Wednesday, June 8, 2011

Farewell (South) Africa

The Cape Town area can be described in a simple phrase - it is The Jewel of Africa! The city itself is immaculate and modern with lots of things to do. With Matthew as my partner in crime, we spent 9 days in Cape Town having a blast. Winter has reared its head here so it's been chilly and raining a bit too often. Our activities have been extremely varied - we toured the city in one of those jump on/jump off double-decker London buses; wined and dined at Victoria &Alfred Harbor; ate and drank our way through Stelenbosch Winelands with a private tour guide focusing not only on wine but cheese, chocolate and olives - yum! We also abseiled (repelled) Table Mountain; strolled through gardens (Kirstenboch is rated among the world's top 5 most beautiful gardens); visited Cape Point National Park (Cape of Good Hope) where we hung out with hundreds of penguins on the beach. We also did a lot of driving along the coast line marvelling at the gorgeous bays - Kaulk Bay, Sea Point Bay and Camps Bay where  the rich and famous come to play.

From Cape Town we moved east further down the coast to Gansbaii - great white shark capitol of the world, and Hermanus - the whale capital of the world. Unfortunately we didn't even get to see one whale; instead, we only saw the gigantic shape/shadow of one under the surface. We were supposed to go shark diving in Gansbaii however 25 foot swells and driving rain kept us land-locked. Instead, we took a drive through another wine region and enjoyed some of the best vistas and landscapes I've ever seen. And perhaps we did some wine tasting too.  :)    After a few days in the Walker Bay area we moved further east along the coast to Mossell Bay - a very popular summer beach destination. The sea had finally calmed enough to enable us to go shark diving - and yes, this was as crazy and exciting as it sounds! The crew would bait the water (out in the open ocean) with fish chum and when the sharks approached the boat they lowered the cage (with us in it) into the water. They continue to bait the sharks by tying dead tuna to a pole and dangling it in front of the cage - definitely a must-do activity for thrill seekers!  Another day trip was spent driving north to Outshorn to the Cango Caves, known to be some of the largest caves in the world. Massive stalagmites and stalactites create incredible shapes and made the walking difficult. We had to crawl through numerous caverns and barely squeezed through some of the openings. Our afternoon was completed with ostrich riding! A male ostrich was blind-folded, I climbed on his back, latched onto his wings and hooked my feet around his chest and he took off just like a horse out of the gate!  

After a few historical museums in Mossell Bay, we continued our venture further east along the coast to Knysna, Plettenburg Bay, and Tsitsikama National Park where we hiked, perhaps the most beautiful hike I've ever done - mountain terrain, green rolling hills and jagged cliffs that lead down to soft sand beaches.   This was followed by another unbelievable experience - bungee jumping off the highest bungee jump in the world (710 feet). Imagine a swan dive off an active bridge (I'm sure you've seen the picture of the South Africa/New Zealand arching bridge over the canyon?) - it doesn't get much more exhilarating than that!!

18 days later I can say that this has been an unbelievable vacation, however my days here are numbered and I'm starting to mentally prepare for my return to the Grand ole' US of A.

In my final days here, it's hard not to reflect upon where I've been and where I'm going. I don't think I have accomplished everything that I came to do but I do think that I have made an impact and a lasting impression on many of the people/children that I met; I know that they, and their minimal existence, will affect me for many years to come. During much of my journey here I have longed for home - the people, our way of life, the technology, and the wealth that surrounds us. However, now in my final days, I would like to stay to remain in a world that is so simple - where very few things are planned beyond today, where little is expected of everyone and the attitude is always 'hakuna matata' - now this has a certain lure that I could barely comprehend 5 months ago when I arrived.

Many thanks to everyone who supported this adventure - to those who shipped medical supplies, children's supplies and toys, and money to buy more of the above locally. ...
THANK YOU!

