Some final insights

1. My great, great, great, great grandfathers were assholes

 The day after our program officially ended in Ghana we hired a driver to take us to Cape Coast, a town about 165 km west of Accra.  Cape Coast is the home of the Cape Coast Castle, a hub for the trans-Atlantic slave trade, beginning in the 1600’s.  After a very bumpy, 2 hour drive from Accra we finally arrived at the castle.  We found a white washed fortress right on the sea, complete with waves periodically crashing on the western walls.

While on a tour, we learned that the castle was built by the Swedish in 1653 but changed ownership several times over the next decade, eventually ending up in the hands of the British in 1664.   The castle was originally designed for gold and timber trade but once Europeans realized the profit potential of human slave trade it was re-purposed.  We were first taken into the male slave dungeons that, at capacity, could hold up to 1000 slaves – unbelievable seeing as how the spaces we saw seemed only slightly bigger than my Los Angeles apartment.  The slaves were held in the dark, musty dungeons for up to three months before they were loaded on ships destined for America.  How anyone could survive in these accommodations for that length of time, without knowing why they were there or where they were going is beyond me.  We also viewed the women’s dungeon, which could hold up to 500 women.  In addition to enduring the terrible conditions in the dungeons, many of the women slaves were also periodically pulled from their chains only to be raped by the European soldiers.

I got fairly emotional during on tour as I took in all of my surroundings at the castle.  It is hard to believe that my European ancestors were involved in this type of activity for well over 100 years – I am deeply shamed by their inhumanity.  In elementary and middle school I was quite fascinated by the trans-Atlantic slave trade; I read books and wrote a few papers but none of the stories that I encountered during my research quite prepared me for what I found in Cape Coast.

 

2. The Fresh Prince would be jealous of this Big Milly Style

We were all exhausted after our emotional tour of the Cape Coast Castle and although we had planned an excursion to a nearby rainforest, we opted instead to return back to Accra a little early for a beer on the beach.  The rest of our stay in Ghana was at a beachside hostel outside of Accra called “Big Milly’s Backyard.”  We were all quite excited about a couple relaxing days at the beach, a much anticipated 24-hour bar and the promise of a menu that included vegetables.   Getting there was quite a challenge as the road to Big Milly’s was nothing short of horrifying, full of over-eager pedestrians and potholes the size of swimming pools.  Our driver was quite concerned about his vehicle as he twisted and turned down the road attempting to avoid the plethora of hazards.  Instead of slowing down, like the average, sane driver, he instead sped up, zooming over bumps and holes at 50mph.  We all held our breath, closed our eyes and prayed a little.

When we finally arrived at Big Milly’s we decided we would stay put for the rest of the trip, not wanting to brave the road again until we were ready to return home.  After some drama with our room (which we had reserved several weeks before), we found ourselves in the Big Milly Suite on the first night.  Although we paid 24 cidi more than we had wanted (about $19), we realized we had been quite spoiled when we moved to a smaller room the next night, which was full of creatures and lacking in many luxuries, most notably a hot water heater.  We managed to enjoy the majority of our stay, drinking a lot of 1 cidi drinks (about $.072) and decent meals.  The beach was not exactly what we had hoped but we enjoyed a few scenic walks and watched the local children play in the waves (whoever said black people do not swim has not been to Ghana).

 

