Cape Coast

As one might expect, as time goes on and we get more and more comfortable with our surroundings, the days get fuller and really start to fly by. We are now well past the half way point for our time in Ghana, with just four weeks left, followed by two weeks in Kenya and Egypt.

Late last week we reached a big milestone at work. We stopped accepting new women into the study, upon having reached ‘saturation’—a qualitative research term meaning that we’d stopped hearing new information. We capped the study at 85 women (a big number for qualitative research!), and are now hard at work following up with the women who have delivered. I personally am a big fan of the follow-ups, as we have realized we are able to catch a bunch of the women on the ward after delivery, before they are discharged. Thus, I get to see their cute babies, tell them how “eff-eh” (beautiful) they are, while trying to recall by the day of the week they were born what their Ghanaian names are. Each morning Doris and I go to the maternity ward, and stop into all the post-delivery rooms to see if any of our women are there and feel up to a quick 5 minute interview. Doris is a wonderfully patient and knowledgeable midwife, so in making our rounds I also have the chance to learn as Doris can’t help but aid the mom’s who are struggling to breast feed or have questions about some aspect of their experience. She’s a very active and attentive midwife—who all the staff love to work with, because she does far more than her share of the work, much to her frustration. All the baby girls have their ears pierced by the midwives before they leave the hospital. Yesterday Doris was horrified to see a baby whose ears had been pierced far too high, bordering the hard cartilage. With a few swift women to the mother, she pulled out the offending piercing, and used the sharp back of the earring head to re-pierce the lobe in the correct spot, and then turned to me to start the interview. Problem solved! Next!

Mondays the antenatal clinic doubles as a postnatal clinic. Fridays it doubles as a children’s vaccination center; Women stride in with their young ones securely sashed to their backs with a stretch of fabric just over a yard long. The carrying technique fascinates me and looks beautiful. To get the babes up there, the women fold at the hips, as if touching their toes, hoist the child onto their back, so that the child’s arm and legs are hugging the mother, and then lay the stretch of fabric over the child’s back. The top bit of the cloth falls just below the child’s armpits, as well as the mothers. The top of the cloth is crossed in front of the mother and tucked in under her arms, leaving the bottom half hanging. The mother grabs both ends hanging like a cape, and scoops them up so the baby’s bottom is cupped just above her hips. The feet of the baby stick out of the bottom of the cloth at her sides, as the excess is twisted together and tucked neatly into the fabric around her middle. The contraption looks secure, is inexpensive, and seems rather comfortable for both parties… of course when the women at the clinic realized we were not well versed in this method of baby totting they were immediately intent on teaching us. We regularly see 7 year olds carting along their yearling siblings using this method, so the idea that we were incompetent at it was pretty hilarious to them. Thus, this past Friday, on children’s clinic day, when lots of 1 and 2 year olds are brought in for shots, Doris solicited volunteer babies. Amused mothers offered up their clueless kiddos for the entertainment of the clinic—watching an obrunie try to be African—quality entertainment! The first volunteer baby thought my obrunie-self was too scary, and wasn’t having anything to do with me. The second smiled the whole way though it—the women got a really good laugh at me, feeling like I was mimicking their method, but turning out a subpar result. I can’t believe women haul their kids like that with giant piles stacked on their heads—just inching through the clinic I was sure my volunteer baby was going to slip out! Luckily she did not, and after a photo-op was safely returned giggling to her brave mom.

