Holy Mole!

Hey there folks. Today I'll cover my recent weekend and the safe and enjoyable method of public transportation I use to get to and from work each day!

The Trotro is easy enough to describe. Take an old caravan style van, place 4 rows of benches in it, add fold down chairs on the ends for maximum accomadation, take it out of the junk yard and place it on the streets of Ghana with somewhere between 15 and 17 people! Sometimes they are loaded on top as well with all manner of things. It is not an uncommon thing to see trotros that have tipped over on the side of the road. Never in town however, only between towns. The other day on my way to work the door on my tro actually fell over. That should give you a good idea of how beat up these vehicles are, and I use the word vehicle only because it has four wheels and an engine, but then again, a lot of things fit that description. Trotros go on predetermined routes, similar to buses, but unlike buses stop anywhere to load or unload and have no time schedule. Basically, the rule in ghana for all public transportation is "it will go when it's full". This can be a little inconvenient when taking a bus to another town and it stays at the station for 3 hours waiting to fill up. Besides trotros, there are also taxis. There is a drop taxi, which works like any standard taxi and a line taxi which also goes on specific routes like the tros, but is a little more spendy. When I first arrived in Kumasi, it took me ages to get to work because getting on a trotro or taxi is no easy task. The first step is recognition. Sometimes the "mate" (one who collects money) opens the door and yells the destination. Otherwise, the mate does a serious of hand motions and pointing. The direction the finger points determines the tro destination. Of course, for an out of towner, these hand signals make no sense to me and the tro would often pass on by unbeknownst to me that it was the one I needed to jump on. However, sometimes there isn't even a word or a hand signal, people just pile in. I believe this is because many people have learned the mates and drivers and what destination they go to. This becomes a huge problem when needing to board the tro. Often there is a mass of people waiting at various location to board a tro. The minute one stops, there is a mad rush to get in. Pushing, bashing, fighting, nashing of teeth... well maybe not the last one. Once you have finally crammed yourself into a tro with 15 other people it takes off and at some undetermined time, the mate decides to collect money and when you want to get off, you yell "Mate", and say the drop area or just point if you're nearby. Welcome to my primary method of transportation.

As for this past weekend, I went with the UW med student and another 4th year medical student from Chicago to Mole (pronounced mo-lay). We snagged a bus from Kumasi to Tamale at 5pm and it only too a little over 7hrs! Much like the tros, this bus had fold down seats in between each row. So, suffice it to say, the bus was brimming. On top of that, much of the road between kumasi and tamale is dirt. It was relatively smooth, so bumpiness wasn't too much of an issue, but dust was. Since no car, bus or tro has AC in ghana, the windows are always down. While this is a relatively effective cooling method, it also lets more dust in than I would prefer. The dust likes to stick nicely to sweaty skin turning slightly muddy. We arrived in Tamale tired, hungry and covering in a very very thick layer of dirt (I felt gritty). We then tried to figure out when the bus left for Mole, which was no easy task at 12:30 in the morning. After getting lots of people to point us in the direction of the bus terminal where the bus for Mole departed we then asked the people around (mostly sleeping) when the bus left. The answer we got was "3 to 4". Not "between 3Am and 4AM" but "3 minutes to 4AM"... Considering that the ghanaian sense of times doesn't really work in minutes, we decided it would be best to show up at 3AM. The others were pretty desperate to wash up. Using our travel guide we took a taxi to the closest hotel (which wasn't too far, within walking distance) and woke the staff to get a room for a couple of hours. After the he showed us the room he said, "ok, so two rooms". It was a tiny room and certainly 3 people usually wouldn't want to stay there, but we were only there for 3 hours. So it took us about 15 minutes to convey to him that we only wanted one room. At which point he went and talked to the manager and returned to tell us we had to get two rooms. We then took matters into our own hands and had words with the manager. He was completely drunk and irrational. He said it was impossible for three people to stay in one room. We then left saying it's one room or none, we're leaving. He then caved of course and then probably went back to his drunken sleep and remembered nothing when he woke up. We also noticed that there were quite a few girls standing around outside the hotel. We had decided at that point it was probably a "multi-service" hotel. After washing and resting briefly in our tiny, run down, and filthy room, we left again for the bus station where we eventually learned that all the tickets had been sold for the bus to mole. After much running around, we eventually negatotiated a private trotro to take us to Mole with about 8 other abrunis. I had had very little sleep by this point and kept drifting off on the ride there. The rode to mole is mostly a dirt road and severely washboarded. The repetative bumps weren't terribly uncomfortable, except when I fell asleep against the window and got a series of lumps on my head in different locations from each time my head hit the window. On occasion the driver would also hit the breaks at which point I would slam into the seat in front of me. I was basically a human pinball.

