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18:15
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Colleen's Ghanaian Adventure
So that's it. I did what i set out to do, had an alternatingly life-changingly wonderful and soul-crushingly miserable time (that i wouldn't change one bit or trade for anything in the world). br /br /Met some incredible people. br /br /Alyssa - US exchange student, you don't get nearly enough credit for being brave enough and deep enough to do what you dobr /Susannah - UK filmmaker - you are sincerely the kindest, accepting, and most empathetic person I think i've ever met in the worldbr /Jeremiah - Nutrition Student - coming back to Ghana and getting to work with a volunteer who was actually trying to accomplish something tangible that they were actually trained to do kept me sanebr /Sheila - Global Giving rep - amazing organization that people should know more aboutbr /Margaret - Head nurse who, although we have had our differences, I have only the utmost respect for her palpable passion for healthcare which drives the whole Centerbr /Joseph O - adopted me into the HIV-NGO field in Ho in the fall and showed me the ropes of voluntary testing, support groups, etcbr /Mujib, Mubarak, and Victoria - hostel-mates who never treated me "white" br /br /of course, Joseph A - letting me and all GlobeMedders stay with him like family. This man does not get nearly enough credit for his genuine sincerity and love for helping people at incredible self-sacrifices while working in a system of "recipients" that rarely acknowledges the concept of being a volunteerbr / br /Also have to thankbr /Of course, the Mind the Gap Fellowship people, Art and Nathaniel for giving me this awesome opportunity, that as cheesy as it sounds, completely changed my life for the better.br /GlobeMedders, for the whole purpose of the organization which shaped my global health formative years, and the people for supporting the HOPE Centerbr /My friends who let me complain to them over gchat and put up with my mid-ghana crazinessbr /and my family who is amazing and i love thembr /br /thank you to everyone! and to anyone who actually has stuck it out and read this thing since August!br /br /thats it, see everyone around.....div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-4301609679675210549?l=colleenfant.blogspot.com' alt='' //div
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17:58
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Colleen's Ghanaian Adventure
I have arrived back in the states, gotten some excellent non-bucket showers, eaten so many quesadillas I might burst, and finally readjusted to US time. br /br /Everything is done with the project I was working on. I was supposed to give a presentation to Ghana Health Service the day I left, but no one from the GHS showed, so I just ended up giving a presentation on my activities for the last 10 months (minus 2 months home) to the nurses from the Center. It went alright except for at the end of the presentation the head nurse asked the other nurses questions about the feasibility of continuing the program and one of the nurses literally woke up from her nap during my presentation (no joke) and said that she thought we were "biting off more than we could chew." br /br /I understand why she says that since its been a lot of work to set the program up, but now all that is left to do (based on the way i designed it) is to give one 2-hour health talk a month, and have 3 days at the Center for training, then just 1 more day in 6 months for re-training of educators. Minus the "trainings" all my program design really does is to just ask the staff to do a teensy bit more (with stipends for their effort) to actualy make sure that existing GHS policies are implemented. Anywho, I'm still pretty confident that this program is totally doable with such little effort on the part of Center staff (with 3 nurses and 2 orderlies and 8 patients a day, typically there is nothing to do at the Center for at least half the day... so why not do some SRH stuff.. and make a little more money..) That as long as people don't just lose momentum and stop caring about health there's no reason for the program NOT to continue.br /br /What I believe will happen, will be that the Center won't do the training until the 2 GlobeMed volunteers arrive in August (so be prepared guys).div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-4292713144473121276?l=colleenfant.blogspot.com' alt='' //div
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17:16
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Colleen's Ghanaian Adventure
So this is probably going to be my 2nd to last post, cause I'll post one more with like a conclusion next week.br /br /Today was the first STI Clinic at the HOPE Center. We tested 13 students for HIV and 11 students for Hepatitis B and then like 15 other random health screening tests. They will come back to the Center Monday and Tuesday for their results. While it was really cool to see things come together, there were a few things that happened that put quite a damper on the day for me and knocked me off my high horse from Monday. br /br /1. When the students first arrived (they came in a mini bus from the Polytechnic) Opening remarks were given. Usually, to negate any possibly of power struggle, I stay basically mute during all of these public events. However, I had to make a comment today because in the opening remarks the question "Who is here for HIV testing" was asked to the entire group about 5 times. Independent of cultural differences, values, etc - that is simply not a question that should be asked to a group who came to our Center specifically for its discreet location (which was kind of the whole point of adding testing to the Clinic in the first place because the hospital is the exact opposite of discreet). So while I make a point to stay quiet and keep all of my opinions to myself and have been for the past 5 months, I actually turned to the speaker and said, why don't we just let the students write their test requests on these cards you asked me to make so that we can keep everyone's privacy. And then I set up a system where the kids write their name, phone number, and requested tests on a card and then call up students 2-3 at a time, sending those for HIV pre-test counseling with the counselor and the others to wait for the lab. Then after counseling the students who wanted HIV tests were told to wait in the same place as everyone else so that it was not obvious who was getting HIV tests and who was getting the others because all the tests were a simple blood drawing. Then the counselors (who it was their first time counseling) were like "Who's getting HIV tests" in front of the entire group. Thus me being like "here are the cards" lets stop asking who is getting HIV tests in front of the whole group! Plus - all I was doing was asking the staff to follow GHS policies and not act in away that is exactly opposite to the whole program which was a purpose we ALL came up with!..... I could not live with myself and keep my mouth shut there. br /br /So what ended up happening was (and I say this as un-arrogantly as possible) I ran the whole thing, bring people to either Peace, Isaac, or Edith for counseling or just to the lab for other tests. So I was the only person who did anything to actually facilitate the testing (which was NOT what I should have had to do, I should have been totally in the background - this was not sustainable) So while yes, we have this testing now at the Center, I don't have a lot of confidence at the moment for how the quality of it will be carried out in the future.. I have written out a protocol so that things can be more discreet in the future but I have no idea if anyone will ever take it seriously because of the following..br /br /2. Before leaving for Egypt I had spent like 6 weeks designing the entire 3 day Peer Training Workshop, creating a participant manual with educational handouts and a facilitator guide that spells out step by step exactly what to say, do, and even designed simple and culturally significant activities. Point - I had never planned on doing "training" but that was what the Center staff wanted. I left these 2 manuals at the Center to be reviewed by the staff so that when I came back we could run them by the District Health Director then I could print out 100 of them. I even wrote an email while I was gone with a reminder to go over these Guides. On Monday I said "hey did you look through these, what do you think." I was told, "Yes, and they are perfect, you should make the copies now."(thats pretty much a direct quote. Well today, I was briefly looking through them with another person and it was becoming apparent that this was the first time anyone has seen them so I non-nonchalantly ask "did you actually read through them?" And then the answer is now, admittedly, NO. Then I was told, before you make the copies, Director needs to go through them. At this point my last nerve was about to snap, and said as politely as possibly - I asked that these be approved while I was away so that it could be done when I get back which is what you had previously told me was done. br /br /My biggest pet peeves of all are lying, taking credit for something that you haven't done, and when people don't follow through with what they say they will do. Those have always been what bugs me most and today each one of those was addressed!br /br /So it was supposed to all be done, and I thought it was, but apparently I was lied to. Literally, the entire program, and everything that I have created was either requested explicitly or the ideas of the staff in the first place. And then once I do it, its not even looked at. I was asked to create a pre-counseling form based off the GHS one, showed it to the staff on Tuesday, got the approval, and then at the end of today, my boss was like, hey can I see one of those, I never really looked at it in the first place.br /br /The whole point of posting this entry is simply to let the people who may be excited about the program or financially support it know the truth, that yes there's lots of good, but there are definitely still lots of issues.br /br /My solace is that, I've still done everything I've set out to do and done it all based on local policies and with the input of Center staff, I really can't do anything about apathy - that's a systematic problem. And come next Wednesday it's out of my hands and I can hope it continues the way everyone has talked about but I cant control other peoples' commitment. That's my limitation and I've completely come to terms with it. Totally zen right now.br /br /So, yeah I'm pissed at how today played out, but still stand by my last entry where I'm still psyched that I've really done everything that I set out to do. Woohoo in 5 days everything is out of my hands so i cant be pissed, or frustrated, or hurt when other people don't do what they say they will do! just going to relax and accept that what will happen will happen.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-3073186263586122742?l=colleenfant.blogspot.com' alt='' //div
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19:53
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Colleen's Ghanaian Adventure
Got back from 2 weeks of travel Sunday and it feels like a ton of stuff has happened in 2 days.br /br /Last night Margaret gave the health talk for a student group meeting at Polytechnic (like a college near where I live) on STIs but I altered it a bit to add more details since the students were older and more educated. The talk went really well, and I played resource person as the biologist on yeast candidiasis which was fun. After the talk we had students pay to sign up for testing at the Center – I thought through collaboration with Regional Hospital.br /br /So I just saw the list of students signed up for testing at the Center. We have 11 students coming in for HIV testing, 6 coming in for vaginal swabs, 5 for Hepatitis B, and some various other ones. Three girls just came to the Center to schedule testing for students from a different school, and I posted fliers around my hostel telling people to come talk to me if they want an appointment. Currently our Lab Man comes twice a week, but given the volume of people who want testing we are going to book a third day which will become a permanent STI Clinic day. br /br /And NO – the testing will not be done by regional hospital. While I was gone, Margaret was going through the purchase orders from the Laboratory that came to the Center in December and it turns out we have 80 Rapid HIV test kits. Seriously. We’ve had them this whole time. WTF. Swabbing and Urine test abilities give us the capacity to test for most of the other STIs and then we have about 50 HepB tests. All of this was initially purchased by the funding from GlobeMed, and then all reagents and replacements and salaries are GHS.br /br /Then Lab Man got an overview on how to use all of these tests and a lesson from a pharmacist on which drugs to prescribe for which ailment. Margaret also now has this information, went out and purchased the necessary drugs (I assume through GHS) and learned how to prescribe them. All we have to do is have a nurse come from Regional to do the actual HIV, Hep B, and vaginal swab tests, and then they will be training our nursing staff and Lab Man. The first “HOPE Center STI Clinic” is this Friday, and we’ve already got like 34 people booked with appointments in my lovely excel spreadsheet. The plan is to schedule the “STI Clinic” for every Friday afternoon.br /br /So just to recap. The HOPE Center now has a functioning STI clinic. That really just happened. br /br /We can test for HIV and STIs, we have the capacity to treat most of them and refer the rest, AND we also have a pretty sick Sexual Health Outreach Program for schools due mainly to Margaret’s captivating delivery of the material. It’s actually gotten good “reviews” since the initial target was 5 schools for health talks and then training, but so many other schools and student groups want the talks that we’ve already given 3 more. We’ve already had about 7 people come from one of the schools for STI counseling and literally 4 girls walked in today from the first school that we gave a health talk at and they want STI tests on Friday at the Clinic. br /br /So basically, um, what I said I would do actually happened and I didn’t totally screw everything up! Who saw that guy coming?? We’ve got a substantive and continuous system of sexual health talks and content based on actual research and identified need, Peer Educator training for SRH Advocates is ALL planned out, and now apparently a functioning STI/HIV clinic at the HOPE Center. I can't believe it all actually came together.br /br /I am incredulous.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-8322279873916862522?l=colleenfant.blogspot.com' alt='' //div
