30 July - 4 August - The Final Stretch!

This will probably be my last post from Ghana! I leave on Thursday for the U.S.A.!

This past week has been full of last minute analysis, presentation preparation, and report writing. I finally got word from the man who was supposed to help me get data. Although the information he provided was not exactly as complete as I would have liked, I appreciated the fact that he finally go back to me!

After an underwhelming response from this guy, I was worried I didn't have enough/correct data to complete my project. I had a momentary freak-out, during which I felt guilty/frustrated/upset...just in general felt like a failure. I couldn't believe I had been in Ghana for so long and would have nothing to show for it. I knew I was the only one to blame, for not being assertive or proactive or smart enough to figure everything out. I allowed myself to wallow in this state for about 2 minutes, then bucked up, sat down and looked at the data that I had and realized I was much closer than I originally realized. By the end of the next work day, after several hours of reviewing reports and papers, I had all the information I needed to at least complete a model for presentation here.

Hours and hours, days and days later (including my first and only weekend that included doing work), I have run my model nearly complete. I have a presentation. I have a (nearly finished) report. Is everything perfect? Nope. But I have a couple more days to review and edit my work and get it as close to perfect as I can. Worst case scenario, I leave Ghana with a few loose ends, go home, and wraps up those loose ends to make an amazing finished product!

23-29 July - Roadblock

It was bound to happen sometime, and I have finally encountered some challenges with my study. I'm almost relieved because everything felt just too easy and I was beginning to feel that I must be doing something wrong.

I am struggling to get a few values I need for my model (transmission rates, costs of treatment, etc.). These mysterious values are proving elusive. After not being able to obtain them from records at the hospitals, I visited the Ghana Health Service office to try their resources. They redirected me to the National AIDS Control Programme headquarters in Accra, whose office I have emailed and my advisor has made several calls, but to no avail.

Nevertheless, I'm not too worried. I will persist a little longer and resort to my multitude of back-up plans if necessary.

I am a huge fan of the Olympics was very grateful to be able to watch the opening ceremonies on Friday night. Ghana is broadcasting the Olympics on GTV. GTV experienced a brief power outage during the opening ceremonies, and subsequently broadcast most of the ceremony's remainder in only green and red, but it was still good to watch! GTV also advertises that they have "full coverage of all of the Olympic events, every detail, LIVE from London"....which is very far from the truth. They show the Olympics for only about 4 hours each day and only show soccer, boxing, and basketball. My original plan for the weekend of sitting in my hotel room, eyes glued to a TV set was not able to happen.

16-22 July - Data Analysis; Reading in Ghana

This week marked the initiation of data analysis. Not surprisingly, data analysis is one of my favorite things. I just love working with numbers, figuring out problems, and interpreting SAS output. Nevertheless....data analysis is not exciting. Nor is it interesting, at least for now. I've determined a few statistically significant relationships, but nothing too groundbreaking...except, however, that a low CD4 count is apparently related to a higher birth rate. Hmm. We'll see.

One huge perk of data analysis is that I get to work from Dr. Agyarko-Poku's office at the foundation of the Asante King (Otumfuo Osei Tutu II). This comes with working at a desk, in air-conditioning (compared to working at the very edge of a desk in a crowded, poorly-ventilated hospital records office). I must say, analysis is much easier when I don't have to worry about sweat dripping on my computer.

View from the foundation office

Life in Ghana has become incredibly solitary. All of the other international volunteers that I knew in the area have left.  Ghanaians seem to enjoy socializing at three points: at work, at funerals/weddings (Saturdays & Sundays), and at church. "Hanging out" on a weeknight really doesn't happen. I was supposed to attend a funeral yesterday, but the driver never came to pick me up. Thus, I am often left to my own devices. One can only watch so many movies in a day and I have spent increasingly significant amounts of time reading. Since arriving in Ghana a little over 10 weeks ago, I have (nearly) finished 6 books:

-In Defense of Food (Michael Pollan) - Fully recommend! This "eater's manifesto" explores exactly why the foods we eat are so unhealthy, from portion size to types of food eaten to food processing. A really enjoyable read, and one that has actually changed how I eat (or...will change how I eat once I get back to the US...not a ton of control over meals here).

-How We Decide (Jonah Lehrer) - Very fascinating book about how humans make decisions, including how we sometimes make poor decisions because we are too informed and how past experiences help make us better decision makers.

-The Man Who Ate Everything (Jeffrey Steingarten) - Pretty decent book from Vogue's food critic. The book starts out very strongly, with Steingarten's experience overcoming dislike of several foods including kimchi and anchovies. The remainder of the book is filled with short stories that describe Steingarten's experiences exploring the world of food...but they become increasingly dense and stiff.

-Shakespeare's Kitchen (Lore Segal) - Described as a "loosely connected collection of short stories" on Amazon, this book feels more like a novel that takes place over a long period of time, with chunks missing in between chapters. Shakespeare's Kitchen revolves around a young woman who has immigrated to the US from Austria as she struggles to make connections while working for a literary think tank. Not that great.

-My Father's Tears (John Updike) - Beautiful portrait of America, presented in (actual) short stories. I really enjoyed Updike's writing - challenging enough, but not inaccessible. I particularly enjoyed his story about 9/11 told from four points of view.

-Inside the Outbreaks (Mark Pendergrast) - Finally, I decide to read a public health book while at my Master of Public Health internship! This book tells of many adventures of the CDC's elite task force, the Epidemic Intelligence Service (EIS). Told through many (many) short recollections of outbreaks and investigations, Pendergrast diligently covers the history of the EIS. It's a little hard to read, given each recollection is a ~5 paragraph case study.


Still on my list for the summer:

-My Own Country - A Doctor's Story, Abraham Verghese

-The American Plague - The Untold Story of Yellow Fever, The Epidemic that Shaped Our History, Molly Caldwell Crosby

-In the Garden of Beasts, Erik Larson

9-15 July - Ghana: For Better or Worse

Big research new of the week: chart review is finished! After several weeks, I'm finally done scouring charts for hours on end each weekday. Moreover, the data from all 818 charts has been entered into Excel. Whew. A little more data collection at the Ghana Health Service Regional Offices, then time to get down to analyzing!

My final 50 charts at Kumasi South Hospital.

This weekend, my friend and classmate, Jen, visited from her internship in Kasoa. We had a great time exploring Kumasi's Kejetia Market and the National Cultural Center. We also attempted to visit the Okomfo Anokye Sword at the Komfo Anokye Hospital, but viewing was closed. Oh well.

Jen loves Ghana and plans to find a job and move here after finished her MPH at Yale next May. I, on the other hand, do not love Ghana. I definitely like it and have enjoyed (and will continue to enjoy) being here this summer, but have failed to be wholly enamored with the country. Although I do my best to appreciate all that Ghana has to offer, I really dislike some things about Ghana. Here are some of them:

I dislike...
-Trash everywhere
-Cab drivers who tell me they know where my destination is, drive for 10 minutes, then ask me if I know where they should be going
-That no one can understand me, despite English being the official language; not ever knowing what people are saying around me
-Dirt & dust everywhere
-Total lack of variety in food
-Automatically having attention drawn to me because I am so clearly out of place

Of course, I also like many things about Ghana.

