Dear Blog

I think an apology is in order.  We have fallen off the wagon and failed to add a post to you for over a month now.  It's not you, it's us.  We've just been so busy...  I have been on term break from Dec 17 to Jan 10, so no teaching, at least not officially, though I did teach a few extra classes during the break which were voluntary for the form 2s (8th grade).  Tricia and I went to Atimpoku, just below Akosombo dam on the Volta river, for Tricia's birthday.  We also sneaked in a trip to Accra for our flu (H1N1 and seasonal) vaccine and Hep C shots.  Then we went back to Kpassa for Christmas, which was spent in the house the whole day, opening presents (thanks!) and eating a boxed homestyle bake ("turkey stew and stuffing" - delicious), cranberry sauce and brownies.  Even though it was just the two of us, we had plenty of things that made it feel like Christmas at home, and we also talked over the phone with family back home.  After Christmas we hosted 6 other PCVs that were on a marathon trek up through the Volta and Northern regions.  They are all serving in the Eastern region of Ghana, and were surprised with some of the regional differences (dirt roads, naked children).  But we wowed them with chili and mango bread and watermelon, and we were grateful for the company.  In other news, apparently our house is capable of sleeping 8 people.  They left early the next morning, and we started packing for a stay in Nkwanta the next two days with some other PCVs in the area (plus a German volunteer with a British NGO).  We relaxed, talked about our service so far, and, of course, made some awesome food.  Tricia and I contributed cheesy enchilada casserole and homemade fudge (thanks to my mother-in-law for the ingredients!).  Then we came back to site on New Year's Eve, as promised, to experience how people in the area celebrate the new year.  At night on the 1st, 2nd, and 3rd (and on the 4th a bit too), they played jams (hip hop music) from giant speakers, well into the night.  They also wore their "Christmas clothes," which is an outfit they buy leading up to Christmas so they can wear it and parade around the village looking good.  Everyone from age 1 and up was decked out in new fabric.  Some wore more traditional dress, others went for more of a Westernized look, with blue jeans and bright "Aeropostale" or "gucci" shirts, which are considered just as formal.  Western culture is permeating Ghana, but it sometimes manifests itself differently.  After the series of sleepless nights from the never-ending thumping bass, the New Year was sufficiently celebrated, and everything went back to normal.  And by normal I mean guys walking by on their way to farm (out in the bush) with their machetes, women fetching water from the boreholes and firewood from the bush, and children running around, unsupervised, naked or in underwear. 

So, I guess we were busy, but not busy enough that we couldn't write.  So we'll make it up to you, blog.  Promise.

Weather

Since arriving here in Ghana one of the topics on our minds the most has been the weather.  Even though we left the US during a pleasantly warm Wisconsin May, the almost-permanent heat and humidity in the south of Ghana was debilitatingly intense.  I don’t think the temperature ever dropped below 70F throughout training.  It would usually start out in the upper 70’s at dawn and ratchet up into the 90’s by about four or five in the afternoon, when the sun started to make its hasty retreat toward the horizon (on the equator the period of “twilight” is shorter).  So, if you are getting up at 6am to take advantage of the cooler time of day (and if you are serious about getting sleep), that means you are going to bed between 9 and 10pm, when it is just a shade cooler than the hottest time of the day.  In a word, it is miserable.  I have adapted by using the warm-weather clothing I stocked up on before leaving the US: nylon khaki pants, thin cotton polos, poly performance shirts. I could count on my fingers the number of days I have worn close-toed shoes here.  Why no shorts?  Well, teachers are encouraged to look professional, as appearance counts for quite a bit (most days my counterpart wears pants and a long-sleeve dress shirt, and dress shoes).  Here in northern Volta we are outside the “southern sauna,” but relief is fleeting.  Kpassa is on the border between forest and savanna.  Just ten miles to the south you will see tall trees blanketing the slopes of the Togolese mountains.  Around here the mountains are a bluish mirage on the horizon, and trees are only sparsely scattered across the land.  Even in the wet season, which just ended in November, the humidity is generally lower than in the south.  The sun, though, feels more intense, maybe because there is less moisture in the atmosphere through which to penetrate.  On a completely clear day, it is like you were shoved into an oven.  By mid-day, the few people that don’t have work to do (read: men) are sitting under mango trees, waiting for the sun to take a more bearable angle.  On school days I have at least two fifteen minute sessions with the sun on my bike ride to and from.  Market days take an extra dose of gumption, as the ride is 30 minutes one way (I skipped market yesterday for lack of gumption).  In the states I loved biking, for the exercise and the pleasant feeling of air rushing past my face.  Here I loath it, mainly because the air that rushes past doesn’t rush at all, but feels like hot, sticky, tasteless jello.  After a heavy rain there is some relief, as the sun’s work of burning the earth has been doused by water.  Some evenings, when I bathed I could see steam coming off my arms and chest, a combination of the lower temperature and high humidity.  How much lower?  Still solidly in the 70’s.