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15:12
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Colleen's Ghanaian Adventure
1. I was at a child welfare clinic last week (where we weigh and immunize babies and I have become a master at writing down the weights..) and one of the mother's who had a 9 month old baby was staring at me for a while. Finally, she asks me if I will marry her son. The 9 month old. I politely decline. But, in Ewe "to marry" is not so different than "to sleep with" - so please make your own connections there. Because I think a mother just asked me to sleep with her baby. Then literally 5 minutes later ANOTHER mother asked me to marry her 10 year old son. Aparently I was really popular with children that day or I somehow come off as a pedophile which I'm going to have to work on. br /br /2. Got robbed again. Walking home Friday night with a British guy (aware that you shouldn't walk alone or take taxis alone as a female at night so I was crashing at the home of these other 2 volunteers). About, oh, 50 meters from this guys house a Ghanaian appears out of nowhere, says something along the lines of "This is Ghana and you will die" and then snatches my purse-wallet out of my hand which contained my Ghana cell phone, 5 Cedis, my ATM and Visa cards, and a USB drive. So I've now had 3 USB drives stolen during my 8 or so months here.. The guy I was with chased after him but this thief was so fast that it was almost impressive..br /br /Sometimes I think I have a giant target on my forehead that just asks for ridiculous things to happen to me here. Oh wait - no I'm simply one of 10-30 other rich white volunteers here who are basically viewed as walking ATM machines - even in a nice ways. Everyone wants to either "be your friend" - which means you buy them drinks or give them things (cynical but actually true from my experience)"be your serious friend," "marry them and take them back to the states," or ask for money even if they are dressed better than you (literally had everyone from guys in suits to chidlren in school uniforms, to homeless people ask me for money when normally they are cleaner and better dressed than me...), or apparently rob. This whole stereotype of GHana being one of te friendliest countries is not really something I have witnessed on any large scale, at least never beyond a superficial level or from a few great people I've met who I've actually experienced mutual respect with.br /br /I'm a little pissed obviously from the robbery, but it is totally true that even many of my Ghanaian friends here spend half of our friendship either letting me buy them things or asking me for my things when I go which really makes a girl feel special.br /br /No, I will not be giving away my laptop, ipod, guitar, camera, or portable harddrive because as it turns out they don't actually grow on trees in the U.S. so it's not just a matter of me getting a new one when I go home. I have to explain that at least once every two days to someone.br /br /But, I'm just in a pissy mood, my project is still going awesome - just finished up the training manuals and peer educator packets so literally the only thing the Head nurse has to do for the Workshops is to schedule them. Everything else is covered. And I'm meeting my brother in Cairo on Saturday for 2 weeks of travel. I think a 2 week break from Ho is really what I need right now.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-387087194992846849?l=colleenfant.blogspot.com' alt='' //div
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14:45
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Colleen's Ghanaian Adventure
For the past month or so I have been hanging out with this girl who has been in Ghana as long as I have and in the past few days she has gone through an experience similar to what I went through last October.br /br /At the end of October last year I felt incredibly lonely and useless. The SRH program that I was working on was indefinitely on hold until the lab would come in, and it seemed as though all of the GlobeMed stuff that I was trying to muddle through was pointless. Combined with the fact that I lived alone in a 6 x 12 windowless room, without any real Ghanaian friends - only acquaintances because of cultural issues and volunteer stereotypes, no western volunteer friends through my own choice, and constant harassment and inappropriate advances from Ghanaian males, I was in a pretty lost place. There was literally no alternative to just hanging out by myself after work every day for months. When a miscommunication happened at the Center in October and I was yelled at for a whole host of things, something snapped. br /br /Being verbally cut down when you are already feeling a lack of self-fulfillment and utter cultural and personal isolation is truly an experience that I would not wish on my worst enemy. To be completely honest, I went a little crazy. I am so lucky that I went home a month early just to be able to rebuild my own sanity before having to sell myself at medical school interviews.br /br /The reason I mention that, is because this other girl is going through a similar experience and, my god I am just aching for her because seeing what I went through in someone else that I care about is just heartbreaking. She came to Ghana on a school exchange program to stay for 10 months. She ended up leaving the school in January because she was getting nothing out of it and she had already graduated high school. Then she tried volunteer teaching for a while, but has also found that to be pretty meaningless and unnecessary. So now she doesn’t know what to do for the next 2 months because none of the volunteer activities in Ho are really that meaningful. She has a similar social situation to what I had, except she has had some western volunteer friends over the months but they have come and gone. For the past few weeks she has literally had nothing to do during the day and not enough money to get out of Ho. When a precipitating conversation happened to her like what happened to me she has had a very difficult time readjusting. Obviously her experience is unique, but the behaviors; the listlessness, the visible defeat, and the general self apathy are just terrifying to witness. br /br /It’s weird how things can come full circle. I really judged myself for sort of not being strong enough to handle all that stuff in the fall – but now I am at least able to put it into the perspective that this situation is really difficult and sometimes people go a little mad when socially isolated and unfulfilled with daily tasks. Maybe it’s due to a certain set of personal propensities to already be in your own head all the time (there are plenty of other volunteers here who say they don’t do anything meaningful but are perfectly content with drinking or going out, doing drugs, hooking up, watching tv, or expensive travel to pass the time), but at least now I know its not just me. I’ve seen a few other volunteers go a little crazy too –these are also usually the ones who aren’t here with a volunteer group or are with a group but choose to separate themselves from it, have genuine projects, and tend to be highly analytical people who sit around and talk about deep dark things instead of just how gross the food is or what they miss from home. But I’ve never really seen anyone else get that bad because when you’re here for 2-3 months there’s a very tangible end to the isolation. br /br /Because I was lucky enough to have the option to go home, and have since come back and have both a better set of daily activities and found some good people to talk to, and -to be honest – have an end in sight; I am trying to do for her what I wish could have been done for me. Empathy is a powerful tool especially to a crazy person, and I’m really hoping that by trying to be there for her (also because she’s cool and my friend of course…) that I can help her not to reach the place where it becomes either go crazy or go home. Last night we had a marathon of It’s Always Sunny in Philadelphia at my hostel, a book exchange (gave her Choke by Palahniuk and The Witch of Portobello by Coehlo, she gave me On the Road by Kerouak and a Vonnegut) and I lent her a little money to travel for the weekend just to get out of Ho. It was fun, and to completely project my own experiences on her, would have been just what I would have wanted a few months ago. br / br /It’s been nice though, to be able to talk about this stuff with someone who gets it, because I think its impossible to talk about it to someone who’s never been here. One could just say why don’t you just make friends, or do something, or whatever, but there really is no easy solution. And even though I’m basically past it, its still a weird thing to remember and see in another person.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-2373276626615358068?l=colleenfant.blogspot.com' alt='' //div
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18:21
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Colleen's Ghanaian Adventure
Things have been pretty busy at the Center lately because everything's kind of coming on at once, and we're currently short-staffed so I'm helping out with paperwork stuff as much as I can (I spend about 5 hours each day staring at the screen of my laptop. awesome.)br /br /As far as the project goes, here's the update.br /br /Initial sensitization health talks have been given at 5 different places (3 of which will be part of the "program") - Secretarial School, Sonrise SHS, and Ho Polytechnic (on Hepatitis B). I already mentioned what we did at the first place, then at Sonrise we gave a powerpoint presentation that I made on Adolescent Reproductive Health, STI signs and symptoms with descriptive pictures, and then I added a part about Adolescent Relationships, feelings, and "safer sex practices."br /br /Basically what i did to make it less specific is to make one generic powerpoint that has reproductive health education diagrams and then the HIV/STI info. Then I made a second powerpoint on Adolescent Relationship (using some really great info I found online) and ABD (abstinence, being faithful, and condom use). So depending on the school's specific requests the presentations can be combined and altered. One thing I really didn't like that we did was the facilitator decided to skip over all the B and C stuff, and just talk about abstinence, telling the 500 or so students that touching privates or engaging in any sexual acts would "spoil themselves." Actually to be more specific, the gist was "girls keep your legs closed or you will ruin yourself, and boys will be boys"br /br /I personally don't believe in abstinence-only education, especially since the whole program is about getting people to protect themselves from STIs which they're getting. I asked this other nurse volunteer to make up the part on "Abstinence" cause I really couldn't take it seroiusly, and he came back with this like 15 slide presentation with an essay per page on how abstinence is the best thing in the world, makes for better marriages, more successful people, and how you could channel those "sexual energies" into things like sports or reading books. When I suggested, very offhandedly about any discussion of masturbation as a presentable alternative I was pretty much just laughed at. Then when I asked if the young nurse practiced abstinence, I was told no. So there seems to be a disconnect between reality and the ideal, and I thought it was one thing for like society to teach only abstinence, but another completely for the GHS to do it.... especially when it is their policy to teach ABC...br /-BTW just for a point of reference, there are these 2 USAID posters that are really common and one has a picture of a girl saying "Protect your dream, abstain from sex" and its counterpart which has a guy and it says "use a condom"br /br /Anywho - so those talks are all done, and we will be hosting a mobile HIV testing unit at the HOPE Center next Wednesday for the students from Government Secretarial. We kind of figured that that would be the point for phase 1 to be done. br /br /One really cool thing is that the head nurse has decided to adopt the project under her own NGO a bit but it will be done through the HOPE Center. I got to spend all of this week writing a proposal to Planned Parenthood Ghana who is looking to support local adolescent HIV/STI programs.. Since I obviously will not be the one to see things through and the Center simply does not have the staff to execute it (none of the staff really seems that interested in going beyond normal GHS stuff other than the super-enthusiastic head nurse), its really good that her NGO will take it on. The idea is that GLobeMed at NU will cover the initial 6 months of the program with the funding we already requested.. but still havent got.. then PPAG will give us either about $5000 to do another 6 months, or $9000 to do another 12 months. Much, much higher than the figures I put forth initially and to be frank, most of that money goes for facilitator stipends, counselor stipends (even though counselors are employees and testing is their job...) fuel, and food for participants. Little goes into the actual content (most of which I have actually already finished and compiled at minimum personal cost). So, it's not exactly how I would choose to run things, but thats how they are run here I guess. The money seems to be out there so I guess they'll get it.br /br /I'm really confident that things will continue more or less as planned with initial health talks, then quarterly student training workshops, then monthly education events that the trainees will plan, then bi-yearly HIV testing offered at each of the schools. All that's really left for me to do is to compile all of the research and education resources into even more usable formats and be a catalytic thorn in everyone's side to keep on the ball....div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-5009304554627901202?l=colleenfant.blogspot.com' alt='' //div
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15:43
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Colleen's Ghanaian Adventure