I like...
-General lack of stress
-How incredibly safe I feel
-How helpful and friendly everyone is
-Bargaining for souvenirs (I really love it)
-The general motivation of Ghanaians to want better things for their country, despite not always knowing how best to achieve those things
-Riding in cars here....it's oddly soothing, considering the condition of the roads/driving style

2-8 July

Research continues to progress consistently and although I enjoy it, the work is rather dull to discuss.

My work-week was pleasantly disrupted by a few afternoons spent at Kwame Nkrumah University of Science & Technology (KNUST), where I sat in on a few classes with their MPH students. To be honest, I was not looking forward to these classes. I had many negative expectations…the lectures would be too advanced or too basic, the English that lectures are supposed to be taught would evolve quickly into Twi, the lectures would be flat-out boring, the room would be uncomfortable, etc. However, my fears were for naught; the classes were extremely enjoyable.

The classes covered HIV transmission, surveillance, and therapy guidelines and were taught by my advisor, Dr. Agyarko-Poku, as well as the Dean of KNUST’s medical school, endearingly called “Prof” by students and fellow faculty members alike. The students in the class were older than the YSPH cohort and were all very engaged in the class discussions. I found it fascinating that the classes seemed to explicitly focus on public health “in developing countries.” Although this makes practical sense, it was just odd to hear all these Ghanaians saying things like “because we’re a developing country, we must create this type of surveillance program.” It also hit me in the middle of a class that the students must have a totally different out-of-classroom experience than students in the Western world…course material is not available online, papers are all written by hand, yet all over the world, other students like me do almost all of our out-of-classroom learning sitting in front of a computer. I learned quite a bit from the classes and plan to incorporate a few aspects of the therapy discussion into my research.

This weekend was my first full weekend not leaving the city! It’s odd to think I’ve been here for a month, but haven’t really gotten to know Kumasi that well. I spent Thursday, Friday, and Saturday nights with Unite For Sight volunteers now stationed in Kumasi – Abbie, Nick, and David. I had volunteered with Abbie during her first/my last week in Accra, but met Nick and David here. We got some really filling Indian food on Thursday, and then went to a few bars on Friday and Saturday night. On Saturday I also attended my first Ghanaian wedding! Similar to my church service experiences, it was interesting, but not overwhelmingly culturally different. The wedding service took place in a church and was almost exactly the same as an American service except it lasted about 2 and a half hours (in typical Ghanaian fashion). A fair amount of time was spent “blessing the couple”, which reminded me more of an exorcism than a blessing…lots of ministers shouting while they stood around the couple. The reception was almost exactly like an American reception, although I don’t have much to compare as I left the reception pretty early in search of a cab to take me home for a surprisingly necessary nap.

Experiencing a Ghanaian wedding really makes me notice Ghanaian culture, especially of those living in big cities like Accra or Kumasi. Ghana has such an interesting patchwork culture, with different traditions and customs coming from the various native ethnic groups, as well as the many European visitors/colonists over its existence. Yet, Ghana has only independence for 55 years. It feels as though Ghana is in its awkward teenage years of cultural development. The country wants so badly to be one of the cool, popular “developed countries” that it is willing to sacrifice its rich background to assimilate. This is exemplified in events like weddings, where tradition has been taken over by tacky Western decorations and music once filled with heritage is replaced by blaring Christian soft rock. Fufu, a totally appealing (to Ghanaians…not me) and critical Ghanaian dish that requires someone, usually a woman, to pound the dough with a large stick, is now mass-produced and sold in boxes, completely consumer-izing one of Ghana’s few traditional foods. These are formative years...will Ghana be able to hold onto and embrace its fascinating culture…or will it get sucked into the Western world with little to show for the many challenging years its citizens endured to gain independence?

With my co-worker, Helena, at the wedding reception

26 June-2 July - Data Collection + Republic Day Weekend

There isn't much to report from this past week...basically just me in hospital records offices, going through charts.

The weekend was very fun! It was Ghana's Republic Day on Sunday, so everyone had work off on Monday. I used the long weekend to visit my friend Jen, a fellow YSPH student in Kasoa. Jen is working with the Cheerful Hearts Foundation. I stayed at her house, which she usually shares with several other volunteers who were out of town over the weekend. It was really neat to see how experiences in Ghana compare. Living in a house with Ghanaian hosts, Jen definitely gets a better understanding of "living in Ghana", compared to my life in a hotel, which is much more of a "life in Ghana for foreigners who are only here temporarily." 

The trip to Kasoa is not incredibly hard, but it is very long. I left the hotel at 6:45 on Saturday morning and didn't arrive at Jen's place until about 6 PM that night (partially due to many detours taken on the road because of accidents). Sunday morning brought a real treat, as Jen made pancakes for me, her, and her hosts. Yum.

We walked around Kasoa briefly on Sunday, then went to Big Milly's beach resort to relax and spent a night hearing the waves crash against the shore. There were so many obronis at the resort!

I spent a fair amount of Monday traveling back to Kumasi, but was able to arrive to the hotel around 3 PM and get ready for a shortened work week!

22-26 June - Weekend in Michigan + recovery day

This weekend involved several things that my weekends this summer have yet to include: more hours traveling than not traveling, being in a room with people that I have known for longer than a month, and not having to worry about a bathroom lacking toilet paper.

I began my departure from Kumasi to Marysville early Friday morning. 6 hours of bus rides, 3 hours of catching up with Unite For Sight volunteers, 13 hours on a plane, 3 hours of taxi/car rides, and several stretches of waiting later, I was finally home for a glorious 34 hours in the States (about 28 hours of which were in Marysville/Port Huron).  The wedding was amazing, but I realized afterward just how tired I was throughout the ceremony and reception. I was cruising on autopilot for most of the event. My apologies to anyone reading this with whom I conversed, especially those who endured a conversation of nothing but me talking about Ghana. Aside from being extremely tired, I also was totally not adjusted to socializing with so many native English speakers. This was especially apparent when anyone asked me, "How are you?" My response was always "I am fine, thank you. How are you?"...because that is the most well understood response in Ghana. As my good friend and YSPH classmate, Raj, accurately predicted during a Skype conversation just prior to me leaving, it just felt like a dream, and now I've woken up, back in Kumasi.

Congratulations, Kathryn & John!

I still can't tell how I feel about including this visit home in my "Ghana experience." I am obviously happy I was able to make it home for the wedding, but going home feels like cheating. I had laundry done in a washing machine and dryer, I bought a ton of granola bars, I dropped off a load of souvenirs that I've already purchased. Most people working abroad for long periods of time don't get to go home, and being here only 3 months with a break included just feels weird. I also got really upset about returning to Ghana when I was back at the airport on Sunday night. I was trying to figure out a way to a) have an excuse to stay in the US, b) have a way to tell everyone involved in my project that I was going to stay, and c) get the things I had left there back home. This was all in vain, as I boarded the plane anyway and did a reverse trip back to Kumasi, arriving very late on the 25th (note: the bus route between Accra & Kumasi has uncomfortably cold air conditioning...definitely wearing pants and a jacket next time!). Once I got back to the hotel and got unpacked, all the frustration/anger/generally negative feelings I had about returning were virtually gone. Maybe it was the after-effects of the sleeping pill leaving me in euphoria, maybe I realized I didn't really have much of a choice,...but probably I remembered that I actually do enjoy living here. I can't imagine permanently moving to Ghana, or any other developing country, but there are far worse things than living here for another 6 weeks! In any case, I won't let a dumb thing like a bad attitude ruin such an incredible opportunity. Cheers, Ghana, let's have an amazing time together.