Outside of work in the clinic last week, Keesha and I tried to spice up our social life with a dinner party—our first evening gathering in Akwatia! We invited our adopted Ghanaian mother/translator/midwife Doris, her kids, and our other helper Joyce over for a bring your own plate and silverware dinner party. Initially we had hoped to make something American, but the scarcity of the necessary ingredients, and some lack of foresight fogged Keesha’s initial dreams of something as classic as a hamburger. Instead, we (ie: Keesha, with me as sous chief) made rice with a mixed vegetable and fish sauce and in a ground-nut paste base. Your choice of drinks: mango juice or kool-aid (now that’s American!). Classy eh? For dessert, there were milo based pancake crepe type items with chopped mango and pineapple. Dessert was definitely the best received. Doris was a hoot all of dinner, reminding me of my mom and making up for an otherwise very quiet table. Other than that, all in all it was a hilariously awkward scene. Doris has two biological children—Blessing and Kaleb. Blessing is away at the University of Ghana, and Kaleb, is waiting to find out whether he has been accepted to University. He had polio as a kid (as have a fair number of others we’ve seen in Ghana) and walks using crutches secured to his forearms. Doris also has an adopted daughter Leena, who is 12. Leena was born at St. Dominic’s, but abandoned by her family. Doris was working on the ward, and really took to the child, leading her to end up adopting Leena when the family never returned. Kaleb and Leena came to dinner with Doris, and despite the fact that they both speak English, I barely got 2 sentences out of them the whole night! Leena would just giggle, and about the only thing I could get Kaleb engaged in was teaching us new words in Twi—leading to a few useful phrases like: “many comb” (I’m sleepy) and “Ed-eh” (Delicious!). Joyce turned out to be a picky eater and was falling asleep at the table—not that I can blame her as she works full time as a nurse in the clinic and goes to school at night. Keesha was pre-occupied with worry that the quiet crowd didn’t like her cooking, leaving Doris and I to do the talking, Joyce chimming in loudly with “Ohhh Efffffia and Yaaaa!” (our Ghanaian names) as a stand alone statement, apparently appropriate commentary for any long silence. When 7 PM rolled around and the staff bus came to pick up the night crew our visitors made their exit, hopping a ride back to the hospital, leaving Keesha and I wide eyed wondering what had just happened. We tried! In return Doris has invited us over to make banku next week, which should again, if nothing else, be entertaining and informative!

Our work week was capped off with the realization that that itchy bug bite on Keesha’s big toe in is infected… with a worm. At first we just thought it was itchy and swollen, and when the swelling moved I blamed it on blood flow diffusing the inflammation… but when the distinct shape of a worm emerged under the skin on the pad of her foot… and then moved overnight, making the diagnosis was fairly clear. Too many Discovery channel terror shows about worm migrating to people’s brains had her fairly ready to lob her foot off and jump the next flight home, but we think we’ve got it taken care of now. The docs think it is a sub-cutaneous skin worm, and have prescribed her daily wormer for the next few days. Apparently that should take care of it, but either way, Keesha has sworn off sandals for the duration.

Friday after work Keesha, myself, and her tag-along the worm, high-tailed it to Accra. As per usual the ride in was eventful. A traffic jam in the construction zone outside of Accra brought our tro tro to a standstill. After a few minutes of waiting, and peering out the window to survey the prospects, our driver decided off-roading was the solution, veering off the road, onto the dirt embankment of the construction site, driving underneath a half finished bridge while being screamed at and chased by angry construction workers, presumably shouting in Twi to get back on the road and off the construction site. Some construction workers foresaw the drivers planned escape route and blocked it off with rebar before we got there, invoking a heated yelling match between the driver and the crew, which somehow mysteriously ended in the crew moving the makeshift blockade out of our way, allow the tro tro to skirt the entire jam, putting us back on the road speeding along to Accra. Traveling by tro tro: strong likelihood of a near death experience, but guaranteed entertainment!

This past weekend’s journey to Accra was to join the Michigan crew for a trek to the Cape Coast area of Ghana. Saturday morning we piled into a chartered 15 person van, with the other SPH and MHIRT students in Ghana and Kofi, and set off for the Cape Coast. The Cape Coast, as one might guess, is on the coast of Ghana, located a few hours West of Accra. We drove over lush lands, less hilly than the ones near Akwatia, dotted with fewer trees and more tall elephant grasses and small hand worked farms. The further we got from Accra the further between towns, stretching into deserted sections of land without a soul in sight.