We finally arrived in Mole around 8:30AM, rested and washed up. Mole is the largest reservation in ghana and is unfenced. The main attraction: elephants, of course. there is only one hotel in the park, which has a watering hole right behind the building. Each morning, the elephants come to cool of and bathe at the watering hole. It was quite a sight. We took several guided trips into to and around the watering hole to observe the elephants and any other animals in the area. There were baboons, several variety of deer and antelope and a few warthogs. There was one family of warthogs that grazed around the hotel and paid little attention to the humans there. While getting close to wild elephants was an amazing experience, my favorite part of Mole was the many large beetles that would come out at night. We fondly called them the retarded beetles and pondered at how they were extinct by now. When they decided to fly, they wouldn't be able to control their momentum and smack into walls then plummet to the ground. More often than not, they would land upside down and not be able to turn themselves over. The best part was when you would nudge them with your shoe they would hiss at you and it would sound like a wind up town. When they were overturned and their legs were going, they perfectly resembled a wind up toy.

We left Mole at 4AM (because that's the only time the bus left) and made it to Tamale around 9. Of course we then discovered that the only bus back to kumasi that day was full. So instead of renting a hotel and staying in Tamale (which was none too impressive), we bit the bullet and got a taxi to take us to Kumasi. It was more comfortable and much faster than the bus (which we passed because it had broken down. A common occurrence). but it was closer to the ground which made it all the more dusty. When I went home and showered (bucketed water over myself) I shampooed my hair and it was a beautiful brownish red. I don't know if I've ever been that dirty... not even in India. Anyways, this has been a long enough post and this internet cafe has had the same song on loop for the past hour. It times like this when I really really miss fast internet. Time to go. Take care everyone.

The slow life

I met 4th year medical student today from UW, of all places. Random but good to have another white guy in kumasi. He's not a volunteer. He's here through UW, but it's nice having him around the hospital because he is very good at explaining things I don't know, which is a lot. The hospital work so far has been rather slow. Then again, the pace of most things in Ghana is rather slow. I'm in Tafo Hospital, which is a government hospital. It's not a large hospital and they don't have a big operation theater. They only have a few units: Recovery, x-Ray, Psychiatry, Maturnity and family planning.

The first few days I spent in one of the consulting rooms. About seventy percent of the time, it's malaria. I now know all the tell-tale signs of malaria. Most of the symptons are expected; sore joints, fever, diahrrea, vomitting, etc. But one of the early symptons I hadn't heard of before was having a bitter taste in their mouths. If the person doesn't have malaria, they usually have hypertension. Otherwise, not much else comes through the door.

I then spent a week in the recovery room, which is very very laid back. The recovery room is where patients are sent after seeing a doctor and are monitored, given IVs and given shots. When I was working, I spent my time giving injections, putting in IVs (which is a little scary the first time) and taking vitals (BP, respiratory, heart rate). Otherwise, I just sat and chatted with the nurses. On my busiest day, 5 people were admitted to the recovery unit. On the slowest day, 1 person was admitted. Even the nurses think the recovery ward is a little boring. It's such a strane contrast to the American perception of medicine. In American hospitals, if you aren't busy, then you're slacking off. People are busy, always running around. Here, people are rarely in a rush in all things.