Thursday, May 19, 2011

More on South Africa


 
Thalaghanio, the 2 year old boy that I live with. He might just come home with me as well!
 If Ghana was the land of the Have-Nots, South Africa is the land of the Have's among the Have-Nots. My experience in Ghana was that everyone outside of the capital was poor, very poor in every sense of the word materially. Their houses were minimal, most lacking electricity, running water and indoor facilities (kitchen and bathroom), the roads were in disrepair - many dirt, the stores are mostly shacks on the side of the dusty roads and most people do not own anything western - TVs, ipods, appliances, cars etc etc.  Everywhere I looked it was poverty! However, in South Africa it is so intertwined, from afar it's difficult to tell who's poor and who's really poor. The informal settlements are much more common than I expected and there does not seem to be any shame in living among them. The shanty-towns are surrounded by small, regular homes and there doesn't seem to be any issues with the proximity. Can you imagine if a few thousands people decided to set up plywood and tin shacks in the empty field in your neighborhood?! Throughout the last number of decades, the government has tried to demolish these settlements, only for them to resurface the following week. They have apparently conceded defeat and now actually provide some services for free - a few water spickets shared among many and port-o-potty's which they service.  Within these informal settlements, there is even a grand disparity between the Have's and Have-Nots. Many are as I'd expect on the inside - dark and furnished with very little, however, others are quite a surprise. The door is opened and voila! I see kitchen counter tops, a table and chairs, pots and pans, a bed, a bureau and even some are show-casing car batteries or generators to run their flat screen TV, radio, cell phones and ipods! Whaaaat??!! And don't forget their designer (knock-off) clothing and bags!

As for me? I'm continuing to look for additional areas of need. I've started tutoring kids when they come to the Center after school. Some of the kids are so far behind, it's apparent that neither school teachers, parents or even the teachers at the Center are tracking their progress/performance. It is very frustrating to watch the teachers at the Center, who are expected to be academic resources, barely function as recess monitors. It appears that these are just "jobs" providing a paycheck and that there is no personal motivation to make a difference in these kid's lives.  I've also been working with the Administrative staff. It's been surprising to see the lack of training most of the women have in what I consider to be, basic computer skills -typing, general organization/prioritization, lack of knowledge in computer programs such as excel etc. Although the pace of life here is slow in general, the pace in the work environment is even slower! The amount of work that an administrative employee accomplishes in a day is comparable to what a skilled admin. at home would do in a couple of hours. Contributing to this are the cultural "tea breaks". 10am is the customary time to have breakfast and tea with your co-workers. Although it's a nice tradition and creates a stronger bond/friendship between co-workers, it would likely be viewed as terribly inefficient in American companies!

Posted in the emergency waiting room of a local hospital. Doesn't matter how many patients are waiting, tea time is policy!
Meals have continued to be a bit of a challenge here as well. I make my own breakfast and there is usually a decent supply of oats, granola, eggs, bread and tea. Lunch is provided at the Center and is usually one of two things every day - chicken in a stew with pap (mashed potato like consistency made of corn meal) or beef in a stew served with pap. And don't forget the salt! Everything is made with a lot of salt (after HIV/AIDS and TB, guess what's the most prominent health issue? High blood pressure! Go figure.) For dinner....that's a little more hit or miss. Most South Africans eat the same as they eat for lunch. However, my project coordinator provides a little more variety for me which includes rice, pasta, beans and spinach. And fried chicken! Lots of friend chicken.  Similar to Ghana and most African countries, the basis of most diets here are carbs, which explains the rather rotund shape of virtually all woman here!  The amount of candy eaten here is incredible too. Everywhere I turn people are consuming "sweets"!

Allison and I with the Center Admin. staff. Notice that they brought a blow-up air mattress rather than blankets to sit on - nice!
Can you say "Bad Girl"?
Before Allison left we were able to enjoy some of the more local festivities. South Africa celebrated Freedom Day on April 27th. The administrative staff at the Center invited us to join them for a brie (BBQ) in a public park on what turned out to be a beautiful, sunny day.

And as you can tell by the picture, I was able to locate some foo-foo beverages to make my day complete (titled "Bad Girl")

We also rented a car and played tourist for a couple of days. We went to a Lion park outside of Johannesburg which, I might argue, was almost as good as the real safari I went on in Tanzania (Serengeti, Taranguire National park etc). I fed the giraffes and ostriches, pet the lion cubs and had some seriously up close encounters with lions. We drove our car through the park and the lions came right up to the car. They put their head at eye level with us in our car - it was scary!



And we also enjoyed a day of zip-lining through a canyon. In a beautiful national park outside of Johannesburg we spent the day hiking and zip-lining and having a blast!

My two months in this area has just about come to an end, however my next South African venture is something that's been on my bucket list for almost 20 years! I'll be heading almost 1000 miles south to spend 2 1/2 weeks in the Cape Town/Eastern Cape region. So many adventures are planned - bunjee jumping, shark cage diving, abseiling/repelling down Table Mountain, crocodile cage diving, sand-dune boarding, wine tasting and more! I'm looking forward to sharing these adventures on, what will be, my final blog before heading back home in mid-June.

I can't wait to see all of you soon!


Saturday, April 30, 2011

Onto South Africa....

African Queen??

