The start of something

Wow. Five months sure goes by fast. It is hard to believe that my adventure is over and I am back in the states. It is definitely great to be home, but I find myself wishing that teleportation existed so I could go back and forth. That way, I’d be sure to have the best of both worlds!

My time in Africa has been the most insightful and transformative experience I’ve ever had. My personal leadership and interpersonal qualities have improved- giving me a greater confidence in myself and my ability to navigate the intricacies of the public health field. I have also gained a deeper appreciation for different people and different cultures. The relationships I formed have left a deep impact; I hope that I have imparted the same depth of friendship as I have received.

My public health education in South Africa and then my hands-on public health work in Ghana have confirmed that this is a field that I find great fulfillment in. It was such a privilege to wake up every morning and get to study/do what I love in a part of the world that fascinates me!

My previous blog post was titled “The beginning of the end.” Upon reflection, my experience in Africa has really just been the end of the beginning. I hope to be able to live and work there again someday, and am already making plans to go back sooner than later. This trip was the start of a new chapter in my life and a gateway to a future career in medicine and public health.

It isn’t often that one gets to experience something that resonates so deeply and leaves such a personal impact. I consider myself lucky to have had these adventures and to have been able to share them with you. Thank you for your love and support during my time abroad. It means the world to me! Until next time…

The beginning of the end

It is hard to believe that my remaining days in Ghana are rapidly winding down. Where has the time gone?!?! I have been so busy working on my research reports, hosting meetings to secure the partnership between GlobeMed and the H.O.P.E. Center, finalizing outreach programs, traveling, meeting new people, and creating memories to last a lifetime. Every day has brought something new that makes it harder and harder to want to leave this amazing place.

Yesterday at the Center, we had a “thank you for a great summer” party with the staff. It was such a neat time to reflect upon our time here and all that we’ve been able to accomplish. As a Bob Marley song came on the playlist (reggae is huge around here), everyone simultaneously broke out into song: “Don’t worry about a thing. Every little thing gonna be alright.”

I think that this song pretty much describes the average Ghanaian’s mentality. Never have I met people who have such a carefree, positive attitude about life. Personal relationships are held at the utmost importance; and the values of hard work, honesty, and integrity are the noblest qualities one can have. It has been such a joy to come to the Center everyday and get to know some pretty incredible people.

My time in Ghana has convinced me that our partnership between the H.O.P.E. Center and GlobeMed will continue to strengthen as we start looking into the upcoming academic year. I am so excited to make this relationship more tangible to our members as we advance communication avenues with our colleagues at the Center. Great things have already happened here, and more are looming on the horizon!

Working hard...or hardly working?

Late-night conversations around the dinner table with friends can bring about some powerful words of wisdom. During our most recent discussion about jobs and career paths, it was agreed that “if you love what you are doing, you’ll never have to work a day in your life.”

I think that this motto can basically summarize my time in Ghana thus far. While we’ve been busy working, our tasks have been so enjoyable that I don’t even know if I can call it “work.” Every day brings us a step closer to strengthening the partnership between the H.O.P.E. Center and GlobeMed (in fact, I just came back from a productive meeting with the regional health director to discuss these aspects), and making progress on the Center’s outreach programs. Along the way, I’ve had a chance to get to know some really amazing people whom I am honored to call my colleagues and my friends.

We’ve also experienced public health work in action through the child welfare clinic days, nutrition and sexual health outreach programs, and our daily experiences seeing patients at the Center. To top it all off, I just finished the last of my maternal health interviews and have started analyzing and interpreting the data. Yes, it’s true that I haven’t been working at all. More like getting to experience so many awesome things while doing what I love!

Last weekend was spent in Cape Coast, the only “tourist” area in Ghana (though nowhere near as “touristy” as one might expect in the states- it was basically a glorified version of Ho with beaches, an old slave fortress, and a really cool canopy walk 40 meters above the treetops- see above picture). I was able to meet up with a friend from high school who is spending her summer in Northern Ghana. It was so much fun to reconnect with her, and I have a lot of great stories from the weekend including: getting lost in a dilapidated taxi, becoming soaked by a giant ocean wave (clothes and all!), hunting giant spiders in our hostel, and many more!