Now that the rains have stopped the new meteorological feature is a phenomenon called “harmattan.”  I think it will make me wish for the heat and humidity to return.  Supposedly it is much cooler at night, though I’m not sure what that means (60’s maybe?  Ghanaians don’t have thermometers and their definition of cold is anything below 80).  In the day it is still scorching, though the lack of humidity provides some relief.  Oh, and there is dust.  Winds come down from the Sahel (maybe even the Sahara?) and blow dust across the land until everything is a shade of ruddy earth.  The grasses dry up quickly, and people here like to catch bush meat by burning large swaths of bush and wait for the animals to escape fire only to be trapped or shot (sounds fair, right?), and the fires get stoked by wind and get out of control quickly.  They can burn for months until the rains come again.  Even at the beginning of the season, I have seen my share of plumes on the horizon, and the horizon itself is hazier even than in the cloud-heavy wet season.

After harmattan, in February and March, they tell me it gets hot.  How hot?  Well, hotter than any other season.  I personally don’t think it’s possible that it could get any hotter.  The only thing you can do, apparently, is drink plenty of water (Gatorade, even) and sleep outside (the heat is too unbearable to sleep inside).  So I have made hammock anchors for the courtyard wall for when the time comes.

Finally, in June, the rains come again to cool things down a bit, and the cycle repeats.  At least in a normal year.  I have already heard of anomalies to these seasons, the most stark one being that the wet season lasted at least a full month longer than expected.  Will it compensate for this with a wet season that starts one month later?  I have heard weather in West Africa can vary significantly from the norm.  On top of that, if I ask five people about the seasons I will usually get five different answers.  So I guess I’ll just find out when it happens. That last realization is especially tough for me, being that I was addicted to weather and forecasting (I checked the temperature and radar ten times a day). I will probably seem strange when I come back to the states because when someone asks me about the weather I will probably just look up and guess at what will happen next.

For those already affected...

And for those already affected by HIV/AIDS, i.e. infected, here's an article from Doctors Without Borders with some bad news regarding treatment of HIV in developing areas of the world (i.e. those areas in which people cannot afford the $10,000 a year cost for antiretroviral drugs (ARVs), not to mention the millions of dollars (billions?) to find a cure for HIV).

http://www.doctorswithoutborders.org/press/release.cfm?id=4887&cat=press-release

World AIDS Day

How did you celebrate World AIDS Day?

I decided that instead of teaching mathematics to my students I would instead talk about and have an informal question and answer session on HIV and AIDS.  I was pleasantly surprised with their knowledge of the disease; they were able to identify the three major ways it is transmitted, how it affects the body (one student answered “it takes away your body’s ‘soldiers’” – he was speaking of antibodies), and how to prevent transmission.  However, they were overly fascinated with transmission by blood (i.e. blood to blood contact), and asked a million questions about it.  Everything from, “If I use sandals that an infected person has used if they have a wound on their toe” to “if a barber is cutting hair with a razor blade and accidentally cuts your scalp.”  I had to keep reminding them that only a small fraction of people get HIV this way, and that the majority get it from unprotected sex.  I also asked how they would treat a person they knew was infected with HIV, and their answers were terrifying.  One told me he would kill the infected person, so that they could not spread the disease further.  Another said he would try to convince the person to commit suicide, for the same reason.  A more compassionate student said they would encourage the person to seek help from the hospital to get the ARV medicines so they can live better.  In general they were afraid of the thought of being around someone with HIV.  I suggested that because it is so hard to know if a person has HIV, and there are so many activities you can do with that person and not be at risk of getting HIV, why not just treat them normally, as you would any other person?  I also emphasized that because the only way to know if you have HIV is to get tested, they should be proud of getting a test done, instead of embarrassed.  HIV is increasingly more prevalent in Ghana by the day, so why not brag that you have been tested and you’re negative?  And for the girls, I told them to not believe a man when he says he is negative but “lost the test results.”  No results, no sex.  The boys laughed at this, but I think the girls for a moment saw their opportunity to assert themselves and control their destiny (which doesn’t happen often in this culture).

