR News, stating that the WHO estimate of 655,000 malaria related deaths in 2010 was actually twice that at 1.24 million people (over 2 children a minute). If that’s true, more than two times the number of people died from Malaria, than died of any cause of death in the US in 2010. Read more here:

(http://www.npr.org/blogs/health/2012/02/02/146303865/researchers-say-malaria-deaths-are-twice-the-official-count)

No matter the actual numbers, malaria is a problem. The good news? Malaria is PREVENTABLE and Treatable!! Studies have shown that when 3/4 of people in a community sleep under insecticide-treated nets malaria transmission is cut in half. Children deaths from malaria are cut by 20% and the mosquito population drops by 90%. It’s estimated that only 5% of children in Sub-Saharan Africa sleep under any type of insecticide-treated net.

Here’s a little tidbit I just learned. The CDC was originally the Office of Malaria Control in War Areas which was formed during WWII in the southern US, where malaria was problematic. By 1949 the country was free of significant problems related to malaria.

While you’re complaining about the snow/rain/sunshine, the price of gas, or the latest app on your iPhone malfunctioning, take a minute to be thankful you don’t have to worry about your child dying before their 5^th birthday from a preventable disease.  

Want to know more/do something? Check out these links:

http://stompoutmalaria.org/

http://www.malarianomore.org/

http://www.pih.org/ (#02 2012 Top 100 Best NGOs by The Global Journal)

http://www.oxfam.org.uk/ (#03 2012 Top 100 Best NGOs by The Global Journal)

http://www.path.org/ (#06 2012 Top 100 Best NGOs by The Global Journal)

A Water Blog

How’s your water? Flowing nicely out of your kitchen and bathrooms sinks? Filling and showering nicely in your tub? With a full tank, flushing your toilets? Here in Jumbo #1 it’s a little different. For a population of 1,700 we have 6 boreholes (mechanical water pumps). It lifts water 60+ feet from below ground via the muscle and sweat of women and children. This week in the village 2 of these 6 boreholes were still working. The rest had broken or worn out from overuse, abuse by small children, and an ever-sinking water table. As a result, there was a 2-3 hour wait to fetch a headpan from each of the 2 working boreholes. The average adult needs ½ a head pan a day to drink, cook, and bathe. If you are the workhorse in your house (a 8-10 year old girl), you typically fetch water before going to school in the morning. Now those 2-3 head pans take 6-9 hours to fetch. Forget school. Don’t mind that exams are next week. If you’re the youngest wife in a family, forget going to farm to harvest cassava to sell at market during a season where there is no money in the house. You have an entire day of fetching water ahead of you.

Here’s some American perspective. Imagine that all the BPs and Kwik Trips closed down. Only one or two gas stations are open in your town. You’re gonna be waiting all day to fill your tank. Okay, so the boreholes are too time consuming, is there another option? The stream nearby! Oh wait, that dried up 2 months ago (and never was safe for drinking anyway). Another? The Kpassa river (which flows year-round). Perfect. This water has more taste AND color than boring, “safe to drink” borehole water anyway. It’s only a 4km walk one-way, so within an hour, you can have a head pan of water back at your home. Only 13% of Ghanaians have access to sanitation (a toilet of any kind). So, drinking unfiltered water from the river can lead to dysentery, giardia, and cholera. Fetching water from surface water sources could also being back guinea worm, which Ghana and outside NGOs worked very hard to eradicate several years back.

How did this become a problem in Jumbo in the first place? No one wants to pay for  water. In most places in Ghana, if you fetch a head pan of water, you pay a small fee before you can draw it. That money accumulates and is used for maintenance. In our village people do not consider that boreholes break and wear out and require money for maintenance. Furthermore, people don’t trust each other with money.  They need  to SEE that a borehole is broken before they are moved to action. And all the while everyone is complaining about water. Here’s the latest suggestion from some women: “Extend the piped water in town to the village, then it will not break down.” They feel donating 1GHC (65 cents) every 2-3 months is too much. The math disagrees, however. Piped water costs 0.2 cedi (12 cents) per head pan. If you fetch 3 head pans a day that’s 0.6 cedi…in 30 days that’s 18GHC ($11.25) per month. This, in comparison to at most 1GHC in two months?!

Now, another thing you might be worried about: how’s it affecting us!? Do I lose sleep over water? Yeah, probably, I’m a light sleeper and a worrier to boot. Are we drinking greenish brown river water? No. We are still drinking borehole water, it just comes at a price. We pay some students to fetch us this “clear gold” from one of the remaining stressed boreholes.

If you didn’t win the latest megamillions lottery, here’s something to be thankful for that is easy to take for granted in the US. If you have safe freshwater to drink, cook, and clean with, you’re better off than 1/6 of the world, or almost a billion people.

March

Before leaving for East Africa, I had learned that a former coworker of mine was coming to Ghana to work with Habitat for Humanity. At the end of her volunteering, they would tour Ghana for a few days before heading back to the US. Turns out that coincided exactly with our return from East Africa, so we were able to meet up with her and convinced her to take the grueling trip up to our site, see it for a day, then take an equally grueling trip back! We were glad to show our village to yet another “foreigner”; I’m told she also enjoyed the visit :) Our chief was also glad, and is starting to see our value to the community, because he has started asking our visitors for transportation to “America.” He is convinced that one of these days the visitor will say yes. Unfortunately for him we keep bringing “poor” people to visit :P

The day after our visitor left, Tricia went for training. It was here that she met the new health trainees and started training them for their service.