And so my South Africa journey has begun! I am almost one month in and have settled in nicely.
I currently live in Clayville and work about 3 miles away in Tembisa, a large township which is halfway between, and about 45 minutes from, Pretoria (the capital) and Johannesburg. I'm staying in a house which is owned by the ABV South Africa Coordinator, however she does not live here. Instead, her cousin Sarah has come from Zimbabwe to act as our "House Mother". Come to find out, Allison, a young American, and I are the first volunteers through the SA program with ABV and although things are generally great, there are some logistical glitches to prove it!  There is also another couple who rents a room in this house who have a 2 year old son, Thalo. Allison and I share a room (although she just left today so I am now alone for my final month) and we share the remainder of the house with the 3 other people. Our house is in a middle class neighborhood with most modern conveniences - indoor plumbing, electricity, TV, etc; however, we are missing most kitchen appliances: no oven, microwave, toaster, washer/dryer or heat. We're going into winter here so heat is becoming a problem - it's become the top item on my list of what I miss most about America! With an average temperature of 115 in Ghana, I couldn't cool down and now I can't warm up! However, no doubt about it, my standard of living here is MUCH more comfortable than when I was in Ghana!
I may in fact come home with this child, - is he not the cutest?!

As for my volunteer work, that is a big improvement as well. I'm at a Children's Center and Hospice. In the morning I work with hospice while I spend afternoons in the Children's Center. Hospice is all out-patient, therefore most mornings I go out with caretakers to visit patients in their home, mostly HIV/AIDS and TB patients; cervical cancer is also very prominent here and by far, the leading cancer among all people. Although the caretakers have received training they are not nurses and regularly I witness them exposing themselves to HIV/AIDS/TB in ways that I can't believe! Is it lack of education/training? Is it the blase' factor that they've been working with this population for so long and have therefore lost their heightened sensitivity? I don't know...probably a combination of both.
Freedom Square, an informal settlement where thousands of people in Tembisa live.
I visit many of our hospice patients in Informal Settlements like these.



Orphanages, in the traditional sense, are few and far between in SA. Instead, they have day-orphanages that function as Child Care Centers, which is where I'm volunteering. Children come to the center during day time hours and then go home, usually to a guardian, at dinner time. There are approximately 40 1-6 year olds who stay all day and approximately 50 6-16 year olds who come after school. Many of the kids at this Center have been affected by HIV/AIDS: 13 of the kids are infected while most of the other's parents have either died from the disease or are too sick to care for their kids full-time. 



Gotta love the alligator outfit!!
 I'm still combating a language barrier, which, again, I did not expect here. Many of the patients we see are very, very poor and much of their living conditions are worse than anything I've ever seen. They have had very little schooling and therefore only speak a small amount of English. The caretakers are pretty good about translating for me but because of the barrier, much of my time is spent observing rather than doing. Likewise at the Children's Center, most of my time is spent with the 1-6 year olds who also speak very little English. Although not being able to effectively communicate with them is frustrating, they need unspoken attention and affection more than anything.

All of the employees at the center are really great! They are welcoming and friendly and have gone out of their way to make me feel at home. They are thrilled to be hosting a white volunteer and have told all of their friends that they have a maloongu (white person) at the center and people drop in just to see us! I'm surprised by this as well because...well...it's South Africa - there's supposed to be lots of white people here. But in this area, there are none to be found anywhere!

Allison and I have been taking some day trips on the weekends and so time has been passing nicely. I will upload some pictures and tell you about those journeys on my next blog.

Until the next time....
Kim


Monday, April 4, 2011

Farewell Ghana....

After  a bit of deliberation, I have decided to leave Ghana early. I feel passionately about contributing to the improvement of something here and I really don't think that's happening. With stars in my eyes, I really had expected to make a difference here, and although I'm sure I've impacted some things, I was really looking for much more. So I will be heading to South Africa later this week where, as originally planned, I will spend 2 months between the kids and in healthcare and then a couple of weeks traveling.

Of course there are many things that make living here difficult: the oppressive heat, the dirt everywhere, the lack of modern conveniences (running water, sinks, toilets, showers, electricity), the general slow pace of life, the discrimination against white people in certain environments, the pollution, the attitude/indifference/lack of care & compassion among health care professionals, the impoverished surroundings, the treatment of the children and the unhealthy food (I don't think I ever covered lunch or dinner, which are pretty much the same: we are always served A LOT of some starch - boiled potatoes, white rice, spaghetti, fried plantains or an African starch - FuFu, Banku, Bola, Kenke; this is usually accompanied by a tomato stew  or a nut based stew where the most prevalent ingredient is palm oil! For dinner we are usually also given a square of chicken on the bone. And by square I mean the chicken was plucked and cleaned and then chopped up, as is, into 2" x 2" squares and fried!).
However, with some time, these have been relatively easy to adapt to and accept. It's been the lack of work ethic, motivation and progress in the work place that has pushed me towards the decision to leave early. As for the pluses, it is the people I will miss the most. Kpando has a very friendly, small village feel that emanates from the people. They are extremely warm and welcoming. Everyday people go out of their way to welcome the yovo (white people), give their greetings and provide help for anything that's needed. But, like every journey, I have had some more memorable and interesting moments that I'd like to share:

 TOP 8 THINGS THAT MADE ME GO "HHHHMMMMM....."
8. At home, it's common to see a dog tied up at a park or outside a store; here, it's common to see a lamb, goat or chicken tied up instead.

7. "Why aren't we giving 10am medicines to the 11 year old hemophiliac boy who has a severe infection from a snake bite and is bleeding from most of his orifices?" I ask. "Because he wasn't in his bed when it was his turn" the nurse tells me. "Hhhmm, he's there now so why don't we go give him his meds" I suggest (mind you all beds are in the same room). "No" she emphatically responds, "He wasn't in his bed when we were there so the afternoon nurses will see him at his next dosing time this afternoon".   (Talk about making me go hmmm...).

6. At home, it is common to see some teens/younger men wearing their jeans below their butt with their boxers showing; here, it is the soccer players who do it most! Men of varying age will be in a rather serious match, playing pretty high level ball and many of them will have their shorts at their hips in the front and literally below their butts in the back.
 
5.At home we have lawn mowers to cut the grass, here boys use machetes to cut the grass.

4. At home, maybe some men will urinate in a somewhat public place in a dire situation, here men will urinate anywhere anytime. In addition, it is almost as acceptable for women to do the same. They do not hide behind a tree or a structure and they do not squat; instead, they pull their long skirts up to their knees, they spread their legs across the gutter and....they pee.

3. In an economy where very few people own a car, how does someone get a live goat home after they've purchased it at the market? Cabs and tro-tros (vans) will not allow them in the vehicle so it's common to see a goat standing upright on the roof of a tro tro with it's feet tied down! It's also common to see a goat strapped to the gas tank area on a motorcycle!

2. Who says I haven't enjoyed any intimacy while I've been in Africa? On several occasions, I've had a goat wander into the outdoor stall while I'm showering.

1. Upon a patient arriving at the hospital emergency room having an asthma attack a nurse asked me "Is asthma an airborne disease?".
_________________________________________________________________________________

This past week another volunteer and I spent 5 days at Cape Coast - a "touristy/beach" area that many westerners visit. 11 hours and 2 buses later we had traveled only approx. 250miles to this beautiful ocean side spot.  We enjoyed some of the history of the area including the slave trade castles, we went hiking in Kakum National Park where we did the famous (at least in Ghana) Canopy Walk, and browsed the busting markets. It was a great ending to my journey in Ghana.

And now my days in Ghana are about over. Thank you to everyone who provided donations to help make life better here for the kids and the patients. I appreciate your support and look forward to sharing South Africa with you soon.

Monday, March 28, 2011

About those changes.....

So, who added Kenney Chesney as one of my Blog Followers?!!  Given how much money I have spent on that man he better be interested in my travels!!   I luv u KC & can't wait 'til August to see u again!  :)

Although the rainy season has arrived a little early, it doesn't do anything to quell the temperatures - our room still holds a steady 87-91 degrees (day and night) and the outdoor temps still average around 118 degrees during the day, although today is 127.5!

In an attempt to alter some of my experiences here, I changed hospitals a couple of weeks ago with the hopes of finding more of what I was looking for: the need and desire for assistance, along with the willingness of the staff to learn and teach. Although I thought I was successful at first, no such luck. I moved to St. Patrick's, a much smaller hospital, more dilapidated, with far fewer resources/supplies, with 28 beds and 4 doctors. There is a general women's/children's ward, a men's ward and a very small maternity ward. There is very little equipment and supplies are extremely limited - while I've been here there have been days where the hospital did not have any gloves or alcohol/swabs (so thank you Dave A. for your donation!). In my western mind that is a huge problem, however they do not seemed bothered by it at all! This hospital is privately owned and compared to the last hospital I volunteered at, it is much more expensive (however still only a fraction of the cost of US health care) for less trained nurses and far fewer resources/supplies. My first day was very hopeful -the doctors' English was pretty good, the nurses were very friendly, there were far fewer nurses and no nursing students. Most of this should have equated to 'yea! Kim will be able to communicate and participate'! However, the patients do not speak much English and therefore the nurses need to be involved in just about everything.  The pace is still incredibly slow and again there is still not enough work for the number of health care workers present. After a few days, the same scenario occurred where much more of my time was spent staring at the walls than doing anything of substance. Even when attempting to create a project or organize something, it was not well received.