This past week, Margaret took us to the area where they make kente cloth, a beautiful woven fabric that is hand-made in giant looms. It was fun to see them make it and we even put on a little fashion show, much to everyone’s amusement. Life is good in Ghana!

Baby backpacks

Babies were everywhere during HOPE Center’s monthly child welfare clinic day this past Tuesday. This is a time when mothers bring their children to get weighed and updated with their immunizations. When I wasn’t busy administering vitamin A droplets or recording medical data in the Center’s record books, I had the chance to play with some pretty cute kids.

For the majority of the day, I held three-month old Christopher on my back in an impromptu “backpack” made out of fabric (his twin brother, Carlos, meanwhile napped in my arms- see photo). This is the common way women hold children as young as 1 month and as old as 7-8 years. It was so much fun and their mothers definitely appreciated the break!

I wish I could say that the legions of young children that I have encountered during my time in Ghana are as cute and carefree as the little guys on my back. However, I have also met some pretty sick and malnourished children during my time here. One such incident that was particularly impactful was the young mother who came to the Center holding her 8 pound child. This would have been perfectly inconsequential had the child not already been a year old. What should have been a healthy, happy toddler looked instead like a sick, frail, and severely malnourished infant. As I rubbed his back, I couldn’t help but think that he weighs as much as I once did at birth.

I think that this experience gets to the core of public health: a critical examination of the socio-economic factors that create a system where one child thrives and another one suffers. There are many issues influencing this. Suffice to say, it has only served to strengthen my resolve to help find permanent, sustainable solutions that will equalize the health care playing field.

The childhood nutrition program that the HOPE Center runs is a good start. This program enables mothers with the knowledge and skills that they need to cook wholesome meals for their children. We have already made significant progress in developing the program to reach out to more people (hence, the focus of my research is to learn about pregnant women’s nutritional practices and find ways to tailor the project to them). We at the Center firmly believe that everyone has the right to the opportunity to live a long, healthy life. One precious child at a time.

Chasing waterfalls

In a span of less than three days, I have hiked the tallest mountain in Ghana and have been to two waterfalls, one of them being the largest in West Africa. Needless to say, I am in complete heaven. The views have been breathtaking (even including what I could see out of the small, dirty window of the rickety 15-passenger van that took us to these areas); and the hiking fabulous (you haven’t lived until you’ve literally had to rope swing across steep inclines while being covered in mud, sweat, and bug spray).

Along the way, I’ve had the chance to meet the most interesting, friendly people. It is always great to have a conversation about life with someone who comes from a totally different cultural background. This has continued during my workweek as well, as I’ve had the chance to get to know some pretty awesome people both at the H.O.P.E. Center and in the surrounding villages I’m researching in.

Every day brings something new- whether I am learning how to prepare local food over an open fire, balancing large bundles of wood on my head, or searching for the best bargain on market day. Ghana is such an amazing country and I am so lucky to be here!

Football fever

The cheering, dancing, and singing started as soon as Ghana knew it had won the World Cup soccer game against the United States last night (2-1). I was able to watch the game in a crowded bar/restaurant in Ho with about 200+ Ghanaians. The celebrations continued out on the street throughout the evening, as hordes of people swept past us singing, dancing, hugging, and cheering. To say that this win is a big deal would be a huge understatement.

I am literally living in a football fever. To see the start of the games in South Africa and then to experience them with a country who is representing the entire continent right now is incredible! I have had some great conversations with Ghanaians (and South Africans) about how much these games mean to them and to their nation. It is inspiring to witness how people come together, regardless of gender, race, and nationality. I can only hope that that this worldwide unity continues long after the games are finished.

In other news, three of my other GlobeMed members have just arrived. It has been so much fun introducing them to the HOPE Center’s staff, the nearby communities, and to show them around town. The partnership between GlobeMed and the HOPE Center continues to get stronger every day as friendships are formed and project progress made. Exciting things are happening here, and it is so neat to be a part of it all!