3. Sometimes a private beach is a bad thing

On our last day in Ghana we enjoyed a delicious breakfast and then ventured out for a walk on the beach.  The day before, the beach was full of people fishing, swimming and just hanging out and we were surprised to find it nearly empty (we later learned that the locals do not fish on Tuesdays).  At first, I was glad to avoid the circus of attention that we tend to attract, but once I realized we were being followed, I longed for the bustling activity of the day before.  The man followed us for a quite a while and when he continued to follow us after we turned back toward the hostel I knew we were in trouble.  We walked quickly and I kept looking back at him so that he knew that I knew what he was up to.  After a while I got a bit distracted and it was in that moment that he came up from behind me and grabbed my camera.  The camera was strapped to my wrist so he was not able to simply grab it and take off running.  We struggled for what seemed like several minutes. One of my colleagues got involved and at one point we had thrown the man onto the ground, but after he got up and grabbed me again and barely flinched when he was repeatedly kicked in his male region, it was clear that we were not going to win the battle.  I finally let the camera go and burst into tears as we ran back toward to hostel.  It was easily one of the scariest moments of my life, but I am relieved that we escaped with only a few scrapes and bruises.  In the words of my colleague, “be thankful that he just stole your camera, not your vagina” – such wisdom.

 

4. There is no place like home

After the mugging, I was more than ready to go home.   We arrived at the Accra airport early, which turned out to be a very good thing as we spent the next two hours navigating the most ridiculously inefficient system I have ever seen.  We were asked for our passports no less than 11 times before we finally boarded the plane.   The whole experience was nothing short of unbelievable although uneventful compared to some of the horror stories we had heard from other tourists.  It is fairly common for visitors to be arrested as they pass through immigration due to various visa-related technicalities.  Immigration officers request that they pay bribes in order to be released.  I breathed a sigh of relief when the immigration officer that questioned me let me through after he had reprimanded me for being a “lazy American” because I didn’t complete one of the dates on my immigration paperwork. 

The next 22 hours were some of the most miserable in recent memory as I was nauseous nearly the whole time, complete with a fever, chills and body aches.  After seeing the movie Outbeak only a few days before, I was nervous I might be bringing some type of rare African plague back into the United States but after a week at home, I am happy to report that I appear to be the picture of health. 

I was overjoyed when we finally landed in Los Angeles.  As we drove home I was excited to see stoplights and traffic laws being observed once again.  Although I enjoyed my experiences in Africa and would not trade them for anything I am glad to be back where the world makes sense again, where I can blend in with the crowd, where I can drink water out of the faucet and can find turkey sandwiches on nearly every corner.

MDI Unwrapped

Our program in Ghana is wrapping up today and starting tomorrow we will be staying at a hostel near the beach call "Big Milly's Backyard" (such amazing names for establishments here in Ghana). We will spend our last three days playing full time tourists. Unfortunately, this also means that we will lose access to the internet for the remainder of the trip. This will be my last post until I return to the U.S - I hope you do not go into withdrawal without me!

A significant portion of my experience in Africa thus far comes through my interaction with participants in the Management Development Institute (MDI). As their teaching associate, I have helped each of them develop Community Health Improvement Plans (CHIPs) so that they may improve their organizations and/or the impact they have on their communities. I have been inspired by their passion, stories and ambitious plans for change.

The projects that have been developed here are dramatically different than those that were developed by the community health clinics that we worked with in the United States. During our Los Angeles programs, we saw CHIPs that largely focused on improving profitability, operations and infrastructure. In Africa, the projects go to a very basic level of educating communities about HIV/AIDS and extending testing, counseling and treatment services to those that need them. These are the stories of the participants I worked with during from the first MDI in Nairobi, Kenya (stay tuned for more about my Ghana participants).



Dr. Ssali and Dr. Kawooya represented the Uganda Cares initiative. They face a rural community where the HIV/AIDS prevalence continues to soar, especially among young people. Many infected youth do not know their status and continue to unknowingly spread the disease to others. At the MDI, Dr. Ssali and Dr. Kawooya set an ambitious goal to double the number of people being tested in their region from 125,000 to 250,000 annually. In order to achieve this they will initiate a public awareness campaign to mobilize the community around the importance of “knowing your status.” They also have plans to implement mobile testing clinics so that access to testing from rural areas is no longer an excuse for not being tested.



