Tuesday, June 29, 2010

Cocoons, Twi, Cheese

Christina, you were right. The cocoon is fantastic. These sheets smell very interesting and it's nice to have something that forces me to wrap myself up (preventing mosquito bites > being too hot to sleep).

Anyway, I just wanted to say that I uploaded pictures on Facebook yesterday, so you can check those out. I have over 100, but I only had 10 minutes left on my session, so I picked random ones. I had a chance to look at the ones I uploaded, and I think I picked the most boring ones, like pictures of where I'm staying and stuff like that. I'll have to go and label the pictures so they're not AS boring.

I submitted my primary application and now I'm starting to get secondary essay questions. Transcribing these interviews is proving to be a total pain, and it takes really long because I can't always understand what they're saying. I think it's good for me, and I'm getting better!! I definitely need to learn more Twi. The stuff I know so far (thank you, how are you, etc.) comes up in conversation ALL THE TIME and I would definitely feel more included if I could understand just a few more small-talk things. Kids love it when I say 'mente twi' ('I don't speak Twi') and they always babble at me in Twi after I say it.

OK Time to find food. As far as Eva and I can tell, Ghanaians hardly eat. When they do eat, it's 70% carbs, 10% spicy sauce, and 20% protein (chicken). Cheese is expensive here and sometimes a little moldy but I don't care. If I can't have milk, ice cream, or cottage cheese, I deserve some expensive cheddar cheese!!!

Thursday, June 24, 2010

“Are you Ghanaian?” “I am tonight!”

June 23, 2010

The title of this post is referring to tonight’s adventures. Ghana played Germany in the World Cup. Germany is a really great team, and Ghana lost. Shy and Ueli (my British and Swiss friends, respectively) and I went out to get dinner around 8:00. We were out when the game ended, Germany: 1, Ghana: 0. Suddenly the streets erupted in celebration. People were skipping around, dancing, screaming, blowing vuvuzelas, honking horns, leaning out the windows of tro-tros. As we walked back to get our egg sandwiches, we got increasingly more confused, as the celebration seemed to be happening in places that didn’t serve alcohol. We asked some people but either they didn’t understand the question or Ueli didn’t understand the answer. Finally, we realized that although Ghana had lost, so had another team in their bracket, which means that Ghana advances to the next round. This was the first time in my time here that I felt a teeny bit unsafe. The sidewalks were so packed with people, we had to be really careful not to fall into the 12”-wide gutters. We walked in the streets, but had to be acutely aware of all the cars going down the street at 50 mph. People grabbed at my arm and when I turned around, they asked me if I was happy or if I was Ghanaian. Instead of saying, “no, I’m from the United States, but I’m rooting for Ghana,” I soon switched to, “I am tonight!” which seemed to please people. We lost Shy in the obstacle course of people, loud vuvuzelas, little kids, cars, and sewers. We soon found him, but it felt very weird to be with only one other guy. I’m definitely not comfortable walking around alone at night. (Mom, deep breaths! I’m not irresponsible!)

So anyway, that was our night. Not super eventful, but I was exhausted from carrying two 5-liter containers of water for about 1.5 miles in the 100-degree weather around noon. I probably shouldn’t have done it on an empty stomach or in the middle of the day, but I’m starting to feel really awful about all the waste here. A lot of people buy water packets for 20 pesewas ($.14) off the vendors on the street. They’re basically sealed pouches of water. You rip off the corner with your teeth, drink the water, and then throw the plastic wrapping on the ground. (so it can clog up the sewers.) I’ve heard that sometimes those packets aren’t full of the cleanest water so I haven’t tried one yet. I’m not too anxious to try one since it’s just water…

OK. Now it’s 11:55p and I’m wiped out. Shy and the two girls (Norway and Netherlands) went out to the club for a little while, but I had a really hard time getting up this morning and I have to be at work around 8:30 tomorrow. Hopefully it’s my last Kumasi interview!!! So I will have finished my 26 in Kumasi. All I have left is 3 in Tamale and then 54 in Accra and the surrounding areas. Wow. That seems like a lot. I’m not going to think about it!! Goodnight!!