Healing and H.O.P.E.

I am in the company of fascinating, wonderful people. Since I’ve been in Ghana, there has been no shortage of men, women, and children coming to welcome me into the community. One of the neatest people that I’ve had the privilege to spend time with is the H.O.P.E. Center’s head nurse, Margaret. She and I have had many conversations about the Center and its partnership with GlobeMed over the last week. Everything from balancing the Center’s operating budget to designing the next phase of the childhood nutrition program to taking steps toward the design of a future maternity ward- we’ve already begun to lay out a solid plan for next year.

It is neat to learn from Margaret. She is a passionate, dedicated nurse who not only runs the H.O.P.E. Center but also her own non-profit designed to empower women throughout the country. Besides her hectic work schedule, she still manages to reach out to those that need her most. For instance, there is a young, HIV-positive mother in town. When her HIV status was accidentally revealed, many in her village forcefully kicked her out of her home and have been hostile to her ever since (the HIV stigma is terrible around here, in case you didn’t catch that). Margaret immediately saw the potential in this young woman (and fell in love with her 5-month old baby girl- see photo) and took her under her wing. She and I have been to visit village chiefs, landlords, artisans, and church leaders so that Margaret can negotiate a future for this girl. Margaret’s persistence is inspiring and her integrity honorable. To be working in the company of such a woman is amazing!

I have also begun to conduct my first interviews for my research! I went into the village of Kodzobi yesterday to talk to six pregnant women and I had four interviews in Ando today. They have gone well so far and I am already getting a lot of good information that we can use to improve and expand the H.O.P.E. Center’s programming. My time here convinces me more and more that this is a place of incredible healing and “H.O.P.E.”

Today’s most recent bug bite count: 47

A change of pace

Greetings from Ho, Ghana! I have arrived safely and am getting settled in the rural village that I will be staying at for the rest of my time in Africa. The pace of my life has definitely changed speed: from the hectic, bittersweet last days in South Africa (the World Cup soccer and International rugby games were amazing) to the relaxed, easygoing lifestyle in Ho. It has been neat to meet new people and try new things such as learning how to administer vaccines to young children as part of a child welfare program I'll be helping with (see bottom photo).

I will be working at the Health Outreach and Peer Education (H.O.P.E.) Center, which is a rural community health clinic. GlobeMed, the Northwestern global health student group that I am now president of, has had a sustained partnership with this Center for many years now. One of my primary goals while I am here will be to continue to expand this positive relationship. This will entail meeting with the Center staff, community organizers, and municipal health directors to ensure that we are all able to advance the Center's outreach programs. I have already been engaged in many great discussions with the Center’s head nurse, Margaret. We are currently in the planning stages of increasing the Center’s current (and very successful) childhood nutrition program. This nutrition program is run by the H.O.P.E Center's nurses who teach mothers how to prepare healthy meals for their children, especially since malnutrition is a significant health concern here. I will continue to give updates on our goals for this program, but suffice to say for now, exciting things are coming!

In addition to the administrative tasks that will cement the partnership between the H.O.P.E. Center and GlobeMed, I will also be conducting my own research on maternal health and nutrition. I will be going into the surrounding communities to interview pregnant women on their current eating practices, beliefs, and knowledge. This will enable us to assess where there are nutritional shortfalls and how we can best respond. One of the aforementioned goals is to expand the current nutrition program’s outreach to include expecting mothers. I hope that my research can provide the informational link that we’ll need to best tailor the program to meet these women’s needs. I am looking forward to the chance to engage, collaborate, and learn from them.

All in all, this change of pace is something that I am already loving. It is such a neat opportunity to be here and I can’t wait to see what the coming weeks will bring!

Let the games begin!

As my time in South Africa rapidly draws to a close, I wanted to write one final South African post before my experience in Ghana begins (not to worry, I will continue to update once I have internet access again)! I have been having a great week, made even better by my time volunteering at Nonceba Child Abuse Center. There is nothing better than the feeling of walking through the door in the morning to smiles and hugs. We've had lots of fun playing soccer, puzzling, arts and crafts (see photo), and more! The children are truly wonderful ; it has been so neat to be able to spend time with them.