Side note: My brother, sister, and I must have the most understanding and supportive parents in the entire world. Not only did my parents pay for my trip home, they also managed to say hello and goodbye to all of their children within a few days. All three of us left on Sunday...Chris back to DC, me back to Ghana, and Kathryn off to Jamaica for her honeymoon with John. Thanks Mom & Dad! 

18-21 June - Data collection begins

From this point onward, my weeks will likely be much less exciting - all the more excuse to have crazy adventures on the weekend. This weekend will be one of the most intense as I make a whirlwind trip back to the States for my sister's wedding. I leave early Friday morning to take a bus to Kumasi, spend the night on a plane back the U.S. and arrive in Michigan on Saturday morning. I'll make the opposite trip Sunday night to Monday night of next week. Crossing my fingers for minimal jet-lag!

Data collection for my project has two main aspects: chart review and gathering of administrative data. The next few weeks I'll be reviewing charts of HIV-positive women and recording data that is relevant to my project, including when they have children, how many children they have, and what kind of co-morbidity (aside from HIV/AIDS) they experience. I've spent three days this week at Suntreso Government Hospital and one at Kumasi South Hospital. The staff at each facility has been so helpful and friendly! Needless to say, reviewing 50-100 medical charts each day is not too exciting, but I haven't gotten too burned out yet.

One odd thing I've realized since moving to Kumasi is just how much I enjoy driving in Ghana. By "driving", I actually mean "riding in vehicles while other people drive me around." Long drives feel just as pleasant as short ones and the roads that seem to have more potholes than smooth surfaces don't even detract from the experience. During Unite For Sight volunteering, I had long drives each day and now I really miss them with only a 20 minute commute to work. All the more reason to look forward to a bus ride to Accra tomorrow!

16-17 June - Drobo/Kumasi

Saturday brought with it my second Ghanaian funeral in 2 days. I woke up very early (4 AM) to travel with Dr. Thomas and his wife, Linda, to the funeral in Drobo. Drobo is a moderately sized city in the Brong Ahafo region of Ghana and is a 3-hour drive northwest of Kumasi (nearly to Cote d'Ivoire). I slept pretty much the whole ride there.

The funeral was for Sir Knight Timothy "T.K." Obeng ("Sir Knight" because of his role in the Knights of Marshall, which I've come to understand is very similar to the Knights of Columbus). I wish I had more to report about the funeral itself, unfortunately there isn't much to report. It didn't exactly live up to my expectations of the widely acclaimed Ghanaian "celebrations of life." The day basically went like this:

Funeral procession

5:30-8:30 AM - Meet the family, see the deceased (we arrived right around 8:30)
8:30-9:00 AM - March to the funeral grounds
9:00-11:30 AM - Funeral Mass
11:30 AM - 12:00 PM - March to the burial grounds
12:00-1:00 PM - Burial
1:00-1:30 PM - Move back to the family's house for a reception
1:30-3:00 PM - Lunch reception
3:00-3:30 PM - Move back to the funeral grounds
3:30-6:00 PM - Formally greet the family and offer a donation

Walking into the burial ground

Basically, a lot of sitting, interspersed with moving in circles. Perhaps the most (only?) interesting part of the day was the burial. Ghanaian burials, especially traditional ones, take place in small plots of forest that have been cleared for graves. It's sort of like a cemetery...but they clear the space as its needed and there aren't really graves. During the burial, women would get hysterical with tears and begin shouting very loudly, but at unpredictable intervals throughout the burial.

Funeral grounds

On the other hand, Sunday was perhaps one of my favorite days in Ghana. I woke up whenever I felt like it (so, 7:30 AM) and got breakfast. I spent the morning doing laundry, lounging in my bed, finishing Lost in Translation, Skyping/chatting with friends around the world - from Germany to Berkeley, CA to Malaysia. After several hours of the most glorious nothingness, I decided to leave my bed and finally see Kumasi. I took a tro-tro taxi into Adum, the city center, and walked to Kejetia market. Kejetia market is pretty huge, but unlike the markets in Accra, it's much more spread out and the people are much friendlier. I got two pirated DVDs - both first seasons of Prison Break and 24 (Lost won't last forever!), each for about $1.10 USD. I later was excited to find out that they both work!

Cultural Centre in Kumasi

I decided to walk to the Cultural Centre from the market and was extremely proud that I was able to find the market on my own with just an extremely outdated guidebook getting me in a general direction. Kumasi's Cultural Centre is also way different than the one in Accra. It was a beautiful space and actually had cultural things, including a library and a museum. I paid 4 cedi (~2.20 USD) for a private guided tour of the museum, which was such a steal! The tour was great and I learned a ton about the history of the Asante people, especially about past kings. The Asante were one of the original peoples in present-day Ghana. They fought with the British prior to decolonization. The whole system is really interesting, especially the part about stools, that is too detailed to discuss here. I also learned that my Twi name, Yaw (because I was born on a Thursday), means that I will "go far".

The day ended pleasantly with a trip to Moti Mahal for one of the most satisfying meals of my life with Ashley. It was great to have a superb meal, complete with hot towels, while discussing Ann Arbor, Michigan, and the tuba section!

I'm staying up way too late to post this, but I am extremely excited to start data collection on my project tomorrow!

15 June - Looking back, looking forward

This is a good “evaluation” point for my time here. I’ve begun my internship, but am not totally engulfed in it yet and I still have plenty of time to make this experience as great as it can be. So I would like to outline a few things I’ve learned and what I hope to get out of the rest of the summer. But first, a some general observations about life in Ghana that I find interesting.


General Ghana Observations
1. Ghanaians are generally very religious, but they don’t shove religion down my throat. I have attended 2 Catholic masses and really enjoyed them. Church services here are much longer – about 2-3 hours. Further, they love naming stores with religious, but unrelated, titles. My favorites have been:
• God is One Benz Fitting Shop
• Precious Jesus Construction
• Lord of Light Bakery
• And… (drum roll) – God is King Razor Wire Fencing
2. Nearly every other building is a salon/barbershop. Almost every barbershop uses a picture of Ludacris on their sign. If he only knew….
3. Phone call etiquette is extremely different than in the U.S. People answer their cell phones in the middle of presentations (including if they are giving the presentation), doctors answer calls while seeing patients…it’s definitely different. People also just call each other to see how their friends are doing.
4. The language “issue” in Ghana is interesting. English is the official language, but relatively few people speak English well. Even the very educated people, like those I work with at the clinic, don’t really have that great of English. There are hundreds of local languages, but Twi is probably the most popular, especially in Kumasi. Ghanaians also have really fun English phrases that they love to use. Some examples are:
• “I am coming.” – meaning: Just a minute.
• “You are invited” (used while eating) – meaning: please take some of my food

What I’ve learned so far in Ghana

1. By far the most important thing I’ve discovered thus far is how important people are in making experiences worthwhile and enjoyable. One huge thing I was hoping to learn from volunteering with Unite For Sight is more about whether I wanted to pursue further education in optometry or engineering. In actually I wanted to learn if I should take a more clinical route or a research-based path? Although the work with Unite For Sight was based around eye care, it wasn’t the type of work I was doing that has helped steer me more toward optometry, but rather just how much I have discovered I love working with people.