However, a work highlight that I have enjoyed is that I've been teaching CPR. Barely anyone here has ever heard of CPR, never mind know how to do it! First, I had to build/make a portable chalk board, which in this environment was a project in itself!  I set up a schedule for all employees of the first hospital I volunteered at, Margret Marquart, which includes about 150people - head of the hospital even wanted administration and maintenance employees to attend. At first I did not have a CPR dummy so I was demonstrating CPR on a pillow! Crazy! Fortunately though, after the first week, the Administrator was able to locate a real, legitimate CPR dummy.  And keep in mind that there are no AED/defibrillators here so it's an interesting concept to teach when the "end goal" isn't even available.  This has been an enjoyable, unexpected twist, but it's a bit impractical here. People do not die from cardiac arrest; they primarily die from auto accidents, malaria and HIV.  The impracticality is evidenced by the fact that none of the nurses/nursing students have ever been trained in CPR!

I've also been volunteering more at the orphanage, Hardthaven Children's Home, in the afternoon. Prior to my arrival, I was told that on my days at the home I would be there 8 hours a day. However, in actuality, volunteers are only allowed at the home between 3 and 5pm! Fortunately I am at the hospital in the morning, but many volunteers have come here just to work at the Home, so this is a huge point of contention for many.   The home could certainly be in much better condition and actually there is another home currently being built (goal is to remove the renting factor to own instead). There are 35 kids who live here ranging from 2-17 along with 4 House Mothers. Fortunately all of the kids really appear happy and healthy. As my Mom says, "you really don't miss what you never had". And even though 6 of the kids have HIV, and many have lost their parents to HIV, there does not seem to be any segregation in the home. I also don't think any of the kids even know that some of the others are sick.   The rooms are small, dark and dingy and numerous children are cramped into bunk beds side by side. The house Mothers sleep on the floor in between the bunks; boys and girls are separated. Very sad to see, but again, they see to accept the conditions without complaint. The Home does not have any running water so the kids walk to the town well every day to fetch water and carry back home on their heads.

The culture here has bred the kids to be very self sufficient - this is at the Home as well as all of the children I've seen/met here. The youngest kids feed themselves, dress themselves, fetch water and participate in household chores. There still is a good amount of time where they get to "be kids", that is, until they reach 10 years old or so. Then much of their free time is spent taking care of the compound (wherever they live), the household chores of cooking, cleaning and laundry as well as taking care of the younger kids. The lack of modern conveniences such as a washing machine, sanitary running water and cooking appliances makes the daily chores take forever! 

Of course the kids are adorable, and yes, there are 3 in particular that I'd like to take home, but this makes watching their traditions all that more difficult. The form of punishment is caining - it is an extremely rare occasion where I've seen an adult speak to a child and have a conversation about the particular behavior in question. Instead, there is yelling and hitting. The biggest problem that I see is that this is a way of life for all here. The adults cain the older kids and the older kids cain the younger kids. It is heartbreaking to see these 12-17 year olds have the responsibility of "disciplining/caining" the younger children. With this involvement the cycle will never end. And I can see it in the younger kids: when they are mad at a fellow child they will yell and instinctively hit them hard, repeatedly.  And unfortunately, I have even seen this among the teen boys and girls.

In addition to my volunteer work, I've also been enjoying some travel lately. Along with some other volunteers, I've enjoyed trips to Tafi Atome Monkey Sanctuary - a bamboo forest where monkeys live in the wild. A guide walks you through and makes "monkey" sounds and voila! they all come running to eat bananas out of your hand! It is seriously cute - while hanging onto the banana, the monkey will peel it and negotiate to get your hand out of the way so that he can take the whole thing out of the peel! (See the pictures that I posted previously.)
We also did a weekend trip to Wlii Falls - one of the more "famous" touristy things to do in Ghana. We were required to hire a guide who led us to the upper falls and then to the lower falls. I generally consider myself to be in decent shape but I swear, I thought this was going to kill me! It only took about an hour and a half  to reach the top but it was one of the most difficult hikes I've ever done! The seriously vertical climb on extremely rough, overgrown terrain was almost more than I could manage!! But it was definitely worth it! Absolutely beautiful with white lilies blooming everywhere around the falls and the basin! The forest was so dense and lush and green - quite a difference from the populated, dirty brown of Kpando proper!  (See the pictures that I posted previously.)