Ghanaian proverb of the day: Knowledge is like a baobab tree; no one can encompass it with their hands.

“I make $500,000 every year. Divide that by 365, then by 24, then by 60. That’s how much I make every minute. You are telling me that you want an hour

June 22, 2010

There are ton of things I still can’t figure out, but I have one that’s weighing a little heavier than the rest. Many of the doctors have been irritated with me for taking up a half hour of their time because there are pregnant women, some of whom are in labor, swarming the clinics and hospitals. That seems totally reasonable to me, especially since most of them didn’t know that they had to participate in an interview until an hour or so before. (Side note: they have secretaries here, but they don’t seem to do the same things as the United States secretaries.) The thing I don’t understand is that they don’t seem to be as excited about medicine and the science behind medicine and invested in patient safety as doctors in the United States. I know that the United States is famous for being lazy, but one of the things that I love about the medical field in the United States is that it does a pretty good job of drawing in the people who are very passionate about medicine. I’ve been discussing the medical admissions process with people from England, Norway, the Netherlands, and Switzerland and they go to medical school when they are 18 or so and then spend 6 or 7 years in medical school. I like the United States system because it allows more time for exposure to the field. When I was 18, I didn’t think that I wanted to be a doctor. It wasn’t until I was 19 that I decided on medicine, and that would have been too late for me in Ghana or any of those countries. So… anyway, it doesn’t seem like these doctors are living, breathing, and sleeping medicine. I guess that’s not good or bad, it just is.

Also, one huge turnoff of practicing medicine in the United States is that there are so many rules. Many doctors are terrified of being sued. Many more are afraid of breaking rules, even if it would be beneficial to the patient. Being in research, I have learned to hate the rulebook. Sitting through 3-hour meetings about how to handle lab rats and use dogs in research (neither of which I do) has driven me crazy, but I have to do it. Here, though, it seems like the system could benefit with some rules. Patient confidentiality: no way. In my interviewing adventures, I have intruded on at least 5 appointments (the doctor who is helping me led the way). These doctors tell me to sit down and wait until they’re done with the case, and then they continue talking to the women about prolapsed uteri or the best contraceptive of choice. Also, all the examining rooms are connected and air conditioned (they are lined up in a hallway that is open to the air), and Sabina (the doctor who is helping me) and I have walked through all of them to get to patients. It’s very bizarre to me, especially since these are all male doctors talking to women about reproductive issues. That is usually almost as confidential as mental health issues.

Another potential confidentiality issue: Forget the computerized medical records movement. The hospital here is using 6” x 9” packets (made out of the same material as blue books) that say “patient record” on them. As far as I can tell, the patient is responsible for bringing their record from the nurse to the doctor. I can’t tell if the patient is allowed to bring the record home with them, but I have seen thousands of patient records lying around, on desks, bookshelves, benches, everywhere.

My personal philosophy about patient confidentiality is that we need to lighten up a little and understand that everyone is human. My (very naïve, I’m sure) belief is that if everyone were able to be open about their diseases or conditions, those things would be less stigmatized. I understand why, in the United States, with media and tabloids and stigmas, medical records must be kept confidential. I guess my complaint about the system at this hospital is that it allows for so much error. Patients can pick up the wrong packet. The packets are hard to identify immediately, making alphabetical filing a nightmare and creating a situation where it is very easy to lose a record. Patients can lose the packet. Patients could alter their medical record, maybe to get drugs or a desired opinion from the doctor. Anyway, I think it is scary that patients have more than read-only access to their medical records.

The title of the post is what one of my earliest interviewees said to me. We later realized that the interviews only take approx. 20-30 minutes, but he kept telling me that he made a ton of money and didn’t have time for me. I thought it was a strange thing to say to a student researcher.