2. Ghanaians are so helpful. They will drop everything to help out a friend. The best examples I have of this are:

• I was walking through Accra with a small group of other volunteers and we were looking for this specific Indian restaurant. We passed a store and asked where to find the restaurant. The cashier got up, as he was handing the customer his change, and walked us a block toward the restaurant, with the customer’s change in hand, before returning to his store to complete the transaction.

• A young boy found a man who was nearly blind about 5 miles from an outreach. He walked the whole distance to the outreach with the man, then paid for the man’s cab fare back to where they met.

3. Ghana is in good shape. People are generally getting some form of health care, food and water are pretty available, and the country is politically stable and safe. I’m impressed.

Goals and Expectations for the next 2 months

1. Ghana is in good shape….relatively. There’s obviously a ton of work that needs to be done here, primarily infrastructural. Nevertheless, I want to stop using Ghana seeming to be doing pretty well as an excuse for how I sometimes approach interactions. For example, the other day I bought buckets to use for laundry and got charged 6 cedi each (about $3.50). I felt like the guy was ripping me off and I argued with him about the price for a short time, trying to get the price down to 4 each. He stayed fast at 6, and I walked away angry with two buckets. Who was this guy, trying to charge me 6 cedi? Hadn’t he made enough money that day? I later reminded myself that I was arguing with him about the difference of about $2. Was that $2 really that big of a deal to me? Probably not. Was that extra 4 cedi a big deal to him? It’s likely…that 4 cedi could probably buy dinner for his whole family.

From now on, I want to remember that nearly everyone I meet here is not living comfortably in an air-conditioned room with wi-fi. They may be happy, but they are still working hard to earn a living and they deserve my understanding and respect.

2. The initial excitement of Ghana has definitely worn off and life has become somewhat routine. Although I am okay with consistency and uniformity, I don’t want to get so into a routine that I lose the appreciation of the opportunity I have to learn and work here.

3. I will only allow myself to use the hotel’s Internet for 1 hour per night, with the exception of needing it for work or for Skyping.

4. On a similar note, I will not become a hermit in my hotel room every night. At the very least, I will walk around and discover new places and meet new people.

5. I will leave a positive impression on everyone with whom I interact. I want everyone I meet to think to themselves after talking to me, “I valued that interaction and I have a deepened respect for the institutions, organizations, and country that Adam represents.” I owe this much to those who I am representing.

11-15 June - First week of Internship

Back in October, I informed Dr. Elisa Long and Dr. Elijah Paintsil that I was committed to a research project in Ghana regarding the cost-effectiveness of different therapy schedules for HIV-positive pregnant women. Soon thereafter, I also agreed to become a Unite For Sight volunteer, but the aforementioned research project that would eventually become my MPH internship has always been the core of how I would spend this summer. Getting to this week has been an extremely long process. In November, I began the arduous process of applying for the Wilbur G. Downs International Health Fellowship. After countless proposal revisions, a tense interview, and more complaining than my friends should have tolerated, I eventually received word that I was granted the fellowship. The fun didn’t end there – I still had to apply for IRB approval, deal with a too-close-for-comfort visa situation, and submit applications for further funding. A little over one month ago, I arrived in Ghana and began volunteering with Unite For Sight, but now it’s time to really get to work.

I was picked up by my advisor’s driver at 8 AM on Monday morning and we drove to Suntreso Government Hospital, where Dr. Agyarko-Poku is the director of the HIV/STI ward. He and I briefly discussed a timeline for the week and he informed me that he is also the personal physician to the king of the Ashanti region (the region in which Kumasi is located) and that we would visit the king’s palace while I am here. Pretty cool. I also have come to learn that I will not be reviewing charts at Komfo-Anyokye Teaching Hospital, but rather at Suntreso Government Hospital and Kumasi South Hospital. I was extremely worried about “hurdles” that I would encounter while doing research in Ghana. So far, this change of locations is the only real shift and I can definitely handle it!

I spent most of the morning getting an introduction to how patients “enter the system” at Suntreso Hospital from a really amazing data manager named Helena. Helena is also a Master’s student (her degree is in Health Informatics) and I can tell that she will be very helpful both with research and getting around Kumasi. In the afternoon, we went to Dr. Agyarko-Poku’s other offices. We briefly stopped at his office with the National AIDS Control Programme and then spent the rest of the time at the office for King Otumfuo Osei Tutu II’s Foundation, where Dr. Agyarko-Poku is the executive director. From the sounds of it, the hospitals will be my main headquarters for data extraction and then I’ll be doing most of my analysis and report writing at the Foundation office, which is in downtown Kumasi (known as “Adum” – pronounced “ah-DOOM”).

Suntreso Government Hospital

Thursday I got a rare break in the day to visit the King’s Palace (Manhyia Palace) for an elder’s funeral. I was really out of place, as Dr. Agyarko-Poku did not tell me it was a funeral, so I was just wearing a striped polo and khakis. Every other person there was wearing a black robe. Whoops. Chalk that one up to “silly obruni”. The ceremony we went to was just one of many that will fill the elder’s week-long funeral. There were tons of members of the royal family there, as well as local governors and politicians. I saw some other obrunis and was confused at what they were doing there also….that is, until we returned the palace on Friday and I saw someone I knew! I ran into Ashley, a current Michigan student, and Michigan Marching Band tuba player! She is working with a group of fellow Wolverines doing a video editing project at the palace. Yet another random run-in in Ghana. This is getting too weird.

Friday marks the end of my “orientation” week and I am ecstatic to start data collection. I just need to start doing something that is related to my project.

Throughout the week I’ve come to really enjoy Kumasi. I have been able to walk around at night after getting home from work and try food from a few local vendors – mostly just chicken and rice, but I need to find the best chicken-and-rice place so I know my go-to dinner vendor! I also tried waakye at Suntreso on Wednesday. Waakye is basically just rice and beans mixed together – pretty delicious!

I also am overwhelmed by my living situation. I have great air conditioning, breakfast is made for me every morning, the shower is hot, the bed is comfortable, and the Internet is pretty incredible. I don’t really know how to feel about this. I had gotten so used to being surrounded by poverty while on Unite For Sight outreaches and now I’m staying in a room that normally costs as much for one night as some households make in a month. Plus, rather reliable Internet makes me feel almost too connected to the world.

9-10 June – Transition

Saturday was a typically boiling hot day in Ghana, but that didn’t stop me from being a productive member of society. I got up early and went to Vodafone with Abbie so we could re-connect to the world. I’m so grateful for all of my friends who happen to be online during the times I happen to sign on (special shout out to Harry Jin, Natalie Price, and Mia Sorkin who, thanks to their respective internships in Malaysia, Italy, and Germany, are much more “time zone” friendly than my friends in the U.S.).