I spent another week in the psychiatric unit, which I had thought would be interesting. Unfortunately all the examinations are done in twi, so it was a little anti-climactic. From what I could tell, most of the cases were epilepsy. Although the psychiactric unit wasn't terribly entertaining, at least they kept me busy doing paperwork and filling out perscriptions. While this particular hospital doesn't offer much variety, they manage to keep me far busier than I was in China and India. Everyone speaks better english here as well so there are always people to talk to and eager to make conversation. Ironically, while everyone can speak good english, they all speak twi to me and try to teach me as much as possible so by the end of two months, I'll be fluent. I'm skeptical.

Yesterday was a bit more eventful. The other volunteers and I did something called outreach where we went to an orphanage and cleaned and dressed wounds of the children. It was a nice change of pace. Most of the time was actually spent playing with the children rather than doing any medical work, but was still enjoyable. One of the little ones crawled up on my lap and took a nice little nap. We get to go next week as well and will get to also care for the adults. Hypertension is the most common problem so we will be taking blood pressure and educating them on hypertension.

Today I spent time in the small theater where they only do minor surgeries. The dermatologist was taking skin samples for biopsy. The UW medical student is going to do his residency in dermatology so he was very knowledgable about the conditions. I think I learned more today from him than I have anywhere else during my travels.

I move to a larger hospital in another week or so where I will have the opportunity to see more. I know this blog is a little uneventful, but so is my work in the hospital. While I do very little, it's still nice to get a general sense of what medicine is like in other countries. Maybe next time I'll have some good stories to write about. I hope everyone is well at home. LEt me know how all your lives are going.

Buzz word: Religion

In light of the recent holiday, I think it apropos to discuss the excessive amount of Christianity in Ghana. The ubiquitous word of God is typically manifest in shop signs. Amongst my favorite are "Thy Kingdom Refrigeration" "Jesus is my Redeemer Real Estate" and "By the grace of God Rasta hairdoo". Not to be outdone, even a little bit of Islam slips in there "In the name of Allah fresh produce". The missionaries clearly sunk their teeth rather deeply into this country early on. While many of them are strong and good Christians, you sometimes get the feeling that they missed to point. I've heard some people spewing out so much religious jargon that it doesn't even make sense. More like they were regurgitating a bunch of phrases and terms they've heard along the way.

Everyone here assumes your christian, so those volunteers that don't even believe in God are put in a rather awkward position and often just play along for the sake of argument. I don't know if Ghanaians would understand if someone said they don't believe in God. While I, myself, am christian, my views aren't entirely traditional in an American sense and are maybe even borderline heretical in Ghana. One of my favorite instances occurred when I was talking with an old nurse, a lovely woman. She had commented on how quiet I was. I said that I'm more talkative when I drink, with a bit of a wry smile. She then ask and confirmed that I was christian and said I shouldn't drink alcohol. I then asked her about Jesus turning water into wine. She said it was alcohol free wine. Even if I had wanted to argue the matter further, I would have no idea what to say, so i let it stand there and shook my head in agreement.

Easter itself was a bit of a marathon. I say marathon because it lasted a little over 4 hours and resembled a dance-a-thon more than anything. There we also three offerings (for non-churchgoers: the time when you give your money donation to the church). I still don't know why there were three. The pastor was also "kind" enough to recognize me in the the crowd (around 400 i suppose, i guess I stood out) and welcomed me to the church. This of course was followed by stares from the rest of the congregation. He then gave the sermon in english instead of twi, which i was very grateful for... I would have been even more grateful if his sermon was more than him saying "Jesus was dead and then rose three days later" in as many different ways as possible. We then went home and slaughtered a goat, then ate it's entrails... I like saying entrails because it sounds far more disgusting that way. Don't worry, they were cooked... and gross and rubbery.