We had learned in past months that Jumbo #1 would likely get replaced with a health volunteer from this group. The result is that the new volunteer will come to Jumbo at the end of April, while Tricia’s (and my) service continues into August. The priority is with the new volunteer and their integration into the community, so it means Tricia (and I!) had to find something else to do. Tricia looked immediately to the health office in Nkwanta, who were more than happy to let her come and work with them. But what about me? I cannot stay in Jumbo, and if Tricia goes to Nkwanta I would also like to go there. This would mean, however, that I am too far from New Agou school to commute every day, and so I would have to end my work there. But what could I do in Nkwanta? I talked to an education NGO in Nkwanta (Ghana Education Project, search them online) and they were also happy to have me work for them. So fear not, we will have something to do, at least for a month or so, even though we are getting kicked out by the new volunteer! It may get boring toward the end, we’ll see!

This week we hosted the new volunteer (trainee for now) as they came for their “site visit” to see Jumbo and get acquainted with it. After the visit we’re convinced that she will be a great fit for Jumbo and is capable of doing some great things here.

One lingering question you may have is, “What about my school – is it getting another PCV?” The answer to that is no. Throughout my service there were some clear barriers to development in New Agou, including an uncooperative community and non-existent support from the district. Once the district changeover takes place I hope these issues will be resolved. I recently sat down with the chief in New Agou and explained this to him, as well as the headmaster and staff. I think they are disappointed that a new volunteer is not coming, but they understand why. They do have the opportunity to apply again, so if they have a change of heart and start to work together I can easily see another PCV getting placed there. For me this is a lesson in the Peace Corps strategy. The first PCV at a site is merely there to explain what a PCV is, live with the community (“integrate”), and identify barriers to development within the community. I am sure that teachers and the chief will spread this information (we may even have a meeting where I can explain it myself) among the community. If they choose to believe what they hear and act, they can easily change. If they decide to ignore it, no development will come to New Agou. It is sad to think about, especially since I call this place my home (for now), but it has a much greater chance at being effective than riding up in a Land Cruiser and telling people to do X, Y and Z and then leaving. The thought of wasting a “white man’s time” and declining an opportunity for development is a powerful motivator for change.

February

The month of February also went by fast, mainly due to our trip to East Africa! Why East Africa? I heard it once described to me that you come to West Africa for the people; you come to East Africa for the wildlife. While there is plenty of culture in East Africa as well, as we found, there is very little wildlife in West Africa, and how can we say we went to Africa and didn’t see a lion?

So we planned a 17 day trip to Tanzania and Rwanda, including a few days on the sublime island of Zanzibar, 6 days of safari in northern Tanzania, and a few days in Rwanda to see mountain gorillas. The pictures have been posted and they say so much more than words, but suffice it to say that it was a singularly amazing experience.

January

After the beach it was back to site. We arrived in plenty of time for the “Christmas/New Year” combined celebration that Konkombas do in our village. It consists of a very odd selection of Western Christmas traditions, including buying a new set of clothes (only one the kids will get all year), making a lot of rice and giving it away (like Halloween I guess), and multiple nights of very loud hip-hop music. Sound familiar? I thought not. We invited the new nutrition officer in Nkwanta to come and see it, as she had no other plans and was finding it difficult to adapt (she is from Accra). As it turned out, some leaders in the community had additional plans for the holiday. They used the main New Year’s celebration (held on the 2^nd for some reason) to announce new bylaws for the village, including no loud music after 10pm, no children and youth out late at night, etc. Not surprisingly, as these new rules were being announced, one of the youth pulled the fuse on the PA. The next moments were chaotic and a bit unnerving (especially for our guest), with arguments between elders and youth. Unfortunately for the leaders, they had not consulted youth about the rules prior to the announcement. Furthermore, most youth in the community do not receive any parenting, but are instead left to find out about the world for themselves. So they formed their own opinions about what is important, and unfortunately they chose loud hip hop, sexual activity, etc. The silver lining in this chain of events was that no loud music was played that night, and we were able to sleep soundly, guest included.

Some days later Tricia and the nutrition officer traveled to the north to visit a nutrition rehabilitation center there as research for the proposed center in Volta region. The difficultly with this travel was that it was over bad roads with very bad public vehicles. Using her powers of persuasion, she convinced the DCE to let her use one of his SUVs for the trip. For a trip that would take four full days of travel roundtrip, plus a day spent there, they were able to leave early on Friday and return around dusk on Saturday.

By the second week in January I was back to teaching and Tricia was back to preparing for training. She went for a one week “training-of-trainers” in the south, leaving me alone at site. Fortunately, when she came back, she brought her friend Tessa, who came from the US to visit. We showed Tessa our village, the market town, my school, anything she was interested in seeing. Her and Tricia then moved on to see other parts of Ghana.

In January we also learned that our village of Jumbo #1 had now been shifted to the district of Nkwanta North. What this means is that now Jumbonians can go to the town of Kpassa (5km) for support from the district, instead of Nkwanta (30km). This change has yet to take effect in the schools and the clinic, but it is a big step in that direction.

