Ghana Blog 1: Akwaaba to Ghana!

Ghana Blog 1: Akwaaba!

I have officially been in Ghana for a week. It is crazy to think that after a semester of anticipation and preparation, I am finally here! The first few days have been a whirlwind. I have traveled a decent amount for someone my age, but I have never experienced culture shock the way I have arriving in Ghana. I am not sure if it was my over confidence, my lack of in depth cultural research, or my precise expectations that caught me off guard, but whichever case it might be, my life is in full swing.

This summer, I will be working under Phyllis Dako- Gyke, PhD at the University of Ghana, Accra – Department of Social and Behavioral Sciences in the School of Public Health, in cooperation with our mentor, Sarah Rominski, PhD, MPH, who is part of the Global Reach Program at the University of Michigan Medical School. All of this was made possible by the Minority and Health Disparities International Research Training Program (MHIRT), which is a program funded by the National Institute of Health (NIH). This summer intensive research training occurs at various universities across the United States, and each school offers stipends for undergraduates and graduate students in a variety of countries. This year, eighteen students from the University of Michigan were chosen to go to Chile, Nicaragua, Ghana, Ethiopia and Mongolia. Seven of us are residing in Ghana, in the cities of Accra and Kumasi.

After traveling abroad last summer, I spent the majority of my free time first semester this past year researching different ways of which I could spend more time exploring the world. When I discovered the MHIRT program, I couldn’t believe it existed – it was exactly what I had wanted. I dreamed of going abroad, but I didn’t want to take more classes. I wanted to gain more tangible skills, especially related to global public health. This program gave me just that, and more. By working this last semester, I’ve dipped my toes into the research world. I gained experience creating, altering, and re-altering questionnaires, of which I am sure, will need more tweaking after pilot testing. I gained more experience writing abstracts and IRB protocols. This summer I will learn how to conduct research in a culturally appropriate manner, different than that of the United States and also different from the previous psychology department research assisting jobs I have done. In the future, I hope to learn more data analysis skills and be able to begin learning how to do my own statistics, a skill that has dumbfounded me for years (considering I haven’t taken any math classes since Calc II in high school, oops). Overall, it’s been a privilege to be selected for the program and to meet people who have sincere interests in health disparities and improving our world. There’s honestly no better feeling than engaging with other students who feel the same passion I do for making a real impact and devoting our academics and futures to a goal greater than ourselves.

My partner, Jenny, and I will be studying antenatal (similar to the term “prenatal”) care (ANC) and birthing complications. Our exploratory study aims to gain further understanding of the birthing experience in the Ga East District of Ghana. In simple terms, we want to gather more data assessing why women choose to give birth where they do, and what factors are associated with their choices. Studies in Ghana show that many women, 96.4%, seek out  at least one ANC visit during their pregnancy (Dako – Gyeke, et al., 2012), yet very few deliver in facilities, as compared to home births  with or without skilled attendance. Some reasons which may contribute to the difference between women who see facility ANC but not facility birthing options include: convenience, limited finances, and cultural or spiritual requirements (Akazili, 2011). In terms of birthing complications, we are hoping to find a correlation that shows how diagnosis of complications can be related to anxiety during pregnancy, and then determining how this may change women’s attitudes about pregnancy and delivery.

Although I am very excited to get started on the project, we recently found out we cannot fully begin pilot testing for a couple more weeks (the school year here hasn’t ended, and the stress of final exams seems to be in the air). This has given Jenny and I a lot of time to think about what to do with our free time. We have gotten somewhat assimilated to transportation and daily activities, however there is still much more exploring to be done.

