Ghanian Culture 101

From Road Scholar Meghan

Just Good Manners

• The people in general are very friendly. You say Good Morning/Good Evening/Hello first and let them respond to your greeting. 
• If offered water from the tap (which there was no way in hell we were drinking), take the glass, pour a bit out of the glass onto the floor/dirt, and at the end of the meeting, give the glass back. None of us could get over how pouring the water out of the glass wasn't an insult, but we were told it is not. Rejecting the water would be an insult. 
• Do not use your left hand for anything. Handing money to a cashier, taking money from a cashier, dispensing meds, taking a pulse, waving, shaking hands, etc. It is deemed improper. Not a total insult, but viewed as not the norm. 

For Medicinal Purposes Only

• Try not to drink bottled water in front of the locals, they don't have any. 
• Try to remember they do medical procedures differently than us and the U.S. way is not the only way. 
• Their version of pain is different than our version of pain, they state it differently, they hide it and tend never to complain about pain. So if you ask them if their pain is a little or a lot, and they respond a little, it's probably a lot. If they say no pain, there is probably a little. That's completely different from the hypochondriacs we get in the States. 
• Despite the cramped conditions in the hospital, men and women would be examined differently and could never room together, even with a curtain separating them. That would prove to be difficult when we took a tour of the hospital a few days later.
  

Air Conditioning and Beer...We're Good Here So Far

The following is from Road Scholar Meghan and her series of updates about her recent humanitarian aid trip to Ghana.  It appears here edited for content and length.

Luckily, we had an air conditioned bus on the 4 hour drive to Cape Coast. I still couldn't get over the landscapes. Amazing trees, shrubbery, and ant hills. Yup, ant hills almost 5 ft high…you don't screw with the ants over here. 

The villages in between the rolling hills were a huge eye opener. Primitive was the first word that came to mind. Billy goats galore, hens, chickens roaming all over the place. Shacks, wooden and no more than 12x12 ft large, mostly with small porches and sometimes painted. As far as I could tell, no electricity or running water. Wooden fires with cauldrons for cooking, and pumps for running water. The shacks were stacked one next to the other for miles. They were mostly businesses on the side of the road, most with titles such as "In God We Trust Hair Salon", "The Lord Is My Shepherd Plumbing Supply" or "Believe In God Womens Boutique". For having very little, the Ghanaian people have huge faith. 

We arrived to Cape Coast and the harbor area and my jaw dropped as I looked out at the harbor. I felt like I was instantly taken back to the Crusades. Wooden gondolas, hand painted with no particular flag hung at the end of the boat. Hundreds of boats. The dirt roads, the billy goats, the roosters, the women carrying baskets on their heads and their babies wrapped behind them in cloth. Never seen anything like it. Still the people would come up to the window asking you to buy products. Children would glance in the window, see the Abrunees and smile and wave. You would smile and wave back at them.

Shortly thereafter we were driving along the coast to the hotel. Away from the gondolas, you'd think I was in California without any sort of development. The beaches were beautiful with palm trees galore and waves like Huntington Beach. If I didn't close my jaw soon, a mosquito would fly in so I tried to compose myself but I couldn't get over where I was--Africa or California?? Then I'd look over at the other side of the road where the land was and quickly be brought back to reality. Mud huts were the local architecture, with thatch roofs made of palm trees and shrubbery.

We checked into the hotel and into our rooms. Rooms were fine, had a/c so I was OK with whatever else they didn't have. Even had a small fridge so we  weren't exactly roughing it..yet. Mattresses, I would soon find out, were made of something similar to plywood. Hard as stone but no bugs on the sheets so we were good. By this time it was 5pm…just enough time for Barbara and I to head out into the water for a quick dip into the other side of the Atlantic Ocean. If I closed my eyes, I was totally back in CALI. Awesome.

Dinner consisted of local cuisine. Appetizers were plantains, bananas fried with a sweet flavoring. Groundnut soup is a fave and I could see why. It was melted peanut butter with Thai spices and ch

icken bits, pour it over rice and you have dinner. Beer in Ghana is fantastic! Four or five different types, I tried something called Star Amber Ale, served in a 20 oz bottle, for 1 Cedi (dollar) 50 pesos (cents). The exchange rate was almost equal so I realized I was going to be quite the cheap date in Ghana. Moreover, a 20 oz bottled water…2 cedi's (dollars). Beer, again, is cheaper than water in the countries I visit. Tell me I don't have my priorities straight. Good food, great conversation, another Star beer and bed.

