As
I boarded the plane and sat down in my seat it finally hit me. I don’t think
you can fully appreciate the emotional ups and downs of traveling abroad on
your own unless you have experienced it. And I was going to Ghana no less,
about as far from suburban Ohio as you can get. And it finally hit me as I sat
down in that plane seat. All the excitement of this great adventure left me and
all I could think was that no one would be there to receive me at the other
end. I was going to get off the plane in Ghana, my luggage would be tragically
lost and my host would not be there to pick me up. But having put so much work
into this trip and having already buckled my seatbelt, I took a leap of faith.
Of course looking back these fears
were ridiculous and that leap of faith was more of a baby step. Then again, all
of my most important learning experiences in Ghana came about in this way, the
accumulation of many tiny steps. I will do my best to tell a series of stories
that illustrate learning moments on my Lilly project. These lessons were almost
always unintended as were the experiences that inspired them. But they were
none the less very powerful and I will be deciphering their effects long after
this paper is written. The first of these lessons was inspired by my learning
of the local language, Twi.
“If you talk to a man in a language he understands, that goes to his
head. If you talk to him in his language, that goes to his heart.” –Nelson
Mandela
I learned about the importance of personal
connections while I was in Ghana. When I chose to travel to Ghana it was at
least in part due to the fact that I had read most Ghanaians speak English. But
within the first few days of living in Ghana I realized there was a catch;
although most people spoke English, they only do so when speaking directly to a
foreigner. Whenever Ghanaians are speaking with other Ghanaians they speak a
variety of local languages or a mixture of English and local language which is
very difficult to understand. I expected that English would be enough for my
time in Ghana but I had ignored the impact of this on my ability to make personal
connections. In my first few days working in the hospital several people
informed me that I “must learn their language”. This was often in a critical or
even challenging tone and it often made me feel uncomfortable. But I decided I
would start learning a bit of Twi (pronounced chwee) the most widely spoken
Ghanaian indigenous language. I bought several children’s’ books that taught
Twi, and my roommates and I would sit and teach each other some basic words and
phrases. I would practice what I had learned while speaking with people on the
street. Walking along I would ask someone, “Eti sen?” (How are you?) And they would answer, “eye”
(good). I would tell a street vendor, “Me da ase.” (Thank you). The look on people’s faces when you
spoke to them in their language was wonderful. They would light up, smile and
sometimes even yell with excitement. I was often taken aback by the responses
but also so excited by these small moments of connection with people who often
saw me as an outsider that I wanted to learn more. I wanted to be able to have
full conversations with people, so I increased my efforts to learn.
I began asking our housekeeper,
Catherine, how to pronounce words (probably the most difficult part) or say
certain phrases after I got back from work in the afternoons. She was always
excited to teach me and always loved it when I used what I was taught. Of all
the volunteers in the house I had the best relationship with Catherine and I count
her as one of my closest friends in Ghana. Another of my dearest friends in
Ghana was a work colleague named Richard. For several weeks during my work at
the hospital I was placed in the insurance office with Richard who was also
volunteering in the hospital. There was not much work to do during these weeks
so we made the best of it and Richard began teaching me Twi. My coworkers loved
to speak Twi with me so I had plenty of practice and my comprehension of the
language increased enormously. By the end of my time at the hospital I was
holding short conversations with all my coworkers and many random people I met
while traveling or exploring the city. It is amazing to see how much it meant
to people when I spoke to them in their language. Learning the language taught
me just how important the personal connections I made in Ghana were to me.
I arrived in Ghana expecting to
learn a great deal about medicine but had instead learned a new language, a new
culture and new people. I think at the beginning of the trip my Ghanaian colleagues
believed I was there only to learn about medicine, and this made them
suspicious of me. They were right of
course. But as I developed my new language skills and was able to connect with
people on a personal level, I realized that it was much more meaningful to
learn about people. I gained the trust of my work colleagues and of many
Ghanaians because they could tell I had a genuine interest in learning about
them and their culture. Probably the biggest challenge in a new culture is to
become a part of it rather than an outsider looking in. This is especially
significant in Ghana, Africa where being white makes you a visual minority,
clearly an outsider. But I discovered that the best way to assimilate is to
speak the native language. Having a desire and working hard to learn about a
person’s culture and life are universal ways of gaining trust and being able to
speak the language is a powerful way of showing this. I will never again be
naïve enough to believe I can simply force myself into another person’s culture
without doing some work to gain their trust first. I may not have known I would
learn the language but my next lesson took me to places I could have never imagined.