January 26^th saw the FIRST OFFICIAL BABY WEIGHING at Jumbo clinic, with over a hundred participants.

January also brought a truly sad event. Tricia’s paternal grandfather passed away after struggling with his failing health. Tricia was close with her grandfather, and was looking forward to attending his 95^th birthday party next September. To mourn the loss of a loved one is difficult. To mourn that same loss while separated from family and friends thousands of miles is herculean.

December

December 1^st marked World AIDS Day. Last year in my school I held discussions on HIV/AIDS instead of normal classes. I had planned to do the same this year, but when I showed up that morning there was a problem. The headmaster had cancelled classes and made a “project” day(during which students doing work either for teachers or for the school) to harvest and shell maize from the school farm. The shelling took the whole day. The next day was a holiday, and then the weekend came, and on Monday we started exams, so there was no chance for me to reschedule the discussions. Frustrating, to say the least. Here these students were, doing manual labor instead of learning about a very important and deadly disease (though with low prevalence in Ghana so far).

When it was time for the new health volunteers (those that arrived June 2011) to hold their in-service training, Tricia was asked to come and help lead some sessions. This was a good way for her to practice her presentation and discussion-leading skills, in preparation for being a trainer for the pre-service training of the next group of health volunteers arriving in February.

Around the same time, the nurse moved into the clinic and officially started receiving patients. Yay!

Before we knew it it was late December, and time for Tricia’s surprise birthday trip. It was held at a guest house along the ocean. Swimming in the ocean and the salt-water lagoon, drinking beer and chatting with other Americans and some Brits, eating wonderful food and lying in a hammock, our faith in humanity and goodness was restored. There was even a birthday cake. With frosting! One evening at 10pm the proprietor came around and mentioned that a leatherback turtle had been spotted on the beach, so I was able to witness the turtle her lay eggs and bury them. (Unfortunately we had to guard the turtle and dig up the eggs and rebury them secretly, as locals will eat both the turtle and the eggs.)

November

The last half of November started out quiet, with me busy teaching and Tricia continuing her seemingly never-ending quest to open a clinic. For Thanksgiving we were again invited to the US Ambassador’s residence in Accra for a traditional meal followed by intense socialization (the kind you engage in after not seeing friends for months).

It has been an idea of Tricia’s for some time now to create a nutrition rehabilitation center in our Volta region of Ghana. When we were in Accra for Thanksgiving she took the opportunity to meet some people that could help make this facility a reality. She met with USAID, the organization that funded her PD Hearth nutrition programs (and recognized her on their blog in Sept 2011), but learned that no funding was available. However, she was directed to a program under the Department of Defense (?!) and was more successful there. Turns out this program, a fund for building schools, community centers, and health facilities (anything non-private that would improve a community), was looking for projects to fund. It was decided that Tricia’s project was a good fit and that she should apply. She was ecstatic; this type of large, expensive, first-of-its-kind infrastructure project is difficult to accomplish.

After a successful trip to Accra, we returned to Jumbo just in time to take part in the official opening ceremony for the clinic! Preparations were made well (in our absence!) and many people came to attend. There were speeches, gift presentations, and even a ribbon-cutting! When they announced the nurse assigned to the clinic, he was hoisted up onto shoulders and carried over next to the chief, where he sat for the remainder of the ceremony. Jumbo has a clinic now!

It's Been Awhile

So…it’s been a while since our last blog post (besides the link to our photos from East Africa). In that amount of time we have been very busy. This problem has only one solution: a shotgun style cluster of blog updates. So put on your flak jacket and helmet and dig your trench deep, because this is going to get ugly.

Pictures from Tanzania and Rwanda!!

 

Links to 3 albums of pictures from our trip to Tanzania (Zanzibar, Tarangire National Park, Ngorongoro Conservation Area, Serengeti National Park, Ngorongoro Crater and Lake Manyara) and Rwanda (Mountain Gorillas, village in the north, and a visit to a Partners in Health Hospital)!! Enjoy :)

 

(point and shoot photos)

https://www.facebook.com/media/set/?set=a.565790630740.2041795.185900425&type=3&l=6f6b7a72ac

 

(DSLR)

https://www.facebook.com/media/set/?set=a.565779552940.2041792.185900425&type=3&l=4b3cb1e3f7

https://www.facebook.com/media/set/?set=a.565783834360.2041793.185900425&type=1&l=0312b69e38

 

I'm off to training the new Health Watsan volunteers, so I've placed the task of updating the blog to Kris :)

 

Lots of Love Always,

 

Tricia

 

48 Hours of Maddness!

(Written Nov. 9th)

Today, I’m doing as little as possible. I will still check in on my Moringa gardens, call the district to remind them to complete some clinic work, read with Rebecca, a middle school girl who’s leg is causing her to miss school, and meet with the village chief. Besides these minor items, it’s a heavy dose of R & R for me. To explain why, let me run through the past 2 days:

(Some background: The Ghanaian government is paving the main road through the eastern corridor, which includes our area of the Volta Region. The work has been split among 3 construction crews. The crew on our section of the road, running from the district capital north to the Oti river (about 60 km) are a group of Chinese engineers that are doing work in Ghana. Jumbo #1 happens to be right about middle of their section, so they've picked Jumbo as the site for their heavy machinery and materials yard. They are currently erecting a concrete block wall that will encircle the enormous yard. Eventually buildings will go up, maybe a well for water, etc. They're hiring local Ghanaians to do the heavy labor and other advisory positions.)

