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)

Malnutrition and other things Tricia combats (no, Tricia isn't malnurished, but her village children are)

--------------Naomi (an orphan) and I at the PD Hearth Program

Malnutrition. Definition: lack of proper nutrition, caused by not having enough to eat, not eating enough of the right things, or being unable to use the food that one does eat. A few months ago, I took three influential people from Jumbo to a workshop about the Positive Deviant (or “PD”) Hearth program. The program focuses on finding basic nutrition in the locally available foods and using it to make children healthier. The positive deviant portion of the program seeks out mothers who are doing a good job nourishing their children. This is my favorite part of the program! The PD mother gets to share with women how they are raising well-nourished children and caring for their children using the same resources available to everyone in the community. How do we find these PD mothers? We have a massive baby weighing! 145 children, all 5 years of age and under, came to the weighing; I was happy with the turnout. With the master Excel skills of Kris, I was able to plot out all of the children on a weight vs. age chart. With some basic math skills, we were then able to calculate the percentage of children in our village who are a healthy weight! Drum roll please… 6%. That leaves 60% low weight, 27% underweight and 7% severely underweight.

What can be done about this? There are several strategies that can be brought forth during the course of the program. The first: family planning! With couples averaging 7 children (and multiple-wife households around 10-15 children), there needs to be a lot of food to go around. Second: education (especially girls and women)! If children are educated, they grow into educated adults who make informed decisions (i.e. how many children do we want and when), and are more knowledgeable about resources available to them (i.e. food that is most nutrient rich). Third: Moringa trees! Also called, “the Miracle Tree,” a single serving of fresh Moringa leaves contains 4 times more calcium than milk, 7 times more vitamin C than oranges, 4 times more potassium than bananas, 4 times more Vitamin A than carrots, and 2 times more protein than yogurt. Unfortunately, goats really like Moringa too; they must sense its nutritional worth and try to bridge their own nutritional gap (nobody feeds them). Finally: have the white lady give money so that you can buy candy and soda and a TV! Okay, maybe that last one isn’t something I think would help.

Here’s what I already do to combat malnutrition in my village. I attend Jumbo’s monthly baby weighings. If I show up, more mothers tend to bring their children (white power—the good kind). At the weighings, I plot each child’s weight on their weight vs. age chart. If the child falls into the severely underweight class I write their name down. I then make a house call to see the child’s home environment. Are there 20 naked children running around eating anything off the ground, moving or otherwise? I talk to the parents and explain why I’m invading their home, and they bring me a chair (white power again). I ask for the child who’s name is in my book, and they bring me the child so I can give them a good look. Numbers aren’t everything, sometimes the child appears mostly healthy, maybe skinny, but maybe just small-framed. Sometimes the child has brown brittle hair, wrinkly skin falling off their bodies and distant uninterested eyes. I describe the last feature as listless, one of the more concerning signs of malnutrition (in my opinion). At this point, the child has either attached itself to my leg or is crying from all the attention. I then talk with the parents about what they farm… not if they farm, unnecessary question in this village. From the list of foods they farm, I point out the ones that that particular child should eat more of, and what they could use less of. We discuss what the child likes to eat and their usual scenario of eating, i.e. shared bowl with 6 bigger siblings, only likes the starchy foods, eats a little then complains of stomach pain… I give them some ideas of how they can get the child to a healthier nutritional status and encourage them to keep trying. I then move to the next house. Generally, I write down about 10 names from each baby weighing, I don’t write down repeats (once I’ve talked to them I only check in with them when they heed my advice and come to the next month’s baby weighing, or if I’m particularly concerned I just star the name and revisit as necessary). I also try to write down at least 1 well-nourished child from each weighing and visit them too, to give them a verbal high five.

In addition, I recently submitted a grant to help pay for bamboo I want to use for fencing. Each clan (there are 12 in Jumbo) would create a fence with the bamboo, near their homes instead of at farm. After the fence is complete, I plan to have them each plant 30-40 Moringa trees in the garden. I’ve already mentioned the benefits of Moringa. If I am successful and the women start using Moringa in their stews and soups, Jumbo will produce massive kids that could give obese American children a run for their money… well, maybe not, these kids do a little more physical activity than American children. In any case, they will be healthier, and parents would have no excuse not to use it, as it is costing them almost no money.

Also, pretty much from day one I have been working to get a small clinic in the village. We’ve completed the work required of the village for getting the clinic and nurse in Jumbo. Very soon I’ll have a nurse to collaborate with on the matter of malnutrition, and I can’t wait! Along with helping reduce malnutrition rates, we’ll have more women utilize family planning methods available at the clinic, and reduce the severe cases and deaths related to malaria and other easily treatable diseases.

