Favourites

My time in Ghana has finished, so I thought some lists of things was a good way to close.

Favourite Things To Do:
 * Being a fashion designer - you buy the cloth, then you create whatever you want. Could be a disaster, could work out. I had both experiences.
 * Riding my bicycle. I can happily say I had the best bike in Tamale. And it was the best bike I've ever owned. I loved cruising around on it, and it gave me small freedoms that kept me sane.

Mine is the middle bike (obviously the best) and was red for speed

 * Going to Ghana Health Service and viewing their public health tactics - my favourite is using clothes as a public health message. 'Stop TB' or 'Roll Back Malaria' or 'Guinea Worm Eradication Program' is everywhere, what a way to sensitise a nation?!

Jervaise in his Stop TB - use DOTS shirt. I tried hard and hinted much that I wanted one!

 * Read local media articles. It is a different form of reporting, and so sensational you can't help but get caught up into the hype. Here is a personal favourite. Take the time to read it, you'll be rewarded.
 * Greeting everyone. I learnt greetings in quite a few languages, and enjoyed using Fra-Fra with the work guard, Dagbani with locals around the neighbourhood, Twi when in Accra/south, Walle when I was in the Upper West and having a go at anything really, including the many languages of the expats in Tamale. It's extremely rude if you don't greet everyone, so sneaking into your office late in the morning never goes unnoticed.
* 'Creating good relationships' with key people at Ghana Health Service. I thoroughly enjoyed and was welcomed openly by the Upper West Team, I was sad to leave.

Friday afternoon in Wa - the Regional Health team and I discussing my mother's arrival, and possible marriage proposals

  * Buying single serves of everything. Why buy a tin of milk powder when you can have a small sachet?

My local store. Rita looked after my every need, and if she didn't have it in stock she'd get a small boy to get it for me.

* And of course, having fun with friends. I made some (hopefully) lifelong friends, and had such a great time.
 

Favourite Observations:
 * Watching what you can fit onto a motorbike. I saw everything from live goats, up to 5 people, bicycles and many more things. Unfortunately you have to be quick with a camera!
 * Carrying things on heads - observing just what the body is capable of. Up to 5 large bowls of charcoal, raw egg trays, litres and litres of water, ice creams, handbags, you name it. Frees up the hands..
 * Babies everywhere - so well behaved. Strapped onto mother's backs. Easily amused by a piece of paper or a small wave. Taken into the workplace, everywhere is child friendly.
 * No smoking. It is highly frowned upon and just does not happen much. Great for an entire population, I wonder how this can translate to other places. As soon as you cross the borders to the Francophone countries, you get delicious food, but also smokers.
 * Sleeping in meetings. It became a game to see who would fall asleep, how long, and who would notice. It kept me occupied and made the meetings more interesting.
 * Being in a work car with someone who had never been in a car before. He was so shocked by the concept of wearing a seatbelt he almost didn't come for the ride. He thought we were tying him down in the car. Very amusing. He also spoke about how he had never been in a plane. It made me think about first times for everything, it is so much more pronounced in Ghana.

I'll take many memories home with me, all of them good. I will write a few more posts, and maybe about how well I'm fitting back into Newcastle - but if you are in Aus - drop me a line!

Surviving Perpetual Meetings

The amount of meetings I go to is crazy. Not only is it usually last minute and lengthy, it is mostly boring. I'm not used to Ghanaian style presenting, I can't maintain my attention as it sometimes takes hours to explain a simple concept. We spent 30 minutes on one slide recently, it had about 2 bullet points on it. On the plus side, the descriptive stories and anecdotes can be entertaining, just after 5 hours I'm usually happy to skip some of the finer details...

So my last meeting was a training session that I have attended at least 4 times already, but I'm more there for 'support' or just 'representing' the organisation. So I amused myself. I did a small study, with the results shown in the following picture;

So in summary;
the presenter took a call while presenting 3 times
the presenter wasn't listening once (this is pretty impressive, must have been an off day)
someone falls asleep: 0. awww, a rarity too, but I was up the front and I'm sure a sneaky nap was had without me seeing. It's the whole point!
the power went out twice (which means projector goes off)
twice I laughed when nobody else was laughing, and sadly, three times everyone laughed but me, I had no idea what the joke was...
only five times did we defer from the actual topic of the training for at least 15 minutes. This is probably a record, especially for the presenters as they love a good story, laugh and the sound of their own voice (there's always one presenter...isn't there!)
I guess it was a small training, because only 7 people answered their phone in the training 'quietly'... and by quietly I mean I could hear the conversation, or I could see them ducking under their chair, or leaning back, or looking up so their voice traveled upwards, and therefore was 'not' disrupting.... that's a personal favourite trait here. The quiet answer of the phone....
We started 2 hours late which wasn't too bad, and the last person arrived 3 hours late which was pretty good too. So all in all, I managed to amuse myself, and it was a good meeting.