Lot for Heavy Machinery...

Two days ago my counterpart Joseph, the Ghanaian I work with most closely in the village, accepted the position of watchman at the equipment yard. This would require him to be at the yard from 7am to 6pm, 7 days a week, holidays included, to field any issues or problems between the contractors and the local community. The job pays 80 cedis per month (about $54USD).

Huge Wall

Now, I should mention that Joseph is probably one of few reasons I've been successful in this village. After 14 months working beside him, becoming his friend, mentoring him in matters of health and otherwise, he was just going to quit. I was completely devastated. I wanted to quit myself.

After discussing my devastation with him one on one that evening (after his first day on the job), we talked again yesterday morning, during which he told me that he changed his mind. He admitted that after talking with me, his wife, the chief, his peers, and elders, he had made the wrong decision and “couldn't be happy with it.” As counterpart and health volunteer, he's doing a thankless job, as the positions are unpaid and have minimal perks. But he understands that even if he doesn't receive money, he can still see some rewards (doing good for his community, the opportunity to be mentored by a Peace Corps volunteer, the cultural exchange between Ghanaian and American) and that, in his words, "God will reward him." In sum, the crisis was averted, but that brief period of uncertainty was extremely trying and stressful.

So yesterday, after receiving this good news, I felt like I had fresh chance at my service in Ghana. I realized that I had taken it’s comfort and ease for granted and resolved to correct this behavior. By mid-morning some community extension workers came to the village. They were doing a survey of pregnant/young mother’s knowledge of vitamin A, Iron, and folic acid supplements and iodated salt. I took the opportunity to ask them how they could better inform the women in the community about those 3 essential nutrients.

Their visit was followed by a visit from a nearby nurse. I had called her the day before when I was in the middle of my debacle with Joseph, so she decided to come and console me in person. I told her the good news that Joseph had relented; we also discussed future plans for the clinic in Jumbo and health initiatives in the area.

After this, I sent an email to USAID. They had featured a nutrition project of mine as a success story. I told them I was honored to have Jumbo featured, but I also took the opportunity to ask for more. My work with nutrition in the village has been successful, but it’s not enough. When children reach a severe degree of malnutrition, they need more than a hospital that will treat them and release. They need rehabilitation, which can be provided more effectively by a Nutrition Rehabilitation Center. There is no such facility in the entire Volta region. So, I asked USAID to consider funding a center in the north Volta.

After exercising my fingers, I decided to walk around the village and exercise my legs. It was market day, a day on which most people do not work heavily. The conversations went something like this:

Tricia: Aa nwihn (Good afternoon)
Villager: Lafeah beh (I’m fine/healthy)
V: Aa nwihn (Good afternoon)
T: Lafeah beh (I’m fine)
V: Ngeen beh? (How’s the day?)
T: Lafeah beh (It’s fine)
T: Beah poah? (How are your children?)
V: Lafeah beh (They’re fine)
T: Acha poah? (How’s your husband?)
V: Lafeah beh (He’s fine)
T: Lituln poah? (How’s work?)
V: Lafeah beh (It’s fine)
T: Kisaak poah? (How’s your farm?)
V: Lafeah beh (It’s fine)
V: Acha poah? (How’s your husband?)
T: Lafeah beh (He’s fine)
V: Lituln poah? (How’s work?)
V: Lafeah beh (It’s fine)
**Laughter, because they are not working**
V: A cha la? (Where are you going?)
T: N cha do. (I’m going here—completely nonspecific, but widely accepted)
**Confused look on villager’s face, it’s market day, she should be going to market**
V: A cha kinyan? (You’re going to market?) A cha Kpassa? (You’re going to Kpassa—market town)
T: Nn nn. N chuun, n cha Jumbo do. (No, I’m walking. I’m going to Jumbo, here.)
V: A cha Agou?
**At this point they’re straining to understand me, still confused I’m not going to market**
T: Nn nn. N chuun, n cha Jumbo do. (No, I’m walking. I’m going to Jumbo, here.)
V: Aa ha! (villager understands me now) **speaking very quickly repeating exactly what I said to all within earshot**
T: N cha nsan (I’m going to the road—asking permission to leave)
V: Yo! Umbor cheen si (Okay, that’s fine, God Bless you.)
T: Cani lituln (Thank you all!)

This is really fun for me, and the villagers appreciate it very much. I am thankful they’re willing to listen hard to me to try and understand, rather than be lazy and call their son or daughter that speaks English. During training I was taught a different dialect, so sometimes it’s a struggle. One of the people I went to greet was a man working with Moringa garden #2. He wasn’t around, so I continued down the main road. I had the same conversation with at least four groups of people in the span of a hundred meters. At one point the villagers were so happy with my language that they insisted I have some of their Ghanaian beer, called “Pito,” “on the house.” My next destination was garden #1. Along the way I was stopped again by the mother of a toddler that has severe astigmatism in one of his eyes. I stopped to instruct them on how to make an eye patch to try and fix the “lazy eye.” For this, I received a giant bowl of tomatoes. There’s no way I can eat them all, but it’s rude to turn down a gift, so I accepted.