In Accra, the city where we are living, most people travel by Tro- Tro. These are large vans of which I think are similar to chicken buses often seen in Latin America. Upon arrival at a stop, the Tro- Tros will come speeding by and slide to an abrupt halt. The “maid” as they call them (sort of a Tro- Tro attendant) will continuously yell the destination at you, however you will not be able to understand him because of the speed of his speech and his accent. Sometimes they also speak in Twi (pronounced “tree”), a local language. Once you’ve boarded the Tro- Tro you will immediately forget what personal space is, and be absorbed into a pile of people as the van takes on the busy roads of Accra. From what I’ve seen, there are very little driving rules here. You go as fast as traffic lets you, or as slow as it prevents you from moving. When traffic is at its highest, the informal employment sector is most visible. People walk in between cars, vans, and motorcycles on the highway, knocking on your windows, staring at you in your car, and offering different goods from Trident Gum to Water and my personal favorite, loose peanuts. However, it is essential to make your purchase quickly because once traffic picks up, you might be out of a few cedi because cars wait for nobody. In fact, most drivers drive within a few inches of each other. There’s no space bubble here. What’s most surprising about all of this is the fact that I’ve seen no traffic accidents. People are relatively vigilant of the road, which is probably enhanced due to their craziness. Even being a passenger sometimes I cant help but stop and stare at the crazy configurations of cars moving in different directions, sometimes I even spot cars facing each other within an inch of the front hoods, hoping to nudge each other out of the way with their stubbornness. Tro- Tros, like anything else, have both positive and negative aspects. They’re incredibly cheap, by American standards. I was told to never pay more than 1 cedi (Ghanaian currency), and even that might be a bit pricey, however they know I’m foreign so I always get the upcharge. 1 cedi is equivalent to about a quarter (.26) cents in the United States. However, sometimes Tro- Tros are hard to navigate, given there aren’t posted routes like buses back home (and I can’t eve understand public transport in Ann Arbor). We were instructed to go to the Tro-Tro station in order to arrive at our destination earlier this afternoon, and what we found was essentially a vast open space packed to the brim with Tro- Tro buses, which complied to be a huge back up of aggressive Tro- Tro drivers attempting to fill up their vans and get out on the road as soon as possible. In the midst of all this were many people, again, selling items (today I was offered mysterious unknown medications for 3 cedi), as well as a few beggars, who are always very hard to turn down.

Other than Tro- Tro, the options are Taxi and Motorcycle Taxi (a name I invented myself). Taxis are also relatively cheap. Jenny and I can take a taxi from where we are staying (20 minutes outside the city) for about 20- 30 Cedis (5 – 8 dollars). We have recently been traveling to Osu, which has been deemed the hang out district by many of the students. Osu is known for its restaurants, casinos, and clubs. I’m excited to try out the nightlife in the next couple of weeks, and possibly take my first trip to the Casino (slightly worried because for those who know me well, I frankly suck with money). Osu is also home to Kofi’s, our U-Mich liaison, favorite restaurants, Buka, of which we ate at twice within three days of arrival. He did attempt a third trip, but I abruptly stopped him. A girl can only eat so much Jollof rice.

Food has probably been the biggest adjustment for me. As many of you know, I’m a foodie and I will probably eat almost anything that’s put in front of me (unless it still has it’s eyes or is a rabbit salad). However, I haven’t been able to fully adjust to the diet here, especially given so many restrictions. We aren’t supposed to eat stews or soups, because the ingredients, depending on the restaurant, which could be left overs from the day before. We also have to avoid raw vegetables and undercooked meats. Fruits can only be eaten if they are freshly peeled, and we were instructed to avoid berries. The only thing I can say though is that the pineapple here is amazing, and I probably could sustain myself on it, if need be. I am hoping to try my first mango soon too considering everyone I know has a minor obsession with them. Usually Jenny and I find ourselves eating at the small café in our dorm, named “Tasty Treats.” Options here include eggs, pancakes, some sandwiches and typical African foods such as rice, beans, and chicken or beef. Behind our dorm is the Night Market, which is similar to the food markets I’ve previously seen in Guatemala. Here there’s an abundance of fruit, and some food stands. I haven’t tried any of the food stands myself, but Jenny didn’t particularly like her 2 day old fried plantains, so we decided to stick to the inside options for larger meals. Other restaurants we’ve enjoyed include Frankie’s and Piazza. Although I’m adjusting to the options, I hope that the natural state of the foods will cleanse my body of toxins. Given everything in the United States is processed and flooded with high fructose corn syrup, perhaps eating real, whole foods, will be good for my system.