This weekend promises to also be amazing, seeing as the FIFA soccer world cup starts tomorrow! I have tickets to watch Uruguay take on France in Cape Town tomorrow night. We are planning on heading to the city bright and early to catch the opening games and festivities. The fact that this is the first time an African country has hosted is like watching history in the making. Saturday, I will be at the international rugby championship, cheering as the Springboks (the South African rugby team featured in the film Invictus) play France. My jersey, flag, and face paint is ready…

I am off to Ghana in a few days, which is so exciting (and a little nerve-wracking)! I am eager to apply the public health knowledge and experiences that I have gained in South Africa to a new context. My time here has been an incredible, life-changing experience. I can’t wait to see what the next chapter of my African adventure will bring! Stay tuned…

A smiling witness witnessed a smile

I have been a witness to the world’s most beautiful smile today. The bearer of this grin was a little boy, around the age of five. He and I spent the better part of the morning playing dominos, coloring, and teaching him how to do a puzzle. The pearly whites came out as the last piece of the puzzle had been put in place. High-fives and hugs were exchanged all around. The pride in his eyes and the smile on his face meant even more, knowing that he has been a victim of childhood rape.

My new friend and his two brothers are currently living at Nonceba, a safe haven for children who have been abused. Currently, there are seven children living at the shelter, all there because they have been the victims of horrendous, unspeakable crimes. The Center is located in Khayelitsha, the second largest township in the country, situated on the outskirts of Cape Town. It is amidst these miles of shacks that young children are more likely to be raped than they are to learn to read.

Nonceba is an incredible organization. It dedicates itself to providing counseling, shelter, and support services for those adversely affected. There is also an attached domestic violence shelter that currently houses nine women. Now that I’m done with my classes, I will be spending the mornings volunteering here. There is no better way I can think to spend my last week in South Africa.

Speaking of my last week here, boy does time fly! It is hard to believe that the quarter is drawing to a close and I’ll be heading to Ghana in t-minus six days! I’ve been busy trying to pack in the last minute items on my “to-do” list. Since I last wrote, I can check off wine tasting, dining at a vineyard with my professors (for our farewell banquet), going to a music concert (to see the South African band “Goldfish”), a night on the town with girlfriends, hiking, and having a potluck off my list. Whew! What a way to kick-start summer!

One-(wo)man band

Surprise! For someone who normally shies away from the spotlight, I have turned into a singing, dancing, Kudu horn-playing entertainer!

My journey to stardom started earlier this week, when we watched a performance by the “Happy Feet Dance Company.” This troupe, comprised of about 30 kids between the ages of 3-15, is an after school dance program in one of the nearby townships. Originally developed to keep the kids off the streets, the organization has built up quite the all-star cast. The children mirrored the style of dance and song common in the old mining towns of Johannesburg (hence the mining boots, suit, and hard hat that is their costume-see photo).

After their wonderful performances, we split into groups to mingle and learn some moves. Before we knew it, we were the ones on-stage, performing alongside these little stars! The whole afternoon was so much fun, and I have now built up an arsenal of new dance moves to break out on occasion. You have been warned…

We also went to a Xhosa restaurant later in the week where we had a taste of some amazing homemade Xhosa food. During the meal, instruments were brought out and we could learn to play. I happened to pick up the Kudu-horn (the Kudu is a large elk-like animal with really cool spiral antlers) that is played like a trumpet. It was so much fun to try, even if the New York philharmonic won’t be calling me anytime soon.

Yet, the real stars of the show can be found in the rural village of Ceres. We spent the day in a one-room church, observing as children were tested for fetal alcohol syndrome (FAS). FAS is a very prevalent issue throughout South Africa and especially in the wine-regions of the Western Cape where farm laborers were once paid in alcohol. This practice has been outlawed, but it has not stopped the pervasive alcohol abuse that exists among the communities. Many women drink throughout their pregnancies, causing growth and developmental defects in their unborn children. These kids face a host of challenges including mental retardation, social and behavioral issues, and a predisposition toward substance abuse later in life.