I really hate to visit this topic yet AGAIN, but I feel like it has been an integral part of my entire time here and I keep running into it again and again. I haven't let myself focus too much on it as I did during Ghana Adventure part 1, because I have chosen to spend my time socializing with other volunteers rather than judging them and feeling superior yet alone. br /br /There are probably 25-30 white volunteers in Ho at the moment. For a town this size, that is a pretty large number. The majority of them teach at schools and a few shadow at the Municipal Hospital, the Regional Hospital, and another Clinc. (i am generalizing, but - )Those that teach come and go as they please and all generally have big plans to buy the school nice things once their 6 week "teaching" is done. Those in the medical field either just shadow and complain how boring it is, or do basic nursing things (even though none of them have any training). THere is a constant theme at the "white people gatherings" of articulating how unhealthy the kids are, or how poor the teaching quality is, and also how important it is that they are helping out, because these Ghanaians need so much help. Swear, I have heard multiple people say how much "help" the poor Ghanaians need. I don't know, maybe I have had my own perception changed through acquired cultural relativism, but I don't think the situation here is a)completely dire as I grew up thinking of Africa, or b)that unless us 18-20 year old volunteers come in and show the medical staff our work ethic or our superior teaching habits the people of Ho would be helpless.br /br /First off, there are plenty of areas in Ghana that I've seen with some serious health issues. Ho isn't great and there is definitely tons of room for improvement but the Ghana Health Service isn't the enemy and they are definintely making strides to keep improving things. And in general, health statuses around Ho aren't apocolyptic. Some of the volunteers were complaining about when they went out to do a school outreach (by the way - not sanctioned by GHS or the Ghana Education Service - so a bit disrespectful if you ask me) that they would treat sores on the kids feet but they would just get dirty again because "the parents and teachers" didn't care. #1 these volunteers have no medical training to be giving health talks (I am a "project coordinator" and I don't even give health talks, I only chime in on Biology stuff) and #2 I have sores on my feet that I can't keep clean too. But you know what? I'm okay. Maybe 8 months ago I would have thought it was a big deal, but maybe we're overly hygenic in the states and cleaning minor wounds daily might be plenty. br /br /It just seems so condescending that all of these volunteers come and think they're here to do good, and probably a lot of them are, but It's like there's this thought paradigm of the helper with their western life education and the helpless who needs tutelage and I think that little paradign is a lot less polarized than we seem to think it is. I've had a lot of students at the technical school where I live be very skeptical of white volunteers and question the kind of "good" they are really doing. But these students are of a different generation (i.e. mine). I don't think people here are as helpless as they are made out to be. Saying, "I'm going to do volunteer work in Ghana" has this whole attached implicit meaning of doing something extraordinary and self-sacrificing for poor Africans, but honestly, I wish saying that "I'm going to do volunteer work in Chicago" would carry the same implicit weight. It may be just because I've been here so long, and maybe I'm giving too much credit to cultural relativism, but sometimes I get like offended by the things other volunteers say about the "state of things here." People get up, go to work, eat food, laugh, hang out with friends, study, get sick, get healthy just like everyone else around the world. Yes there are differences and room for change but I don't know I think there's a lot of disrespect for local norms among the volunteers here.br /br /Part of me almost thinks that if I grew up in a town where white kids had to travel halfway around the world just to help me because I was so needy and I had to be so grateful, that eventually i would become disempowered and just wait for help to get off the plane rather than pick myself up and look to my own countrymen. br /br /Yes, I realize this whole essay reeks of my own self-rigteousness and I generalize, but this is truly what I encounter daily.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-7836379773181968018?l=colleenfant.blogspot.com' alt='' //div
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15:17
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Colleen's Ghanaian Adventure
After looking at my calendar and realizing how quickly time as gone, I have been trying to organize my time to get as much as possible done before I travel on May 2nd. br /br /Basically what was decided was that I would complete “Phase I” of the Sexual and Reproductive Health Program” and then do the preparations for “Phase II.” What that will entail will be the completion of the initial sensitization health talks at the 4 selected schools; Government Secretarial, Mawuko Girls SS, St. Prosper’s college, and Sunrise Academy SS (actually 5, because we went to Bankoe JSS just for good measure after Government Secretarial). The knowledge analysis is done for the first three, and we’re not going to give the questionnaires to the last 2. We’ve already completed the Sensitization talk at Govt. Sec. 2 weeks ago, and now we are working on planning out the peer training workshop for that school to be done this April. With the exception of Sunrise Academy, the other schools are on exams now and will break until May so we will give them their Sensitization talks in May just before I leave. We will be giving a talk at Sunrise Academy this Friday.br /br /The Sensitization Health Talks are pretty decently planned out for these secondary schools. The first thing we will do for the schools that have done the questionnaires is to go over the collective risk levels. Following this brief overview on powerpoint, we begin with a basic overview of reproductive anatomy and development. For this we have diagrams on slides and I also made a few posters with the same diagrams to use in case of power outage. After this part we also have diagrams both on power point and on poster of STI information using pictures of diseases that we were able to capture from one of the videos. Then if that school wants more information on HIV we will show them our HIV dvd. Finally at each of the schools we will have an extensive question and answer session about everything we have covered and then introduce “Phase II” of the program.br /br /Phase II of the program will be divided into 2 parts. Because of the school schedules, the training sessions for the secondary schools will all be done in June or July with the assistance (hopefully!) of some of the GlobeMed volunteers. For Government Secretarial, we have to do things a little differently because the students are more mature, so we are giving them a separate Peer Educator Workshop this April. I have been working with the nurses on activities and lesson plans for the workshop. So far what we have planned is another overview of STD signs and symptoms, review of menstruation and female health issues, then an activity on negotiating safer sex. We’re going to try to make the “training session” as personal as possible, by only training 15 leaders. We will also spend much of the time in small groups working on how best these new leaders will be able to communicate this information to their peers. The first task of these newly trained leaders will be getting their fellow students to attend a mobile voluntary HIV testing and counseling session at the HOPE Center that will be put on by the Regional Hospital.br /br /When the other volunteers come this summer they will be able to work on the training sessions for the other 4 schools.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-6846520211426004958?l=colleenfant.blogspot.com' alt='' //div
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18:17
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Colleen's Ghanaian Adventure
Today was the official launch of the public aspect of the sexual and reproductive health project that I have been working on since August. br /br /After analyzing alllll of the questionnaires last week, myself, the Head Nurse, and two male nurses have been furiously searching for materials in and around Ho. We have an excellent DVD that I borrowed from an HIV organization in town and burned for the Center. Then the Head nurse got some really old VHS' from a friend at Planned Parenthood Ghana. Most of the VHS' were very old and not very relevant, but there was one on STD's that had good pictures and symptom descriptions. I got the okay to travel Monday and Tuesday, but when I get to the Center on Wednesday all of a sudden we are presenting to one school today, Thursday. br /br /So, we arrive at a Secretarial school at 9am to begin the program in an auditorium. The two male nurses have been entrusted with burning the STD VHS onto a DVD, and the Head Nurse was responsible for borrowing a projector from the Ghana Health Service. I brought along 120 packets with very simple information that I got offline and edited it to be more culturally appropriate on menstruation, STDs, HIV risk level, and yeast infections. Yes this seems like a random mix, but these were the needs of the students identified in their questionnaires. The plan was, 9am I give a brief presentation to the students about the data from the questionnaires to explain the collective risk levels and behaviors. Then we show about 1 hour of this HIV film, have a question and answer session, then show the 20 minute STD film, follow that with a final Q A, then distribute the packets and inform the students that they should come to the health center with any concerns and we would be hosting a training session at the Center in a few weeks to follow up on this information.br /br /So, because its Ghana, pretty much nothing goes according to plan. First no one except me shows up until 9:10. Then we go to start and the screen of my laptop isn't turning on (this was to be hooked up to the projector to play the movie so everyone could see). Then we try Margaret's computer, but it isnt working either because there seems to be a problem with the projector. For some reason I am also told that now we want to do the STD video first. Then of course, I give the brief presentation on the questionnaire and that goes fine, but while I'm doing that, Margaret has gone to the Center to get the TV. Then we realize that the DVD connector cords are across town at her office. br /br /Still following? br /br /So, while she is gone, I'm trying to fix my computer and get it to turn on finally and put in the STD video. I guess the two male nurses didn't check the quality because it looks like crap and the sound is almost non-existent. Margaret comes back with the TV and DVD player and we turn on the STD video. Since there is no sound Margaret attempts to just talk over it, but that doesnt really work either. Finally we give up on that video and just show the HIV one which goes fine. After that video Margaret gives another brief talk about risk level and then we actually have a really great hour long QA. The students loved the packets and said they got a lot out ot the qA. As we were finishing Margaret told them to call me with any questions so i gave an auditorium of 70 girls my phone number. Excellent.br /br /All in all it was a ridiculous day, but I actually think it went well. the expression, Oh, Ghana, fits very well. The students were very patient with us and really participated in the QA. They said that they will choose 15 of them to represent the school and become trained in these health topics to serve as resources for their peers when we do the training soon.br /br /Hopefully things will go much more smoothly next time. (and by the way, GlobeMedders, fully expect me to ask you guys to buy the HOPE Center a projector and speakers to bring when you come this summer. They costs over $1500 here....)div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-2172400558796275871?l=colleenfant.blogspot.com' alt='' //div
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17:50
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Colleen's Ghanaian Adventure
This past Friday was the Ghanain independence day. I went to Accra Friday with a dozen other volunteers from Ho to go to the big celebration at this national stadium park place. (I will post pictures soon). It was pretty cool, not much to comment about it, but the pictures came out nice. There were a bunch of students in the middle of the field like singing and marching. There were also different branches of the military and polie represented. Then the President of Ghana, Atta-Mills, was at the head of the stadium along with various other important people. I have no idea what was said or anything because it was really loud and incredibly crowded. br /br /After the celebration, I went to the beach in Accra with Tony (paramedic volunteer), Susannah (filmmaker volunteer), and Evans, a Ghanaian university student in Accra. The beaches are INSANE. So, so crowded, and such a small area to swim in, imagine 1000 people just standing in the ocean in a mass about 100 yards accross and out to about their waists in the water. br /br /We didn't go in, but we just kind of hung out. Since Tony has dreadlocks, we are constantly approached by "rastafarians" who want to talk to Tony about music or sell him useless souvenirs . Eventually a guy comes trying to sell us drums, but we don't buy and instead have a mini little jam session on the beach. Very fun.br /br /Saturday through Tuesday I went back to the Green Turtle lodge with 11 other volunteers from Ho since it was a holiday weekend. It was good, but far less relaxing than last time. Long story short, I almost died twice. First i was swimming and then got caught in this super strong riptide and got pulled really far out to sea. When I tried to swim parallel I couldnt and then started freaking out and hyperventilating. Luckily I kept myself together enough to realize the biology of what was happening and that I was losing oxygen, etc, and rather than try to keep swimming while blacking out, I waved my arms and like 10 people came out and saved me. It took us forever to get back in because this riptide was huge and strong (and by the way, not even there when i first got in the water). But then I got in and stopped hyperventilating, stopped blackout out from lack of oxygen, and everything was peachy again. Except for the horrible embarassment at being "that girl" for the next 2 days.br /br /The second near-death incident is more sarcastic, but I was chilling out in a hammock between 2 cocnut trees listening to good music, completely relaxed, when a coconut fell twenty feet and crashed about an inch from my face. That would have definitely been the most absurd way to go. killed by coconut.br /br /So that was my weekend, a little dramatic, and now I get to be constantly plagued by the delightful "what does my life mean" questions, and "what does death mean" so that should be fun. br /br /I know it sounds bad, but really it was okay, as soon as a i realized what was happening, my $160,000 NU Biology education kicked in and the situation was under control.br /br /i even went back into the water the next day (while holding someone's hand of course!)br /br /I think I'm going to lie low for the next few weekends though... just to be safe until I get my luck back....div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-1923842964381517128?l=colleenfant.blogspot.com' alt='' //div