Other than cleansing my body, I’m hoping Ghanaian culture will cleanse my mind. Junior year showed me the physical strain that stress puts on my body. I have developed a bad habit of pretending I am not stressed, and therefore not letting myself feel any stress mentally as I “power through” my exams, assignments, and papers. However, this has resulted in the development of serious strain on my body from sleeping problems to chest pains. Yet, Ghanaian culture moves slow. Slow like walking through pudding, slow. I have noticed myself walking slower through the streets, and taking my time, because at the end of the day, I truly have nowhere to be. The data collection hasn’t started and other than a few meetings and appointments, I am free as a bird. I never have free time without obligations, so I am a bit confused about what to do. Most college students can attest to the fact that free time means a guilty Netflix episode or two or four, followed by a long study session and annoyance that time was wasted on something as “silly” as relaxation… or maybe that’s just me. Either way, Ghana is sunny and new, and I hope that my abundance of free time will be used wisely while I am here. I have even slept more here than I have in the last few months of my life in Ann Arbor. I’m not sure if I’m adjusting to the time or I just realized how worn out the semester had made me, but I have taken quite a few naps and have slept for more than twelve hours a few nights (normally I cannot sleep without waking up at least every four). Given that Internet is kind of sketchy, and there’s no TV’s, I have started pleasure reading my first book in about two years. It has been amazing; I wish I had packed more books! I have also attempted journaling along with my consistent hobby of posting these blogs.

Spiritually, I am also hoping to gain new insight. I was raised Catholic, and I have posted some about my struggles with religion and faith in the past, mostly while I was visiting many churches and cathedrals in Spain. As much Catholic, Judaic, and Islamic history that Spain had, I never felt immersed into a very religious society. Rather I thought the traditions and customs had religious roots, which had eroded into cultural practices for all to appreciate. While I understand and respect this, especially since the situation is similar sometimes in the United States, the environment in Ghana is different. There are signs everywhere that proclaim people’s love and adoration for Jesus Christ. The people are truly living their faith; they are announcing it in all forms available to them. Political Campaigns have slogans like “Swag Up for Jesus.”  Tro- Tro’s are named “Tro-Tro for Jesus.” Even sides of buildings proudly proclaim, “To God be the Glory… Thank You Jesus for the Victory.” Practicing Catholics know that mass usually lasts around an hour, and if you are feeling lucky with a short homily, it lasts about 45 – 50 minutes. Jenny and I attended mass this past weekend, to be greeted with a two hour mass. I can’t pin point where the extra time came in, but people seemed to absorb more of what the priest had to say. Parishioners truly sang the songs, of which half were in English and half were in Twi (either way I couldn’t read the projector without my glasses).

As far as making friends, it has been a little rough considering all of the students living at our campus will be moving out within the next week or so as their semester ends. Some new students will be arriving to live in our international student dorms, however we have heard that the campus pretty much clears out. This means two things: good WIFI connection but lonely hallways. Coincidentally, the first girl I met here happened to be a student from Calvin College, which is about 20 minutes from my home in Grand Rapids. It’s crazy how small the world is sometimes. In fact, some of the girls from Calvin knew people I went to high school with. Jenny and I have also talked with some of the other students who have been decently helpful with finding restaurants, telling us how to do laundry, or where to purchase basic necessities. One student even told us we seemed to navigate better than most students who just moved in, she even asked us if we’d been to Accra before (Hah, fooled her, we are always lost to be honest). Sometimes the situation is fairly intimidating, and being one of the few white Americans on campus, I get stared at everywhere I go. I have learned that Ghanaians are blunt and will tell you like it is. Going along with this, they will stare at you without regard for your discomfort. I have even seen guys put half their bodies out of moving vehicles to rubberneck at Jenny and I… questionable decisions if you ask me. Although it is a bit awkward, I am starting to become used to being a spectacle and overtime, as I gain confidence, I bet I will no longer notice.

Overall, I have learned quite a bit in my first week. While some of it has been hard, I must admit, I am never too afraid of a challenge. I have never been one to be homesick, but I do miss the familiarity of certain aspects of my life, however I am appreciating the freedom I have in Ghana, as well as the opportunity as a whole. While applying for this program, I realized I had never wanted something so bad in my entire life. I could feel the need for it in my bones. It was one of those deep, all encompassing feelings that took over my mind and wouldn’t quit until I had put my all into the essays and interview. Thinking back to last October, I can’t believe how quickly time has swirled around me. Here’s to another journey! Hello Ghana!

P.S. Sorry for the lack of pictures, as I stated the WIFI connection is a bit shaky, so I was unable to upload any with this entry. More pictures to come!