Ghanaian proverb of the day: It is the fool's sheep that break loose twice.

Monday, June 14, 2010

Pictures

Ok so I wanted to upload images. But the connection must be too slow or something. I would have just uploaded Eva's pictures, and she's put some on her blog. SO... here's Eva's blogsite: http://www.evaghanawild.blogspot.com/

xxoo,
Erika

Sunday, June 13, 2010

“Like everyone says, ‘no woman, no cry.’”

Friday, June 11, 2010

These past three days have been really productive. I have interviewed 13 doctors and they have all been very nice and insightful. I have a total of 85 interviews to do, so I only have 72 left!!! Transcribing the interviews is already really hard because the Ghanaian accent is so strong. (Side note: Ghanaian is pronounced “GHA-nee-in” and not “ghah-NAY-in”).

There are a lot of things I can’t figure out, and I have seen a few troubling trends, but I don’t have time to write about them and I don’t want to offend anyone, so those scraps of ideas will be in the next entry and will be edited better. This one will be slightly more upbeat.

Anyway, I am really enjoying a lot of aspects of this country. Everyone says hello or good morning on the street, and I am constantly reminding myself that you can’t start a conversation with, “excuse me, where is the ATM?”… First, you need to say, “good afternoon! How are you?” I imagine that if I were an American businessman, I would be really annoyed that it takes so long to ask for directions or buy bread, but I am not usually running anywhere, and it is nice to have instant friends. There are so few white people in Ghana and Ghanaians waste no time in shouting “obruni” (white person) at you, but they are also very eager to help you and to teach you things about their culture.

I also really like how the birthing process seems more natural here. I’ve never been attracted to water birthing or the “doctors are evil and snatch babies so let’s give birth at home even though my pregnancy is high-risk” theory, so my reaction to this hospital’s practices surprised me. It is very cool to walk through the lying-in ward and see 8 newborns sleeping in a bed with their mothers. No IVs, no monitors, just mother and child (mostly girls, with already-pierced ears). It seems so natural. It is refreshing to see a very human scene in a non-sterile fashion. I know it’s not rainbows and butterflies—the national maternal mortality rate is terrifying and there are women scattered all over the floor of the ward because there aren’t enough beds for all of them. In the past 3 days, I’ve seen about 150 women who look like they are ready to burst. They are lying on the benches, in every chair, on the curb, in cots outside the operating theatre. Yesterday I saw a very pregnant women in a bed by the operating theatre and she was moaning and grabbing the IV pole—clearly in pain. The nurses completely ignored her and kept watching the World Cup channel. I don’t think it was out of cold-heartedness—I think that’s just how things are. You fight through the pain. The nurses don’t stoop to the level of pain. Women have been giving birth way before C-sections and epidurals and episiotomies. I guess they can handle it? It was a little unnerving though.

Right now I’m living with Eva, a rising UofM M2, in the Kumasi Catering RestHouse. She’s one of the most enthusiastic, optimistic, and appreciative people I have ever met. She is doing facility assessments of 8 rural district clinics; 4 that have obstetricians and 4 that don’t, so she will be traveling all over. (I don’t envy her for that…) This Wednesday, she’ll be moving to the Agroyesum clinic, a Catholic district hospital. I’m not sure where I’m going to live when she moves—the doubles are 75 GhC (Ghana Cedis – pronounced ‘seedies’), which is about $60. My budget allows for $25 a night, but I have no idea how long I need to be in Kumasi. I need to do 31 interviews in Kumasi and 54 interviews in Accra, so I’ll probably need more time in Accra. The rooms are $8/night at the hostel in Accra, so it should even out. Anyway, the head of Ob/Gyn at the Kumasi hospital is really adamant about getting Eva and me to move to the medical student hostel but I’m not sure whether that is on the KNUST (Kwame Nkrumah University of Science and Technology) campus or at KATH (Komfo-Anokye Teaching Hospital). Right now I can walk to the hospital which is where all my interviews are, so it is really convenient. Both hostels are in Kumasi but I definitely don’t want to move to the University campus because I’d have to take a cab every morning, and I’m not really sure how to do that! Anyway, I have 13 of the 31 interviews completed, so maybe I’ll be done by next week and then can move to Accra. Who knows. Probably not. Ghana time is KILLER. I watched the opening ceremonies and half of the first game of the World Cup today in the Ob/Gyn office, only to be told an hour later that there were no more interviews today. I went home and took a much-needed nap (yes, Rachel, I was very grumpy afterwards).

