Not all those who wander are lost: TSsst!!

Dry, savannah-like, deserted no-mans land reaching to the horizon. When you imagine being on the road in Africa that is what most of us would imagine. Give or take the occasional elephant or mud-hut village of course. This weekend Karin and I went on a little trip again, this time to the east from Accra, to Ada Foah, a little town right on the edge of land were the Volta river flows into the sea. The view from my window in the crowded tro-tro was just like Africa how you imagine it: dry, savannah-like land as far as the eye can see, with the occasional (dry) tree and village in the distance. However, surprisingly, it wasn’t no-mans land. Frequently no more than a half built structure of a building, or a fence (typically only one-sided) with a ‘keep-off’ sign, indicated that this piece of land in the middle of nowhere was property of ‘The Frimpong family’ or ‘University College Central’. No neighbours, no near-by village, no water, no nothing, just some lonely bricks piled up in a brief spree of ambition. I really wonder what people thought when buying that land and building that foundation, really... why there? Or actually just: why?

A four square meter wooden shack called ‘God’s First Fashion Centre’ was the first thing that indicated that we were coming near Ada. Ada is basically a quiet fishermen town with almost more churches than streets. We stayed in a small two-person hut near the ocean, on the quiet side of town. It is funny how small things like a shower (one I could actually stand under!) with good strong water flow can be so satisfactory. Saturday we spent pedalling a wooden canoe (which we rented from a fisherman at the jetty) around one of the islands in the river delta. The fact that we wanted to paddle ourselves was quite amusing to the guy (those crazy obruni’s!) but we could tell we weren’t the first tourists to have asked for that. The area was beautiful! Small villages on the waterside with stark naked children enthusiastically waving at us while having their daily bath in the river, fisherman pulling the nets back in, quiet mangrove greenland with some birds, and a group of jumping silver fishes in our track, sparkling in the sunlight. To finish off we headed to a beach hut playing music, where we found a bunch of other tourists scattered out on the beach, as well as local Ghanaians on a weekend trip. Quite a contrast after our morning stroll through the almost deserted town!

But before you start thinking I do nothing but exploring Ghana, a bit more on my weekdays. The last couple of weeks I’ve been going to the antenatal care clinic. Because I don’t have full clearance yet from the ERC (I still need to get my informed-consent-form translated, but it’s all going on African Time), I couldn’t really start interviewing women at the antenatal clinic yet. However, since my interviews with the staff are in English, I figured that it wouldn’t harm just to start with that. So after a couple of days of working along with the midwifes to do the standard check-ups of pregnant women and new-borns, depending on the day, (of course combined with plenty of observation...) I really started to get to know the midwifes and asked some of them for an interview. Although it was quite difficult to really go deep during the interviews (the whole concept of a clinical trial is new to them), I am quite happy with the info I have so far. I am looking forward to doing interviews with the pregnant women though... Although that will be even more difficult since I will be working with a local female translator/research-assistant (sounds very official) and I won’t be able to really guide the interview. The good part of the research-assistant is the fact that she will also do the transcribing and translation of the recordings (which is an incredible boring and annoying job). Yay!

Besides the normal working time at the ANC, there are some other activities that I just spontaneously take part in. Last week for example there was a neonatal resuscitation training for the midwifes (they don’t have the luxury of a paediatrician on-call). Very good for refreshing my memory, but also interesting to observe. The trainer was one of the midwifes that I did the training with during one of my first weeks, organized by an UK/USA NGO. So I knew that she had learned that some things (like sucking-out the babies throat and nose with a non-sterile balloon suck-thingy after all deliveries) were proven useless or even harmful (increasing the risk of laceration of the airway because of the deepness they do it, as well as increasing the risk of infection because if the dirt that accumulates in the balloon), but she somehow managed to say that new knowledge within the same sentence that she advised everybody to still suck-out all neonates! Old habits die hard, I guess.

This week I get to go to a one-day Gynaecology and Obstetric Millennium Development Goals Conference in a fancy hotel here in Accra, definitely looking forward to that!

It is interesting how fast you adapt to the way things go somewhere. While during the first weeks my hands were itching to give the once white coats of the doctors a good scrub to make them white again instead of the redish-dusty-grey they are, I today noticed that my own white coat is not as clean as it used to be either. I realise that I remind the midwife when she forgets to ask the obligatory donation of blood by a family member of a new pregnant client (the only way they can keep the blood bank running). Also, I’m not surprised anymore when the midwife gets a bit of extra money pushed in her hand after the consult, or on the other hand the request for money when some kind of examination is performed. Not only is every speculum (‘eendenbek’) bought/rented for a vaginal examination, also the hospital maternal health folder is paid in cash, as well as the plastic cover for the physical exam bench, which the patient is supposed to bring everywhere she goes in the hospital. Medicine needed in the hospital needs to be fetched by a relative at a big pharmacy (sometimes a 20 min tro-tro drive away, longer when the traffic is bad). All this, even with some sort of general health insurance at place.

Also more wide-ranging things, like saying ‘sorry’ for things you can do nothing about, but are just generally bad luck. The other day I scraped my knee in a tro-tro (my long legs never match the bench size) and when a lady in the back of the bus saw the tiny drop of blood on my knee while I was climbing out of the tro she prodded my shoulder, and very genuinely said: “I’m sorry!”. Like there was anything she could have done about it! And this is just one of the examples, it could have also been that the battery of my phone died (“I’m sorry!”) or that the stapler ran out of staplers (“I’m sorry!”).

Nevertheless, there are some things I can not get used to. Like the hissing sound people make here to get someone’s attention. It’s a mixture between the sound someone makes when rolling their eyes at something (‘tssss...’), when you are unpleased with something (‘tssss.... you must be kidding me!’), when a constructor is trying to draw the attention of a hotty (‘psst! Lekker ding!’), or when someone is secretly trying to sell you something on the street (like in India the “tsst! Madam! You want grass?”). With me it is just associated with indignity or something, I don’t know, but if I use it (which unfortunately is quite necessary sometimes) I try to compromise it with a very big and kind smile... which must seem hilarious for Ghanaians. The Weird Wide-grinning Whispering White Woman. Yup, that’s me.

Finally I just have to point out that this has been my first month in Ghana already (yes! That long already, time flies!). I’m looking forward to the rest!

Take care and until next time!

Ps. I’ll post some pictures that actually have me on them later. Since I’m usually the one behind the camera those are on Karin’s camera...