An Introduction to Rural Africa

This week I had my first taste of the rainy season. Thankfully, I haven’t been caught out in one of the torrential downpours yet, but I’m sure it’s only a matter of time! Since we’ve been here the sky has been mostly cloudy, always dangling the possibility of rain. I can’t imagine what the temperature would be if it was regularly sunny… yikes! Monday, the clouds stopped threatening and got down to business, with a few hours of pelting rain. When the rain started I was in the doctor’s library with Ella, when it subsided and we ventured out to find food, we discovered that the carpet of red dirt had turned into an obstacle course of pot-hole puddles and dangerously slick clay. Add crutches, one flip-flop foot, and trying to get to a canteen that’s a good 30 yards off the road (beautiful sidewalk for 15 feet outside the door and then dirt the rest of the way to the road) and you’ve got yourself a hot mess! Somehow I managed not to fall outright, but I might as well have. By the time we got home (half hopping, half taxi) we were both so covered in red clay that we had to take our shoes and my cast off outside the hostel and washed them before coming in. The manager came out to check on us, and gleefully informed us that the rainy season had started! No kidding! She was really cute about it—she was sure we’d be thrilled, as the daily rain reduces the temperature a bit. I gotta say, sitting covered in mud, washing my cast and then confined to my bed for the rest of the day while the cast dried, I can’t say I was that stoked about the rainy season!

The big outing this week was a visit to Akwatia, where Keesha and I will be doing our research. We move to Akwatia for good on this coming Saturday (May 22nd), but Dr. Adanu wanted to take us out to scope the place out, and be introduced before we make the move. We left Accra Tuesday early afternoon. Keesha unfortunately had her first taste of the infamous stomach problems we’ve all been warned of. She spent the ride trying to sleep to avoid puking in Dr. Adanu’s car. I sat up front taking in the scenery. We headed out of town initially on the same route we’d used to head to Kokrobite. Outside of Accra, as you move North of the coast, the landscape turns to rolling hills. The hills just North of Accra are smattered with an array of houses, creating a scene that from a distance looks oddly like the ticky-tac houses on the hills outside of San Francisco. The crowds of Accra thin slowly—the city is sprawling, and with traffic, takes a good 30-40 minutes to escape. Every set of loosely obeyed traffic lights, for the first 10 or so miles outside of the dense part of the city, serve as a conduit for a swarm of hawkers and often a larger market that sprawls on the four corners of the crossing. My toothpaste tube is almost sucked dry, so I had my eyes peeled for a toothpaste hawker (I saw one last week and failed to jump on it!)… but alas, no toothpaste on this trip.

At one the lights we turned off the main road, and headed out on a sometimes dirt, sometimes pavement, intensely pot-hole ridden road. I have no idea how anyone gives directions or figures out where anything is. As far as I can tell, there are no maps and no road signs. I asked Dr. Adanu how he knew where to go—he said you get taken there once and just remember… or get lost and ask people where whatever you are looking for is. Pretty quickly off the main road, roadside stands gave way to rolling hills of tall grass, banana trees, green baby coconuts, and torturously ripe mangos. We sped along, interrupted frequently by stomping on the break or swerving around pot holes. The tall grass made every curve a blind turn. Tro-tro drives frequently risked coming into the outcoming ‘lane’ around the turn to miss a pothole, and passing uphill doesn’t seem to phase anyone but me. Every few miles at first, and less frequently as we went, a little village would pop up: mostly a short stretch of houses build snug against the road, with a few houses depth of clearing behind them, dirt plots with roaming goats, and a few roadside stands. Some structures were cement, most where semblances of wood and rock, and more than a few were mud huts with thatched roofs in a variety of conditions. We passed through one sizable town, Asamankese, with an active market, just 15 miles from Akwatia.

As we drove there was almost always a pedestrian or two in sight, either an adult carrying a heavy load atop their head, or children walking home from school in matching uniforms. Multiple kids walking in the opposite direction saw me and screaming ‘Obrunie!!’ jumping up and down and pointing as we sped by. It was pretty funny. From the look on some of those kids faces, I’m pretty sure I’m the first white person they’d ever seen.