Another weekend trip was to Ho Hoe..not so far away but a popular spot for Westerners to visit for some R&R. A hotel there offers "western" food along with a pool, lounge chairs, a bar and most importantly, indoor plumbing of a toilet and a shower! So we anticipated helping ourselves to some posh relaxation.  Only problem was that there really wasn't any "western" food (mostly more of the same fried African starchy food we get at home), it started to downpour and thunder about an hour after we settled into our lounge chairs at the pool, and although our toilet was fabulous, the shower didn't provide more than a trickle so we still had to resort to a bucket shower... but I guess it was indoors....oh, and we had Air Conditioning!

Tomorrow I am leaving with another volunteer to explore Cape Coast - a beach town area about 8 hours from here, even though it's probably less than 200 miles away. Gotta love dirt, bumpy roads and not so great vehicles! We'll be staying there for 5 days and will be enjoying some beach R&R as well as exploring some of the castles from the slave trade era as well as a national park for some hiking.

Every week I am growing more fond of Ghana and especially it's people. Every day I am still affected by the extreme poverty here and the perseverance of the people. It is so refreshing to see that they are friendlier and potentially happier than many I have seen elsewhere in my travels. Again, perhaps they don't miss what they don't know....

Until the next time,
Kim

Wednesday, March 16, 2011

Time keeps on ticking, ticking, ticking....

Some of you have been e-mailing me asking how I spend my days...well here's the loooooong version of it: Generally life here is very slooooow and very hooooot. I wake around 6:30am and by then the kids have already cleaned our compound (picked up the trash that people drop everywhere, swept every inch of the property focusing mostly on the goat/sheep/chicken feces) and done their laundry (hand washed in a bucket). I have my bucket shower in the outdoor stall (assuming there's water, which there hasn't been for the last 5 days!). We have breakfast delivered in a basket to our outdoor table at 7:30am - every day it is the same: white bread with Lipton tea. I have finally located a stall here who sells "peanut paste" (natural peanut butter) which I add to a banana sold locally as well. Off to the hospital at 8am, which is only  a 5 min. walk - Margret Marquat Catholic Hospital, which is the largest facility within 100 miles or so,  has about 150 beds, 4 doctors and tons of nurses and nursing students. My 1st two weeks were spent in the maternity ward - that was quite an experience! There is a delivery room which has 4 "stretchers" and there are 4 patient rooms, each which have 8 beds. There are no privacy curtains and when the women have to go to the bathroom they usually squat on the floor and use a bucket they brought with them. Unless a woman has a c-section (which is approx. 35% of the births), they are not offered any drugs - all births are 100% el natural!
The morning starts with nurses rounds - we fly through each room with very few words being exchanged with the patients. Although Ghana's national language is English, everyone here speaks Ewe. So it is very difficult to follow any communication because it's mostly in Ewe. The nurses will answer any questions I have in English but it gets rather tiresome to have to ask a million questions to understand what's happening with each patient! Nurses' rounds through 25-30 patients usually takes about 15 minutes. A doctor usually arrives around 8:30 or 9 and then we all do Doctor's rounds. This time each patient is "addressed" by the Doctor however 3 of the 4 doctors are Cuban and their English is...well...let's just say not understandable. So each patient is asked "Are you fine?" and if they do not respond with something convincing then they are often discharged. To watch the attempt of English dialogue between the local nurses and the Cuban doctors, it's a wonder why more patients aren't actually  harmed by the miscommunication! Most of the time I have no idea what they are saying even though it's a mixture of English and body language!

I have now watched/participated in a good amount of deliveries and c-sections. It is so incredibly different than the US. Here, most women are not involved in their healthcare. Procedures are not explained to them and they just do as they're told, often without understanding why. The lack of respect that the women receive during their labor, delivery and very short stay is shocking! It is common for the mid-wives and doctors to yell at the women because because they have not positioned their body appropriately for an exam or during delivery, or because they've groaned during delivery, or because they have items on their bed after they've been admitted. A common procedure here, done almost daily, is an EOU - evacuation of the uterus. This is done when a woman has a miscarriage which results in too much bleeding or, more commonly - almost daily- when a woman tries to self-abort. Women here are able to obtain cytoxin, a prescription used to induce labor at term, without a prescription. So a woman will take this at home, deliver the fetus usually without the placenta which will cause hemorrhaging requiring emergency care. When they arrive at the hospital, it is common that they will not admit that they were pregnant, never mind that they have self-aborted a fetus at home.