After catching up with the world, Abbie and I took a tro-tro back to Telecentre, where I began packing in preparation for the next day’s trip to Kumasi. My packing was pleasantly interrupted by a visit from Mposo, a 2005 Yale School of Public Health graduate. One of my outstanding professors from this past year, Dr. Robert Dubrow, helped put us in contact and from there we set up a brief meeting. Mposo is originally from the Congo, but has been working in Ghana for the past few years with an organization that aims to eliminate neglected tropical diseases (NTDs) in 5 West African countries. We had a great conversation about the elimination of trachoma, my favorite NTD. Ghana has officially moved from the “eradication” stage to the “surveillance” stage – awesome!

The rest of the day was spent packing, chatting with other volunteers, and a return trip to Vodafone (as I was packing I realized I had left my flash drive there – luckily, someone had returned it to the desk. Thanks for being honest, Ghanaians!).

I went to bed pretty early because there was a van taking other Unite For Sight volunteers to Kumasi with which I was hitching a ride. The van was originally supposed to leave around 5 or 6 AM. Late Saturday night, we got word that the van would now leave at 8 AM. As Sunday morning arrived, 8 AM passed, and then 9 AM. The van finally departed at 9:45 AM (I don’t think I’ll really ever get used to Ghana time). The driver seemed a little disoriented, and we soon realized that after about 45 minutes we were traveling back to Telecentre Guest House. The driver had forgotten some supplies for the Kumasi clinics…so we finally, officially left Accra around 11:30 AM. After a long ride, we arrived in Kumasi around 5:00 PM.

I left the Unite For Sight volunteers near Suntasi Circle, where my on-site internship advisor, Dr. Thomas Agyarko-Poku, met me. We took an extremely short drive to my new residence – Lizzie’s Hotel. Lizzie’s is no Ritz Carlton, but I still feel extremely spoiled to be staying there. I have a “suite” to myself, complete with sitting room, bedroom, and bathroom. My room has all the amenities – air conditioning, a hot shower, a TV that gets one station (that only broadcasts soccer, but will luckily show the Olympics next month), and there is rumored to be Internet access soon. The room usually rents for 100 Ghana Cedi per night (about 55 USD), but my incredible advisor bargained down to only 60 Ghana Cedi per night!

After organizing my room, I took a walk around the neighborhood. Unfortunately, it was 7 PM on a Sunday, so almost everything was closed. I did find a gas station where I bought a FanChoco (frozen chocolate milk), jelly, and popcorn. I nabbed a pork kebab from a woman grilling on the way back and enjoyed a delicious dinner on my own while watching Lost.

4-8 June - Last week with Unite For Sight!

This week marks my last week with Unite For Sight and also my one month mark of being in Ghana! I can’t believe my time with Unite For Sight is almost over – I definitely could keep volunteering here and wish I could stay working on my research with them more.

Monday’s outreach was pretty busy, but instead of a ton of patients, we just had a ton of volunteers. Eight volunteers are with Crystal Eye Clinic this week, half new and half old. We split up into pairs so the veterans could train new volunteers at the various stations. Nevertheless, there was just not that much to do and many of us were excessively bored. Oh well. The town where the outreach took place, Teshie, was right on the Atlantic Ocean, so I took a walk in the middle of the rather slow day to go enjoy the waves crashing into the shore.

Tuesday was significantly more eventful, as Matt, Mitch, and I were scheduled to go to the clinic instead of going on the outreach. With clinic days come a much later start for the day (10:30 AM – whoa!). I took advantage of my morning off by:

1.      Writing blog posts for the last week

2.      Getting a phone for the rest of the summer (right now I borrow a phone from Unite For Sight to make local calls).

3.      Attending a “church service” at the guest house with a few volunteers who had the day off. The guest house staff brings in a preacher once a week to give a service to them. It was really interesting!

4.      Watching half an episode of “Lost”.

The day only got better from there. Jerome and John (Crystal Eye Clinic staff members) picked us up at 10:30 and we drove to Crystal, with a random stop at the Accra Mall on the way (Jerome wanted lunch)…which meant I finally got to buy some more pita to make PB & J’s! When we arrived at the clinic, Jerome gave us a brief tour and then we waited outside for about 3 hours before any of the Unite For Sight surgeries began. Around 3 PM, we suited up for surgery observations. Many, many things about operations are different in Ghana than in the States, but perhaps one of the most outrageous thing is that everyone in the operating theatre wears sandals…doesn’t make sense to me, but it seems to work for them!

We got to see a ton of surgeries, including cataract, pterygium, glaucoma, and Steven Johnson’s Syndrome. The first surgery went fine, but during the second one I started feeling really light-headed and had to leave the room for about 30 minutes. After leaving, I was already formulating this post, with long tangents about how I’m so glad I decided medical school wasn’t for me because surgeries always make me dizzy, etc. But instead, I went back into the theatre and ended up watching about 10 more surgeries, with a much clearer head! I really enjoyed watching the surgeries, especially the glaucoma one, during which the ophthalmologist, Dr. Clarke, cut a small flap in the patient’s eye, created a channel for the fluid to leave, and then lightly re-sealed the flap. Dr. Clarke mentioned that a very similar procedure is done for glaucoma in the U.S.

Wednesday’s outreach was pretty uneventful, but Thursday’s was really great. The outreach was in Buduburam Refugee Camp and we screened patients from Liberia, Mali, Burkina Faso, Nigeria, Niger, Sierra Leone, and also some Ghanaians who lived in nearby towns. Some of the people had really great stories – one Liberian man had been in Ghana for 14 years and was saving up so he and his family could return to Liberia in December. It was so gratifying to help these people and I’m happy we were able to hold an outreach there! Friday’s outreach was also pretty uneventful, but we did get invited to the Chief’s home to meet with him. Unfortunately, this meeting was not as exciting as it may sound…he spoke to the eye clinic staff in Twi the whole time (about 45 minutes) and no one was translating for us, so the meeting was pretty boring for the volunteers.

So that’s it! Unite For Sight is over and I move to Kumasi tomorrow to start my internship on Monday! Volunteering with Unite For Sight has been an incredible experience. I’ve met outstanding people, from other volunteers to clinic staff to people in the community, learned so much, and really been able to fine tune some research skills. I am so happy I chose to include this experience in my summer. Looking back, there were times over the last 8 months or so that I kept second-guessing why I chose to be so busy this summer, but I’m glad I had enough foresight back in October to undertake such a hectic summer schedule.

On to Kumasi!

25-27 May - Weekend in Accra

I was fortunate once again to have a Friday off (this has come to be almost expected…I feel a little spoiled). We spent Friday walking through the Jamestown area, including visiting the lighthouse, Independence Square, and Osu Castle. Unfortunately, visitors without appointments are not allowed in Osu Castle, so we couldn’t even get close enough to take pictures. We then walked toward the Osu neighborhood and had a very American lunch at Frankie’s Hotel.