So the question stands: what have you done for World AIDS Day today?  Now I know you could go out and buy a new Project Red iPod, and that would fund AIDS relief…somehow (I’m not sure about the details).  You could even give money more directly to aid organizations working on AIDS relief and prevention of HIV.  Honestly the most important thing I think you can do is educate.  Otherwise HIV will continue to spread like wildfire.  In the states everybody knows about AIDS and HIV.  Here, I would venture a guess that people get it before they have even heard about it. Not all get it because they are promiscuous.  Some even thought they were being smart and asked their partner, but were lied to; still others simply don’t know how to use a condom properly.  If everyone were equipped with this knowledge, HIV wouldn’t stand a chance.

On Coartem: 24 pills in 3 days

From the WHO website, “Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells.” Common symptoms include fever, headache, and vomiting. Additional symptoms may include muscle aches and fatigue. I was easy to diagnose as I displayed all of the typical and moderately typical symptoms. Also, I had taken my malaria prophylaxis 2 days late. Why did I forget? Well, unfortunately one of the side effects of the malaria prophylaxis is forgetfulness… go figure. The symptoms usually appear about 2 weeks following the bite of a mosquito. Again from the WHO, “If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.” My symptoms started Monday the 8^th of November in the evening. By 0130 early Tuesday morning I was pretty certain I had malaria. I called the PC physician to describe my symptoms and was diagnosed in less than 4 minutes. I prepared slides with some of my blood to have examined at a later date in a lab, and then took my first 4 pills of Coartem. “Coartem is a highly effective and well-tolerated malaria treatment, providing cure rates of up to 97%, even in areas of multi-drug resistance.” (Wikipedia)

I had a fever up to 103.4 at its max. The fever stayed around 101.4 for 3 days against my attempts to control it with Tylenol and ibuprofen. Aside from that I was quite nauseous and developed a viral infection. I have learned that it is normal to develop viral infections while having malaria. Malaria suppresses your immune system so you’re more susceptible to additional illness. My throat is still sore and tonsils are still enlarged, but visibly improving. I’m no longer nauseous, but am back to having no appetite. The lack of appetite is likely from the malaria prophylaxis; I hope to get on something else soon.

So, day one of malaria was supposed to be a girl’s night J. I didn’t feel that malaria could stop that, so I had 2 PCVs that live near me over for the night. Kris was gone at PCV training for the week, so I felt like I needed some company. We cooked a minestrone soup and ate pineapple and salsa on tortillas! We also walked a bit around the community. I probably exerted myself a little too much, so decided to make it a one-day affair. The next 2 days I spent in bed, trying to stay hydrated and resting in between villagers stopping by to make sure I was still okay. Their concern was appreciated. I’ve now finished the treatment and am just waiting to feel better. I no longer have a fever (yay!) but feel as though it may take awhile until I feel back to 100%.

Lesson learned? Yes. Malaria is not something I’d like to try again. Luckily for me I had access to the best medication within seconds of diagnosis. I already sleep under an insecticidal treated mosquito net, don’t go outside once it’s dark and I wear long sleeves and pants as much as possible. I’m lucky, I really am.

“In 2008, there were 247 million cases of malaria and nearly one million deaths –

the majority (85%) were in children under five years of age. In Africa a child dies

every 45 seconds of Malaria, the disease accounts for 20% of all childhood

deaths. An African child has on average between 1.6 and 5.4 episodes of malaria

fever each year.” (WHO)

I guess this is one of the reasons I am here. There isn’t a malaria vaccine, but there are many ways to prevent malaria. I know at some point in my time spent here I will educate about mosquito nets. Their use alone has shown to decrease mortality by 20%! I will also educate about what causes malaria. Many people in my village have told me that malaria comes from working in the sun. In addition I will educate about the signs and symptoms of malaria. If more children took medication soon after displaying the symptoms of malaria they would be fine, just like me.

I know a lot of people were praying for me this week (thank you). I won’t give all of the credit of my feeling better to the Coartem, I know that the prayers played a large role. Kris comes back from training tomorrow evening. I know he wishes he would have been able to be home with me this week, but I managed all right. He’s brining back a lot of packages from home that have been sitting in Accra for far too long. I miss you all but am realizing more and more that I am needed here, so look forward to another 21 months of updates from Ghana!

Hanging out in bed, the backdrop is my lovely avocado green mosquito net!