Another very different aspect of labor here is that the husbands/fathers are never involved in the delivery. Mother's or Auntie's bring the pregnant woman in but even they are not allowed to stay in the delivery room. Instead the patient is brought to the communal delivery room where she will join everyone else in labor without any privacy - there are no dividing curtains nor any sheets provided and the sarong style dress that most women wear upon arrival is removed as they hit the later stages of labor. They each lie on stretchers/tables that remain flat - no elevation of their back nor anyone or anything to help hold their legs.   Even after birth when the Mother is returned to the Maternity ward patient room (shared by 7 other women, again without any privacy curtains), the husbands do not come to the hospital.

Each woman is responsible for bringing just about everything needed for delivering a baby. In the delivery room they must bring a small plastic sheet, an absorbant square pad and a "sheet" for the delivery table/stretcher (a piece of fabric). Also a smaller sarong of fabric to swath the baby in, as well as another sarong of fabric for the nurse to clean up the baby and the mother following delivery, is also required. They must also bring their own blade for the nurse to shave them (not a razor, but an old fashioned blade), as well as a bucket to urinate in, petroleum jelly to rub all over the baby and more plastic and sarong sheets for the bed that they will transfer to in the maternity ward after delivery. Sanitary napkins are also required....graphic/rated R info here....these are used to stop the bleeding after giving birth or any other situation where a woman may be bleeding vaginally. Those of you who are Mom's or are in the medical field should be feeling appalled right now....they insert the sanitary pad into the vagina, through the cervix and to the uterus to stop any bleeding. They leave this in place and instruct the Mother to remove this pad an hour later when she is back in the communal maternity ward! Can you even imagine!!

After the birth, the baby is immediately taken away from Mom, and is not returned for at least half an hour or so. They wait until the placenta has been delivered and until both Mom and baby have been cleaned up. During that time, Moms rarely ask about the baby - what the sex is, is s/he healthy etc etc?

Another oddity is that most medication needed is the responsibility of the patient. If they require anti-biotics etc the doctor will write an rx and the patient or a family member has to go to the hospital pharmacy to purchase the medication. It seems the only medication that the nurses provide are IV blood, saline or Ringers lactate etc.

This hospital is in much better condition that I anticipated. There may be 8 patients to a room in all wards (surgical, medical, maternity, children's and outpatient) and only 4 doctors for 150 beds and only 1 mercury blood pressure monitor per ward but it has running water, real toilets, normal walls/ceilings/floors, overhead fans for most rooms, A/C in the operating room, latex gloves, 1 x-ray machine, 1 ultrasound machine, 2 ventilators, an oxygen tank in each ward and some rather sophisticated eye exam equipment.  Although many of their techniques are antiquated or unsterile by western standards, I'm still surprised at the relative cleanliness of everything, especially given that everything outside the hospital is layered with dirt and grime.

The biggest challenge that I am having thus far is that I am very much under-utilized and therefore I may, in fact, die from boredom! I work at the hospital from 8-12:30 M-F and usually do not return after lunch because I have spent much of the morning doing nothing. Of course there are births etc but there is so much waiting for.... nothing! I have found that the hospital is really overstaffed! There are only 4 doctors but there are lots of mid-wives and nurses, and at least a gazillion nursing students. So it is actually hard to DO anything when there are so many  healthcare workers present, and this leads to a lot of sitting around. So many of the white volunteers (there are 5 of us in the hospital currently) are resigned to watching rather than actually participating - not exactly what I had in mind for this venture!This has lead to frustration in areas where I had never expected 1) Even though this area is very poor, there really is not a need for more healthcare workers 2) It is very difficult to learn anything because, although the national language is English, everyone actually speaks Ewe and 3) It is very difficult to share anything with the nurses because, for the most part, they do not care about learning or improving. They are not interested in learning how to keep equiptment sterile or how to educate their patients etc etc. So all in all, I am not doing as much as I'd like, I'm not learning as much as I'd like and I'm not sharing as much as I'd like....hhhhhmmmm....what's wrong with this picture??!!  :)

Over the past week, I've taken some steps to hopefully improve my experience here....I'll write more about that the next time.

Miss you all!!

Saturday, February 26, 2011

My first week in Ghana

FYI: My Blackberry phone 781-799-7888 has been suspended/disconnected and I now have a local number here. I can receive texts but currently I can not respond - not sure what the problem is and hope it's figured out soon!
Feel free to call:  233 205 696 770 . Ghana is 5 hours ahead of EST

I've now been in Ghana for one week. In many ways it is as expected and in other ways there are surprises at every corner. I am in Kpando staying in a family compound of a man named Peter, approx 60 yrs old, who owns a plot of land with 8 small, rustic "houses". These are filled with extended family and 2 rooms are for volunteers who are involved with the Hardthaven Orphanage or have come to work at the hospital through a non-profit ( IE me via A Broader View).  Volunteers stay here because Peter's son, Edem, approx 40, is a community activist and in addition to being the founder of the orphanage, he is involved in many charitable efforts here as well.

