Medical Emergency

(photos pending reliable internet)
The waiting spaces of Clinic Days at the Baptist Medical Centre are dark, hot and loud. People begin cramming into benches at 6am; by 6:30 when the lorries arrive carrying the sick and their relatives, the benches are filled, and the floor is running out of space. People go through the check-in process with any number of ailments, from the minor to the dire—and often the more serious it is, the farther away they have come from. Most rural communities lack orthodox health facilities of any kind, but the majority have herbalists, traditional healers and birth attendants who can deliver babies and effectively treat malaria, some snake bites, fevers, and even minor cholera without leaving the community. Those who must leave have almost invariably been treated insufficiently or inappropriately, and are weaker, sicker, and in more danger than they were before. The doctors of the BMC tell me of the “fracture specialists” that treat in many communities, including Nalerigu, by twisting, turning and massaging of the broken limb. For every time this method is successful, they say, they have to perform two amputations of gangrenous, poisonous, deadwood limbs. The rainy season tends to complicate things; severe cases of malaria, pneumonia, typhoid and cholera become a daily challenge at the hospital, and fractures, black cobra bites, and accidents become commonplace as people work their farms.

Wards are filled with the smells of sanitation fighting the odours of road dust and human sweat, as the relatives and friends of those admitted visit daily, regardless of the distance traveled to do so. There is no fee to visit, but the meals, bed, care, blood transfusions, consultations and medications come at a price. A bad bout of malaria in one member can cause a family incredible stress—it becomes the choice between risking the loss of a family member, and risking the whole family's starvation after food is sold to pay medical bills. Nevertheless, the line at the pharmacists' counter never seems to thin. In Ghana, there is a medicine for everything, parceled out in old collection envelopes from American Baptist churches.

The small sun shelter of the Nutrition Centre is always bursting with mothers cradling children suffering from “kwashiorkor”, the grotesquely bloated stomach and frail body of television famine victims severely malnourished during their most crucial developmental years. Healthier children, wrapped in a sea of IV tubes and watching Ghanaian children's television with broad smiles on their TZ-coated faces, are often there too. It is the worst now, during the rainy season—it has been a whole year since the last harvest and the flood that destroyed farms and homes, and under normal conditions some of the villages that send their sick to the BMC may not have had a stable food supply in 9 months, forget a supply that is nutritionally balanced. Despite this, the Nutrition Centre is one of the more pleasant, relaxed sections of the hospital. It is one of the few places that deliver much-needed medical assistance that is relatively risk-free.

Despite the lateness of the day, and the line of almost 300 before me, I am ushered to the front, given immediate consultation, blood smears and tests, and sat to wait as my relatively minor case is rushed to the forefront. I ask the American and Swedish doctors serving me to place me at the end of the line—and am answered with ominous honesty that there is no “end of the line”. Those sweating and suffering around me for hours before I even entered the grounds do not so much as raise an eyebrow in indignation.
White privilege strikes again; I am heart-heavy for the rest of the day.

