Ghana: Lush tropics, sweat and red dust!

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Hi everyone! Have tried to send something for almost two weeks. Between lost connections and computer failure....

A few words about Ghana and where I am.

Aworowa is a village in Techiman district, in the Brong-Ahafo region. Hopefully, you can locate on a map. Is northwest of Kumasi, a large city and headquarters of the Ashanti region. Aworowa consists of a small town and surrounding rural homes. My position is at the Aworowa Health Center, aka Aworowa Clinic. About a 10 minute taxi ride from Techiman (costs $.50), a small city with huge outdoor market, and full array of businesses and bustling activity.

Work has picked up sufficiently at the clinic. Not the most stimulating, but I am helping, and the staff are thanking me and appreciating my work. Most helpful is going with nurse Emelia on outreaches to isolated villages (as Mama Alice says, "into the bush"). We take a kit that includes vaccines, scale, vitamin A, patient registers and set up a clinic at a central spot outdoors in the village. Our spot includes a tree with a sturdy branch of appropriate height from which to hang a rope and scale. I weigh children up to age 5, and we dispense vitamin A to children from 6 mo. - 5 years. Some of the infants and toddlers scream with fright, while others calmly smile into my face as they hang from the the scale suspended in "weighing pants." I'm always happy when mothers provide their own, as those provided by the clinic are usually very dirty. While I do this, Emelia registers and gives scheduled immunizations. I also help with registration and tallying patient data. Have been doing this twice weekly. May 5-9 was National Child Health Promotion Week, so was busy at the clinic doing same type of work. Happy to report many healthy children. Minority are malnourished, and some scarily so. But, public health nurse seems rather nonchalant about it. Emelia, on the other hand, is a good nurse, and gives careful counseling to those with underweight children or those losing weight. I point out ones with problems, and ask her to speak to the mothers.

Also helping out with patient registration at the clinic, including filling out insurance forms. The national health insurance plan costs 20 GCD (about $19.90) per year, and covers all medical, including prescriptions. Patients receive free care, health center remits insurance forms and are reimbursed. Probably won't do much more in the way of nutrition here. Patients speak limited to no English, and my Twi only goes as far as basic greetings. But I am comfortable with the nutrition education given by the nurses and midwives, at least to mothers, and those expectant. If time, I may do a poster, but the medical passbook each patient is given has a good section on nutrition, including pictures of types of foods to eat.

My observations from trips into the bush tell me that the farther in, the poorer and less literate people are. While many of these villagers seem very poor in appearance, people overall seemed happy and were very friendly and welcoming. Most people are farmers or do menial labor. Appeared that few children attended school, and those in the local primary school of my first village defected to hang around me to watch every move. The children are absolutely delightful, yet many are very dirty, wearing ragged garments of all sorts. A male toddler might have on a skirt, while a young girl might wear a huge dirty t-shirt with one shoulder bared, the huge neck line hanging down the arm. And yet, many mothers, even in the poorest places, always have their children dressed and groomed well. This week, at the farthest-in village I've been to, the women were fascinated by my water bottle, which they have never seen, and my Kleenex. One woman was delighted when she gestured questioningly with a wiping move toward her back, and I nodded, plus motioned wiping my face and blowing my nose. I gave her one, and she excitedly showed the others and explained how it could be used.

Possibility of me teaching at local secondary schools is squashed. Ok with me, now that I have lots of little jobs with the clinic and outreaches.

Bits and pieces:

Time: I may have mentioned that I am 7 hours ahead of Pacific Daylight Time, which is great to be in the same half of the day as those at home.

Money: Currency is the Ghana Cedi (pronounced CD), which is equivalent to $.92-.95 USD. Also, is broken down into 100 pesewas, like our penny. No real conversion, just figure 1:1, unlike calculations needed for Kenya shilling, which was 60 something to the USD. However, the current Ghana Cedi has only been in effect a few months, and was prior 10,000 times. So, prior 10,000 cedis is now 1 Ghana Cedi. And merchants, traders, etc., commonly express price in the old currency. But, am mostly over the confusion now. For instance, if someone quotes 2,000 - I know they mean 20 pesewas (.20 Cedi).

Roommates: My two Danish roommates have gone. They planned for two weeks of solid travel before departing the first of June. They really got around the country. I can see a real benefit in coming as a duo. No other volunteers are currently scheduled. I am enjoying my single status - no surprise to those that know me well. Cleaned the room well when roomies left. Mama Alice removed their beds, as they were her own, and took them home. I got her permission to rip up the god-awful plastic pseudo-linoleum that was on the floor. It had many tears and holes, plus ants were living under it at the edges, and it harbored mildew underneath. I scrubbed the bare floor with bleach, and am planning to paint the concrete floor with gloss concrete floor paint. I told Mama Alice I would buy the paint and do the painting, which pleased here. The consulting room floor has the same gross flooring, which she would like to treat the same as my room, so I will likely do it, too.