I continued on to garden #1, and greeted the house owner near it, and those resting under the mango tree. My friend Rebecca was also sitting under the tree. She speaks fair English. She was also holding a baby, so I immediately borrowed him for my baby fix and sat under the mango tree for a short time speaking as much of the language as I could. I understood when they asked me in Likpalnpaln “why don’t you have a child?” I couldn’t answer well in the language, so Rebecca became my impromptu translator. This was a prime situation for me to encourage better family planning. Men of child producing age asking me why I don’t have children. I told them, because I practice “family planning.” It was translated and they laughed (it’s still a very new/unheard of concept). The particular child I was holding is the mother’s seventh. I told them that I wasn’t ready for children. First, I explained that I wanted to be able to support all of my children, before they are born. Second, I explained how to do “family planning,” through the use of condoms, pills, or an injection. I’m sure I didn’t make believers of them, but the seed was planted. As I walk through the village many of the mothers ask me to take their child to the US, both for a better opportunity and to relieve the pressure on the mother). This is their startling but practical solution to the problem – I hope they see my advice as a better solution.

Carrying a baby to visit Garden #1

The sun was getting intense as it neared 1 pm, so I walked home, greeting along the way, trying to insist that I had not just come back from market. I sat down to rest, and after 5 minutes Rebecca was at my house! I greeted her and asked her why she had come. Her family had sent her because she wasn’t doing anything else. (Read: “Go to the white lady’s house, she’ll probably have something for you to do.”) I seized the moment, and asked if she wanted to read one of the books I had bought in preparation for a library. Thus, yesterday marked the unofficial opening of the library! Rebecca was the first patron. She swept out the room, and we washed our hands and sat on a prayer mat and read. We also went over the alphabet and made letter sounds. She did well with some help and a lot of encouragement.

With Rebecca and her "brother"

I was able to rest in the house alone for another 10 minutes before calling one of the Chinese contractors we’d met a few days prior. He’s a nice guy, and is intrigued by our presence in the area. I asked to meet with him in Jumbo to ask a favor. Two days ago, I noticed pickup trucks going to and from the Jumbo river collecting barrels of water for the construction. I knew I’d need some water soon for mason work on the clinic. I figured, why not ask if they can use their nice truck and bring me some water, instead of putting even more pressure on the one working borehole in the village. He said, “no problem.” I was floored. We then walked over to my humble clinic site. After looking at it for a second, sizing up the work to be done he said, “Okay, so you’re going to need some sand too, so we’ll just drop some off here, and if you need some gravel, no problem.” He continued (as my mouth was gaping open), “You know, cement is 15GHC a bag, I can get you some for 14GHC a bag.”

He then asked where Kris was. I said in town, at market (it was already past 4pm). He was surprised, and said, “let’s go pick him up; I have some business in the town anyway.” I called Kris, told him to stay put and we met him in town. Kris still had things to buy in the market, so I accompanied the contractor on his “business.” We ended up talking for the next 1-2 hours while trying to find a source for sand, picking up grateful market women along the road on their long walk home from market to the more rural villages. We talked about Peace Corps for a long time, about sustainable development and the programs I was doing. I’m almost certain he still doesn’t quite understand why I would do such a thing, but it was not for lack of trying to explain. We also discussed less serious topics like American TV shows (his favorites are Friends, Prison Break, and Desperate Housewives).

By the time I returned home, it was well past dark (6pm). I continued my work for the day, by making phone calls. I like to “bother” people in the district as much as possible, so they complete their work on time/don’t forget about Jumbo. Once my phone calls were finished, Kris made me eat an egg sandwich, and I watched the Badgers VS UNLV game (thanks Uncle Phil!).

Those 48 hours were not normal for me; it was an extremely busy two days, physically and emotionally. Such is my life, full of surprises. Each day brings new challenges, successes, relationships and experiences. As the motto says, “Peace Corps is the toughest job you’ll ever love.”

Recognize

Check out this blog post on USAID's website. It will sound familiar, as it is describing Tricia's PD Hearth program from June 2011. The funding came from USAID, and now they are sharing the project on their website as a success story.

The Ghana Travel Experience

Travel in Ghana is, much like in other developing countries, an experience very different from travel in the US. We have alluded to this in the past when talking about Ghana, but have never attempted to describe it. After one year of regularly experiencing travel like this, and after a trip back to the US that reminded us how organized, efficient, and pleasant travel can be, what follows is our account of “the travel experience.”

The experience begins fairly innocently. You are to travel to a nearby town to visit a friend. So you go to the transport station, find the vehicle going to the town you want, and buy a ticket. No problem. So you set out to find the “station.” With no signs or other obvious indications of where the station is, the best strategy is to ask a Ghanaian. They respond by asking you, “Which station.” What? There’s more than one? Ok, I want the station that will have a vehicle that will take me to my destination town. Oh, that’s station A. It’s just up the street… But immediately another Ghanaian interjects by advising you instead go to station B. It’s much easier to navigate, they say. But Ghanaian A insists that at this time of day you will not get a vehicle from station B to your destination. This is where the power of statistics is your friend. Immediately ask a number of other Ghanaians until you have a consensus. Ok, most people say station A. How do I get there? It’s just up the street and then right and down the hill. After a few wrong turns (it was actually a right and then a left, then down the hill) you reach station A.