Blanc, la mystere

(photos pending functional internet)
I have always thought that I am here to learn, so that later I may teach. The nature of my placement—short, probing, and with a very able partner NGO—made me very aware from the start that the majority of the impact from my stay in Ghana will likely spring from how my experiences here are leveraged in Canada. With this in mind, I began my sweat through the savanna asking questions, taking photos, and chronicling everything I could about the lives of those around me, justifying as I went that things were different where I come from, and I would like those at home to understand. It has taken me six weeks and innumerable conversations to realize the hubris and backwardness of my attitude towards my learning here, and it flooded into my vision at the quiet, embarrassed question of a child politely asking, “Why are your legs different colours than your arms?”
After explaining the concept of sun damage to skin, and laughing at the gasps of shock when I revealed my considerable Birkenstock tan, I realized what I had been doing for weeks: instead of absorbing their way of life alone, I had also been sharing my own. Instead of downloading, I had been exchanging. And in that process, I had been learning much, much more than I would have if engaged in a solely one-sided process.
Westerners are truly a strange breed in a place like Ghana, coming from all over the world for short stints of busy, alienating and culture-shocked time. Just as so many people in Canada believe through exposure that the face of Africa is that of the World Vision child, many people in Ghana believe that the face of the West is an equivalent of Donald Trump in a safari hat. At transit stations, it is assumed I am going to tourist-driven National Parks in Damongo; everywhere I go, people ask me for my water, money, clothes and jewelery, because it is assumed I can just go and get some more. These requests increase when I mention I am working in development—in Ghana, “development work” is a highly-paying profession, the equivalent of being a banker or an accountant in Toronto. The dichotomy between what many Ghanaians think they know about Westerners and what they actually DO know is a mirror image of what Westerners think they know about Ghanaians.
It's not much.
I was met with disbelief and laughter when I talked about Canadians eating soup with a spoon, and no solid mass of grain to compliment it; when I talked about snow 5 months of the year, and temperatures of -25ºC; when I mentioned that it cost a lot of money to get to Ghana, but I am not being paid for my work here, and may have trouble paying my rent next year. I have been met with anger at children passing on the street who swear that I promised them a soccer ball gthe last time I was in Ghana, and frustration from Mamprusis when they mistake my name, because "all you whites look the same". I have been met with wonder that in Canada there are no legal and few social sanctions against Mulatto children or registered landed immigrants; that women own houses equally with their husbands, have full autonomy within a marriage and receive alimony payments in divorce; that there are people in Canada who suffer from poverty, and live in the dangerous streets without assistance from the government.
I had come to Ghana prepared to be a sponge, when I should have come prepared as an emissary. For every fact, attitude and truth that I don't know or understand about Ghanaians, they have an equally gaping void of understanding about me—and more questions than I have time to answer in my short months here. In every one of their queries stands an attitude, and every conversation about my life and country yields an insight into theirs. All learning is an exchange, and their steps towards understanding me yield ways in which I can understand them. The foreign, the White, and the places they come from seem to be a mysterious, mythical paradise to escape to and an easy way to reach happiness for the many, many Ghanaians that ask me “How can I get to Canada?”. Perhaps with learning, with exchange, they will slow their search for a way out of their wonderful country, and discover the opportunities and potential for greatness that brought me to it.

Farming Season

(photos to come pending functional internet)
When the long-awaited rains finally come in, the tone of Nalerigu shifts in subtle, but perceptible ways.
The town empties out during seemingly random hours, before and after which you see men walking hand-made hoes leaned on dirty shoulders back from their farm acres. Goats and pigs, usually left to wander in and out of traffic and yards indiscriminately, are tied to anything and everything they cannot wrest from the ground--an act of protection for the maize shoots newly sprouting everywhere. On my walk home from work I hear the repetitive "thwack" and "thud" of hand-ploughing as every patch of fertile land surrounding compounds and other buildings is softened and converted into garden patches by women, children, and young men. Tractors roll in and out of narrow footpaths, reaching impasse after impasse with donkey-drawn carts, motorbikes, and water-carriers. School attendance wanes as family farms become priority; schools lie dormant when it rains, with no students or teachers able to trek through the pounding elements to wake the colourful buildings up. Lush green overtakes the red Ghana dust as weeds, ground cover, and eventually crops all spring into frantic growth. It is a time of work, but not of anxiety--provided the rains are good.
This year, it appears they are not. I am told by veterans of Nalerigu that by this late in the season, the rains should be every day, instead of the every-four-day schedule meteorology has roughly endowed us with. Nalerigu natives try to keep their optimism up, no doubt as a means of protection against the memory of the inordinate damage of last year's drought and flood. Food aid still streams into East Mamprusi to raise the burden of farmers that lost not only their homes and belongings, but the very topsoil that keeps them alive, to the rush of water south from Burkina last September. Though it makes me uneasy, I am glad for the aid this time--if just to give these farmers an opportunity to sow again, and try to rebuild their foundations.
We at PARED are just as affected by the difference in pull the farming season exerts. Farms and farmers become priority as we engage in the CIFS Food Security Initiative proposal process, late due to rains and the aforementioned lack of anxiety many experience during this season. The busy nature of these few months pose difficulties with this CIFS process: ploughing and sowing season is not the best window in which to request the time, thought, effort and dedication of subsistence farmers literally ploughing for their lives. Unfortunately, the timeline was not ours to choose: CIDA, possibly remembering the ease of summer vacations past, calls the shots on the FSI's with the snapping of purse strings and the urgency to help.
It rained very early this morning, after a day of scorching temperatures and blistering sun. Already the ground is dry, reverting to the sandy guinea savanna it is, from the fertile croplands we need it to be. Nevertheless, all around me on my walk to work I see maize leaves struggling towards the sun, more proof of this nation's dogged determination to survive.