Our first day in Cape Coast was a tour of Kakum 

National Park. A small rainforest (it couldn't have been that big, we heard sirens in the background at one point) but the way you walk though it was completely unique. It was called the Canopy walk. You were not on the ground but walking on an 8 inch wide wooden platform, with rope woven on either side about 5 feet tall, hoisted almost 300 feet above ground and only connected in random spots by a large tree. While the animals were not to be seen at all, the views were absolutely incredible!!! While others were crapping their pants because they realized how civil engineering was so not involved in the design of the walk, I was living it up with my camera. I figured if hundreds of people before hadn't fallen, why would I? We ended the Canopy walk, had fresh coconut juice from a coconut a local chopped open for us and left. I bought a t-shirt in their gift shop. I had to. I had no other clothes.

Our last day was spent at Elimina Castle, a slave castle from way back when. People from all over Africa were brought here to be sold and traded for slavery. It was one of the largest ports for slave trading. Women were brought here to please the Governor and then bought and sold for slavery. Horrible dreary place with the stench of slavery still embedded in the walls. Not only did it make you nauseous, it made you realize how much the people have gone through in their history. This was our introduction to the "culture" part of the trip. I had a feeling this place would be brought up in our "de-briefing" later that night, and we were going to talk about how we felt. Not without a Star beer in hand though.

Lunch was at the harbor area and I ordered another local favorite, pavlava: Spicy sauce with onions and cabbage, poured over rice. (Side note, the group is trying to put together a cookbook of local Ghanaian dishes...highly recommend buying one, they have some great cuisine.) Then Janet, one of the other RN's introduced me to Castle, a local fave beer. It's Guinness but lighter and not as filling with a sweet side. I found my new addiction. Thank you, Janet. I also ended up ordering a coffee, and when the waitress repeated the word I jokingly said, "Yes please, large coffee, hahaha." 

Well, she took that very seriously and ten minutes later handed me a large Thermos full of hot water and two instant packets of coffee. OK. Won't make that joke again. The table was in hysterics already knowing what a huge fan I am of coffee, Starbucks in particular, and I had pretty much had no coffee for a few days. Coffee in Ghana consists of instant Nestle Café. Period. However, I realized that one of the other team members brought his own Mr. Coffee coffeemaker and--get this--5 pounds of Dunkin Dounuts roast. Nope. Still not drinking it. I'll stay with the instant stuff thanks.

After lunch it was back to the hotel to start our official planning details, orientation to Ghanaian culture, and of course, the "de-briefing". Without the beer, I was still able to wing it and talk about how I felt, without rolling my eyes. I knew the beer was going to follow shortly anyway as dinner was approaching.  Dinner followed the orientation, with local cuisine galore and Castle beer to be had. Good conversation, and good night.

Crazy American Arrives In Ghana

The following is from Road Scholar Meghan and her series of updates about her recent humanitarian aid trip to Ghana.  It appears here edited for content and length.

I met Barbara, the other RN from Boston Medical, at the ER on the 30^th of October to head off to Logan…at 10:30am. Our flight wasn't until 2:30pm but we had a huge autoclave that we needed to be rid of ASAP via check-in luggage and the awesome crew at EasCare ambulance arranged to drive us to Logan. So, once again, I got a ride in an ambulance without being sick. Nice. 

We checked in, had breakfast, and tooled around a bit. When I arrived at the gate to board the plane, the flight attendant said, "I'm sorry, but you will have to gate-check that bag. It's too large."

This bag had all--and I mean all--my personal belongings in it, including medication for the communities, all my scrubs, all my personal clothing…you get the picture. And we had a very quick layover in JFK before going to Accra, Ghana.

I replied, "No, it's not too big. I really can't gate check this. It will fit."

"Miss, it is a very full flight. Your bag will follow you to your final destination, but you need to check it."

Like hell it will. I'm going to Ghana, not Georgia.

I was already putting together a rough draft of a nasty letter I was going to publish to Delta when my bag did not make it to Ghana. But I figured, "whatever", and dropped the bag at the gate. I turned to Barbara as we were boarding the plane and said "that bag is so not making it to Ghana." She smiled, probably knowing I was right, and we buckled our seats and set off.

With a quick layover at JFK and an immediate boarding to Accra, we were off. I noticed a few people on the flight from the orientation the month prior, but I was tired and figured I had two weeks to get to know them and passed out for the majority of the flight. When the captain announced our landing in 20 minutes, I opened up the window and glanced outside for a peek.