The Goal is not at the end of the Road… The Road is the Goal
-Unknown
Almost every weekend that I was in Ghana, my
roommates and I went on an adventure (a term used liberally by my South African
roommates to describe experiencing something new). I expected to go on a few
trips with our host to all of the touristy sites around Accra but I learned
quickly that this would not be enough. During my second weekend in Ghana, I was
persuaded to take a trip to the Volta region, a rural tropical region in eastern
Ghana, with my South African roommates, Rosa and Mitchel. While on the trip we
fed monkeys, saw an enormous waterfall, rode some motorcycles and got caught
outside in an enormous storm (a common theme in Ghana). I was hooked from this
first experience onward. I wanted to travel as much as possible, see as many
new and interesting things as I could and generally have some great stories to
tell. But I learned an important lesson through all these travels that was not
apparent to me at the time. The experiences that I remember most vividly and that
are the most meaningful to me are not the destinations but rather the course
that I took to get to them. My favorite trips were those completely off the
beaten path, sometimes even taking me places and doing things I had never
intended. One such trip was to the Eastern region.
One weekend my roommates and I left
the house early in the morning to catch a trotro, a van used for public
transport. We had planned out a great day of travels to the Eastern region. We
saw an enormous palm tree with 6 heads and then stopped in some small towns on
the way to a waterfall. When we arrived at the waterfall we were told it would
be expensive to get in so we decided to start walking back to the previous village.
We were walking on a lonely road through the jungle when my roommates spotted a
path going into the forest. We decided, myself begrudgingly, that we should see
where this path led. Quite literally we went off the beaten path. The path
wound through the woods and then opened onto the side of a large valley, continuing
alongside a cliff. The views were beautiful with mist rising up from the valley
and exotic trees all around. It was raining steadily as we walked along the
path but as it began to get dark we decided to make our way back to the road.
We got to the road and it started to pour, the rain coming down in buckets. Of
course there was not a car in sight so we began walking. We came upon some mud
houses with people sitting out on the porch who invited us in. They were
incredibly nice, giving my roommates somewhere to change into drier clothes and
inviting us to shuck maize with them. They even went out into the rain to hail
a trotro for us. When a trotro finally came along we all piled in. I was the
last one and as I sat down the mate (the guy who takes the money and opens the
door) handed me a little 4-year old girl to hold. The little girl stood between
my legs leaning into me to keep her balance. Trotro rides are rather rough so I
held on to her to make sure the braking didn’t jolt her too much. As time went
by it seemed that I was supporting this little girl more and more, her small
frame leaning on me for support. I looked down and finally realized she was
asleep. I leaned back and rested her head against my shoulder, trying to keep
her comfortable the rest of the journey. I was tired, wet and cold but I would
have loved to sit there all day. Needless to say the Ghanaians in the trotro
including the girl’s mother found this all very amusing.
This adventure taught me that it is
not where you go but what happens to you along the way. The moments that you
will remember are not seeing some big waterfall or even a cool palm tree but
rather a little girl whose name you don’t even know falling asleep in your
arms. It is also rather exhilarating to go where few people have ever laid eyes
on and have a truly unique experience. I grew closer to my roommates in these
experiences; getting caught in the pouring rain in the middle of nowhere does
that to people. In the case of my South African roommates Rosa and Mitchel I
made bonds that I hope will never be broken.
A few weekends after our first
adventure my roommates and I traveled to Cape Coast about 3 hours from Accra.
We had a long weekend so the first two days were spent seeing tourist sites. On
Sunday afternoon we found ourselves at a trotro station with nowhere to go
because the trotros don’t run on Sunday’s while most everyone is at church. Off
to one side of the station was a sort of small stadium that appeared to have
something going on so we checked it out. We walked up, the gate was slightly
ajar and no one was there to take tickets so we walked in and sat down. A
soccer game was being played and the stadium was about half filled with excited
fans. It had been raining most of the day and so the field was very muddy and
the game was a bit sloppy. We watched the last 20 minutes and then it went into
a shootout. We were still unaware who these teams were or what they were
playing for but once the shootout ended the fans erupted. A barbed wire fence
surrounded the playing area, but players and fans both ran and jumped up on it
in their excitement. Players ripped off jerseys and in a few cases their pants
as well. Fans rushed onto the field, and mayhem ensued. One of my roommates
went on to the field with his camera to snap some pictures and the players
rather liked that. We would later find out that the game was a
semi-professional championship for the region. After it died down we went back
to town and found ourselves a hotel to change into dry clothes, and put our
bags down. We found a local bar nearby that was showing the EURO soccer championship
game between Italy and Spain and made ourselves comfortable. The place filled
up with locals who were very animated the entire match. It was a great
experience, enjoying Ghana’s favorite sport with all the local people.