Saturday was not too eventful. A small contingency of us visited the National Museum. The museum itself was underwhelming, but it did house an incredible photographic exhibit on malaria that I found really interesting. One cool thing I learned was zooprophylaxis – using animals as a preventive measure against disease. Dog owners, for example, are better protected against malaria because mosquitos may bite dogs instead of the owners, thereby decreasing the probability of an owner being infected. Yet, if a person acquires too many pets, their house may become a “feeding ground” for mosquitos, and chances of being bitten actually increase.
On Sunday, the new volunteers went to Cape Coast to have a similar trip to ours a couple weeks ago. Instead of repeating the trip, Lauren, Casey, Jamison and I went to Aburi to visit the botanic gardens. The gardens were really beautiful and we had a great lunch right in the center of the gardens. Aburi itself was also a neat city. It’s set up higher in the mountains and so we got to enjoy slightly cooler weather and an amazing view of Accra.

2-3 June – Reunions and Oceans

Saturday was a really great time! In the morning, Ernest led an orientation for all of the new volunteers. The old volunteers attended as well to share our experiences (and also learn a little, because we had an outreach during the day we should have had orientation!). Listening to Ernest share information, I couldn’t believe how ingrained so much of the volunteer experience had already become. Getting around Accra, helping at outreaches, bargaining for taxi rides...everything Ernest discussed just seemed like part of my everyday life. Ghana is really beginning to feel like home!

After orientation, Matt, Celia and I went to Vodafone to use high-quality Internet. The Internet at Telecentre had been pretty rough all week, so we were excited to actually be able to respond to e-mails! We all thoroughly enjoyed our hour and a half of Internet time (so ridiculous that I was satiated with only 1.5 hours of Internet, considering how often I am using the Internet in the States). We went to Osu to grab dinner at Zion Thai restaurant. We had heard about the restaurant while we were leaving Heritge Indian restaurant earlier that week when a man in a minivan pulled up to us and shouted “Have you eaten at Zion Thai restaurant?” (none of us had, nor had we even heard of it). We were in for a surprise! We met Jimi, Camry and Abbie at Zion Thai and really enjoyed an appetizer called “Chicken on Bed” (chicken fried onto toast) and pad thai. I definitely will be recommending the restaurant to future volunteers!


Side note: On the way to Zion Thai, we ran into Jen, a fellow Yale School of Public Health student! It was so good to see her again (I had gotten lunch with her a couple weeks earlier) and it’s pretty odd to think that I “run into” friends while in Ghana!

When we got back from lunch, I was extremely excited to see Matt and Laura, the only two volunteers in my original crew who were still here. They had just returned from two weeks with Charity Eye Clinic in Kumasi. We caught up for a few hours, then went back to Osu, to fulfill Laura’s strong craving for cheese pizza from Mamma Mia’s. Some of the new volunteers came with us and got very spoiled with pizza on only their second night in Ghana. We got to hear about the new volunteers’ experiences at the Art Center. Based on their stories, they still have quite a bit to learn about haggling with Ghanaians – one volunteer paid 80 Ghana cedi (about 45 USD) for a small drum – yikes!

Sunday morning involved a few a volunteers leaving for a 2-week outreach in the Volta Region. The remaining volunteers took a day trip to Big Ada, which is a great beach town, and also Bismark’s (one of the drivers for Crystal Eye Clinc) hometown! We went on a boat tour that included getting to hang out in the Atlantic Ocean and visit a small village that brews rum from sugarcane that grows nearby. We all tried the rum and it was…strong. A few volunteers purchased the rum at a great deal of only 5 Ghana cedi (~2.75 USD), but I’m interested to see how they do getting it through customs. We headed back to Telecentre fairly early to make sure everyone was well rested for a great week of outreaches and Dorcas, who works at the front desk, made me a delicious dinner of Ramen noodles with onion. Mmmm…

28 May – 1 June – Crystal Eye Clinic Outreaches

This was an unusual week of outreaches with Crystal. Our first day we went far into the Eastern region and split off into two groups because 9 volunteers were scheduled with the clinic for outreaches! My group went to Akoase and spent a really long day seeing only a handful of patients. With only one staff member with us who was able to perform examinations, the day moved pretty slowly. After a long day, the rest of the group joined us and we headed back to Telecentre, but not without stopping at a rest stop for some jollof rice. I don’t think I’ve discussed jollof yet, but it’s a really delicious version of rice that’s made with a sort of spiced tomato base. Jollof is probably one of the few foods from here that I will attempt to make for myself when I return home.

The following day was one of the only clinic days that many volunteers would be able to attend, so those of us not going into clinic technically had a day off…but Jamison, Lindsay, Casey, and I went on the outreach anyway. The outreach was in a huge, newly renovated Catholic church and moved very efficiently with a good-sized clinic staff and a great corps of volunteers. After the outreach, we were invited over to the priest’s house to eat fufu with tilapia stew. I don’t think I’ll ever really come to enjoy banku or fufu, but as Jeffrey Steingarten explains in The Man Who Ate Everything, trying any food 8-10 times will make that food enjoyable. Maybe by the end of the summer I’ll be craving fufu!

Wednesday and Thursday were interesting because many volunteers left Wednesday night. Our outreach team was pretty small, because new volunteers weren’t arriving until Friday! Heavy rain led to pretty dismal community member attendance on Wednesday, so we weren’t too swamped. A few other volunteers and I had a new experience Wednesday night for dinner…Indian food in Ghana! We ate at Heritage Indian restaurant in Osu (a neighborhood in Accra with a ton of not-totally-Ghanaian restaurants and bars). I couldn’t believe how great cheese naan and chicken tikka masala tasted…it was unusual to actually enjoy the amount of spice in a meal and not just have my throat burned by pepe. That meal satisfied cravings I didn’t even know I had.

Thursday was another slow day, this time for inexplicable reasons, but with just Ernest (the optometrist), John (a driver), and two volunteers (Casey and me), it was probably for the best that we weren’t overloaded. The community organizer treated us to fufu before we left. 3/10 tries down…only 7 to go before I’m a fan!

On Friday, a whole bunch of new volunteers arrived and Thursday night there were 22 volunteers staying at Telecentre! That figure is ridiculous, considering there were only 10 of us during our first 10 days! For one day (Matt and Laura, who had been in Kumasi for 2 weeks, would return the following day) , I was officially the most veteran volunteer at Telecentre and it was crazy to think that 3 weeks in Ghana had made me knowledgeable enough to teach others about what I’d learned and experienced.

5/21-5/24 - Elubo Outreaches

Casey, Lindsay, Matt, Jamison and I have had a great week in the Western region around the city of Elubo, where we have been doing some huge outreaches. We got to the Super Gardens Hotel late Sunday night. We had fun figuring out how to shut a bathroom door that doesn’t stay shut, but does lock from the outside.