As you approach, if you are any skin color other than black, you are immediately surrounded by Ghanaians, all asking you questions at the same time. Obroni, how are you? Can I carry your bag (and then ask you for money later)? And the most common: Where are you going? Some of these interested folks are actually the vehicle drivers or mates (basically an assistant), but the majority are just sitting around waiting for something to happen. You now have to choose between politely answering all of their questions and losing an hour of your daylight in a place where night travel is significantly more dangerous, or in ignoring them all, except one, whom you ask where the vehicle to your destination is now parked. I suggest the latter. Oh, it’s over there (*points*). You can see the wooden sign with the town name painted on, resting on top of the vehicle.

But wait, what’s this? There are two signs! One is resting on a minibus with four rows of seats (four to a row), looking like a car bomb had recently gone off near it recently. The paint is faded, windows are missing, there are holes in the floor, and in big letters across the windshield it says “ENEMIES ARE NOT GOD.” No kidding. You look inside and see it looks empty. As for the second vehicle, it is a Mercedes-Benz bus, longer, much taller, and slightly wider. Also, much worse-looking. Six rows, five to a row. You avoid the sharp metal edges as you climb up to see how many people have boarded. It looks about half-full. This brings you to major decision #3: Which vehicle do you take? You decide that while the minibus (called a “tro-tro” or just “tro”) has fewer passengers, the overall number remaining (vehicles don’t leave until they are full) is less. Congratulations, you just engaged your brain in thinking critically. Unfortunately you are probably the only one in the station doing so at that moment. You go to the wooden shack functioning as the ticket counter and buy a ticket for the tro. You walk over to it to claim your seat (first come, first served) by placing your bag on it and try to figure out how to kill some time.

One hour later, and five cedi poorer from buying stuff for sale in the station, most of which you do not need, the last ticket for the tro is purchased. The car is full up, the ticket man says. The driver appears from out of nowhere and yells at any passenger that hasn’t yet boarded, which is all but three (the tro seats 18 including the two in front next to the driver). Chaos ensues, as passengers simultaneously are boarding the tro to find their seat, deboarding to urinate or buy some food, and leaving the station completely to find the other passengers, who have wandered off as they were waiting. Ten minutes later, most passengers are in their seats and ready to go. One passenger is arguing with another about whose bag was placed on the seat first (if the argument is co-ed, the man wins and the woman is forced into the less desirable seat). You also notice that the seat next to you is empty, save for a small bag. Who is sitting there, you ask. Just then a very large woman saunters up to the tro with three large bags. That’s who. The other three people in the row, have to deboard and wait for the woman to find her seat. When you board after her and try to sit, you realize that she is taking up her seat plus no less than 50% of yours. Also, one of her bags is on the floor, cramping your leg room.

Thirty minutes after the last ticket is sold, the tro leaves the station. You feel relieved and send a notification text to your friend. “Car has finally left!? :( “ As the text is sent the tro lurches right and veers into a fuel station. Seriously? The driver leaves the engine running and tells the attendant to put in thirty cedis worth of fuel. After taking the money, the attendant obliges. A few minutes later you hit the road again, this time for good.

Now, not all roads in Ghana are what one would call “good.” In fact, most of them are in the broad category of “un-good.” However, there are different degrees of “un-good.” There are paved roads pockmarked with potholes. There are unpaved roads that are well-drained and escape major erosion from rains. My personal favorite, and the standard in the northern Volta, is unpaved and ravaged from rain. It’s actually not even a road by most standards. It is soil and rocks, mounded up into the shape of a road, with a ditch carved on each side. These roads are subject to the worst of potholes, and every rainy season they are washed out completely in some places.

The journey you are taking begins on the first type, paved with potholes, and halfway changes to unpaved and ravaged. Great, you think, at least for the first hour it will be pleasant.

Wrong. The driver proceeds to floor it between every series of potholes, swerving recklessly all over the road to avoid them in addition to other tros, motorcycles, supply trucks, even fuel tankers. Depending on the standard accepted by the passengers, they occasionally beseech the driver to slow down, be more cautious, and in general show that he values their lives even marginally. Notice I didn’t say “he or she”; all drivers are men, most are young, and they drive like they have everything to prove.

Having experienced the relative organization and efficiency and safety of travel in the US, at this point the events start to build up and you start to become frustrated. You focus this frustration on the driver. Doesn’t he realize the danger he is placing everyone in? Doesn’t he understand that to get there a few minutes later is acceptable if it means avoiding a head-on collision at high speed, not to mention the other vehicles on the road? Your anger builds with each swerve, each pothole he attempts to miss but fails, each time the wheels catch air and your head strikes the bare metal roof, until it reaches the level of rage. At this point you silently demand an ultimatum: If this driver hits a big pothole one more time, I am going to lose it. Within seconds, you hit a pothole so big that your head hits the roof, something loose on the floor below you strikes your legs, and the bag in your lap flies up and into the seat in front of you. This is the climax of the trip, emotionally speaking, as you are faced with the decision of losing your mind or finding some other way to cope. Whether it is prayer, meditation, or simply willing yourself to reclaim some degree of calm, it works. You come down from your mountain of rage. The emotional and physical abuse starts to feel less sharp and jarring and more dull and continuous. The road has not changed, it is still punishing you, but your perception of it changes. Is it a higher level of consciousness? It's possible. Once you break through this threshold, for the first time since boarding you actually thing you are going to make it.