Giving

I may sound skeptical about development work; I've had many generous offers from people at home to help me 'make a difference' here that I have refused, and possibly offended people. I have just come from a meeting that has provided the perfect example for you as to why I cannot just take money or items and contribute to 'developing' Ghana...

A well meaning NGO donated $200K for supplies to a very poor district for a new maternal health program. Four years later the supplies are collecting dust in the warehouse. Why? The district still has only two midwives - who were last trained in 1995.

A perfect example of how money can be mis-spent. and quickly. My meeting is about how to identify needs, and where to be most effective. Sometimes with so many problems, so many shortages, it is hard to prioritise and programs can be directed in the wrong area (as shown). This new move is positive, and needed, a good step forward.

Back to it!

What do you want me to do with that?

Community Spirit

The most impressive thing I have seen over the year in Ghana has been the hard work of the community members for the benefit of their friends, family and peers. The most impressive program I have witnessed is called Community Case Management (CCM). The program is a Ghana Health Service program, with funding from UNICEF. It focuses on the biggest childhood killers in Ghana; 1. Malaria, 2. Diarrhoea and 3. Pneumonia. These are so common in children under 5 that this one intervention, if implemented universally, would reduce the number of under 5 deaths by 63%.

It is a program that is used in many countries, with the difference in Ghana being that the people running the program, assessing the children, going from house to house, being on call 24/7, and administering the treatment are all community volunteers. The community can nominate 2 people, who are then trained and equipped with educational cards, medications and reporting forms.

These volunteers are mostly women, which in the rural areas, means illiterate with no, or very little education. The volunteers diagnose and treat children using the skills taught to them in annual training sessions, a challenge in itself when you are trying to educate without the use of written tools. Role plays are a large part of the training, yet I never quite understand how the volunteers manage to remember the amount of information they do.

Volunteers attending training. Often with their own children. They are in charge of their supplies - in the white boxes, they carry these around on their heads, or if they are lucky, on a bicycle.

The main thing about the program, I have learnt, is that it increases the use of health services by poor children. Due to location, lack of services, lack of roads or transport or other factors, health facility-based services alone do not provide adequate access to treatment (in many countries, not just Ghana), and, not within the crucial window of 24 hours after onset of symptoms. So CCM brings the treatment to you.

It is affordable, treatment is cheap, and if you can’t afford even the recommended amount, it is given for free. Oral rehydration salts for diarrhoea costs a parent about 5c. Of which, 2c goes to the volunteer as ‘motivation’ – the only form of payment these hard working people receive. They are not officially identified as Ghana Health Service employees, and must keep other, sometimes multiple jobs to make ends meet.

The volunteers are given a large workload. Treating, screening and providing follow up care to the whole community. They must report to the closest health clinic once a month with the statistics of who and what they have treated, and re-stock their medication boxes. No transport is provided, these volunteers may have to walk kilometers, with no reward at the end. However how do you fill a report form when you cannot read or write? One health worker I met created a system to help him get reports from the volunteers. In a large jar put a grain of maize for every child 6-11 months treated for malaria. A grain of rice for every child 6-11 months treated for diarrhoea, and a grain of sorghum for every child 6-11 months treated for pneumonia. In a small jar do the same thing for children aged 12months – 5years. Genius.

It is innovations, cooperation and programs like these that makes this country so interesting. Yes, you get many volunteers who do not report, or health workers who demand written forms, but bit by bit Ghana is adapting its programs and building up its people to create something that will one day be a solid health system, built firmly on the strength of its amazing communities. This is dedicated to all the volunteers who give their time to the program, I am so proud of them, and continually hold them in such high esteem. I wish for them to be recognised and given employment entitlements, better status and the thanks that they deserve. 

Meet one of the volunteers - click here.

I Wish I Had A Mango Tree...In My Backyard...

Mango Trees. Best invention ever.

Mango trees are the perfect creation. The best infrastructure in northern Ghana for so many things. They are the best designed tree that I have seen. So multipurposeful.