Food: Overall good, and some delicious. I'm getting lots of veggies, and tons of fruit. Mangoes and oranges, especially, abound. Mangoes everywhere. We visited an orange orchard and were given 4 bags of oranges of various varieties. For variety have purchased a few apples, which are a nice change from tropical fruit occasionally. Also eating pineapple - extremely sweet and juicy. Pineapple here is less plentiful and more expensive than in Kenya, but still a bargain, compared to home. In Techiman, costs .90-1.00; in Aworowa have bought for .30, but not often found there. Also eating lots of avocado - purchased in Aworowa at 4 for .10; while .30-.40 each in Techiman for large size. One of the women (Kleenex lady) at an outreach this week gave Emelia and I a bag of avocadoes. Bought some tomatoes a couple of days ago to eat fresh for a change - used in cooking for most meals, as well as tomato paste, which is added to most veggie combos/stirfries, which they call stew.

Staples here are cassava, yam (a huge tuber with rough brown peeling and white starchy inside), maize and maize flour, beans and white rice for starches. Plantains also, but they are expensive (to the local poor) now due to dry conditions and lower availability. Plantains and bananas abound during the rainy season. Protein includes fish, meat, beans, eggs, and groundnuts. I'm not seeing milk in people's diets. Chai not taken here, whereas almost an addiction in Kenya.

Animals for most part are fed off the land, and the life of many a chicken, sheep and goat looks pretty bleak. Egg yokes barely have a yellowish tinge, so little vitamin A. I am given a one-egg omelette for breakfast each day, with tomato and red onion sauteed in. I augment it with a whole wheat roll (made by Mrs. Asare's Confectionary in Techiman) slathered with avocado, and sometimes sliced tomato. Sometimes also a slice of roll with groundnut paste (fresh ground local peanut butter) and cashew fruit jam. Visited a Benedictine monastery here - beautiful, scenic setting, and the life of a monk ain't bad - very nice housing, etc. I would guess that a major part of their local earnings come from proceeds of the cashew orchard. Yes, cashews are grown here. The nut is quite valuable in price, while the fruit that grows on the outside of the seed (nut) is popular for jam. The monks make cashew fruit jam with lemon (trees on site) and fresh ginger. It is thick and chunky, and not too sweet. They also make mango chutney, and cashew fruit schapps with a variety of additives, such as mahogany bark (medical value explained to me by one of the brothers).

In addition to goat, chicken, and beef (I assume), a very popular meat here is a bush rodent, that I can't remember the name of, rabbit and antelope. Fish is eaten regularly, but comes from the coast, down south. Usually, my lunch and dinner both contain fish. Sardines and a larger fish, but still very small (size of a cell phone), that they call salmon, but clearly is not! The sardines I smash up in my food to help tone down the flavor, and the larger one, I must debone prior to breaking up in my food. Fish here, as in Kenya, is cooked whole. Past hosts learned early not to give me the head, as much would be wasted, and is a delicacy to them (as well as the stomach and other internal organs!). Occasionally I get the head portion of one of these small fish, but usually get the back half, which has the better white meat (to my squeamish taste anyway!).

I frequently get beans (mostly black-eyed peas), and a variety of veggies in lunch and dinner stews. Tomatoes and red onions are a staple, then green beans, green peppers, summer squash, and local dark leafy greens. Soup, stew, and pounded food is very popular here. Mortars and pestles are necessary kitchen implements. Foods commonly pounded are greens, seeds, cassava, and yams. A big industry here in processed cassava, called gari. Outdoor gari factories everywhere. Employs lots of people. Jobs include peeling, cooking, squeezing the water out, grating into small curds (using baskets with fairly large spaces) then to the texture of powdery parmesan cheese, then cooking over large grills to remove remaining moisture. The resulting cassava powder saves people a lot of time in food prep, and is used, along with pounded yams or maize for staples such as fuyu and kenkey that are eaten at least daily, with soup and stews. I tried one time, but that's it for me. I do not like doughy, pasty things in my mouth, or going down into my stomach.

Cooking is done outside over an open fire, or charcoal burners (small barbeques), or in a kitchen structure (I'm sure the wealthier with nicer homes have modern kitchens). My cooks are Emelia (breakfast and dinner), nurse who lives on site in staff housing, and Abigail (Abby), ward assistant/orderly who lives nearby, but cooks my lunch as part of her job while on duty at the clinic. It's kind of embarrassing, but that is by Mama Alice's direction, and they don't seem to mind. At least it's part of Abby's work day, but I really feel bad that Emelia's work day is added to before and after because of me (all volunteers). They deliver the food on a tray to my room, and I take it back to the house when done. Now that roomies are gone, I eat in my room, which I much prefer to the consulting room next door, where we all used to eat.

Well, I think that's enough blither blather for today. Next time, some culture, and some of the sights I've been trekking around on the weekends. In case anyone is wondering, Ghana is a very safe and peaceful country. No political or tribal unrest. Definite tribal boundaries, languages and customs, but peaceful coexistence as Ghanaians. Most people love peace, and discourage rabble-rousing between tribes. So, very safe, even for single woman traveler, and people very helpful. Plus, no government corruption. So, transportation prices are set and uniform. Only need to be careful about arranging for private vehicles and guides. Agree on vehicle price up front, and make sure guide is legitimate.

Until next time, take care all. Time is going fast for me, and can't believe I only have less than 3 weeks left at this location, then to my final program.

Peace and love,
Deni

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