Photo Roundup #2

I'm currently Ill with a capital "i", so I'll post extra later: for now, photos from the past weeks;

Rita, my seamstress, working on the manual sewing machines that turn out most of the clothes in the Northern Region

Mother and children, sowing maize at Kukigbini--a community in which we're running a CIFS food security project.

Um, CuteOverload? I win. Two of the three stooges, my tiny cats at the house.

Nalerigu women carrying firewood to sell--a last resort for a majority of women in the North when the food runs out, and a major player in the desertification and lack of fertility in the farmlands here

A village chief carving the handmade hoes that most people, young and old, use to till acres of land with their hands and the strength of their backs

Boys and girls of Kukigbini, androgynous through malnutrition and frightened of me, but respectfully standing still--their mothers wanted a photo.

PARED at work--a village woman collecting the culmination of a partnership with OXFAM, a metal donkey cart for carrying water, goods, crops, and often people.

There are so, so many more--this week I venture into tourist country, to Damongo and Mole National Park for the midsummer JF retreat. Expect updates when healed, rested, and able to eat again!

An Open Letter to Ghanaians Who Eat

Dear Ghanaians,

Since coming to your wonderful country and meeting you wonderful people, it has been brought to my attention in an overwhelming number of ways how little I understand you. My best efforts have yielded small victories, and I continue in the fight to reach even a meagre level of comprehension of the way you think, work and live, but there is one facet of your life that, try as I may, I do not think I will ever understand.

Ghanaians, you eat like crazy people.

Let me explain. In Canada, I am rarely referred to as a big eater; there are a few dishes on a few occassions that prompt me to pile a plate and a half of food into my digestive system in less than an hour, groan at my own gastronomical hubris, and go have a nap, but in general I tend to respect the fact that the human stomach is only as big as a fist. Stupidly, I assumed this was less of a cultural thing than a humanity thing, and that eating what I would consider sane amounts of food was fairly standard issue all over the world. Ghanaians, I'm sorry for my Western-centric stupidity, but the fact that I'm so terribly, terribly wrong does not help me reconcile that on a thrice-daily basis I see portions bigger than my whole head being shoveled into skinnier people than I've ever seen off a runway in Paris. I would give my left leg for one-tenth of your metabolism, especially in light of the fact that in addition to centering on gargantuan portions, the overwhelming majority of your diet consists of carbs and water. I, the struggling vegetarian, am staring at an entire culture of people being pleaded with to eat their vegetables, because no one has managed to engineer an ear of corn or a yam tuber with the vitamins, minerals and fibre that people need to survive on only yams or corn, the way you're trying to. And you must know it somewhere in your minds, too, because you don't let yourself eat without putting yourself through a certain degree of torture and punishment for not having the salad. Whether it's stirring TZ thicker than molasses over a roaring charcoal fire in 45 degree weather, or systemically pulverizing yams into fufu like you're working on a chain gang, there's really no such thing as an easy meal here, is there? Who first looked at a yam and said "Hey, lets peel this, boil it, beat the living crap out of it for no less than three hours, pour boiled hot peppers all over it, and put it in our mouths every day for the rest of our lives"? And how do you eat the same meal, multiple times every day, for twenty eight years, and still miss it when one day someone passes you some rice and beans and reminds you there is food in the world that is not TZ?