May 28th I finished my first PD Hearth Program. Most villages do the program about two times to capture the most malnourished children; unfortunately, I’ll need to do it at least 5 times to reach the most severely underweight children in Jumbo. The program is a nutrition-focused cooking program, lasts for 12 mornings and enrolls 12-15 children (this group included 12 mothers). Each morning mothers of the children selected are shown a nutritious meal to cook, using protein rich food such as ground soya beans, peanuts, fish and Moringa. Then they cook it and feed it to their children. The left-over food is sent home and fed to the child throughout the day.

Our 1st PD with a girl 4 days older than him

Fufu and palmnut soup!

A busy day @ the clinic, baby weighing + PD Hearth Program

Another morning of nutritious food @ Hearth

This first two-week program went well, especially for it being my first try! Most of the women came on most days (I have some ideas for improving attendance in the future). The kids ALL ate the food, and liked it too! Not one child in the group lost weight. Rather, three maintained their weight from the first day and the rest all gained some weight! The child who gained the most weight gained 7.6% of his body weight!! (You try that in 12 days!) In 2 weeks we’ll weigh these children again to check if the mothers are still doing what they’ve learned in the programs while at home.

This is Nakoja, he gained 7.6% of his body weight & was out “biggest gainer”

Tomorrow I’ll start with a second group, this time with 13 children and their mothers. The PD (positive deviant) for the group is a 3.5 year-old girl born into a farming family. As farming is the most common occupation for people living in Jumbo, I was excited to hear how this ordinary (read: very poor) family was able to keep this young girl so well nourished. Their secret? Moringa leaves in her food at least once a day! I’ve been trying to push moringa at any opportunity (baby weighings, community meetings, nonchalant conversation). If I would have been smarter, I would have “planted” this type of mother into conversation much earlier. Regardless, I was given a real-world example of what moringa can do for a child’s nutritional status. The other women in the program are now very excited about moringa, so I told them all to go home and nag their husbands about working a small plot of land so they can use my funding for bamboo to have a moringa garden of their own!This is Jagri, she's the PD for our 2nd group, a very healthy little girl!!

In other news, Kris and I are getting excited about our vacation to the US in less than 2 months! Cheeseburgers…mmm… The rains have arrived, so it’s now cooler, but also more humid, muddy and, well, wet! We no longer have to rely on fetching and pumping our water; we instead collect rainwater from the roof. We are also preparing for a youth camp in June. We are also getting ready host some brand new (less than 7 days in country) Peace Corps Trainees (PCTs). One or two of these PCTs will venture on their own from Accra to our village to see what life is like for a PCV in Ghana. I can’t wait to share insight and advice with the PCTs to help them transition to their new life in Ghana as a Peace Corps Volunteer. Sometime in June I’m co-leading a project that is loosely based on “Take Our Daughter to Work Day.” We’ll take some girls from my village to a bigger town to see women with occupations other than farming. Its intent is to provide girls with positive role models, encourage them to stay in school and to strive for their dreams. We’re also getting ready to say goodbye to PCVs who finish their service starting in July. I guess this will officially make us the “old group.” We’re at the one year mark in our service and can hardly believe how fast the time has gone. A year from now we’ll be busy planning our reentry to life in the U.S. We miss you all, thanks for all your continued prayers, thoughts and support!

Nature (written 4-27)

For this post I will step away from the usual “update” theme and talk about one of the many gradual changes of perspective I am experiencing here: Nature.

In the states I was very much a fan.  Anything from a simple walk in a park or in the woods to weekend camping trips could easily invoke my appreciation and general awe of nature. The sound of wind rustling leaves in the trees, birds singing; the sun piercing through those same leaves and forcing your pupils to adjust; the smell of a fresh spring morning.  It was all wonderful.  I thought that in Ghana I would find a parallel world of sights, sounds and smells not so different from this.  Turns out I was wrong.  Something happened – gradually, preventing me from recognizing it until it was too late. Don’t misunderstand; there are countless wonders here in Ghana that are just waiting for you to experience them.  Gorgeous sunsets.  More stars than you’d think ever existed.  Birds of extraordinary colors and songs.  Unfortunately there are also a number of unsavory experiences to accompany the these, experiences I didn’t expect to find in this parallel nature.  Going outside to brush my teeth in complete darkness, then coming back out in 5 minutes with a light only to realize there was a scorpion crawling around in the courtyard. Going out to the latrine and on the way back having my shadow chased by a camel spider. Waking up at 3am, then 4am, then 5am (repeating until I decide to get up) by roosters crowing.  The constant, epic battle between bamboo fence and goat.  A heavy rain washing away the earth under the corner of the house.  All of these experiences, while mostly harmless, have left a foul taste in my mouth when it comes to nature.  Now, when I bathe under starlight, all I see is just random pinholes in the sky, instead of Orion lying prone (and every day lower in the western sky), the big dipper to the north, always upside down, etc.  When I peer outside the screen door in the morning I am looking for goats in the far garden (the most deteriorated of the three) or children throwing rocks at the fence (or house, or cat, or anything), not at the sun spraying light onto the moringa trees.  Yes, somehow, I reached the point where I now abhor nature. I don’t think about what kind of tree this is, or what kind of insect that is.  I just know which trees will rot if you use them for fence posts and that every insect that lands on my skin should be immediately swatted and disposed of.