Our time in Ceres was also spent observing a focus group that is run by a non-profit organization. This group consisted of about ten women (and a few men) who voluntarily come on a regular basis to discuss everything from malnutrition, FAS, domestic violence, and alcoholism- all issues that they face daily. We happened to come on the last day of their focus sessions, when they were receiving their course completion certificates. The smile on their faces and the pride in their eyes as they boldly walked to the front of the room to receive their certificate amidst the wild applause was an Oscar-worthy performance!

Behind Bars

Yesterday, I was fortunate to visit Robben Island, the site where Nelson Mandela and other political prisoners were held because of their resistance to the apartheid regime (a period of intense oppression for black and colored (mixed race) people by the white minority). If you’ve seen the movie Skin, you’ll know what I’m talking about.

Walking around the empty yard where prisoners once spent eight to ten hours of every day doing manual labor was an emotional experience. I could only begin to imagine what they went through here. Viewing Nelson Mandela’s tiny cell (see photo) and speaking with an ex-prisoner (who had been convicted for five years for leading a student protest movement against the regime in the 80’s) was incredible.

My trip to Robben Island has been just one of the many reminders of the consequences of apartheid. Last week, I visited District Six, a residential area in Cape Town that had been deemed as a “whites only area” under the Group Areas Act of 1957. Shortly after the implementation of this Act, the government forced thousands of colored and black people to relocate to informal settlements on the outskirts of the city. The entire area was demolished, businesses closed, and homes destroyed to make space for white people to move into the area. Because of the cruel removal of these families, no one wanted to move into the district, leaving wide spaces of undeveloped land in the middle of the city. Today, the land remains largely empty (with the exception of a once bustling Main Street-see photo), an eerie testament to a legacy of oppression.

Even my daily conversations with locals who lived during this dark period of South Africa’s history have given me incredible insight into life under apartheid. Many of them remember when they had to carry around “pass books” that dictated where they could and could not go, whom they could marry, and where they could live. Imagine the Jim Crow Laws of our country, but ten times worse.

Apartheid was a horrible “prison” that bred racism, inequality, and hatred. Yet, a discussion with a young, black entrepreneur or a visit to a non-profit organization dedicated to promoting tolerance reveals a country that is slowly working to break free from these bars that are holding it back. One only needs to visit the empty cells of Robben Island prison to see how far this country has come.

A Tale of Two Health Care Systems

On Friday afternoon, I visited a private hospital. However, this was not the ordinary type of facility I have seen before. Most of our previous excursions have been to the public sector- a very different system in terms of resource availability, staff quantity, overall appearance, and patient population. This particular facility was well supplied and managed. It was as if I had been transported back to Illinois for a typical day of work at Evanston Hospital.

In immediate contrast to this private hospital is the plethora of public health care sites that are (often) dilapidated, poorly resourced, and overcrowded with patients- many of whom do not have health insurance (let alone stable employment or a permanent living structure). The disease demographic is different as well. HIV/AIDS, tuberculosis, and violence-related injuries comprise the bulk of the medical cases seen by the staff at public clinics and hospitals. In contrast, the private sector typically interacts with patients suffering from chronic conditions such as cancer, arthritis, and cardiovascular diseases.

These two vastly different medical systems symbolize the much larger socio-economic divides that have plagued this country for centuries (and are getting worse by the year). To drive past affluent gated communities to get to the townships where I interact with people who are living among scrap metal is a powerful experience. Something that lingers on my conscience long after the day is finished.

Yet, the optimist in me is convinced that it is this precise emotional turbulence that will be the catalyst for positive change. A change brought about by the hard work, dedication, and compassion of individuals who are committed to promoting social justice (in my case, social justice through public health equity). To quote American anthropoligist Margaret Mead, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it is the only thing that ever has."

(Other photos include my recent excursion to Table Mountain and the
Bo-Kaap district of Cape Town).