On another note, for those that were wondering, I just found out that I did not get accepted into UW Med school, much to my dismay. I'm a little bummed out at the moment, but as I've been saying, med school is a big commitment. I should be thankful that I have another year to live my life freely without obligations or responsibilities. Now I just have to figure out what in the world to do with my life while I start the laborious application process all over. I hope everyone is well and healthy. Keep in touch as always.

Introductions

I supposed jumped into things too quickly last time without giving some more general information. I realize the last post was rather short, but I hope to be posting on a more regular basis than before. I don't want to run out of things to say, so I won't drown on too long for each post. Secondly, while Ghana is a totally different developing nation, I don't forsee myself having crazy stories like I did from India. I could be wrong though! So here we go.

I'm living in Kumasi, which is the second largest ciy in Ghana after the capital Accra. It's busy... really busy. The streets are more crowded here than in China or India, which boggles the mind since the population of Ghana is burgeoning. I'm livig with a family of 5 in a house about 30min from downtown Kumasi. I'll say more about this later. As for Projects Abroad, they have volunteers in four regions throughout the country: The Hills, The Coast, Accra and Kumasi. There are about 15-20 volunteers here in Kumasi and I somehow happen to be the only guy. Most of the girls are brits and 18-19yrs old doing their gap year. I get on with them well enough, but I often find myself adrift in a sea of estrogen. Another male doesn't come till early may. He will also be my roomate. Until then I will be the only white man in Kumasi... what a responsibility. I'm currently working at a small government hospital which is rather bare bones. They only have a maturnity ward, a psych ward, a dermatologist, and a few resident doctors. They also have a small operating room, but only deal with minor surgeries. I'll talk more about my medical placement later on, after I've experienced a bit more.

That's the basics i suppose. Each country has offered a different experience. But this one feels very different from the others. I think I'm so used to being in a different culture that all the strange little quirks this place has tend to pass me by a bit. It's hard for me to keep from comparing ghana to the other countries I've been to, and even harder to relate to the other volunteers. I suppose it's just not as "fresh" for me as for them. I imagine I'll eventually settle into my own though and things will work out well. Otherwise, I have no real complaints. Hopefully somethig crazy will soon happen so i have an exciting story to relay. As for now, I hope everyone is well.

Hot Hot Hot!

Hey there guys and gals. Sorry I've been late in my first Ghana blog. Facilities aren't always readily available. Well, after my long moratorium at home, I have returned abroad to try new foods, experience new cultures, see new medicine and basically sweat like a pig. There is so much to talk about I will try to give it in installments. Each post will feature an interesting aspect of Ghana and my life hear.

Today, let's talk about... talk. Suffice it to say, I was well excited to come to a country where i can finally understand the language which is being spoken around me. Much to my dismay, the moment I stepped off the plane and was picked up by the TPA employee, he started teaching me 'twi', the most widely spoken african dialect in Ghana. Apparently, there are 36 different dialects. While English may be the official language, it is not commonly used, however everyone knows how to speak it. So once again, I am in a sea of babel. The english they do speak can be confusing at times. For example, instead of saying "I'll be back", they say "I'm coming". Image arnold saying that instead... just doesn't have the same ring to it in that thick austrian accent. Language was a major barrier in china and india primarily because english was rarely spoken. You could also say the same thing about Ghana. It often takes me several tries to determine what it is they are saying even when i understand all the words. This is especially difficult in the hospital. It is also interesting that not everyone speaks any english. I believe this is because people only learn english in school, or if there particular tribe speaks it. My host mother, for example, speaks very little english and has to communicate to me through my host sister. For all i know, she could be playing some crazy game of telephone with me. If i end up doing all the house chores, I might start to suspect something... Anyways, let's hope my "talk" today wasn't too mundane and will keep you coming back for more installments. Hopefully they will be far more frequent. Take care all of you.