I’m really glad I listened to the first Twi cd before I came. They definitely speak Twi here, but it seems to be a mixture of Twi and English (pronounced Chreeee and Bruofu, respectively). Eva and I met a guy selling acrylic paintings on canvases and he has tried to teach us how to speak a little Twi. So far, no marriage proposals like we expected (white people apparently tend to flatter themselves), but he did mention that there was ‘chemistry’ and if he came to the United States, he would be able to identify me immediately. Yea RIGHT! He showed us where to buy fruit, and at least by Ghana standards, he hasn’t been too hell-bent on making us buy any of his paintings. (So far, I like his paintings the best, and I’ll probably end up getting one. Some of his are really gorgeous.)

The title of the post, “Like everyone says, ‘no woman, no cry’” was said by one of the street vendors. He sells paintings. Apparently he also teaches painting at the orphanage and he went to the University of Ghana for a few years to study art, but Eva noticed that the paintings were all signed, “Frank” and he told us that his name was something like, “Akimbwafa” or something like that. He caught us as we were leaving Vic Baboo’s Café, which is a pretty safe bet for travelers. We saw a TON of obrunis there—4 white people! Anyway, this guy sets up shop right outside of Vic’s and gets the obruni crowd. After he showed us all of his work (despite our saying over and over that we weren’t looking to buy anything tonight), he launched into this Eminem and Bob Marley quoting rant about how we are all connected and we all love each other and we’re one spirit. Then he told us he was going to give us a surprise and give us 42% off the paintings. “We’re really not looking to buy anything” didn’t do anything—he started saying, “no, that’s okay. I just wanted to show you so if you respect my culture (‘cultaaaaaah’), you would show me and buy one” etc. He was very nice and taught us some Twi and said he would teach us how to drum. Apparently it’s a pretty hopping street on Saturday nights.

I have tons more to write, but a combination of NO INTERNET ACCESS ANYWHERE (AHHHHHH) and sleepiness is persuading me to stop rambling. Oh, and COMMENT!!! Even if you just say hi, it makes me feel like someone is actually reading this blog!!

Ghanaian proverb of the day: Rain wets a leopard’s skin, but it does not wash out the spots.

Tuesday, June 8, 2010

I like your movement.

Monday, June 7, 2010
Last night was probably one of the top ten sleeps I’ve ever had. I went to bed at 8:00p (that’s 4:00p Ann Arbor time!!) and woke up briefly at 1:00a to heavy rain. Fast-forward to 7:30a when I wake up (feeling awesome). Shower. Brushing teeth is going to take some getting used to… Because you can’t drink the water, you have to rinse with bottled water and juggle stuff to make sure it doesn’t get wet. I had to do this in Peru, but I think my limited experience with sterility in the lab and hospital has made me paranoid.

Right now we’re waiting for Kofi to come. We think he said that he has a meeting here at 8:30, but he wasn’t clear whether the meeting was with hospital people or with us, or both, or neither. Deep breaths, no biggie. I’ll just keep writing.

I promise that this blog will not be so surface-level and detailed in the future. Right now I’m writing it so I can keep track of the date and all that stuff. Since I’ve been in the room for most of the time I’ve been in Accra, there aren’t any huge culture-shocks or ridiculous things on the street to report. I will need to work on my personal statement tonight but for now I just want to stay organized and not freak out about medical school. Depending on the speed of the internet connection, I’ll probably be able to post a picture or two for each entry. I don’t think internet cafes are wireless, so it will probably be a hassle to put pictures and stuff up, but I’ll try.