On Monday we went to Tarkwa and saw about 325 patients in one day. Ernest, the optometrist with us, has discovered my love of Microsoft Excel and relatively fast typing speed and has me covering data entry at every outreach while we’re in the Elubo area. Although I love giving visual acuity exams, I still get to see some patients while entering data and also really do love Excel, so I can’t complain too much. When the volunteers introduced ourselves to the crowd of community members at the beginning of the day, I got a great laugh out of my “ma chay” (“Good morning”). The Ghanaians really love to hear obronis (white people) speaking Twi. I generally get a light chuckle from anyone who I tell “thank you” in Twi.
On Tuesday, our outreach was in Ichaban, only a 25 minute drive from the hotel. It was definitely my shortest drive to an outreach yet. It was also extremely hot and humid! The weather has been a little more manageable with the help of rain coming more often, but today was an exception. I took a break from data entry to do some visual acuity exams outside in the sun for about 30 minutes and my shirt was drenched in sweat. We did, however, see over 300 patients again, so all the sweating was definitely worth it. On the way back from the outreach, we stopped at a chop bar that has great fufu and Matt, Lindsay, and I got our first tastes. Fufu is very similar to banku – a very doughy, starchy ball that is eaten with stew. We got an extra bonus because we ordered ours with goat meat. Fufu is not my favorite, but I did really enjoy the goat!

Wednesday we had another short outreach to Kwesi. The church where the outreach took place was enclosed in a large gate, which helped everything stay better organized, but also really eliminated any hint of a breeze. The people in this area were extremely nice, except when the line to see the doctors got too long. At that point, a fairly loud and aggressive argument broke out every time a new patient went to the doctor, as everyone shifted chairs to the next available seat. Ghanaians generally have little sense of queues, but when one does form, as happens during our screenings, they take it very seriously. A highlight of my day was sending my first “small girl” on an errand. Ghanaian adults often have children who are within shouting vicinity run errands for them, like getting change for larger bills or buying them a bag of water. These errands usually begin by the adult beckoning “small girl!” or “small boy!” During a short break after doing visual acuity screenings, I saw a girl who looked about 13 years old sitting nearby and called her over to go out to the street to buy Fan Choco’s (very delicious frozen chocolate milk) for the volunteers. It was very satisfying to not only send my first small child on an errand, but also to enjoy a cold Fan Choco on a hot afternoon!

Thursday, our screening took place in Agona. The church where the outreach took place was very small, so visual acuity screenings took place with the eye charts attached to the Crystal Eye Clinic van. There also was no space for me to do data entry near the medication/eyeglasses dispersion table, so I found a little landing on the stairs up to the church’s balcony and set up data entry camp there for the day. Toward the end of the day, a couple of 10-year old named Obed and Buesba started hanging around my chair. I talked to them for a while and they decided they wanted to help me, so they would go outside to pick up patient’s slips from medication dispersion and bring them to me to enter into the computer – so helpful!

We ended up seeing about 1200 patients in 4 days in the Elubo region with 80 referrals for surgery. The week was not the most glamorous, but it was really rewarding!

5/18-5/20 - Extended Weekend

I was very fortunate to have both Friday and Saturday off from Unite For Sight. On Friday, the Crystal Eye Clinic, the staff of which has been leading our outreaches, had a meeting with local community volunteers and then I was not scheduled for a Saturday outreach.

On Friday, the Nicoles & I went to the Accra Mall. It is an extremely nice mall and it really felt like I was temporarily transported back to the U.S. We didn’t buy too much except a few groceries, but we did eat at the food court. The pizza and ice cream were both extremely satisfying. We also saw a movie (The Lorax) at the mall’s movie theater. The theater was equally as plush as the rest of the mall. On our way out, I got one of my biggest surprises in Ghana so far – running into someone I know! I saw Clementine, a friend from the University of Michigan, who is in Accra for the summer, working on her MPH internship with the University of Ghana Medical School. I knew Clementine was in Accra and had actually made tentative plans to meet up with her on Saturday, but it was still extremely coincidental to see her at the mall! Friday night was the last night with our original core group of volunteers, so we went out to an Italian restaurant. Nicole, Matt and I tried ordering on of the “specials”, gnocchi, which turned out to just be small shell-shaped pasta in a boring marinara sauce…what a waste of 20 cedi!

On Saturday, Matt & Laura were departing for Kumasi for outreaches and the rest of the volunteers were scheduled to go on an outreach with the Northwestern Eye Clinic, but I had the day off, so I planned to meet with a couple friends who are also in Ghana for the summer. Clementine, who I had run into the day before, brought 4 other volunteers with her program and Jen, a friend from Yale School of Public Health, also brought another volunteer from her internship program in Kasoa (about 45 minutes outside of Accra). We met at the Labadi Beach Hotel, which was a really fancy hotel, even by U.S. standards. I devoured the bacon cheeseburger and fries (below) that I ordered, knowing full well that I may never see another one while I am in Ghana. It was great meeting many other volunteers and hearing about their summer projects. After lunch Clementine, Jen, and Jen’s friend, Amanda (I think her name was Amanda?) and I trekked to the National Museum, excited to see their exhibit on malaria. Unfortunately, the museum closed right as we arrived, so we just headed toward the Circle and walked around. The Circle is a stop for tro-tros (vans that drives around/between cities and has routes similar to a city bus), but it was pretty hard to get around the area because heavy rain and wind earlier that day had knocked over many trees, signs, and billboards. After walking for about an hour, we parted ways. I went back to the Telecentre, met a few Unite For Sight volunteers who had arrived back in Accra from a couple weeks in Kumasi and our group went to a chop bar to watch soccer projected on a huge screen. I have never seen the chop bar so crowded! Bayern was playing Chelsea for the World Club Championship (I think…?).  Casey, one of the volunteers who had come from Kumasi that day, is an avid Chelsea fan and helped clue in the rest of us on how the season had gone so far. Regular game time ended with 1-1, so extra time was played and eventually the game came down to penalty kicks. Chelsea ended up winning and the whole street went insane. People were running around, singing, dancing, tearing off their shirts, jumping on cars, taking pictures with us, waving flags…just a ridiculous scene! It was really fun to experience the night!

Sunday morning I got up bright and early to go to church. I went with a couple that lives next door to the Telecentre. The husband is a teacher and the wife works at a bank. They were both extremely nice and we drove to church at 6:30 AM (with their 11-month old son). Mass was surprisingly similar to the U.S. The church was extremely beautiful with many stained glass windows. Mass was all in English and I felt very comfortable participating in nearly all aspects. A few things were slightly different. Offertory took place by each member walking up to the altar and placing money in a collection bin…and there were also two offertories, one at the time I expected and another at the end of mass. Mass also “ends” with a lecture-type presentation by the priest. This Sunday, the priest talked for about an hour on the different kinds of prayer and had time for questions from parishioners at the end. All in all, the service took about 2.5 hours, but we were done at 9 AM because it started so early!

Later on Sunday, we met two new volunteers, Lindsay and Matt. Jamison and I took them around Achimota to the ATM and to get phone cards. It’s incredible to think that 10 days ago, someone had to show me around! Later that afternoon, Lindsay, Matt, Jamison, Casey and I packed our bags and headed to the Takoradi in the Western Region, where we’ll be spending 5 days doing outreaches in this area.

First week of outreaches

This week has been pretty busy with an outreach each day! My "outreach team" for the week has been both Nicoles, and Alex and we had a really great time traveling to four communities in the Eastern and Volta regions of Ghana.

On Monday we went to Asubone Rails, where the outreach took place in a church. The trip was pretty long (about 3 hours each way) and it rained on the way back - which was great because there was way less dust! Ernest, an optometrist with Unite For Sight, kept us pretty entertained on the way back with lots of singing. We got a little taste of Ghanaian pop music.