They 1. Provide delicious fruit. And so many too; enough for a small business (or full belly). 2. Give far reaching shade. So much that they house many school classes, and if you pass by a community it is almost guaranteed that all the men will be sitting under one. 3. Are the perfect height. You can stand/sit under them, reach for a mango, and still get some solid shade, never a problem of hitting the head. 4. Provide some life to the desert. Green all-year round. In the dry season in flat Ghana you can see lone mango trees kilometeres away, they are the only relief from the heat.

There are 3 in my backyard. All currently bearing the most delicious fruit. It feels so indulgent to be able to add the most tasty mango to any meal at the moment, and dream up cocktails, recipes and other uses for the plentiful fruit. Ghana food, you aren’t so bad…

mangoes mangoes mangoes

Ripe for the picking

dam! have to wait for it to ripen, life is so hard...

Corporal Punishment

Driving past schools here can sometimes see either all the kids out in the field with machetes cutting the grass (apparently it's bring your own machete), or a whole class being punished. Like this photo. We stopped when we saw this entire class was being punished. The headmistress was involved, and it actually took a lot of convincing to make the teacher stop the punishment. Apparently the class had all laughed at someone, so the entire class was being punished. Finally my colleague succeeded in stopping this punishment, but who knows what happened an hour or so later.

I haven't had much to do with the education system in Ghana, just heard what other people know who are working in it so I don't have a good background, just observations. Corporal punishment is the norm, and when teachers do turn up (mostly they don't), it's highly likely someone that day will get some form of punishment. I think this one is one of the worst. As my driver put it, it'd be better to make them do something useful, or so they learn from it - maybe picking up all the rubbish around the place.

It's hard to watch, and I'm so glad we could intervene. But it was a temporary fix. Apparently there was a survey on children in schools recently, and the children voted to keep corporal punishment in schools. But maybe that was due to fear of repercussions. I have friends who have volunteered as teachers, and the children ask to be punished, they are used to the discipline, or expect it.

Ghana is on target for reaching the Millennium Development Goal #2 of Universal Education, however this has simply meant building plenty of schools. There are no qualified teachers, and the quality of the education is poor. As I have not had much experience with the schools, I have only entered a few, I'll end it there. But Ghana has made me appreciate the education system at home so much, and makes me hope for many more improvements in Ghana.

Lost In Translation

I was asking for an interpretation of a word I did not know yesterday. The conversation ensued;

Dee: “What does this mean?” (pointing to a word)

Z: “oni”

Dee: “Oh. What is that?”

Z: “You don’t know oni?”

Dee: “No. Is it some sort of local drink?”

Z: “Oni”

Dee: “Oni...”

Z: “Oni”

Dee : “Oh…. Ok. Oh. Hunne-y!”

Z: “hmm, yes, oni”

Dee: “hahaha. Oh the accent.”

(no reciprocal laughter)

Yes, a long winded conversation, and me thinking I’ve just learnt about a new food that I could look into, but really we were talking about good old honey. (why not laugh about it? I guess it’s not that funny, to  me it was).

We all speak English here, but the pronunciations are different. People in Ghana are used to the American or European accent, but the Australian is fairly new, and very different to Ghanaian English. I often need my own interpreter. Luckily my colleagues mostly understand me, but more often than not, when I’m in a meeting one of them will have to repeat what I say to everyone. To me, sounding exactly the same, but to people (especially of the north) here, it’s entirely different. I guess take 'oni' and 'hunnee' as two entirely different words.

I mostly have problems with Ghanaians pronouncing words that start with ‘th’. This is not pronounced ‘th’ like we would say ‘theory’ but instead pronounced ‘te-ory’. It has been quite confusing for me. You don’t ‘think’, you ‘tink’. You ‘tank’ someone rather than ‘thanking’ them. 'three' is more like a roll of the tongue, and my colleague had to write 'threat' on a piece of paper for me to understand the word. Whenever I am absolutely stumped by what someone is saying, mostly it’s a ‘th’ word. But knowing that doesn't help!

Other lost in translation fun includes telling a Ghanaian friend he has nice pants. He stared strangely, and as a wave of emotions went over his face, he exclaimed “oh, you mean my trousers?” followed by an explanation of how pants means underwear, and it was in fact an inappropriate comment. Having worn a skirt that day, I made sure I didn’t make the statement that I wasn’t wearing pants...

I just found this image at www.villageaid.org/ghanas-honey-rush.html the honey here is delicious.
Very different to that from home.