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16:30
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Colleen's Ghanaian Adventure
This week was good, kind of boring. Let's see...br /br /Last weekend some of my friends and I went slacklining, which I've never done before. This guy Tony brought a rope and we strung it between two mango trees then walked on it. All part of my whole becoming a big dirty hippie thing. It was fun and a bunch of Ghanains came and stared at us like we were crazy, but then we convinced a few other people to try it out and they got a kick out of it. br /br /Sunday, Jeremiah and I went to a church service in Ando which was neat. Except it got pretty akward when 8 other yeavous showed up who have been living with JOseph. It was totally fine with just me and jeremiah cause he had been before and they all knew me, but then all of sudden it was like 10 white people and about 12 community members so we kept getting singled out for our opinions on Christ and such.br /br /Jeremiah, the other volunteer who was working at the HOPE Center on Nutrition left on Friday. A bunch of us threw him a surprise going away party Wednesday night at Tony's host dad's house. Everyone at the Center is going to miss him like crazy because basically all of the nurses absolutely adore him. He thinks its cause he's a guy, which is probably true. We actually had many conversations about how much easier it had been for him as a guy because he was totally welcomed in the village and he could meet Ghanain guys in town to be his friend without the whole weird "I want to marry you, or at least have sex with you, vibe." (for some reason Ghanaian girls tend not to really socialize with white people as much as Ghanian guys do, but I'm starting to wear a few down). It's kind of funny cause everyone at the Center likes him so much more than me and he can like contradict people and tell them they are wrong or doing their jobs wrong or express his own opinion and completely act on his own different ideas and the sun still keeps shining out of his ass. If you can't tell I am terribly jealous of his being a guy in this scenario and how much easier certain things have been for him. But it's not a spiteful jealousy, I swear, since he's pretty much been my Ghana BFF for the past month! br /br /But, that was a bit of a tangent. So Friday I went to Regional Hospital to plan a collaboration with the head doctor at the HIV counseling and testing unit there which was pretty much amazing. Then Jeremiah and I tro-troed it to Accra, had some delicious American-style burgers then I said goodbye. After saying goodbye, I went to my usual Accra haunt, the Joska Hotel where I was welcomed wonderfully - they were out of rooms but called a million places to help me get one, the lo and behold they found a room right there that they didn't see. (TIA - this is africa). Then I met up with Emma, a girl from Evanston who is spending a semester at NYU in Accra and we had some wine and appetizers with all her housemates. After leaving there I met up with my friend Suzannah, a filmmaker from the UK who knew some guys in Accra. They were actually really sweet and not at all trying to hit on us or marry us. It was almost shocking because it was just like any other male-female interaction in the US. They took us out to all the "posh" spots in Accra in their nice car with blasting rap music. Very surreal, but very fun. Saturday back to Ho, now I'm just relaxing until Monday.br /br /Wednesday I am going to present all of the graphical representations of the analyzed sexual health data that I have collected from 3 schools so all the nurses can brainstorm solutions to the gaps and we can design the content of the training. THen we launch the program at some ceremony or whatever, and then we start educating some people about STDs and HIV at workshops so that they can be peer educators at their schools. br /br /Thats really it, nothing too exciting, everything's pretty routine now. Been here officially a month and its like home.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-535247726065310587?l=colleenfant.blogspot.com' alt='' //div
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15:59
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Colleen's Ghanaian Adventure
There are 2 male nurses that I am working with to design this adolescent sexual health program who are using this program as part of a launch pad within to launch their own health NGO (non-governmental organization). That has me thinking quite a bit lately about the whole concept of forming ones own non-profit org or NGO.br /br /I think that NGOs are such a weird concept, or at least the idea of forming one is. Often its seen just like starting ones own business, only the capital that is used is solicited not earned. So someone says they want to start an NGO then they get funding for an office, a computer, copier, staff stipend, etc. What I don't get is why you need all that stuff to do good, why don't you just do it. Shouldn't helping people be a willing sacrifice anyways, and the help itself as its own reward? Like, for example, you may not have your own computer or a/c or whatever, but if you have an NGO you can get donors to pay for that stuff to both use for your NGO and also for personal use. Its like having an NGO is like getting status both materially and socially. I don't understand all of this emphasis on needing "stuff" or specifically really nice "stuff" to engage in basic acts of human decency. If your a health worker who wants to do HIV advocacy or whatever, then why start an NGO? why not just do your job, but better?br /br /It seems like many NGOs that I have seen here do some really great stuff, but more often then not the primary beneficiaries of the NGO end up being the NGO itself since they get all these stipeds, status, and things. If you want to do something to "help people" (and p.s. I hate that phrase but can't really think of another one. but thats a whole different essay), then you should just fucking help people. Don't ask for money to do your job or demonstrate human compassion. br /br /There's like this whole market for NGOs and billions of dollars out that that people just tap into because its like you get so inundated with the idea of NGO funding that it becomes expected that you deserve your share of the pie if you want to help people. Its like hey, I want to help my community, therefore the global fund needs to pay me to do it. There's this whole consumer attitude of donor funding because its not attached to any real donors in any real personal way, its just like a crapload of money out there for the taking. Maybe I think there's just too much money out there without any real relationship between personal donation as a way to help, and the idea of getting said moneys.br /br /Doesn't that just ruin/cheapen the whole concept of community service? I'm not trying to criticize all NGOs that seek funding because its obvoius that you do need some "things" to assist in development work. But I think the availability of funds is so weird its like often what NGOs "need" isnt alway expressed in a respectful or responsible way. I also think it really dirties the whole concept of "NGO" which I don't think needs to be so formulated and systemic such that its now basically a status business when it used to be much more vague and altruistic. The people who really just "do good" because they feel compelled to do so and dont ask for new cars or computers, or whatever, and just use what they have end up way off of the radar because they aren't seeking as much funding. You can't make a business out of helping people. Having a really nice office, or a sick kitchen, or a brand new SUV doesn't equate with doing good. You could just as easily meet people in the community, or cook cheaply, or use what transportation you already use to effect the same change. And maybe it'd be more meaningful and lasting if it was done that way. br /br /One thing about my project that I really don't like is for example, I wanted to use just a very small amount of funding on the training and outreach component. Like $250 for food, drinks, and folders for the students, and then the content be just communication based about health topics that all the nurses are basically already paid to do. But now everyone else wants like projectors and flip-charts, and instructor stipends, and a million other things that have exactly no influence on any of the quality or the content. Human resource and the community service attached shouldn't come with a price tag, and if the content can't be valued as is then what tangible value is going to come from any of this. Sure, its going to look sweet on paper and in pictures, but that seems entirely superficial to me. I don't want this program to end up like all the million other health programs that come in "train leaders" leave a bunch of posters and parephenalia around and then just peace out once the funding stops. Maybe if those programs had been more content, less appearance, then we wouldn't have to keep doing them all over again.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-7822094107801991361?l=colleenfant.blogspot.com' alt='' //div
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18:17
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Colleen's Ghanaian Adventure
I spent most of last week going to schools with the questionnaire that I developed. The questionnaire is divided into two sections. The first section is called “Sexual Health Practices.” In this section I asked 11 questions about age of sexual debut, number of partners, contraceptive use, and any outlets people may have for sex/contraceptive questions. The second section is called “Basic Sexual Health Information.” In this section, I asked another 11 questions about basic facts about HIV, STDs, testing, and signs and symptoms. The last question of the questionnaire is an open-ended question asking “What sexual health issue would you like more information on.”br /br /I went over the questionnaire with all of the nurses in the Center to verify that the English was simple enough and they were culturally relevant. The nurses said that for those people under 18, there would have to be a second questionnaire excluding the first section about contraceptives and sexual practices. However, after making 100 or so copies of the “under 18” version, the nurses have changed their minds and decided that everyone should just get the full one. Last week we went to 4 schools and gave the head of schools an explanatory letter and a copy of the questionnaire to get their approvals to come.br /br /On Wednesday morning (7am!) I went to the Mawuko girls secondary school (like high school) with the head nurse and 2 male nurse volunteers who want to make their own NGO or something. We left 100 questionnaires with the health education person to administer and then we’re supposed to collect them next week. Then we went to St. Prosper’s College, also secondary school, and gave them another 100 questionnaires to distribute to their kids and we’re supposed to pick those up next week too. Finally, we went to this Secretariat School, like a trade school to become a secretary, and gave out 71, watched them fill it out, then collected them. I went back to that school on Friday by myself to give out an additional 42 questionnaires. br /br /So now I’m trying to compile the data. I’m like 1/2way through the Secretariat School, but it’s a pain. My goal is to have everything at least in the computer by Friday, then I’ll do a summary write-up that we’ll use to get the education part tailored to the identified needs. Apparently the education/outreach component is going to be based on peer-training done at the Center and followed up with education talks by the nurses and ongoing support to the student that we educate and train.br /br /Since I’m trying to be all zen and whatnot, I’m just going to go along with what the other nurses decide to do, even though I have some very different ideas about the details of the training, cost efficiency, and proposal writing. It’s hard because generally anything I suggest or say is not really respected because im white, or whatever reason, but rather than rock the boat I’m just going to suck it up and un-invest myself a little bit. It’s a very weird dynamic because it’s all very passive aggressive and I guess I just have to act less “strong.”br /br /Anyways, my goal is just to do a kickass job going over all of the data and presenting it. Then I will feel successful if that contribution is well done and then at least the rest actually happens.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-8190813155235108242?l=colleenfant.blogspot.com' alt='' //div
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18:18
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Colleen's Ghanaian Adventure