Andrew and Diana represented the Northern Uganda Malaria, AIDS & Tuberculosis Program. Northern Uganda has endured intense armed conflict for the last two decades. Although the situation is improving, the HIV/AIDS prevalence rate in the region is the remains over 8% (over 250,000 people). Post-conflict, the region has limited resources for the care and treatment of people living with HIV/AIDS (PLWHA) – there are currently only four CD4 machines in the entire region (used to monitor T-Cell counts in PLWHA). At the MDI, Andrew and Diana built a strategy to maximize the capacity of the CD4 testing machines in order to reach to 13,000 additional PLWHAs in Northern Uganda. Their project will begin with an assessment and evaluation of the cost effectiveness and performance indicators of various models of care.



Maryam represented the Benjamin Mkapa HIV/AIDS Foundation in Tanzania. The Benjamin Mkapa Foundation works to build the capacity of health workers that provide HIV/AIDS care and treatment in Tanzania. Many areas of Tanzania are very remote and the people in these areas have poor knowledge about HIV/AIDS, how to prevent it or how to treat it. Furthermore, many HIV/AIDS infected pregnant women in the region deliver their children at home instead of established health facilities. This results in increased rates of women passing HIV/AIDS to their newborns, as they are not aware of preventative measures they can take to protect their children. Upon her return to Tanzania, Maryam will institute a program to better train community health care workers so that they may conduct outreach activities to engage rural pregnant women and educate them about the benefits of delivery in health facilities. Though this program, she hopes to reduce the transmission of the virus from mothers to child by 20% in one region of Tanzania.



Samali and Henry represented the AIDS Information Centre Uganda. There is increased HIV/AIDS awareness in their region and they have found themselves inundated with demand for HIV/AIDS counseling and treatment services. With limited resources, they must find new, innovative methods in order to meet the demand for their services. After the MDI program, they believe they can reach 200,000 more clients through programs designed to mobilize the local communities including home to home care, community camping and couples campaigns (to engage the male head of household in counseling and care).

Not cut out to be Ghanaian

1. Old Bob is the gateway to good food and local celebrities

As it turns out, Old Bob does have fairly good food – hands down the best meal I have had in Ghana thus far (though after you read insight #3, you will see is not really saying much). After braving unbelievable traffic, we arrived at the restaurant and were introduced to the owner, Angela. When asked for recommendations, she told us that Bob’s seafood was the best in Accra and probably in all of West Africa - a claim that I could not let pass by. My seafood platter was pretty good but I could have done without the deep fried baby barracudas.

In addition to raving about her seafood, Angela also raved about her brother Fritz, a member of parliament in Ghana and the man who gave Obama the tour of the former slave holding facility at Cape Coast, Ghana during his visit in July. We were rather impressed, and my professor said “wow, I would love to meet him and hear his stories.” Angela gave him a ring and as we were finishing dinner Fritz walked in just in time to sing happy birthday to me and watch as I blew out the candle on my fried ice cream (delicious). He then shared a drink and many insights about Obama’s visit, Africa and the world (he liked Michelle best). Fritz has his hands in a number of different activities from entertainment to health care to politics – as he spoke I wondered if all his stories were true. How could such an important man randomly show up to chat with a few American tourists at his sister’s restaurant? I googled him and found that indeed, he was Obama’s guide at Cape Coast. I got his card - organic networking at its best.



2. Ghana is Obamarama

Speaking of Obama, remnants of his July visit are everywhere in Accra. As you drive through the streets you see huge billboards welcoming him. Just like Kenya, there are Obama trinkets for sale in all of the markets including art, bags and t-shirts. At first I thought that the merchants were just trying to take advantage of ignorant American tourists, excited by seeing their President’s image on souvenirs, but then I saw the woman below at the market yesterday, decked out in her Obama gear. Obama is kind of a BFD.