Not that the other food strays very far from what you're used to. Every single Ghanaian dish I have ever had fell into one of four flavour categories: hot pepper, peanut, okra, and/or fish. Most things you like to put in your mouth for a meal fall into a number of these categories at once. And when you cook anything else, somehow they still wind up tasting like one of the Big Four. Never in my wildest dreams did I anticipate shrimp-flavoured chicken, but Ghanaians, you delivered. And when I say "chicken", I mean -a chicken-: for you, Ghanaians, the whole animal is meat. Opening up the compound freezer, I was mistakenly surprised to see that the "meat" that was fulfilling my protein requirement later in the day was actually the slack-jawed, scream-of-avian-terror face of a rooster's still-feathered head staring at his own dismembered feet. Well, waste not, want not, right Ghanaians? There's gotta be at least flavour value in muscles, veins, bones, face, extremities, skin, hair and horns, which is why it all winds up from the soup pot to my plate. Hey, and it removes the necessity for subtle work when lopping through an entire pig/cow/goat/donkey/fruit bat/dog/pigeon/fire-licked roasted trout with a machete, as "meat" of varying sorts tends to be dealt with. I guess any animal is meat, too--why, just today, one of you told me that eating dog meat adds 5 years to your life.

I'm really trying to get it, Ghanians, please believe me, I am. Every day I eat the TZ, I pound the peanuts, I try to fan the charcoal fire, cover my hands with food and shove them in my mouth to the knuckles like I have seen so many of you do. And there are some foods you've cooked up that I actually really enjoy--your palm nut soup and rice balls are fantastic, really, they are! But I still manage to disappoint you by being incapable of consuming the amount of food put in front of me, even when pared down in anticipation of the fact that you're feeding the Salaminga, and she doesnt eat.

So Ghanaians, what I'm trying to say is I'm sorry, but no matter how guilty I feel about it, I'm of pretty solid certainty that I'm physically, mentally and emotionally incapable of eating like you do.

But hey, food prices keep going up... so at least I'm cheap to feed!

Sincerely,
-Ash

Training Days

If this first month of my JF placement has yielded anything, it is an awareness of, dread of, and ultimate appreciation for training. Since my embarking on this journey, more of my waking hours have been spent in training than in any other activity: of the 5 and a half weeks I have spent as an EWB volunteer, one was ill and locked in my room, and 3 were in training. And now, I have done the inevitable, and shifted from the trainee to the trainer. This past Wednesday, Thursday and Friday I worked with the PARED team to design and implement a training on the Canadian Initiative for Food Security (CIFS) proposal development, the next project we are taking on in approximately a dozen of 190 communities in Northern Ghana. The point of the Initiative is to involve communities in choosing, designing and implementing a project that will reduce or eliminate the number of months they go hungry in a year. The point of the training is to help our team develop the skills to first facilitate this process in the community, then develop it into a proposal to persuade the Canadian government to grant the funds necessary for its completion. I was trained in these skills with a number of my PARED teammates two weeks ago in Tamale; in classical West African fashion, while I fretted and stressed about preparing for delivering this to the rest of the East Mamprusi district, my coworkers refused to worry about it, delivered on the fly, and experienced at least moderate success.