After two hours of slaloming around pot holes on country roads, we reached Akwatia. We didn’t really venture into the actual town, which we could see on the hillside opposite the hospital. We spent our 24 hours in Akwatia getting acquainted with the hospital grounds and staff. The hospital was founded 50 years ago by German nuns, who still preside over it. The grounds were actually quite beautiful. Everything was freshly painted following the recent 50th anniversary celebration. One of the features that stood out most to me was the entrance guarded by gaits. Outside the gaits there is a little covered section of benches under a sign that reads ‘Visitors Lounge’. The hospital has strict visiting hours: a few early in the morning, at lunch, and again in the late afternoon. Family members ride in on tro-tros from neighboring villages, and sit waiting in the visitors lounge (with the occasional goats and chickens) until the gait open for visiting hours. Then the drive up to the main building is flooded with women in colorful African wraps, carrying basket lunches to their loved ones in the hospital. The hospital is a cluster of single story buildings, painted yellow, with dark trim, and interspersed blue arrow signs indicating the purpose of each building “Children’s Ward” “Casualties” (?) “Dispensary”. We’ll be working with women at the antenatal clinic, which is actually a row of benches under a roof, but otherwise open air. There is a cubicle of walls behind which the midwifes and nurses do there exams. Otherwise women sit in the shade, and open air, awaiting their check up on a hillside overlooking Akwatia. Health work, while being outside? Now that’s something I could get into!

Keesha and I spent an interesting night on the hospital campus. The cute, well-maintained campus includes housing for many staff members, and backs up to a catholic school and well groomed soccer field. I ventured out and explored as much as I could on crutches while Keesha crashed and tried to get her tummy behaving again. Dr. Adanu left to spend the night with friend in a neighboring village, but a broken drive shaft brought him back to Akwatia. The part had to be brought out from Accra in the morning (no one travels on those roads at night!), and Kofi ended up having to come out and pick Keesha and I up. Keesha and I stayed the night with Dr. Adofo, the head OB/GYN at St. Domic’s. We thought we were staying with him and his family, but his family is now located in Accra, where the schools are better for the kids. Thus, Dr. Adofo had a spare room for us in his hospital provided home on campus. I had grand (dis)elusions of eating dinner with a family and maybe even learning to cook a Ghanaian dish. But alas, instead Keesha and I went without dinner or breakfast, as they simply never materialized. Starving children in Africa? Around noon the following day, we confessed to Dr. Adanu that if we find food soon we’d be sacrificing him first!

With a bit of food onboard, we met our translators, and summer companions, Doris and Joyce. Both are hospital employees on vacation, who have been hired to work with us during their off time. Doris is motherly in age and demeanor. She’s a midwife who works in the labor ward, and seems very interested in the research. She offered to teach us Twi while she translates too! Joyce is a little quieter but also very nice. She is a community health nurse, who was born and raised in Akwatia. They’ll be with us during the interviews and will be helping us to translate the interviews into English afterwards. We learned an interesting fact too, which hadn’t crossed my mind. Everyone here speaks Twi, but no one writes it (almost all signs are in English—Ghana was a former British colony and English is the government language). Thus, actually getting our consent form translated into written Twi is a bit difficult, as very few people actually write in Twi—Dr. Adanu and our translators do not.

The last bit of business we had in Akwatia was sorting out our summer housing. Dr. Adanu had been under the impression that we would be staying on the hospital grounds-- an idea I was pretty stoked on. However, the head nun informed us in a German accent, that that would not be possible. Seems like they don’t reeeally believe that you are coming until you arrive and show your face in Africa… it seemed like they were really hashing out having us there as we arrive. Oh well, that’s the way it works here! Once housing was settled on the ‘estate manager’ drove us to it—St. Dominics recently built a few condos to house staff a few miles from the hospital, away from town. Keesha and I will have run of a gorgeous ground floor flat in one of the small cluster of condos. The apartment is actually lovely—the nicest housing we’ve seen! There are two separate furnished bedrooms and bathrooms, a dining and living room, and a kitchen, with basic utensils, a half size refrigerator, and gas-camping type stove (no ovens here). My only worry is that it’s not within walking distance to anything except banana fields. Apparently a hospital bus comes to pick up workers at 7AM sharp. The manager was less clear on the buses to take us home, and said a taxi should cost 2 cedi. It will take a little trial and error but I’m sure we’ll figure out a reasonable routine, and access to food somehow 

Though in the back of my mind I knew it was a possibility, both Keesha and I swallowed hard when we learned that Akwatia has no internet cafes nor does the hospital have any internet access. Dr. Adanu joked, that though the place is well-kept, it’s run by old German nuns, what use do they have for internet? Touche! So my dear followers… if you’ve read this far  my posts may get far far more sporadic. We’re looking into a wireless plug-in internet connection, that charges by the minute, like a phone call. We’re hoping one won’t be too costly, so we can at least check in periodically! If nothing else, we’ll be making occasional trips in to Accra (if we can figure out the rural tro-tros!), and will be sure to update then! I promise I’ll do my best to check in as much as possible!

So this is it! Off to the rural region I go!

Hugs and love to all.