I suppose there is an elevated wildness here (farmers often suffer from snakebites, malaria is a constant threat) that my life pre-Peace Corps did not prepare me for.  But what then do you call having only 100 yards of broken trail separating me from a black bear? Or exceeding the temperature rating of my sleeping bag?  Or Are these experiences not wild?

When I settled in at site and started to notice the behavior of Ghanaians toward nature, I was appalled.  For most, the strategy is simple.  By fire, flood, or weapon, eliminate (that is, kill) any “wild” living thing that is considered even the most moderate nuisance.  Why not just let the snake cross the road instead of swerving to hit it?  Why kill the small ground squirrel if they are taboo for your culture to eat?  Now that my own attitude toward nature has soured, I can almost relate to this behavior.  It’s somewhat chilling, but it is also eye-opening.  Maybe the people I know here aren’t entirely ignorant in how they view nature.  Maybe nature brings enough negatives here that it’s just too difficult to see the positives.

The last remaining question for now is this: Is this a trend that will continue through my service, and even when I return to the states, or will some event, or gradual therapy (read: frequent walks in the woods), jar me from my melancholy and allow me to appreciate the beauty of my surroundings again?  I’ll let you know.

We have a secret in our culture, and it's not that birth is painful. It's that women are strong. ~Laura Stavoe Harm

It was about an hour until dark in the village, nearing 5pm. I was busy recovering from a minor GI illness, i.e. sipping Gatorade and watching The Man in the Iron Mask (really enjoyable movie by the way). I got a call on my cell phone from Joseph, the Ghanaian whom I do most of my work in the village with. He sounded most excited and happy on the phone, which has a very contagious effect on me. He said, “Madam, the TBA is planning to deliver this afternoon, you should come.” I said I’d be right there. TBA stands for Traditional Birth Attendant, also known as a traditional midwife. From Wikipedia, “Traditional midwives provide basic health care, support and advice during and after pregnancy and childbirth, based primarily on experience and knowledge acquired informally through the traditions and practices of the communities where they originated.^” From my experience here in Ghana, this definition is mostly true.

I’ve told Jumbo’s TBA multiple times that I wanted to be present for any and all births she attends; it’s taken this long for her to take me seriously. I believe she thought I wouldn’t be able to handle the scene, even though she knows I was a nurse in the states. I walked over to the TBA’s house. I was told she was in the bathhouse (pictured below) and that I should go see her. I looked around the corner of the bathhouse and the pregnant mother, for being in such an uncomfortable location and position, looked calm and comfortable. She was sitting on a concrete step on the floor of the bathhouse in the clothes that God gave her. Labor must not be happening I thought to myself, this woman is in no distress at all! It was a cool evening, as a storm front had passed over, bringing no more than a few sprinkles of rain, but bringing welcome cool winds and a cooler temperature. It was even sprinkling lightly still.

The "delivery room" was the one on the right ----------------- note: concrete step

Not 10 minutes following my initial assessment of “not in labor,” she had moved to the floor of the bathhouse, shoulders resting on a light piece of fabric. Now join the reinforcements. Two women entered the bathhouse with the TBA and me; they were the knee-holder-backers. I envisioned a squatting birth, but instead it was to be a birth brought forth while in the least gravitationally assisted way (while lying on one’s back). She pushed for 2 seconds, and then relaxed. She spoke calmly something in Likpakpaln - I imagined it to be something like, “I’m tired and am just going to lie here, and I could use some water.” I couldn’t believe how quiet and calm she was! At this point, I was given a little stool. About six inches off the ground, with a base (for my bum) 6 inches by 10 inches; I shared it with another woman. Believe it or not, it was a lot more comfortable than squatting on my heels and not the most uncomfortable seat I’ve experienced in Ghana. I then realized that there were a number of additional people in this small bathhouse-turned-delivery-room. I stopped for a second to count six people total: the TBA, myself, 2 leg-holder-backers another women with a flashlight sharing my humble stool, and, of course, the pregnant mother. The midwife was not squatting, instead she was standing bent over at what seemed like a 90-degree angle, constantly “checking the baby’s progress” and preparing the way for the baby’s head. How can a woman of at least 60 or 70 years of age be bent over in that fashion for that long? I was amazed at her agility. I envisioned a less hands on labor, but though it appeared uncomfortable for the mother, she displayed no signs of suffering.