This was, in a most West African fashion, a great learning experience with a steep learning curve. It quickly became clear that the colloquial, fast-talking, metaphor-slinging Canadian Ashley was neither necessary nor useful. A simple, humble, minimalist, confirmatory, laboriously slow-talking West African version took her place. This Ashley converted everything into a question to the audience in a clear attempt to maintain the audience participation necessary for consciousness to continue among them. She ended every second sentence with a variant of “Does this make sense?” or “Do we understand?”. She took pains to tease out explanations, examples, pros and cons, potential challenges and their solutions for every task she posed to the group. She did this because she had no idea what kind of understanding was being reached (if any), but had every terrifying idea of the fallout for the communities and the work made for her if she screwed this up. Essentially, this Ashley had absolutely no clue what the hell she was doing. Luckily, she was told whatever it was she did, she did it moderately well.

Next week we embark on the daunting but exciting process of community entry, building a relationship with people of different tribes and tongues, and helping them to decide on and eventually acquire what they need the most to build their own opportunities. I'm excited to begin; and will definitely keep you all posted.

Lifting Hearts, Lifting Wallets

I'm not a classically religious person. While I value a concept of God, I highly value the secularization of our educational institutions, our places of healthcare and government. I'm a strong, strong advocate for freedom of belief, and for a religious system working FOR you, rather than the other way around. When I came to Ghana hearing of the primacy of belief over proof and the importance of religious institutions to the social fabric, I came interested to see the way they weave together with the society in which I would be living for the better part of four months. I am a little surprised at my first observations.

It did not shock me that my coworkers and host family were surprised I had no church. It was equally unsurprising when they offered--or rather, demanded--that I attend church with them; this was something I had expected from the start.

Rather, what surprised me was the operations of some of the churches I went to.

Sitting in a plastic lawn chair with the words "Assemblies of God Church Nalerigu" punctured into the sides, I watched the people who had spent the last three weeks explaining their suffering, asking me for the water I drank, the food that I ate, the clothes I was wearing and the small change I carried, the people who asked every time that I answered I worked for an NGO "Well, how will you help me out of my poverty?", pulling ten Ghana Cedis--the equivalent of two weeks' pay for many--out of their pocket for the offeratory. A pastor at the front of the church called for donations like an auctioneer, demanding ten as the price of their salvation and watching people leave their seats to trek to the front to contribute, a hero among their congregation. A prayer was said, and another request from the pastor--five Ghana Cedis. More contributions, from more people with children waiting in the aisles, all skinny legs, round stomachs and wide eyes. Yet another prayer; a request for two Cedis. Prayer, then one Cedi. I think of the assembled 80 people dressed in Sunday best bought and tailored especially for church, I was the only one who contributed nothing. I was too at a loss to move or think.

I have no doubt of the positive effects of religion on a population at risk. Congregations can serve as an extended family, a social (and sometimes even fiscal) support net, and a wellspring of spiritual support in the inevitability that times become difficult. Nevertheless, I left the church building paralyzed with anger at a system that can so easily work against the very people who support it. The money given in this way every week could put a KVIP latrine and rainwater collection and storage in every house, and cut malaria, cholera, and the workload of women and girls in half. In this town, it could give electricity and cold food storage, allowing people to keep meat and vegetables for more than one day, and increase the nutritional balance (and therefore the immune system and health) for the whole family. It could buy more uniforms and books to put their children in school than they would need, and still have money to pay for a lunch each day in lieu of a feeding program. What does it do for God? Where does it go, after the journey from the pocket of the impoverished to the offeratory basket is over?

In Canada, offerings like this are pooled to help the needy, the unfortunate, and often those in developing countries. In Nalerigu, the signs of clothing drives, donations, missions and feeding programs are everywhere, from the cast-off 1997 Nike tank top and Addidas backpack on my host sister, to the phased-out western textbooks at the Junior Secondary School. East Mamprusi alone boasts the Baptist Medical Centre, with its prayer meetings and American surgeons, and the Presbyterian Agricultural Station, with its agro-training and farming implements. I have no doubt that the majority of the help or handouts in Nalerigu comes from various religious institutions. But I also have no doubt that they are all Western religious institutions, harnessing the over-abundance of Western money.

I am shaken by the question; Who does Ghana donate to? And what does that say about why I am here?