Then you hear a loud pop and the tro veers across the road and toward the ditch. Flat tire. The driver manages, without the aid of power steering, to keep the vehicle on all four wheels as it grinds to a halt. The driver, knowing exactly what the problem is, doesn’t even glance at the tire as he walks around to open the sliding door (only the outside latch works) and let the passengers out. Some immediately walk to the ditch, arrange their pants/skirts, and urinate. Others collect their bags and search for the nearest shade. All indications are that it is going to be a while. But you have already crossed the aforementioned emotional threshold, so anger is not an option. Instead you conjure up a hypothetical situation even worse than the one you are in now, and use it to console yourself. A wry smile even appears on your face as you exit the tro and walk over to the shade of a mango tree.

Even more ironic humor is experienced as you watch the driver attempt to repair the flat. He first has to remove all luggage from the rear cargo area to access the spare. This is no small feat, as the area was so crammed with bags at the station that the door would not shut, and had to be tied with rope between the frame underneath and the precariously weak rear window wiper arm. Once the bags are out, the tire is removed and inspected. It is hard to believe, but the tire tread is even worse than on the flat. It’s practically bald. The driver sets to work removing the flat and installing the spare. As he lowers the vehicle’s weight onto the spare (not including the weight of passengers and cargo) it becomes clear that the spare was not fully inflated. A collective groan emanates from the passengers and they start to accost the driver for failing to plan ahead. After enduring a good five minutes of well-deserved verbal tongue-lashing, the driver announces that he is going to drive back to the previous town on the barely inflated spare, fill it, and come back to pick up the passengers and luggage. As another verbal tongue-lashing ensues, the driver hops in, executes the worst Y-turn ever, and drives off.

Thirty minutes later he returns with a fully inflated spare. Luggage is loaded, passengers board, and the driver takes off with even more gusto than before, but not until that Benz bus, the other choice at the station, passes us. You realize that the reckless driving you experienced before was the norm, and that since the driver was running “late” he may not be able to get back to his base town (the one you left from) that day. He is still in the denial stage of this newly-realized grief, as he mashes down the gas pedal not only on good stretches of the road but through the potholed sections as well.

Fifteen minutes later, the bottom of the road drops out as you make the transition to unpaved road. The driver does not appear to notice this, however, and continues to drive with reckless abandon. He passes the Benz bus, but it passes us back when the driver has to slow down for a monster washout. We pass the Benz bus again, this time for good. But in your enlightened state you barely notice as you speed toward your destination. The thought crosses your mind that the spare tire has already been used, leaving no backup in case of a second flat, but it immediately is whisked away by an irresistible feeling of peace. You search for humor or even casual interest in what you observe through glimpses out the right window (the left window is completely blocked by the woman and her bags). You laugh out loud when you see a toddler throw a small rock at the tro as it passes by, and again when you see a man crash his bicycle down into the ditch to avoid the tro as it passes by.

You are surprised when you look at your watch again and an hour has passed. The tro wheels lock up and you slide to a stop. You are in some small village, but this is surely not your destination. The driver opens the sliding door – this time with greater difficulty – and a young woman, in a very nice dress and embroidered cloth scarf, exits the tro and emphatically greets a woman standing just off the road. Her face, clothes and luggage are all a faded, orange-ish, dust-covered version of what they were when she boarded at the station.

Another thirty minutes pass and you finally see your destination town in the distance. As you descend the hill the tro stops, seemingly every few hundred yards, as people request to be let off. This minor annoyance is overshadowed by the exhilarating realization that you are almost there. Your legs ache and begin to cramp, and you wonder if they have forgotten how to stand and support your weight. You pull into the station in your destination town and, in too much of a rush to park, the driver jumps out to open the door. Passengers pile out and immediately start to slap themselves with handkerchiefs to beat out the dust. They repeat the ritual with their luggage as they retrieve it. All around them people are calling out names of nearby towns and ushering people into other vehicles. How could anyone want to go through this again? But then you realize that you will have to do it yourself, albeit in a few days, when you are scheduled to return back. You cringe and try not to think about it as you call your friend and walk out of the station.

Atta

------------------------------------(Atta's Father Bitumba)

September 4^th, 2011, it was going toward twilight; I was sitting under a shady palm in the Bichabob clan. I was told the day before that a young girl had died. I had told the family I wanted to visit them and learn about the now-deceased girl. The family agreed and was very appreciative of my curiosity. To compare, I noted, “My grandpa turned 94 years of age just 2 days ago,” I said to Joseph (my translator). “Oh! Then he’s too old,” he said excitedly with laughter in his voice (he meant that as a good thing). I began with my questions. “So, please, how old was the girl that died? Was she in her 20s?” “Oh no, she was 19 or 20 maybe…they say they have the date written,” they told me. Good, I thought, as I wanted to give the most accurate representation of this deceased girl as possible. The father of the deceased girl returned with a book – a bible, believe it or not, reminding me of the old family bible my mom has in their house next to the recliner. It was filled with dates, names, and accounts of births. “Atta, is the girl’s name,” they said. Upon searching the front pages of their family’s bible, I found no such name. “How about Tawia? Was she Atta’s sister? Was Atta older than Tawia?” I offered. “Tawia is her sister, but she’s younger, they think Atta was 2 years older,” they replied. Okay, so Tawia was born in July of 1988, we’ll give Atta a birth year of 1986. This meant she was about 25 years old. My age.