Given that I am living in a pretty large community of 15k people, the living conditions are worse than I expected. Things look bad mostly because everything is always dirty.Because it is so hot and dry year round, there is no grass and very little flora/fauna so everything is dirt. Since water is scarce it is always dry and the red dirt blows everywhere! Everything I touch is covered with a layer of dirt: the floors, table tops, chairs, shelves, tables, my bed, the sink, my suitcase and me!  Most homes are made of clay and have corrugated tin as roofs. There is trash everywhere and it is the norm to litter. It s actually a difficult challenge to find trash barrels anywhere in public!

I share an "apartment" with a (approx) 23 yr old Canadian woman, Taylor. Our apt. consists of 1 room which opens up to a shared covered porch/deck area. We have 2 beds, a card table, a very small sink attached to the wall (no faucet/water, just the sink fixture), one overhead light and an overhead fan in our room.
A 19 yr old male from RI lives in the "apt" next door, and in town there are 4 other white women from Denmark - that's it for white peeps in all of Kpando!

The area that I live in is a highly populated village maybe 3 or 4 miles miles from the center of Kpando. I live on the main street and therefore there are always lots of people, animals, mopeds, cars, taxis and tro tros everywhere. There are stalls/shacks selling just about everything lining each side of the street. The area is bustling all of the time. Kids and adults stare all of the time nd often yell out yvoo (white person)! 

It is hot all of the time! Days are sunny and usually around 110 or so with a good amount of humidity. My thermometer in our room registers about 90 during the day and drops to a comfortable 87 or so at night!!

As for a bathroom/shower? There is an outhouse about 25yards away in the back of the family compound, which is shared by all. This is probably the part that I dislike the most here. It doesn't exactly have a toilet...it's, more or less, a permanent structure but no actual toilet and therefore hovering is a must!! There is also an outdoor space for a "shower". Again, no running water so this outdoor structure has 4 walls, no roof and no light.So you take your bucket of water to this area and do your best! At certain times during the day, the city turns on the water and those who have tapped into the line (like us) attach a hose and fill two 55 gallon drums. At some point the line goes dry and you need to wait until the city sends more the next day. Our situation is unique, I think perhaps wealthy by Ghana standards, as most families walk a distance to fill containers at the city well. Each night I watch the pilgramage of women and children walking to/from the well with buckets on their heads.

As expected very few people have electricity. Again we are very lucky/fortunate that our compound has some electricity which is used for a little light at night. The internet cafe is not very far away and is very inexpensive, albeit slow! But that is a big win for me and keeps me sane!

Next log in I'll share how I pass my time.....which, needless to say, is sloooooooowly!

Saturday, February 19, 2011

Sayonara Tanzania

After 21 days in Tanzania, Emily and I will be saying our farewells today as I continue onto Ghana and she heads home. All in all, Tanzania was much as I expected. Our game viewing on the safari was awesome!  We met some great people in our group and our guides showed us not only incredible animals but we had some very real experiences with the people of Tanzania. We visited a Masai boma as well as a local primary school, two experiences which were very far outside the realm of our American living. Primitive and poor with minimal resources are daily aspects of their lives. Kids holding out their little hands asking for money is a norm, but what is more heart wrenching is that they appear starved for love and attention. They approach us with more confidence than I expected and are eager to speak English and play with our cameras. Some of the kids slipped notes to us with their address on it hoping for continued communication/money...

Zanzibar has been .....different than I expected. We stayed in Stone Town for 2 nights and wondered around on our own. Tiny passage ways with lots of little stores, create a maize easily getting us lost around every corner. No street signs, but lots of chickens, people, and mopeds occupy these tiny alleys. Although the port town has a good amount of charm, buildings have not been kept up, there is much dirt and garbage everywhere, and people spend their days just hanging out on street corners or on store stairs.

After Stone Town we ventured about an hour north to the Nungwe beach area and this is has been wonderful! Our hotel is modern, with flat screen TV's attached to each bed, mini-fridge in the room, an infiniti pool and even ice! And great Internet access.




Off to Ghana today where life will be much slower and communication more difficult. Hope to be in touch soon - miss you all!

More pics from Tanzania



More Safari in the Serengeti,T aranguire National Park and Ngorogoro Crater



Safari in Serengeti