Although I had wanted to see a soccer match
while in Ghana, I had never expected to see a local championship game. I was
expecting to sit in a big stadium with a full crowd and a team of famous
professional players. Instead I walked late into a half empty stadium to watch
a match with a bunch of players who only played part time. But it was so much
better than I had imagined. I had seen what Ghanaians were truly passionate
about. It wasn’t fancy and there were no TV cameras or reporters there for the
game. The people who had come all had their team’s jersey on and could probably
tell you the player’s life stories. They cared deeply about the team and spent
their Sunday afternoons in the rain just to catch the match. Looking back I
wish all of my experiences in Ghana could have been this spontaneous. I had a truly
unique experience that brought me closer to the people and to understanding the
culture. In the future I will try to stay away from the path most traveled
because although there are good experiences on this path, the truly transformative
experiences can only happen when you take a risk and step out. Taking risks is
just one of many small lessons learned in Ghana. I could probably go on for
pages with stories but instead will delve into my experience at the hospital, a
much different lesson.
Pure and genuine religion in the sight of God the Father means caring for
orphans and widows in their distress and refusing to let the world corrupt you.
James 1:27
I will finish with some stories and
observations from my time in the hospital. Although I don’t believe that my
internship was the most transformative part of my experience, it had a
significant impact. The experiences have most definitely shaped my medical
philosophy and future aspirations as a doctor. In fact I am now seriously
considering a specialization in infectious disease of which I saw many in
Ghana. I have also come to the realization that I would possibly work outside
the U.S. to help serve people in the greatest need. I will borrow from previous
observations that I made while still in Ghana.
It is not so much that there is any
more suffering by the people who came into the clinic, but the fact that they
did not have the means to fix it. The hospital itself has the expertise, staff
and resources to diagnose and cure most people, but the people who came into
our clinic either could not afford the treatment or were not in a position to
change the circumstances that got them sick in the first place. This is saddest
and most sobering fact of all.
I wrote
this passage during my last week in Ghana while working with an obstetrician
seeing patients. Many people believe that it is a simple matter of bringing
better doctors and medicines to developing countries like Ghana to solve their
healthcare woes. But I learned firsthand that it is so much more than that. Even
when a trained experienced doctor has all the tools and resources that he or
she needs, the patient may not be in a position to reap the benefits. They may
be unable to get to the clinic, either because they are too far, or don’t have
enough money or can’t afford to take a day off of work. Sometimes they have had
such negative experience with medicine before, whether themselves or in their
family, that they are distrustful of the entire system and won’t be compliant.
In fact I experienced this tragedy firsthand when my friend Catherine’s brother
died of a “fever”. We attended the funeral and experienced the aftermath of
losing a family member to an unknown killer. I can understand why people
neglect medicine when it is sometimes so powerless to provide them and answers
let alone comfort. The lack of higher education for most people also poses many
difficulties. Much of the disease that I observed was caused or further
exacerbated by the enormous problem of poor nutrition. All of these problems as
well as many more must be addressed simultaneously with improved medicine if
any real progress is to be made. I am glad that my eyes were opened to this fact
while volunteering in the hospital and I think it will make me a better doctor
someday.
I
believe I learned an immeasurable amount from my time in Ghana. The
repercussions from this trip will affect me for years to come. But for this very
reason it is difficult to look back so soon and reflect on my experiences. I
still do not believe that I have fully digested everything that I saw and
experienced. It is all very raw. I learned a great deal about medicine and
experienced a great deal of previous knowledge firsthand. However, I learned even more about adapting to
and living in a different culture. I learned about Ghana and Africa, and enjoying
it so much so that I will be going back in January, to South Africa. As I
conveyed in the first paragraph I began with a great deal of fear, even if I
did not let it on. But with fear comes the opportunity to grow and transform
that fear into confidence. I now feel that I can go anywhere in the world and
quickly integrate myself with new people. Ghana was truly a serious of
unintended but wonderful lessons that I hope never to forget.
Me Do Me Ghana
Dedicated to my housemates.