I just had the best weekend that I’ve had in as long as I can remember. I traveled to a place called the Green Turtle Lodge with my two friends Tony and Jeremiah. Most beautiful, peaceful, yet engaging place. In short, awesome.br /br /Getting there was pretty crazy. We left Ho at 5am on a 3.5 hr bus to Accra. Then from Accra we had to taxi across town to a different bus station for another 4 hr bus ride to Takoradi (heading west across Ghana). From Takoradi, we got a Tro-Tro to Aguna Junction, then from Aguna Junction we had to hire a taxi for the 35 min ride out to basically the middle of nowhere. 14 hours after we left Ho we arrived at the Green Turtle Lodge.br /br /The eco-friendly lodge was founded by two Brits who are into saving the sea turtles. All electricity comes from solar paneling, self-composting toilets, public showers, and all meals are prepared cheaply from locally grown food by the staff which is entirely from a nearby village. For the low price of 3 Cedi per night, I shared a tent on the beach with Jeremiah and Tony for 3 nights. br /br /There were probably about 20-30 other lodgers and we had the beach all to ourselves. What is really cool is the type of traveler that goes to the Green Turtle. It was primarily volunteers, Peace Corps, and ex-Pats. The three of us ended up spending all of our time with 3 teachers from Norway, Sweden, and Australia, and a Peace Corps guy who had been in Mali.br /br /Our days consisted of getting up with the sun, playing in the ocean, eating good food, reading books in hammocks, playing in the ocean some more, and sitting around talking about everything from environmental sustainability, volunteering in Ghana (good and bad things), culture, religion, economics, music, politics, development, relationships, to our future plans (generally all noble), and then of course playing in the ocean some more before watching the sunset. Each night was ended by our little group of 7 laying out on the beach watching the stars.br /br /It was pretty much just a big hippie commune. No one showered all weekend except in the ocean and we shared food, music, drinks, etc. We attempted to dreadlock this kid Andrews hair, and we drank milk straight from coconuts that we cut down. I probably spent a good hour or 2 a day just walking along the beach by myself too. br /br /It was so chill, and the conversations were exactly what I’ve been craving for so so long. It was basically paradise, and I am so much more inspired by finding people in my generation from all around the world who are relaxed, awesome, smart, adventurous,and really passionate about sustainable development things in a very thoughtful way. We’ve decided to call our little subculture new-bohemian. Not quite hippie, but bohemian. And I’m really into that right now.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-7100825332852728667?l=colleenfant.blogspot.com' alt='' //div
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18:12
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Colleen's Ghanaian Adventure
So I’m basically turning into a big hippie, what with all of this “me time” where I spend hours contemplating the meaning of life.br /br /This book I’m reading “Chaos” has actually really helped me to be able to articulate, at least within my own head, the feeling I’ve been having for the better part of a year now. I’ve really been struggling, both pre-Ghana, and even more predominantly so since I came here, with my own self-concept. The idea of what makes me, me. I’m a big picture kind of person and I really like to be able to see what the sort of master plan of my life is, i.e. becoming a doctor, saving the world, what have you. But the part that has been alluding me is who I am now. It’s been difficult, in this weird transitional phase of my life. I’m not in Ghana permanently. I’m clearly starting med school in August, but I am here for a given length of time. I am no longer a student, but I’m not in medical school yet and on the path to my future self. So I’ve been stay-up-at-night bothered about who I am now. Am I the person I was in college? Or am I the person that I am when I am back in Dekalb? Or am I neither of those, and are those both just formative components of me. Anyways, so what this whole “Chaos” book has helped me to comprehend is the idea that I don’t have to be either of those people. I really like the idea that the book puts forth about the transitional physical phases in nature like turbulence or phase-state changes. It’s the whole concept of finding order in the chaos at the boundary. And likewise, understanding the chaos that springs naturally from order. br /br /So now my new thing is, is that a person can be none of those so called ordered components and at the same time all of them at once. There is no need to make the conscious choice of how to be, because the more natural state is to be in continual motion to infinity. However there is a natural internal order or pattern that exists within that undefinable transition, or chaos, and my philosophical stretch is to decide is that natural order is what truly has quality. And following that ordered chaos – i.e. life transition stages, rather than trying to ascribe some meaning to ones self is better. I don’t have to be the professional student, or the future doctor, or the small town girl, or whatever noun I could insert there. I can be all and none at each point in time as long as I don’t try to force anything and pursue “qualities” or goodness in the everyday chaos. br /br /This new revelation (or as I like to say, existential life crisis of the moment) has allowed me a new kind of calm. I’m trying to conceptualize what it means to be all of the roles I think I am and none of them. And to be just okay with the akward transitional me without any particular defining trait. I don’t think anything really can be condensed down to some sort of catchprase that sounds easy and swallowable like “This is what I am doing”. Everything is infinitely complex and interwoven with everything else. And the metaphorical leap is that is this weird time in my life. I’ve been mentally uncomfortable with trying to understand what exactly this experience is and what its broader purpose is. It may not mean anything in it of itself. Or it might. Or it might be I don’t need to try to force it to be anything, it’s the life-manifestation of that transitional chaotic boundary where any definable characteristic of quality just goes on rippling through life ad infinitum. br /br /(For the record I read Chaos by James Gleick, then Zen and the Art of Motorcycle Maintenance by Robert Pirsig, then followed that up with Buddhism Plain and Simple by Steve Hagen and I may or may not be completely insane.)div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-7063903380478866030?l=colleenfant.blogspot.com' alt='' //div
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18:11
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Colleen's Ghanaian Adventure
I had the most ridiculous morning today ever. Last night I went with my friend who also volunteers at the Center to town to visit some of his friends from the village. We were walking back and since it was late he walked me back to my hostel. It was about 10:30 or so and since he lives in the village (by where I used to stay) he couldn't find a taxi to take him home. I invited him to sleep on my floor rather than walk home alone through the bush in the dark. He had his backpack with him that contained his computer, camera, passport, all the research he'd done, etc. So the door was locked but when he got up to go to the bathroom sometime in the night i guess he left it unlocked for the 2 minutes or whatever while I was still in the room sleeping. He came back, locked it, went to sleep. br /br /Six am we wake up so he can get home to get ready to go to the Center and we cant find his backpack anywhere. We scour the room, the kitchen, bathroom, everywhere in my small place it might be. We know he brought it with him, but just to check he goes back to a drinkspot that we stopped at for a Guinness (no, we were not drunk) and it is most definitely not there. Then the freaking out begins. I tell the porter to the hostel, the head nurse shows up, some of the guy students I am friends with get all worked up. Then we go to the hostel office, THEN we go to the police station. The chief of police gets involved. The other volunteer has to make a formal complaint, explain why he was at my place, etc (at this point everyone thinks I "brought him home")THEN the shit hits the fan. The police chief brings officers to the hostel in a big police van. One guy has a gun. They're freaking out like lock all the doors, no one leaves. Then they basically ransack all the rooms on my flooor. Of course they can't find anything. Meanwhile I'm trying to go around to every person I see to apologize for the fact that the police are searching their rooms, and by the way im pretty sure at least half the people in the hostel now hate me.br /br /So we made formal police report, and the other volunteer will have to go to the US embassy in Accra on Monday (and clearly the trip to the turtle place has been postponed). And basically everyone in the entire town knows that a yeavou got robbed at the hostel, but he doesn't stay there, and he was staying with the yeavou girl. br /br /One guy said that sometimes people will take things for a little while to "punish" people and then give them back. Like maybe cause I "brought a guy home" the bag got taken. Who knows. We've tried to explain to as many people as possible the whole situation (come on, there was no way he should have walked home alone!)but the gist is, a yeavou got robbed while spending the night with a yeavou girl. br /br /and everyone knows. I'm 95% sure I just heard the girl who works here at the cafe mention "laptop" and "defiat hostel" and of course "yeavou."br /br /Ridiculous.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-3583262002704058772?l=colleenfant.blogspot.com' alt='' //div
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16:45
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Colleen's Ghanaian Adventure
So far (one week..) this half of my Ghana time has been quite different than the last half, and that is a very good thing. I’ve got a legitimate outline basically told to me by the head nurse for how I am going to proceed on this project. And I’ve got a good group of volunteers to hang out with and actually talk to about real things. And there are some students in the hostel I’m getting to know better. br /br / There is a new nurse at the Center who is going to be working with me on the fieldwork component of this project. We will be going to about 5 secondary schools and giving students the questionnaires that I designed and then modified with input from the nurses at the Center. (There are 2 questionnaires, one for under 18 – without any mention of actually having sex or using contraceptives because GHS can only preach abstinence to them…… and one for above 18 which asks the same basic information about what students know about STDs and HIV but also asks about current sexual practices.) br /br /I just finished writing letters of introduction that will be given to each of the heads of the 5 schools. Once we get their approval and schedule dates to come to the schools we will go and distribute the questionnaires to the students. Then we will meet up and go over the results (grunt work with statistics and stuff to be done by me) and figure out exactly what the gaps are in sexual health knowledge within this target population. Once that is accomplished it will be a matter of the nurses going out to the schools to give lectures on the needed topics on a regular basis and having nurses at the Center trained in the specific counseling areas. Additionally, I will work with the head nurse to write letters to various larger organizations to get any existing educational materials on the aforementioned topics, i.e. Planned Parenthood International in Accra, GHS, etc. One of the draws will be that, because we now have a laboratory, we can encourage people to come to the Center to get tested for STDs/HIV as well and that way personal counseling will be administered. br /br /Phew. I was seriously terrified that I wasn’t actually going to end up doing anything and wasn’t going to have anything concrete (other than, “oh I changed as a person…”) to put in a final write-up. Although it’s early, so it’s definitely still a possibility that I’ll completely fail. Fingers crossed.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-3278205787227657759?l=colleenfant.blogspot.com' alt='' //div
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13:03
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Colleen's Ghanaian Adventure
I arrived in Accra late Wednesday night and then tro-tro'ed it out to Ho Thursday morning. I spent Thursday cleaning out my room and kitchen since its the dry season now and everything was covered by about 2 inches of dust. I also found 3 dead cockroaches and a spider that I've decided to name Herman. br /br /I went to White House on Thursday for some delicious Jollof rice and chicken sauce and I accidentally found myself in a white-people party. There are 2 high school seniors in Ho on a school exchange program and about 5 other random volunteers. Friday I went to the Center for the first time. It was akward, but fine. There is currently another volunteer named Jeremiah who does nutrition stuff and we actually get along pretty well. I didn't get a chance to talk to the Head Nurse about exactly what I'm going to be doing over the next 4 1/2 months because she and the other volunteer were compiling the yearly returns (I helped out on the 3rd quarter ones and they take forever). So i figured I'd just tackle that conversation on Monday.br /br /The mood is alright, I got a bunch of warm welcomes, and only one creepy "hey dude, get your freaking hand off my leg" moment so far. The students in the hostel are all busy studying for their exams on Monday, but since I've decided to be less anti-social and self-isolating I asked all the girls in my hall to go out and celebrate with me once they're done - although I have no idea what that's like here.br /br /Next weekend I'm going to go to this place called the Green Turtle Lodge with these 2 guys, one is a volunteer from Oregon, and the other is the other volunteer at the Center. It seems like its going to be pretty cool, $3 for a tent on the beach, and its turtle mating season or something so the turtles are all supposed to be on the beach. It's a little early for travel, but I figured I'd better take advantage of traveling with guys while I have the option since I probably shouldnt really travel alone.br /br /Anyways, I'm kind of in a weird purposeless space cause I don't really know what I'm doing yet, but I'm still on this naive health kick. I read half a book about physics and the chaos theory yesterday and I did yoga (even though I got a bunch of "oh look at the crazy white girl" looks from my neighbors!)br /br /I'll post some pictures of my room soon when the internet is more stable.br /br /till then,br /br /in much, much warmed weather than you are. br /Colleendiv class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-4738367771810591388?l=colleenfant.blogspot.com' alt='' //div