Wow. Beautiful, rolling, green hills with tall trees all around. A light haze covered the area but it wasn't anything close to smog, it was probably the result of the humidity. At the bottom of the hills, small villages with dirt roads and small concrete houses no more than a single story high. Only the main roads were paved, most of the roads were dirt (as I would soon find out, with major potholes). No skyscrapers, nothing modern that stood out; but beautiful.

We got off the plane to a bright sun and it all started right there. The heat, the humidity, the "oh my God I need a shower" feeling. The airport was not air conditioned...anywhere. We went to immigration and met Emma, one of the other RN's, who is some kind of big shot in Accra (and with airport security conviently).  We breezed through customs, all medical supplies and medications in hand. At baggage claim the two large red suitcases I checked in arrived, all filled with medical supplies and extra scrubs. I saw a cute little Mickey Mouse bag go around and smiled. Then I saw it again, and again, and again. Curiously, I didn't see my gate-checked bag going around. Ever. 

I was shocked, obviously. Several of the team members told me, "let's just wait a bit, it might show up." I then told them I gate-checked it and they quickly got the point. Off to lost and found. I informed the desk that I would not have access to a car and they would need to deliver my bag to my address in Swedru. They took down the info and miscellaneous phone numbers and we were all off to Cape Coast for an orientation before starting work in Swedru.

We stopped briefly in the city center for money exchanging and lunch. If you thought taxi drivers were nuts in Boston and NYC, you haven't been to Ghana. I would love to see what the driving test is like over there, if they even have one. Overcrowded streets, congestion and confusion like you can't imagine and in the 8 inch space between cars, people trying to sell you random products and tourist stuff.  They knock on the window with baskets on the head filled with products, produce, water, candy, cell phone cards--everything. And they're stubborn little things too. They'll stare you down, hoping to break you and you'll buy something. They were not mean in any way, just extremely pushy. Then you get out of the car and it doubles. 

You'll be totally surprised to find this out but in Africa, we sort of stood out...just a tad. People were yelling "Abrunee! Sista! Here! Come here! Free to look at my things! Take a look!" 

Abrunee, I quickly learned, is what I was: a white person, not in a derogatory sense, just a title. Sista, meaning sister, is somewhat a term of affection. 

I had men coming up to me saying "Hello. How are you. What is your name?" 

They held their hands out to shake and I accepted. "Meghan, you?" I asked. 

They would give me their name, I would respond with a nice to meet you and they would then ask me to look at their products. 

"No, medassi" ( meaning, thank you). 

They would ask again. I would smile and say no. They would say OK, see you later. 

Right. Bye. 

Yet sure enough the people I gave my name to, I would see again.  As we headed back to the van that stood out amongst everything else, they would have a product for me...with my name on it. Dammit, tricky little bastards. 

"Here, I made this for you! Free, no charge, you are my new American friend. What is your email address.?" 

Oh hell no. So, just like I did in college, I gave them a fake email address, smiled and said goodbye. The suckers of the group wouldn't have a chance in hell and would cave in and buy. Me, not so much. I threw them off by asking if they sold underwear since I didn't have any.  And they would give me a funny look and walk away. 

Crazy American.

Four Days To Go

The following is from Road Scholar Meghan and her series of updates about her recent humanitarian aid trip to Ghana.  It was originally sent by Meghan on October 26th and appears here edited for content and length.

Let the countdown begin! It's four days left and I'm headed to West Africa. Got all my shots, picked up my Malaria and Cipro prescriptions, and sort-of started packing.

Though I have, with time, gotten much better at pre-packing and arrival times at airports, if you know anything about me, I don't plan ahead very well. In fact, those of you that have traveled with me know I tend to  pack ten minutes before I'm headed to the airport, only to get to the airport 20 minutes before the flight leaves (I think I have only missed one flight ever because I was late, thank you very much).

The only reason I'm mostly packed four days before departure is because I have to give a list to one of our directors as to what is in the suitcases for customs purposes. For the last week or so, my living room has looked like one of those underground plastic surgery clinics in South America, minus the meds and needles. The local ambulance companies and individuals in the medical field have been quite generous with giving us miscellaneous medical stuff, so we've divided all the supplies into each of our suitcases. Now all of the supplies are packed in a big, ugly, cheap red suitcase I bought at an outlet store and am giving to the people of Ghana once we leave. Now all I have left to pack are personal items which I might not have gotten around to buying yet...like towels, bedding for the hotels, sunscreen, bug spray, meds for God knows what I might contract over there.