Our first destination was Kakum National Park. The area was declared a National Forest in 1931, and became an official National Park of Ghana in 1994. The park’s main claim to fame is a jungle canopy walk. From the ranger base at the park, complete with a super-pricey gift shop and bar, we hiked a half mile or so into the forest, gaining 250 metres in elevation, over a less than successful attempt at a stone paved path. My crutches never would have made it, but on the walking cast I was a little slow but mostly steady. The first bit of the walk was a mix of deciduous and jungle flora, dense with thick veins (strong enough to swing on… not that I tried or anything) and exposed roots. Along the path were a handful of hand painted signs labeling a few types of trees and species of the forest. My favourite trees included the kyenkyen trees, whose root bases start to spread from the tree a few feet above ground, creating a handful of skinny wedges jutting out from the base for a few feet before disappearing into the ground and the bamboo trees, whose thick cluster of shoots creates a bush looking tree whose base spans a good twelve feet. The real tree heros of the park are the tallest trees the Baku, whose thick stalk straight trunks rise far above the forest canopy. It’s on these trees that the canopy walk was built. The canopy walk is a series of hanging bridges, supported by rope and wire 30 metres above the forest floor. The Indiana-Jones like foot-bridges start from a hut built on the side of a valley, stretching out over the forest, to a series of Baku trees. Swaying under the footfalls of tourists, the walkway offers a unique view down through the jungle trees below, and across the sprawling valley beyond. Unfortunately, given the popularity of the canopy walk, the outing is less than serene, and therefore not likely to result in spotting any fauna to go with the flora. According to the ranger station information postings, the Kakum jungle is hope to a variety of monkeys as well as forest elephants… all of which evaded my probing eye.

Out of the jungle, Kofi directed us to a beach resort 20 minutes from the park. We were all a little amused at his choice of lunch options, as when asked where we wanted to go we unanimously said somewhere local and cheap. After passing a number of truly Ghanaian establishments that any of us would have been content with, instead, Kofi lead us to a picturesque beach, with a beautiful outdoor restaurant overlooking the ocean waves, an outdoor swimming pool for hotel patrons, and allegedly an 18 hole golf course. I think Kofi’s idea of cheap is a little jaded after hosting a few too many international research meetings and donors! The view however was beautiful. Before lunch a few of us went for a stroll on the beach, whose spotless golden sands were contrasted to volcanic looking rock formations spotting the shore, creating foaming explosions of water every time a wave rolled in. Afterwards, with a coffee and tuna-tomato sandwich in hand (not coincidently the cheapest option…), I had readily accepted our lunch location! The other patrons were conveniently crowded around a living screening of Ghana’s second world cup game, projected on a wall, leading us to delay the continuation of our journey until the game ended in a 1-1 tie against Australia.