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5:35
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Colleen's Ghanaian Adventure
For anyone who actually still reads this guy, I will be flying back to Ghana this Tuesday night after so so many weeks back home in Illinois for med school interviews (I'm going to Tufts MD/MPH!) I'll get to Accra late on Wednesday and then take a tro-tro (crowded passenger van) out to Ho in the afternoon on Thursday. br /br /It feels good to be going back to do something again. I am quite a bit more apprehensive and less excited this time than before, but I am determined to make the most out ouf my remaining 4.5 months. There are a few things I am planning on doing differently this time. br /br /1. I am pretty much done with any "GlobeMed" work. Everything's pretty kosher on that front now, and it seems like this partnership is going to be fine. That, and its no longer my role to worry about it. I am going to worry about Sexual/HIV health education and outreach at the Center. No more, no less! Basically I will be going back and using a questionaire that I developed during Ghana trip part 1, and then get right to work with the Head Nurse on designing the specific education and outreach that will hopefully end up as an official "project" sponsored by GlobeMed. br /br /2. There aren't going to be any other volunteers I know to use as a social safety net when I first arrive, so hopefully I'll be able to spend a lot more time getting to know the Ghanaian students that I live with in my hostel. br /br /3. I'm going to get really healthy and use this time to do all the things I've always wanted to do - basically my attempt to fill the void that is 6pm-Midnight solitude everyday when I need to be home to be safe in my delightfully windowless room. I got a bunch of books on philosophy, buddhism, nature, history, and of course a ton of fiction. And I'm bringing my yoga mat and some yoga dvds. I'm also bringing my guitar back with me for a creative outlet.br /br /4. Travel more, get to know more people, places, and practices. Know more about Ghanaian politics since the election, know more about sexuality in this region of Ghana. Basically improve my own cultural intelligence. br /br /All that, and I'm going to make a serious effort not to get too depressed about the horrible poverty and difficulties of life and overcoming any sort of self-imposed cultural isolation. br /br /Overall the goal is to be able to sincerely believe, come June, that I have actually done something worthwhile with my life for 9 months. I am definitely not even close to there yet, but I'm hopeful!br /br /Big goals. We shall see won't we.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-7244104469516101610?l=colleenfant.blogspot.com' alt='' //div
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23:54
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Colleen's Ghanaian Adventure
I finally posted my pictures from my trip to Lome, Togo. If you scroll down to the bottom of this page you will find a link to my Picasa page where my pictures are posted. Enjoy - but not if you don't like looking at dead animals.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-6746034590518215348?l=colleenfant.blogspot.com' alt='' //div
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Colleen's Ghanaian Adventure
I was originally scheduled to fly home on November 29th for medical school interviews (beginning on December 2nd in NY), and then return to Ghana on the 19th of January to continue working. Basically giving myself about 6 and half weeks to schedule medical interviews and celebrate Christmas with my family.br /br /However, I have been very overwhelmed, to say the least, with a lot of the events at the Center and kind of the overall everything that I've been trying to do. I have been having a really tough time trying to make sense of everything with this partnership and how everything is done on all sides, from financial decisions to project implementation. When I came to the Center, it became very clear to me (and was basically told to me by the people that I've been working with) that before any more projects were brought to the Cetner and money was sent from the US and what have you, everything that has happened at and with the HOPE Center needed to be dealt with.br /br /So when I came in trying to work on a VCT/STD outreach and testing project, I was told that a lab needed to come in first. Then I was told that in order to bring in a lab GlobeMed needed to figure out their finances. In order to figure out their finances, I spent weeks and weeks going over old money transfers, the fluctuating exchange rates, reports from accountants, and (for those of you who know how much I despise Microsoft Excel) poring over spreadsheets on Microsoft Excel.br /br /All the while I was trying to at least put in a bit of groundwork on the Sexual health side. I think I've done okay on that front - not great - but okay in that I think I've made a lot of great contacts and been able to get a pretty good feel of not only how parts of the GHS works, but also how a couple other groups working on HIV operate.br /br /But, doing all the partnership stuff has really put a strain on me. Things work differently in Ghana and the US. I've really struggled with a lot of the personal interactions that comprise the bulk of this whole partnership work. I think Jon (my old Co-Pres) said somthing along the lines of "the trouble of working with people is working with people." Oh yes. br /br /So. While I greatly enjoy what I've been doing - I find myself constantly saying "I wouldn't trade it for anything" or "I hope to do something like this for the rest of my life" I need to take a bit of time for myself before I begin the mentally draining flurry of medical school interviews. I am now back in the U.S. 4 weeks before I orginally meant to come home. It was a very quick decision. Once I decided to come home early the best flight I could get left on Friday. 5 days after I made that decision. So, now I am home resting for about 4 weeks before my first medical school interview, rather than the orginal 48 hour turn around I had originally given myself before landing in Chicago and interviewing in New York and then doing interviews for 3 weeks, Christmas with my family, and then 2 more weeks in January in case I get any more interviews.br /br /This break will honestly be exactly what I need to be able to go back in January and really focus all of my available resources on this HIV/STD project. I feel that this is actually the perfect time to take a break. I was able to work through and create spreadsheets of ALL of the financial transactions between GlobeMed and the HOPE Center for 2008. And the GHS, local partners, and GlobeMed(will soon) have all of that information so now my hope is that everyone who fulfills a financial role can be completely aware of the finances. This should be good. That way there can be no misunderstandings about where money has gone, or who spent what money, etc, etc. And now we have this really clear bank account that is shared by some GHS reps and a GlobeMed rep so that the GHS will have control over the money that is spent at the Center, but GlobeMed (who sends the money) will be able to see when money is taken out, who takes money, how the money values are affected by exchange rates, etc etc. br /br /In order to have this bank account, I basicaly just wrote out all of the processes that have been done in the past for this partnership. I made a document of "articles" that spell out, as explicitly as possible, how project proposals are made and reviewed, what the mission, vision, and objectives are of the Center, and tried to formalize this abstract "board" that basically existed before, but now its on paper.br /br /When I was leaving the Center, the laboratory money had come in and construction had begun on what should be an incredible diagnostic lab. Now, when I come back in January, the steps should all be in place for us to put in the HIV and STD testing into the lab and then work on the education and outreach portion of this program.br /br /br /So. Thats a brief rundown of everything I've done and basically my attempt to justify my early return! I really adore Ghana and all of the charm and friendliness of it. When I walked out of my usual internet cafe 2 days before I left I literally had 5 small children ran up and gave me huge hugs. For no reason. Seriously, where else does that happen?br /br /I will take this break seriously, and hopefully within the week I'll have a good meeting with the GlobeMedders up in Evanston to explain all of this GlobeMed stuff. This way when I go back in January, not only did I leave on a good note, already wanting to go back, but with as much of the partnership stuff sorted out that I think is even possible for me to do.br /br /This is likely my last post until January, so hopefully I'll get to see most of you over this break, but if not, I'll pick back up in January.br /br /till then,br /br /(a clean, showered, and stuffed on American food)br /Colleendiv class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-1708590702045027974?l=colleenfant.blogspot.com' alt='' //div
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9:31
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Colleen's Ghanaian Adventure
Thursday through Saturday of last week (16th-18th) was a national outreach program where nurses and community health "volunteers" went out into the communities to provide Vitamin A supplements, polio vaccines, and dewormers (mebendazole) to children under 5 and vitamin A to postpartum mothers. I was able to go along as the head nurse of the HOPE Center was the coordinator for the subdistrict of Abutia, on the western edge of the Ho Municipality. br /br /Over the course of 3 days, our small contingency saw about 4,000 children and mothers. I helped out on the first day because I was trained to determine which children received which supplement based on their ages, but I chose only to observe on the second day because I think I was getting in the way. THis region is extremely isolated, and white people are apparently rare - so trying to squeeze 2 drops of oral polio vaccine into the mouths of children who screamed at the sight of me sort of made the work more difficult. It is such a cool idea, that all over the country of Ghana, thousands of health workers are out at the same time doing the same thing. br /br /This program was national - and so really had nothing to do with the HOPE Center as we provided no funds or manpower except 2 of the nurses who were regularly at the Center simply spent these 3 days working in a different district and not at the Center. Abutia was quite another experience of Ghana. I think staying in Ho for most of my time has given me a bit of a skewed sense of the poverty in Ghana. Ho is generally not that bad off. Yes there is still a disproportionate amount of health concerns, but it was nothing to what I saw in Abutia. br /br /Basically the program consisted of teams of 2-3 people, either nurses or community "volunteers" who were given a stipend of about $6/day. They would find a shady place to sit and then see the children one by one. It was very interesting to see how much accessible transportation affects healthcare. I've read Mountains Beyond Mountains to hear about the roads in Haiti limiting health access - but its really crazy when you see it firsthand. The roads to Abutia were TERRIBLE. Everyone of us had horrible headaches by the end from bouncing along on barely passable roads with deep trenches snaking through the gravel in a pickup truck that probably had absolutely no shock absorption. It took hours to get from the municipal hospital - where most cases are referred - out to the hard to reach areas. Some places couldn't even be reached by car (and really no one in the area even has a car anyways) and nurses has to get out and walk a few more kilometers in the sweltering heat with polio vaccine carriers to get the the people. That is true dedication. One of the sets of community volunteers had to literally cross a mountain - on foot - just to pick up the vaccines to be used - and then would have to make the 8 hour trek (one way) again 2 days later to return the unused vaccines and pick up their $6/day stipend.br /br /THe one village where I helped out at was really suffering. Even to go to the monthly child welfare clinics to weigh and immunize the children - the mothers would have had to travel like several kilometers to go there. Or if the nurses wanted to hold a clinic in their village it would have involved multiple bus rides and walking since taxis go that way maybe once a day and charge enormous rates. The head nurse brought along some of the vaccines to immunize some of the children who had defaulted. br /br /And malnutrition. The community where we are currently working with our nutrition project has nothing on these kids in Abutia. At least half of them had the swollen belly and red hair of kwashikor. There were open sores with flies buzzing around them, and coughs that were clearly productive. Relatively speaking, the poor of Ho that the Center serves are middle class compared to the 4,000 or so people we saw out in these villages. If we could have done the nutrition project in one of these villages too.... but I guess you can't help everyone. br /br /It really sucks that pretty much the only health access that these kids and their families had was nursing outreach. And they finally see some health workers and "all they get" is some vitamin supplements and a vaccine. Which from a public health standpoint is unarguably vital, but from an "oh my god look at the poor african children" standpoint is just not enough. Yes its a start. And I honestly couldn't even fathom a way for these people to get more treatment. It is almost impossible to reach them.br /br /Right about now I wish I had that MD/MPH (and a ton of money) to get a good 4x4 car and provide medical treatment, from a doctor, to these remote areas. How fun would that be to set up small clinics with nurses to do outreach and triage and then travel around as a doctor to provide medicine for people who probably need it the most. I feel like I can't really do anything right now.div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-3333386600741948926?l=colleenfant.blogspot.com' alt='' //div