I bought mosquito repellent clothing. That was different. They smell a tad funny,  but I'm not going over there to pick up a date so whatever keeps the bugs away I'm fine with. I'm making a trip to Walmart on Monday, so I should be all set. I also went to the grocery store to stock up on Vitamin water, protein bars and pre-packed tuna cans.  I'm still counting on getting the travelers bug so I can lose a few pounds. 

All in all, everything is going smoothly so far. The one issue I've had is with the "travel agency" we are signed up with. Long story short, it's been a lot of "who's on first" action going on. I have gotten a phone call from one agent, who speaks very broken English,  asking me for the credit card number for my flight, only to have her call me five minutes later asking for the number again, not remembering she called prior. The agency said they found us a deal on a flight, but I and another nurse found the same flight, same airline, etc. cheaper on another website. Oops.

They forgot to email me my itinerary. That was another three phone calls.  Then there were multiple calls about my passport and Visa fees. I drank a lot of wine the night I had to mail out my passport to these people. But I have just heard that our director has our passports in hand safely and ready to go. Good. Good riddens "travel agency".

I received an email from one of the directors yesterday, telling us where our lodging is going to be. Sounds like we won't exactly be roughing it. The first hotel is located in Cape Coast, near the beach, complete with air conditioning,  small fridges, and even Internet access. Most likely I'll try to shoot out an update from there.

We'll spend two days in Cape Coast getting training on what we will be doing and information on the general Ghanaian culture and proper etiquette, if there is any. From there it's off to Angona Swerdu to the government hospital and the clinics where we will be working. Sounds like the setup for lodging there is a suite layout with bedrooms and a common room. They have air conditioning as well. The last two days will be spent in Accra, the capital. It's wind-down time before heading back to the states. I believe there is a business center at that hotel so that's when another update will probably be sent. Then it's back to the States.

Though they mostly speak English, I should probably start looking at that page of language translations I got over a month ago at our meeting and start learning how to say the important phrases, like "Do you take credit cards?", "Where is the bathroom?", and my personal favorite phrase, which I have learned in over 10 different languages:

"Two beers please."

Cheers

The following is from Road Scholar Meghan and her series of updates about her recent humanitarian aid trip to Ghana.  It has been edited for content and length.

My first thought was "No bloody way!?! THEY ACCEPTED ME?!?! AWESOME!!!"

My second thought was..."What the hell am I doing??"

And of course the third thought was "How the hell am I going to pitch this one to the parents without someone having a breakdown??" A few weeks back, after I had already applied, and NOT told the parents, I met them in Washington D.C. for a mini family reunion/vacation. At dinner, with an alcoholic beverage in all of our hands, I spilled the beans. The conversation went like this:

Meghan: "So, I might have applied for a trip to do some medical volunteer work abroad."

Mom and Dad's eyes get big..the ears perk up and the hands start clasping together. They're bracing for the news. My sister's Eileen and Katie hold back a laugh, knowing that the next ten minutes are going to be a great show to sit back and watch. 

Mom: "Where?"

Pause...wait for it.....

Meghan: "Slightly south of London....."

Mom: "Meghan...get it over with...where??!"

Meghan: (big chug of beer, then...) "Ghana?"

Mom takes a big sigh, with the "of course you are!" look on her face. Dad pops in immediately..

Dad: "I don't like it, it can't be safe. Is it safe?"

I spend the next ten minutes pleading my case that yes, it is safe, there is no war going on in the country, they have electricity, indoor plumbing and even two universities. I will have the proper immunizations and everything will be just fine. 

Dad still isn't too convinced. And like the typical father, asks that other imminent question...

Dad: "How much is this going to cost?"

Meghan: "I'm paying for it all. Promise. We'll be doing fundraisers, raffles to raise money. It will be fine."

Dad: "I still don't totally like the idea of you going to a third world country."

I decide to shoot back with what I thought was a foolproof, win-win, comment.

Meghan: "You know Dad, Mother Teresa did all this charity work and you never disapproved of her doing it!"

And without so much as a breath in between...

Dad: "Mother Teresa didn't owe me money."

I almost choke on my beer. The table goes into hysterical laughter.

Touche.

Dad, 1. Meghan, 0.

As far as I was concerned, the hardest part of the trip was now over with. The parents knew. And I switched on the planning gears and started, well, planning. 