Tuesday, Wednesday, and Thursday were pretty similar - though not quite as much rain. Pretty long drives to Bleamazado, Krobo Odumase, and Dagbamate, and all really great times. I've become pretty great at sleeping in a car that continuously goes over speed bumps. I also finished Michael Pollan's In Defense of Food. I think I'll be getting a ton of reading done here!

Tuesday was especially great because I got to start interviewing participants for my research project. Only 4 participants from last year showed up to the screening, so I didn't do too many, but the 4 I did conduct went pretty well, I think!

5/12-5/13 - Weekend off!

We were very fortunate to have this whole weekend off – our outreach got canceled on Saturday and no one leaves Accra for longer-distance outreaches this week, so Sunday was free too! Saturday morning involved our first taxi ride. We decided to go to the central market in Accra to explore the city a little more. We had a group of 6. I was hoping we could go “Cameroon style” (fit as many people in the cab as possible)…but the cab driver in our first cab was not playing that game, so we split into 2 cabs. My cab was me, Matt, and Laura and we made it to the central market after a long, hot, traffic-filled 45 minute cab ride. We looked around for the others for a short while, but gave up after about 10 minutes and just walked around on our own.

The central market was two things: hot and crowded – crowded not just with many people, but with many things. There was stuff everywhere – mostly cheaply made shoes, trinkets, clothes, and kitchen utensils, but also local “fresh” foods (“Fresh” in quotations because most of it was effectively cooking under the blazing equatorial sun). The fish stench was especially pungent. After a couple hours in the market, we headed back to the guest house to get break from the heat in some air conditioning. Upon arriving, we discovered that the rest of our group never made it to the market, but were stuck in cabs for 2 hours trying to just get to the market, before giving up and heading home.

Sunday was much more eventful. We all took a 3 hour van ride to Cape Coast. Our first stop was Kakum National Park, which is referred to as a rainforest, although it technically is somewhere between a moist evergreen forest and a semi-deciduous forest. We took a short hike through the forest and then went walking through the canopy on rope bridges! It was absolutely beautiful and full of tons of greenery all around.

We stopped for lunch at a hotel that had a restaurant on an island in the center of a pond and the pond was full of…crocodiles. Some of us took turns touching the crocodiles…their skin is much softer than I was expecting. We finished the day at the Cape Coast slave castle. Cape Coast was one of the largest pick-up points during the slave trade and the castle is where slave traders stayed (while the slaves stayed in the dungeons below the castle). It’s crazy to think that the castle is about as old as our entire country and was also really devastating to hear about the horrible lives the men and women who lived in the dungeons – and life didn’t get much better once they left. Cape Coast was a really friendly, vibrant beach town so the castle was really juxtaposed in its place there.

Arrival + First Unite For Sight Outreach

After a long, but uneventful flight to Accra, I arrived in Kotoka airport just before noon on Thursday, June 10th. Getting through customs was really easy and I quickly found the driver with Unite For Sight waiting for me at the airport. I expected the arrival to be similar to my arrival in Cameroon a few years back – extremely hot, crowded, overwhelming, and, honestly, pretty scary. On the contrary, the arrival in Accra was actually pretty pleasant, albeit still very hot. Several other Unite For Sight volunteers ended up being on my flight, including two undergraduates and an ophthalmologist traveling with her son.

We enjoyed a short drive to the Telecentre Guest House, where we got our rooms. I’m rooming with another volunteer, Matt, who just finished his junior year at Duke. The Telecentre works pretty well for accommodations – each room has a bathroom and shower and our room has a great balcony/porch. The Telecentre should also have Internet, but it has been down and/or spotty pretty much since we’ve arrived.
After settling in, all the volunteers (Matt, Nicole, Linda, Alex and I) walked around the city, exchanged currency, and bought credits for our cell phones here. The city is pretty nice, and better developed than I was imagining. Later, we went to a bar (which is apparently called a “spot” here) and got dinner and drinks while watching some football on a large projector screen. It was akin to going to Buffalo Wild Wings to watch football on Saturdays in New Haven. After returning to the Telecentre and enjoying the (amazing!) air conditioning, we met the rest of the volunteers who arrived that day – Laura, another Nicole, and Jamison. We went to bed shortly after because we had our first outreach the next day!

Our outreach was in a community called Ashanti, which I think was in the Eastern region of Ghana. The outreach was great. It took place in a church and (I would guess) about 100 community members had assembled by the time we arrived. Ernest, an optometrist with Unite For Sight, gave a brief introduction about eye health and then each of the volunteers introduced ourselves. We then broke off into stations for the vision screenings. Jamison, Nicole, Matt and I gave visual acuity tests, with the help of our amazing driver, Bismarck. Then, community members visited Ernest or Dennis, an ophthalmic nurse, for a more thorough examination. The other volunteers helped dispense medication and eyeglasses that were prescribed by the clinicians. After working for about 5 hours, we were offered a delicious Ghanaian lunch (our first real Ghanaian meal) – banku and tilapia in a pepe sauce. Banku is a dough-y/starch-y mix that is fermented in plastic. It’s very similar to fufu in Cameroon (which is odd, because Ghanaians also have a dish called fufu, but it is not the same).

I have really enjoyed my first two days here! The other Unite For Sight volunteers are outstanding, as are the Unite For Sight staff, and the people in Ghana. I’m looking forward to the next few weeks working with the program.

A few other things I’ve noticed…
1. Maybe I’ve just forgotten what Cameroon/Nicaragua heat is like…but man, it’s HOT.
2. I am much more comfortable just getting around here…I’ll chalk it up to experience.
3. I feel extremely well-supported and safe.
4. The language “barrier” is odd. Although English is the official language and Twi is also commonly spoken, Ghanaians speak many languages/dialects…yet they all seem to understand each other. I have no idea what people are saying when they are having conversations with each other, but most understand English fairly well when I speak with them.


Much love to family & friends!

Pre-Departure

This blog is meant to provide updates about my time in Ghana this summer for my family, friends, and any others who are interested in reading.

I leave for Ghana tomorrow evening and will arrive the following day around noon.

Brief run-down of my trip
May 10 - June 10: Unite For Sight
I will spend the first month of my trip in Accra with Unite For Sight, an outstanding global health organization with the mission of eliminating preventable blindness throughout the world. One of the major ways they improve the health of the communities in which they work is by partnering with local leaders to provide vision screenings in rural areas. From these vision screenings, community members are assessed for various vision issues, including refractive error, for which Unite For Sight offers eyeglasses, and cataract, for which Unite For Sight helps eliminate barriers to corrective surgery by subsidizing costs and assisting with lodging and travel for the surgeries.
In addition to performing general volunteering duties with Unite For Sight, I will be continuing a project of a recent graduate of Yale School of Public Health. This project focuses on evaluating how Unite For Sight's services for cataract surgeries impact individuals' poverty levels.

June 11-August 9: National AIDS Control Program
The remainder of my summer will be spent in Kumasi, working on my internship as part of my Master of Public Health degree. I have been working very diligently on this project since October 2011. The main project of my internship is developing a decision analytic model to compare therapy programs for HIV-positive pregnant women. Decision analytic models are really cool - I'm specifically using a decision tree for my model.


That's it for now! More updates to come post-arrival.