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10:12
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Colleen's Ghanaian Adventure
This past weekend I travled to Lome, Togo (the country just to the east of Ghana) with 2 volunteers from another organization. Togo is very similar to Ghana, but there are some rather pronounced differences that I picked up on duing my brief 3 day stay. br /br /First, Togo was a French colony, and so while as in Ghana most people speak their own local dialect, French is the official common language. I personally speak no French, and one of the volunteers I was with knew only very basic French so it was a bit of a challenge getting around. But with lots of hand gestures, pictures, and key phrases we were able to manage pretty well.br /br /Second, the economy of Togo is not as developed as Ghana's. Poverty is much more apparent in each small thing. There are more potholes in the roads, most taxis are actually motorcycles which you climb on the back of,(not cars like in Ho), and there were only a handful of buildings in Lome, the capital city, that were more than 1 or 2 stories high. In Accra, the capital of Ghana there are quite a few underdeveloped areas as well, but there are also lots of shops, restaurants and hotels that you would think you were back in the US. In Lome there were far fewer tourists, or white people than in Ghana and I think the pack of us 3 were a bit of a spectacle walking around.br /br /Third, there is a distint "otherness" or difference - I'm not quite sure how to describe it. Lots of people have tribal markings or small, barely noticeable tatoos on their faces. I actually got a bunch of compliments on my eyebrow ring - where as in Ghana (and other places) people usually point and say "why is that there?" And people were more grabby then I've found them to be in Ghana, and there were more beggars or children who would literally grab your hand and try to follow you around asking for money.br /br /We crossed the border Friday night from the town of Aflao, Ghana where I visited a VCT a few weeks ago. It was a bit late since our transportation was delayed because of the rain, so it was a bit scary walking into Lome without much Cifa (togolese money), french ability, or a clue, but we made our way to a hotel just fine. As a side note... I absolutely love random traveling when you only have a vague idea where you want to go. Enough to be safe, but also less enough to be able to be completely relaxed. br /br /The next day we went to this huge market where they sell everything from fish, live and dead chicken, food, candy, underwear, cloth, pots, food, office supplies... everything! For basic things like food, there really isnt haggling. But I bought some yards of fabric to have a sweet Togolese dress made and for curtains back home. I did some expert haggling to pay only like a dollar a yard when the lady tried to charge me like $4/yard. br /br /On Sunday, before we left, we went to a "Fetish Market." It was awesome. Coolest tourist thing I've done here. It was a market for the local sort of voodoo. there were tables of dried monkey heads, stuffed crocodiles, elephant tusks and skulls, necklaces made out of snake vertebrae, and 2 live monkeys. I'll post some pictures soon. We were literally the only people int he small market except the dozen or so vendors themselves. One of the volunteers and I went to a booth and got a little mini lesson on the "white magic" where a shaman explained what all the fetishes or tokens, meant and then blessed them for us. After some more expert haggling ($60 down to $8) i got some little trinkets blessed for some people back home.. so its going to be a voodoo themed christmas this year.br /br /I wanted to get some dried monkey heads to bring back, because honestly, what says merry christmas quite like a dried, decapitated gorilla or chimpanzee. but I really didn't think I'd be able to sneak those past customs....div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-8196095060493813997?l=colleenfant.blogspot.com' alt='' //div
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11:04
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Colleen's Ghanaian Adventure
Today was the second School Health Outreach. The nurses go to the schools and give the students a health talk. For primary students it was on dental and personal hygeine. For JSS (like middle school) students, it was on reproductive development and the changes that take place in our bodies alongside a small bit of sexual health. Because we have been allowing some volunteers from another organization to come along, they have brought 2 nurses with them from the UK and their organization has agreed to pay for some of the treatments. After the talks are done, the kids have any wounds dressed and minor illnesses like fungal infections or malaria treated by the nurses.br /br /Today was very interesting. The two nurses from the UK were helping Bertha, our Center nurse, do wound dressings and two of the other volunteers - 18 year old high school graduates from Britain - asked if they could do wound dressing as well. I basically gave them a mini-lecture on how since they had no medical training, it would be both illegal and entirely unethical to allow them to dress the wounds. While I whole heartedly believe my stated rationale, it was difficult. The nurses were overwhelmed by how many children had sorse. At lest half of the several hundred children had worm or fungal infections. Having these two other girls help would have made this process exponentially more efficient, but they simply weren't trained. It is also difficult, because all "wound dressing" means is you put on gloves, wash the sore with antiseptic, and put a bandage on top. Any person with a basic understanding of first aid could probably do it. But it didn't feel right to let these girls do it, simply because they were bored and knew how to put on their own bandaids, and had the presumptive respect in the community because they were white.br /br /This goes back to an issue that has been on my mind for some time, and I remember talking to Sarah a bit about it when she was still here. What do you do in a situation where there is an overwhelming amount of need. So much that it breaks your heart each moment you are there. But anything you can do is not sustainable. You can't have the health of the schoolchildren be dependent on getting treatment from the white doctors who come for 6 week stints and dependent on the resources they pour in to the area in exchange for allowing them to get "medical experience." Because what happens after they leave? But, at the same time, why shouldn't you help now, when you can? At least that would be one less sore that will get infected, or 6 months when the child won't have worms. This is difficult, because I've been indoctrinated in GlobeMed and really, truly believe in changing how we look at "medical missions" towards sustainable projects. But how can you tell a small child that you are building health infrastructure when all he's asking you for at the moment to pay for his Tb drugs at the hospital? It's going to take a long time to make these changes, and sometimes you want to tell those people who are doing the temporary relief that all they are doing is just reinforcing this whole neo-imperialistic Western relief of the poor Africans which reeks of condescension and racism. But they are doing some good aren't they? It's like there are some people who only do "relief" work, and some people who only do "sustainable development." How do we merge the two so that we can get benefits at the present but long term change? br /br /One idea I proposed to Margaret and to the Organization's director, was that instead of just having these volunteers come observe, or perform functions that they shouldn't be doing, we host a training workshop on basic triage techniques, wound dressing, and recognizing malaria and fungi to refer the children to the nurses. That way they could take what they are doing as more serious, and be more accountable for their actions while probably even gaining more valuable experience and being useful to the nurses for something other than their money.br /br /At the end of the day today, the two volunteers who wanted to treat wounds offered to buy "the children with the worst uniforms" new ones. So now they are going to do that. supposedly. I have their phone number, so they better.....div class="blogger-post-footer"img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4560662317956479827-7206800361816030292?l=colleenfant.blogspot.com' alt='' //div
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Colleen's Ghanaian Adventure
Is this one. br /br /I've received recent criticism for being so open on my blog. Especially about the recent "almost rape" incident. Alright , I realize that the people who may or may not be reading this are quite a diverse group. Everyone from family, friends from home, friends from school, GlobeMedders, GlobeMed and CGE supporters, and even some people I don't know. But, since this group of supposed readers is so diverse, I have made a conscious choice to not have a particular slant to this blog. The way I write is the way I think. I've tried to capture the most important things that I've experienced, especially those that have caused me to think the most. I've included day-to-day experiences every now and then to provide some context to the rest, but that is boring for me, so I will only do that at the request of someone important, like my mom. br /br /So this blog is an extension of me. I am honest, I am blunt and sarcastic, I hate bullshit, and if I think that something is wrong I will say that it is wrong. I won't write something by stating "negative, but postive, etc." I process things like that separately. Take mea culpas for the negatives. put them in past. then move on to positives. Don't defend your negatives with positives as that devalues both items. I can only be so political about how I write until I eventually feel like I'm being disingenuous to myself. The only critic I have to live with is me, and I hate lying and have a very high standard of open dialogue. I think honesty is one of the most important things and if I can't be completely honest when I do something I simply won't do it. br /br /So that's how I would choose to define myself, and I'm terribly sorry if you've been bothered or offended by anything that has been put on my blog, but I really can't do it any other way. br /br /In response to the last post, in particular, the "ugly" section. Yes, safety is a concern. Believe me, I had a much more in depth conversation with my parents on the subject. But I truly believe that so many other people, especially college-aged girls have gone through a similar experience, that when it happened to me, instead of being quiet about it or secretive, I'd much rather be honest, myself, and just confront it. It was a really crappy situation, but I handled it (to pride myself) wonderfully. If things had gotten worse or physical, I probably would have put that up on the blog too. It is dangerous for a young woman living alone anywhere. Chicago, Evanston, Ghana, DeKalb. I'd love to say that what happened to me was some Ghanaian phenomenon. But I bet I could name at least a dozen people including myself who have had the same thing happen to them in the US and I think most of you could too. So, yes, that might be something you don't want to hear about. But it happened, it happens, and unless we can talk about it, stuff like that is going to keep happening to young women everywhere.br /br /and, to step back off my feminist soapbox, I am being safe. Any person, if they were honest, could acknowledge that there is always going to be some risk invovled when you are living alone in a foreign place and I had totally left that out until the last blog. But I'm careful. I've changed houses to be more careful. I don't travel alone, I don't go out past 8pm ever. I don't give out my phone number. I check in with Margaret regularly now. etc. etc. That is the complete reality of the situation. Things ARE hard. but I'm dealing. I'm an intelligent person who can take care of herself. I'm focused, I have common sense, and a delightful new public health skillset. And I would hope that all of those people who had some role in getting me here would know and trust that and - instead of being upset with my honesty, commend that I trust in your integrity to trust in mine. br /br /And if you ever want a clarification of anything I may post on this blog, all you have to do is email me.div class="blogger-post-footer"img width='1' height='1' src='//blogger.googleusercontent.com/tracker/4560662317956479827-2796658942146219047?l=colleenfant.blogspot.com'//div
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12:43
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Colleen's Ghanaian Adventure