The final stop on Saturday was the St. George’s slave castle in Elmina. St. George’s Castle, also known as Elmina Castle was built by the Portuguese 528 years ago, eventually changing hands to the Dutch and then English. The castle was the sight of unthinkable atrocities during the years of slave trade. It holds the horrific statistic of having seen the more slaves pass through its hallowed doors than any other site. An estimated 10 to 15 million slaves were marched across present day Ghana and further, to the Elmina Castle. Half of the captors died between capture and departure from Africa, marched and starved to death. The castles sits in ironic glory jutting out on a gorgeous strip of sparking sand, its white exterior glowing in the sun, lit by the colorful backdrop of the bustling fishing port of present day Elmina. Above the castle on a nearby bluff sits St. Jago’s castle, build after Elmina for the fortification of the slave trading grounds. The waters have receded over the years, leaving the castle mote empty-- the waves a solid 10 yards from the walls, rather than flesh against them. A well versed tour guide led us through the castle, sliding room to room conveying the white castle’s many dark secrets. Our first stop was one of the female dungeons. Up to 400 women were stored in the dungeon at a time, sometimes for up to 2 months, laying skin to skin on the uneven rock floor, with little light or ventilation, and only a bucket at each end of the room for release, if one was strong enough to walk there. Other than the dark and foreboding nature, the first sensation that hits you in the dungeon is the smell. It reeks of human waste, even now, after two hundred years of airing out. The stench really is from the battering the room took—only the dungeons smelled that way. From the dungeon we were led into an adjacent courtyard, open only to the blue sky, bordered on the second floor by a wrap around balcony. It was explained that this is where the women got their only exposure to sunlight. Once a day the whole crew of women was corralled into the courtyard. The castle Governor would stand over the crowd on the balcony and point to his chosen woman to rape that day. The rest of the women would be sent back, while cold water was dumped over the selected woman to clean away some of the months of dungeon filth. She was then marched up the stairs to the Governors layer for him to do as he pleased. If she refused, in the middle of the courtyard lay a bowling ball size steel ball to which she would be tethered to until the next day, forced to stand, and go without food. Sorry, I may have failed to warn that this post ends on a less than cheery note.

Out of the women’s quarters, we were led through the men’s and into the ‘room of no return’. 10-15 slaves were tied together in a row and marched through tight corridors, into a light-less room, out through a slit in the wall just large enough for a crouching body, then down a ladder onto an awaiting boat. Peering out the opening today, the sea has shifted, so sand appears below, the ocean to the right, and a picture perfect view of Elmina and beautiful Ghanaian fishing boats to the left. A haunting contrast to the moldy damp dark castle inside, whose only color is offered by the handful of memorial tokens leaning against the wall in the room of no return. From there we continued on to the areas for delinquent staff and slaves—the staff area with air vents and natural light, the slave area without either. We then moved up onto the second floor, touring the spacious Governor’s quarters, kitchen and dining area, pausing for breath-taking views over the castle walls.

One of the most interesting and controversial topics the tour ignited was that of religion. Elmina was home to the first Christian church in Ghana. While still under the purvey of the Portuguese the church was moved from the town, into the interior of the castle. Thus, in the center of the largest slave castle in Africa stands the oldest Christian church in Ghana—a country now incredibly smitten with the Christian faith, with rates of Christianity around 90%. I remain in the belief that if you have spiritual or religious beliefs that give you hope and meaning, or peace and perspective, I fully support your right to worship and mediate on those thoughts. But all too often, religion is used as a tool to leverage much more than a broader meaning to life. I fail to understand how a religion brought to Ghana by the very people that raped the country of humans and resources has been so whole heartedly endorsed and embraced. The oldest Christian church stands in the middle of a freaking slave castle! It’s not the idea of people embracing a religion that frustrates me, I just find it baffling—I know there are aspects of community, of tradition, and unity that draw people to particular religions, but in the case of a country like Ghana, and many others, some of the doctrines informed by purported religious ideology is incredibly frustrating and hypocritical. Obviously, as this old church site attests, at one point slavery was fully endorsed by the Vatican. Today it is clearly not. That is a radical shift in ideology, the acceptance of an entire race—and entire continent. Yet today, religious doctrines continue to single out groups to outcast and wars to wage on differing branches of humanity. In Ghana for example that war wages strong against homosexuality, which more than one Ghanaian has informed me results in a direct ticket to hell. A few hundred years ago someone on the very soil they stand may have declared similar pitiful worth, while manhandling their ancestors, the indigenous people of Africa. The point being that if you believe in a higher being, I respect your right and the meaning it may bring to you to worship and covet those beliefs, but standing in a slave castle staring at the walls of a church centered in its courtyard, I can’t help but beg that religion cease to be cast as a tool for laying judgment, defining superiority, or asserting power. Using it as such has led the world astray time after time, and need not be repeated.

On that note, love from Ghana,

Halley