We had our first team meeting in New York City two weeks ago.  The group consists of about 19 people: six doctors, seven nurses, a photographer, a writer, a sculpturer, and a social worker. If you haven't looked at the Unified for Global Healing website, it's not just a medical team. They combine medicine with art to teach the population about healthcare. To get messages across about malaria, AIDS, diseases in general, they use art, since most of the under-served communitiescan't read and write.  It's unique to say the least. 

Though they all seem like a great group, I wouldn't be surprised if I catch myself burning incense and doing yoga on this trip.  Obviously, there's nothing wrong with that, but anyone who knows me knows I'm not the yoga type. At all. But at our meeting I learned  there's a cocktail hour every night, so everyone wins. Cheers.

I've gotten all of my shots...six of them. Fun times. Paul, the nurse that gave them all to me, said I was very good and didn't cry. But for two days after my arms were in complete pain. That Hep A shot will kick you. I got a prescription for Malarone, the pill for Malaria and will take that right before I leave and while I'm there. I also got a prescription for Ciprofloxacin in case the food and travel  takes a number on my system. Let's just say while I won't be drinking the water (only bottled), rumor has it I will be visiting the porcelin god a few times the first few days and losing a few pounds. I think that's a total upside; who needs the Atkins diet, just go to Ghana!  

I'm still determined to make it for that cocktail hour every night. 

Ghana Or Bust!

The following is from Road Scholar Meghan.  It is the first in a series of posts about her recent humanitarian aid trip to Ghana.  It has been edited for content and length.

For the last few years I have worked at Boston Medical Center in Boston, MA in the Emergency Room as a nursing assistant, ED tech, whatever p.c. term they use nowadays. I love it. Lots of trauma, fast pace, lots of teaching, lots of experience, lots of amusing stories to tell my friends when they're felling sad (really, they call and ask me to "tell me one of your ER stories, I need a laugh"). The hospital serves mostly lower income families in the city, the homeless and the immigrant communities. The staff, on their own, is very committed to serving this population and, as a result, have joined or formed some outside, non-profit organizations. One of which, Unified for Global Healing, was co-founded by one of our ER Doctors, Thea James. For the last several years, she, along with other people, have traveled to underserved populations and given free medical care to those communities. Well, this year the trip is to Ghana. 

I had (FINALLY) passed my nursing boards back in March/April and the state of MA gave me my official license to practice nursing.  Shortly thereafter, I was looking for nursing jobs all over the place. I was still working at Boston Medical as a nursing assistant because I hadn't really found a nursing job yet. It's a common practice for nursing students who have finished school and even taken the board exam to stay at their current place of employment, as a nursing assistant, for a bit before going out to get a real nursing job. I was in the lounge one day having lunch and I saw a poster with the tagline: "Want to go to Ghana?"

 I looked at the nurse sitting next to me and said "Sure! I'd love to go to Ghana!", paused for a bit, then said  "Where's Ghana?"

So I "Wkikpedia'd" GHANA and this is what came up..enjoy. 

Anyone that knows me realizes I don't take travel lightly. I'm all in if I say yes. Anna, a friend of mine from college, told me one day she was traveling to London for the weekend and, very lightly, asked me if I wanted to go with her. Much to her surprise, I said "Sure!", and bought the ticket. She barely knew my last name at that point, so it made for an interesting conversation. A few years later, she asked me if I wanted to take care of a bunch of kids at an American Boarding School in Switzerland....Yup! Love to! I've had Boston neighbors casually get to know me and at a girls night out, very lightly, ask me over a few drinks if I wanted to go to West Palm Beach in Florida for a few days....Just tell me when! You get the point. And I have the pics to prove it all.

Needless to say, when I said yes to Ghana, I wasn't taking it lightly either. But this trip was going to be somewhat different than any other one before it. I was going to be working, as a nurse, in a foreign country. Granted in Switzerland, my title was nurse, but I was supervised by an actual licensed RN and took care of privileged 6 to 10 year olds whose biggest complaint (minus my one Japanese hemophiliac who I rushed to the local hospital one night) was that their sunscreen smelled funny. Ghana children are going to have slightly different complaints, like "I have malaria". Just a smidge different. But from the moment I chose nursing as  a career, I wanted to do international work. When I found out the trip was a short two weeks, it was enough to convince me it would be a great "stepping stone" or foot in the door to international healthcare. 

I turned in my application. Knowing there were only a few slots available and lots of people applying,  I was pretty sure I wouldn't get accepted but figured at least I'd be on their board when I applied next year.  After an hour long telephone interview and two weeks, I got the email. 

"Congratulations! We welcome you as part of the 2008 medical team to Ghana!"