As it was now growing dark, I utilized the most amazing function on my cell phone, a light! I soon became the reliable source of light to illuminate the slow progress of the labor. As a Ghanaian would say, “the mother was not serious at all!” Her version of pushing consisted of notifying the assistants that she was going to push, pushing for a second or two, and then relaxing back saying something quietly. After long, the women began to grow tired of her lackadaisical manner. They would encourage her verbally whilst pushing, then yell at her and threaten to whip her with a long, thin stick. The bathhouse was a dual bathhouse, meaning 2 bathhouses attached to each other with a 5-foot wall separating them. At one point during the labor, a man came to bathe in the adjoined bathhouse next to us. He spewed some advice (like he’d know) and yelled at her for being lazy. Two hours into the labor, I began to worry; we had been able to see the baby’s head for over an hour, but her contractions were not intense, the woman had no drive to push well, and some of her anatomy seemed to be blocking the best route for the baby. What now? Another younger TBA came to help figure out what was taking so long. A rag soaked in alcohol (the drinking kind) was placed over the baby’s would-be entrance to the world. A long prayer was said over the pregnant mother’s belly. There was a very hushed conversation between the mother and the TBA. My concern grew. Many different women exited and entered the bathhouse. I stayed constantly with the mother; I didn’t think she should be alone.

I paused to say a prayer of my own, then listened to my surroundings. A large semi truck, likely full of yams, was slowly navigating the Jumbo hill, down-shifting loudly. Frogs were calling for their lovers in the Jumbo River. A chorus of children under the age of five were bantering in the compound attached to the bathhouse. Two dogs, also in the compound, had found something to fight over. Women were angrily shouting advice and distain at the mother. A mother goat had lost track of one of her babies, and was desperately bleating for it to come back. Men were discussing their days and their latest grievances (usually pitifully minor) as loudly as possible. Someone had a radio blaring static. Further in the distance was some hip-hop Ghanaian music playing, heavy on the bass. I was sure the baby could hear all that was going on outside its safe, dark world. Would I willingly enter such a chaotic place? I guess I did by joining Peace Corps Ghana, but did I get a 9-month sample of this soundtrack to help me make my decision? I did not.

Throughout the labor, we had many observers at the bathhouse. A dog came to see what all the fuss was about; many chickens flurried in and out; the would-be big-brother (in his birthday suit) often peeked around the corner; women from the compound and neighboring compounds came to let the mother know she was taking too much time; and men came by too, though they didn’t come close for a look but rather clicked their tongues (the best way to vocalize disapproval) when receiving the status update. There were now a total of eight women in the small “delivery room.” The baby’s head was visible still, and the woman was going to give it one last go. Thankfully, her last effort was her best, and the baby’s head emerged, and with some encouragement from the seven non-laborers present, the mother was able to push one last time to help the baby fully enter its new, noisy world.

I shouted “usaapwaan!” A girl! They all laughed and agreed. The little girl gave a healthy albeit gurgely cry and the TBA washed her mouth and nose secretions away. She was squirming vigorously, a good sign. Some thread was brought and the umbilical cord was tied in a few sections. I helped hold the slick, flailing limbs so that ties could be made well, cell phone light between my teeth. A new razor blade was brought and the cord cut (I checked it to that it had the correct 2 arteries and 1 vein). I then tried to give the slippery baby to the mother, but instead was instructed to carry it to a room in the compound. With surprising security, I carried her in one arm to the room and placed her on a soft bed made of several clothes on the cement floor. I gave instruction that the mother should eat well when she was able and that she should start breastfeeding immediately. Those present agreed that it would happen that way. I was offered drink (probably to be something heavy on the alcohol content) as it was tradition to do so after such a difficult labor, but respectfully declined. They thanked me repeatedly, and the TBA gave me an approving smile (I imagine she was thinking, “You didn’t pass out!”), I told her, “until next time,” to which she responded, “until next time.”

So ends my first first-hand-experience of a birth in Ghana. I believe it will be the first of many - at least I hope that is the case. I have not found a more important, blessed, or happy event to lose sleep over. This particular girl was born into a life of hard work and likely disregard, but she has also been given the chance to overcome adversity and change our village of Jumbo and the whole of Ghana for the better. I have certainly set my sights high for this baby girl, but without wishes, hopes, and dreams, how can one begin to envision a better world?