-------------------------------------------(Family Bible)

Atta was born in 1986 to her mother Yaa and father Bitumba. Yaa and Bitumba are both farmers, farming yam and cassava. Neither of them has gone to school, and they’re not sure of their age (they actually ask me to tell them how old they are). I told them they were “old,” to which the whole of family around our meeting place responded with laughter and acceptance. Bitumba has 9 children and 2 wives; all are living with the recent exception of Atta. He doesn’t have any hobbies, he just farms. Yaa has given birth to 6 children, she tells me all are still living except for Atta, which I doubt as they tend not to include children who pass before they reach the age of 5. In Konkomba if a mother gives birth to a child, and that child dies, her next child will be named Jagri, meaning that the deceased child has come back again. There are a lot of Jagri’s in this village.

---------------------------------------------(Atta's mother, Yaa)

Yaa is confined to the compound because she “has become blind.” Atta has 6 living siblings, and one daughter named Umborinye. Umborinye means “God Knows” in Konkomba (the local language); she looks no older than 5 years. Atta was married to a man named Tamanja, he only officially was married to her, but I was told he had 2 wives. The other one was just for “friendship,” not official. Tamanja will take care of Umborinye now that Atta died. Atta farmed yams and cassava at her father’s farm, attended church in the village, and attended school up to 4^th grade before dropping out.

-----------------------------------------(Atta's Daughter, Umborinye)

“She was sick a long time” was the answer I got in response to the question whether or not her death was sudden. When I asked them to describe the sickness, Bitumba talked for a long time in Konkomba. When he was finished Joseph said, “She had epilepsy.” “That wasn’t all he said, Joseph! Translate it all for me!” I said. “Okay, well, one certain day she met a man, he gave her money and told her to buy food with it. She bought food and brought it home. She was preparing it in the courtyard by the fire when she collapsed in front of the whole family. They all saw it. She was shaking and throwing her limbs around; she had a lot of saliva around her mouth. When her eyes finally opened and she stopped shaking they asked her what had happened, she didn’t know.” I pressed, “So do they think that man who gave her money to buy food caused her sickness?” “They haven’t seen the man before or again, and neither did she,” he replied (implying that they did indeed think the man had something to do with her sickness). When I asked how long ago her first attack happened, no one could remember, just saying, “a long time, and she’s been falling monthly.” On the 2^nd of September, in the evening time “just like now,” (the time period of the interview) she had a similar attack. The whole family saw it again. This time, her eyes never opened again.

“So then what?” I asked. “We never bury a person during the day, the sun is too hot. So, since it happened in the evening and the coffin wasn’t ready, we had to wait until the next evening to bury her.” Dying young here isn’t good. If you’re old and you die, that is natural and normal. If you die when you are old, you will receive the honor of an immediate funeral 3 days after you die, then you will be “buried in your house” or near your home/within the village. If you were very old and respected you will have a “final funeral” later on when the family can raise enough money to have a big celebration with lots of eating, drinking, and dancing. If you die when you’re young, it’s unnatural and often suspect of something evil. In this case you will be buried in the “kichee” or cemetery, in the bush, far away from the village. Your family will mourn for 3 days, then return to normal daily life. If a child dies, there’s even less observance given. The child is buried, again far away from the village in the bush, and only close family is privy to the fact that a child is gone. Not many people notice and the most visibly affected person is the older sibling on who’s back that child spent most of their days.

--------------------------------------(Child carrying younger sibling)

As a person raised in a 1^st world country, one of my first instincts is to find out exactly why a person died. This situation was no different. Epilepsy is surprisingly common in this village. No one in Atta’s family has a history of it thankfully. If there’s medicine available to the average Ghanaian, I don’t know of it. I asked the family to share with me anything else about her, but unfortunately the lasting impression they have of her, is her post-epileptic behavior. “She’d been very stubborn, you ask her to do something, she won’t mind you.” “Once you have epilepsy you won’t have good mind again.” I can only imagine the amount of brain damage resulting from untreated monthly seizures on concrete floor for “a long time.” So it was likely she died from an untreated seizure.

I considered my curiosity satisfied. But this is a significant difference between my culture back in the states and the culture here. People don’t ask why someone died here, it’s not important to them, it isn’t realized as a potential learning point to prevent a similar death. Death is immediately accepted, no questions asked.

I remember when leaving my job at the UW Hospital I had a premonition of being frustrated with the lack of resources in Ghana for treatable illnesses, this has come true. Save for malaria, dengue and yellow fever, dysentery, malnutrition and the many other 3^rd world diseases and conditions we have in Ghana, we have 1^st world chronic illnesses as well, without access to 1^st world resources. As a result, people die here—more than would otherwise. I didn’t write this to make you feel guilty or for sympathy. I wrote it to expand your knowledge of the world, to show how things are in different areas and cultures and how people cope with their situations.

At the end of my time sitting with Atta’s family, I asked them if they were sad she was gone. They responded tearfully that of course they were sad. To an outsider, their way of coping with death may appear cold and callus, but it’s their tradition. It’s not lack of caring or feeling sad, it’s simply how they do things.

-------------------(Umborinye and her cousins in the compound where Atta lived)