3. Sad tummy = sad Jess

It has been nearly two weeks now since I left home and homesickness is beginning to surface. After some contemplation, I blame it on the food. Unlike Kenya, everything in Ghana very oily, vegetables are nearly non-existent and the fish is inedible (for me), as it has not been de-boned. Beyond just not tasting that great, the food has also left all of us with upset stomachs (or worse). It is sad but true that my mood is dramatically altered when my stomach is not happy. I am starting to become anxious to go home, longing for my own bed, a turkey sandwich, a chocolate chip cookie and a bowl of broccoli.


4. Opportunities to purchase random crap are everywhere

Although we are saving many of our Ghana tourist activities for after the program is over, we did find some time to go in town yesterday to visit a couple of markets. On the way to the market we had to drive through dozens of hawkers, selling goods to the cars passing by. “Would you like a screwdriver? No? How about a rubik’s cube? No? How about a painting of the last supper?” The most random mix of crap I have ever seen in my life – highly entertaining.

After getting through the hawkers, we arrived at Makola, the largest market in Accra. Makola started off okay as we visited a couple of stands offering fabrics and jewelry but quickly went downhill. Somehow we ended up in a claustrophobia-inducing maze of fish, shrimp, giant snails and pigs’ feet. The smell was more than I could handle and I nearly had a panic attack when we could not figure out how to get out. Despite my horror, I am glad we went so that we could get a look at where locals shop and what they eat. I have no intentions of going back though, ever.



After a rough experience at the Makola market we asked our taxi driver to take us somewhere a bit more “touristy”. He took us to a much more open market that had jewelry, wood carvings and art. We were all were able to find a few things to buy here although overall I have been disappointed that there does not seem to be any items of higher quality for purchase. I am afraid that most of my purchases will fall apart in short order. Perhaps we are going to the wrong places – I hope we can find the “right places” before we leave. My Ghanaian cidis (the local currency) are burning a whole in my pocket.

27 in Ghana

1. Old Bob has a fine dining establishment in Accra

We have not yet had the opportunity to see Accra because the college campus we are staying at is about 40 minutes (depending on traffic) from the city center. I have enjoyed being in one, enclosed, safe place but I am getting a little bit restless to get a better look at what life is like in Ghana. Just in the nick of time, the professors that we have been working with invited us out to dinner in the city tonight. We are going to a restaurant called “Old Bob’s” – sounds questionable but apparently it is delicious. I hope that it is a suitable birthday dinner and that, somehow, they have magically imported a birthday cake from Sweet Lady Jane’s.

2. Even a Star cannot beat a Tusker

Having developed quite the Tusker habit in Nairobi, our waistlines could have probably benefited from a hiatus in Ghana, but as you might have guessed, we will have nothing of it. We quickly discovered the two local lagers, Star and Club. We had a taste test last night in my room over a friendly card game. We can no longer drink (and gossip) in the hotel bar because, in Ghana, all of our participants are in the same hotel as us – so every night will be a mini pajama party. Star came out on top in the taste test but it will never replace my beloved Tusker.



On the topic of beer, we also discovered that Guinness is quite popular here. The small bar downstairs stocks two types of Guinness lager (or we thought they were both lager anyway). On opening night, some of the guests brought their children to dinner. At one point we looked over and saw what looked like an eight year old boy chugging a Guinness. We were relieved when we found out that the Guinness the boy was drinking was “Malta” which is a non-alcoholic malt beverage made by Guinness – thank goodness!

3. You sweat a lot when you run in the jungle

Being on an enclosed college campus, I have finally been able to resume some type of exercise routine. In Nairobi there was a small gym in the hotel with a single bike and treadmill, but it was only open during certain hours of the day, and because I despise the treadmill I only worked out a couple of times. My colleagues and I have run the last two mornings, and although people stare at us like we are crazy, I feel much better now. This morning, we saw two other people running - I got a bit giddy with excitement when I saw them; it seems that we are not alone in the world! Running here is a bit more difficult than at home in Los Angeles because of the intense humidity. After only a couple of miles I was drenched with sweat - that will teach us to run in a jungle!