The title of this post, “I like your movement” was something that a guy said to Eva and me as we were exploring around the hostel. We appreciated the directness, thanked him, and kept walking.

Ghanaian proverb of the day: You must act as if it is impossible to fail.

Akwaaba!

Sunday, June 6, 2010

Akwaaba to my blog!! I think the easiest way for this blog to stay organized is for me to write in either bullet points or chronological order. We’ll start with the chronology of the last 20 hours.

Saturday:
3:30p—my bags were PACKED in the car. An hour early.
4:30p—we pick up Eva and drive to the airport.
7:30p—I get on the plane to Atlanta.
11:30p—I get on the plane to Accra.
… fast-forward 11 hours. Not the best night’s sleep ever, but it’s fine. Side note: I think I might have airplane-induced RLS,
Sunday:
2:30p—(now we’re on Ghana time. 4 hours later than Michigan time.) We land. Get through “customs” and grab our bags. Kofi and Dr. Anderson were waiting for us at the airport. About 15 Ghanaian guys try to help Eva and me with our bags, even though we have Kofi who knows what he’s doing. We pay them, drive to an air-conditioned restaurant, drink some bottled water and establish an action plan for the next few days.
4:00p—We check into the international student hostel. It’s near the Teaching Hospital, which is where I’ll be doing stuff in July. Kofi introduced us to Ella, another UofM student who has already been here for 4 weeks. It was so great to see someone with a shirt that said “Michigan Volleyball” on it. It turns out that she went to Greenhills and knows Hannah. What a small world. When Eva wakes up from her nap, Ella, a grad student at Brown, Eva, and I will walk over to His Place, a restaurant down the street.

Anyway, we’re only here one night. Tomorrow we’ll fly to Kumasi and meet Dr. Anderson there, where he’ll introduce us to the hospital directors in Kumasi and then take us around to the clinics that Eva will be evaluating. That will probably be helpful because I think I’ll be traveling to those clinics at some point to interview the Ob/Gyns who work there.

Now on to scattered bullet-pointed thoughts:
• I like Accra. It reminds me of Lima, Peru in that it is dusty and filled with pollution from the cars, but there’s something about the city that makes me feel a little more optimistic. There are kids washing cars and selling things at every stoplight, just like in Lima, but they don’t seem as desperate. Maybe it’s because these kids speak English, and I’m sure I’ll see much more poverty in other places, but this place seems like it’s developing, not like it has tried to develop and then has been squashed down and stunted.
• I just took a shower. I didn’t have to sponge-bath or anything—there was a rusted handle and a shower spout. The water smelled vaguely of pond-water, but I was just happy to get all the sweat and airplane off of me. I’m not picky—as long as I can rinse my hair, I’m good. It is going to be so hard for me to remember not to open my mouth in the shower.
• Speaking of drinking shower water, I am PARCHED. I still haven’t taken my morning malaria pill and it’s almost 6:00p here. I hope Eva wakes up soon so we can go grab dinner and water.
• Mom, my cell phone number is: 011-233-24-707-7555. Right now I have like 2 minutes, but I’m going to buy some more ASAP. Kofi had phones ready for Eva and me—we’re using phones that previous UofM students have used. What a relief that we didn’t have to go get phones. I was worried about that.

In conclusion… nothing spectacular has happened, which is GREAT. No lost bags, no faulty visas, no plane crashes. I’ll take it. I’m excited about this summer. I’m glad that we have the night in Accra because I don’t feel like I have to explore and memorize street names and buy groceries and make phone calls and check my email and put my clothes in drawers and get my stuff organized. We’ll save that for tomorrow night.

Ghanaian proverb of the day: A child who asks questions does not become a fool.