It has been quite a week, to say the least. I've been so busy and anxious and stressed that I haven't been sleeping very well in my new home, but it seems today has been a turning point and things are looking up.br /br /The bad: I have been trying to sort through all of the HOPE Center finances so that we can be more accountable in the future. Financial oversight has been only minimal at best to cover the sending of the money through to the spending of the money that is sent. So I spent the last 2 weeks basically diving headfirst into the thrilling world of accounting. After many literally sleepless nights where I'm kept seeing dollars and cedis running through my dreams I think I've gotten things worked out. I set up a new bank account at the local branch of Barclays Bank in the name of the HOPE Center. This account will be a subsidiary of a GHS account, and therefore all dollars sent by GlobeMed will have to be accounted for by this government institution. To create this account I had to draft up a board of directors for the Center and formalize all of the policies and procedures for sending money, writing proposals, what running costs are incurred and who covers what. So, super fun time. But its done! After spending most afternoons in the long long lines at Barclays to talk with the bankers I got the account number today and gave all that info to the GlobeMedders so they can send the money for the lab! br /br /the ugly: I thought I was doing really good trying to make Ghanaian friends. I never wanted to be like the other volunteers here who only hang out with each other. So I've been being my friendly, polite self - but still trying to be cautious (I carry pepper spray everywhere). And I almost got into some trouble on Friday night. A 19 year old guy who has been occasionally joining my usual table at my restaurant where I sit an read said his family wanted to meet me (a very normal thing to say) so invited me for dinner. I had sat with this guy like a dozen times and he seemed totally harmless, not to mention 3 years my junior. So I go to his family home (in an area I am very familiar with) for Fufu and to meet his parents. Lo and behold what do I walk into but a single room with a couch and a bed and dinner and a movie and no family. So instead of getting date raped I like literally ran away. Akwardly stood up, mumbled sometihng about a husband back home, and speed walked out. I had really thought I was being careful, I almost never give out my number and try to dissuade all of my potential future husbands, but apparently not careful enough. I learned a very valuable lesson. It really sucks to not be able to just be myself and be friendly with everyone, but I guess I'd rather sit and read alone that find myself in another situation like Friday night.br /br /AND... THE GOODbr /Got to end on a good note. Today was awesome. Margaret, my surrogate mother, and I had a good conversation about Friday so I was able to get out of my own head a bit which was wonderful. And we got the account number at Barclays today. And I started writing what can only become the great American novel as of yesterday. On Friday I borrowed a really great DVD and instruction manual about HIV from my friend Joseph at FUGI to burn a copy for the Center's sexual health resources. And I got a phone call today from this woman at USAID who I've been emailing with and she has agreed to send the Center a bunch of pamphlets and short documentaries on family planning and how to involve husbands. This will be key in setting up the small Sexual and Reproductive Health Resource Center. Then since she was unable to offer me anything in terms of non-family planning SRH, she gave me contact information for people at Marie Stokes, Plan, and Planned Parenthood in Ghana. I emailed Marie Stokes today, and will email the other two tomorrow.br /br /Sorry that was long but its been awhile and lots and lots has happened.br /br /love and miss you all!br /br /Colleendiv class="blogger-post-footer"img width='1' height='1' src='//blogger.googleusercontent.com/tracker/4560662317956479827-9192213616584278415?l=colleenfant.blogspot.com'//div
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8:09
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Colleen's Ghanaian Adventure
Since this blog is comprised almost entirely of "Fant Rants" (thanks Nathan for the name), at my mother's request, here is a bit of information about my daily life in Ho.br /br /Each day I wake up around 7:30, eat my breakfast which consists of bread and peanut butter (or sometimes just bread), and 2 cups of cold coffee. Then I walk on a series of gravel roads in the bush to the HOPE Center to get there by about 9am. Once there I will do any number of things. If mothers have come for the nutrition demonstration, I will interview them with Bertha (to translate from Ewe) about some basic demographic info and weigh and measure their kids. Then we sit around talk, or I sit at my computer trying to make sense of a lot of data or work on documents to formalize the day-to-day proceeding of the Center. Margaret usually comes in around 10-10:30 and then the mothers will get a demonstration on Weanimix and a nutrition talk and then Margaret and I usually hang out in the office for a while chatting about whatever. br /br /If there is a child welfare clinic that day, that starts at 8:30am and we're usually busy until around 1pm. To help out, I will register and weigh the kids, plot their weights, and copy this down in the record books. Once this is done the nurses will give the kids immunizations, vitamin A tabs, dewormers, and then talk with the mothers about any recent health issues.br /br /Around 1pm or so, either we'll make lunch at the Center of rice and beans, or Banku, or rice and stew or I will walk 10 mins to the village junction to catch a $0.40 taxi to town to get food. After lunch I run errands either for the Sexual health project or for myself and either spend a bit of time at the internet, or sit at a restaurant and get a drink and read, or currently I've been going to the market to get things for my new place. br /br /Since it gets dark at like 7pm and there are no street lights I usually try to be back at home by 7-8pm. Then I relax, usually read more, or listen to music, or watch a tv episode on my computer. At Josephs, he usually wouldn't come home until like 9 and then go right to bed. Last night at my new place, since the light in my room didn't work (i replaced it this morning) I sat outside with 2 guys and we just talked for like an hour to pass the time before sleep.br /br /and then, repeat.div class="blogger-post-footer"img width='1' height='1' src='//blogger.googleusercontent.com/tracker/4560662317956479827-4401513899269830735?l=colleenfant.blogspot.com'//div
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12:28
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Colleen's Ghanaian Adventure
I just posted pictures on my picasa site (link should be at bottom of page). There's one album of randoms from around Ho, the nutrition project, and the Africaso conference. I put up a second album of some shots of my new home! It's all pre-my decorating ability, so it basically looks like shit. But it'll get better. I bought a mattress and pillow today and put that in, I stole 2 chairs from the HOPE Center, I'm using the blanket Sarah stole from KLM, and the sheets that Nikita left behind. The really nice old guy, Victor, who runs the hostel is getting some of his carpentry boys to build me a small table/desk tomorrow for cheap so I don't have to buy one, get a taxi, then walk up the gravel hill to the hostel and the four flights of stairs to my room with a table on my head.br /br /to keep this place from looking like total crap, I've decided to hang some fabric on the walls to cover up these really tacky magazine pictures that are glued everywhere. I spent like an hour today trying to nail fabric into the cement walls. Since I don't have a hammer, and I got the nails for free by looking pathetic, I tried to use a large rock as a makeshift hammer. I think I managed to bend every single one of the nails in half, smash three fingers, and only succeed in getting one nail to go all the way in. Then I tried superglue - but that doesn't work either.br /br /I'm going to regroup and try again tomorrow. I am determined to go to bed tomorrow night in my new home!br /br /Annndddd... the diagnostic laboratory is all complete, the proposal has been sent to the GlobeMedders, and hopefully the money will come in soon! There's not really a whole lot for me to do at the time being until this lab gets going so now I wait!div class="blogger-post-footer"img width='1' height='1' src='http://res1.blogblog.com/tracker/4560662317956479827-2254980714602751054?l=colleenfant.blogspot.com'//div
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9:42
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Colleen's Ghanaian Adventure
Since my last two blog posts were incredibly long and whiny, I feel that it is now necessary to change my tone. Yes, I do believe very strongly in everything that I said, and most of those things have been weighing on my mind for literally months and months. After suffering from a delightful bout of angry insomnia on Friday where I simply could not sleep because all of these issues had finally solidified in my head and I needed to get them out. br /br /I guess I should add a note that those last two entries were in relation to a lot of older issues at the Center that are currently under the process of being fixed. I am also completely confidant that they will be. But its going to be a long, complicated, and difficult process involving lots of conversations, so sometimes, I feel its better to put those more negative thoughts out into a public forum comprised of lots of GlobeMedders who I would think also worry about these issues, than discuss all of it with my current close friends - the HOPE Center staff. And better than keeping it to myself as I would probably go crazy. While this blog is public and its purpose is to keep everyone who may be interested informed about what is going on at the HOPE Center - its also my only outlet for cathartic rants and self important judgment. But, now that I have said my small piece, I think that my mental state has progressed past the frustrations, to match my current activities which are all positive and focused toward the future.br /br /A few bright notes, I'm literally minutes away from sending the completed laboratory proposal to GlobeMed at NU so they can get to work on that. And tonight, I've made plans to finally sit down with Joseph now that he's back from Accra to try to understand logistics and get his input into the laboratory. And the things I'm looking forward to most are the moves being made in terms of sexual and reproductive health at the Center. I will be meeting with Joseph, Margaret, and Dr. Eleeza later this week to both pitch my idea for incorporating sexual and reproductive health resources into the Center and discussion the scale and steps that will be taken. I will be emailing a USAID person either tomorrow or the next day to get a feel for what type of work they might be interested in supporting once I've got a slightly more concrete plan of what I want to say to her. It's exciting stuff, and a lot is happening each day. Yesterday I was hanging out with some people in town and they were asking what I was doing. When I mentioned the HIV/STD stuff they literally attacked me with questions for 45 minutes about HIV, STDs, sex, stigma, condoms, etc, etc. Definitely reassures me that I'm on the right track and so is the HOPE Centerdiv class="blogger-post-footer"img width='1' height='1' src='http://res1.blogblog.com/tracker/4560662317956479827-557859887143273112?l=colleenfant.blogspot.com'//div
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13:13
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Colleen's Ghanaian Adventure
Definitely not going to make myself any friends with this guy. Its long, and sort of hates on GlobeMed at NU... but I desperately need to get all these thoughts out of my head and this is really my only quasi-public outlet.br /br /Currently, the basic functionality and program management at the Center is haphazard at best. The governance and vision lies in an obscure gray middleground, with no individual party taking ownership of the Center and its capacities. The Center is not an NGO. The Center is not a GHS facility. Nor is the Center a “GlobeMed site.” The partnership of the “project” – if you can call ensuring the basic healthcare rights of several communities a project – is between GlobeMed at Northwestern, the Ghana Health Services, and apparently the Center staff and Center itself. GlobeMed at Northwestern cannot logistically have any genuine role in oversight or implementation at the Center simply because of distance, nor can it sustain the ongoing costs of a multifaceted health center. The GHS already sustains dozens of sanctioned health centers of its own design and implementation withing the Ho District. The HOPE Center itself; if it is to be seen as an actor in this triangular relationship, is some odd mixture of the two entities with neither willing to take on the role of its governance.br /br /The important question is, untangled from the bitter ramblings, what is the future of the HOPE Center? From what I can gather, the goal is to have the GHS ultimately cover all ongoing costs of the Center, and GlobeMed will send, let’s be optimistic and say $12,000, a year for projects. br /br /Second, who develops the projects? Who controls the spending on the projects? Who is responsible for making sure the projects are implemented in a way that’s in line with the GlobeMed manifesto? Who will be auditing the account that NU sends money to? Unless it’s a GHS acct, it won’t be the GHS. Who seeks out projects that will bring together GlobeMed and the GHS? That “who” seems to be understood as that obscure body that the HOPE Center supposedly represents. But I can’t for the life of me figure out what that is. Basically, right now, that “who” is me. I’m the one basically managing the relationship between GlobeMed and the GHS and how that plays out at the HOPE Center by doing the account auditing, the project proposal development and management. I’m the one (and Sarah was) interviewing the community members to try to keep “GlobeMed” accountable to their well-being. And I’m not trying to be self serving when I say this. Don’t get me wrong, I absolutely love doing all this stuff and hope someday to make my life out of it, but I’m going to medical school next year. Who’s going to do all that then? br /br /The three people who most closely embody what the GlobeMed HOPE Center/Vision is here on the ground are the head nurse, the district director, and the Center Director. Both the head nurse and district director answer to one party – the GHS. They deal with the Center because of their placement. Realistically, they are not going to go out of their way to throw more resources at the HOPE Center, both because there aren’t that many to go around, and it’d probably be more financially efficient to throw those extra resources at more developed health centers anyways. (Since we’ve been assertive and well, rich, we’ve got them to commit resources to us that as I quote “make other district centers jealous”)And the Center director, as much as he is well-intentioned, it’s not good sense to have him as the sole arbiter of thousands of 5K-raised dollars. And he has dozen of other projects that engage him. And while he has miles of NGO experience, he has never before dealt with healthcare infrastructure or programming. Not that I have either.br /br /So, is that our best case scenario? That hopefully someday soon the GHS will pay all ongoing costs and NU supports small projects. I think here is where the flaw lies. If we want to create a good and responsible health center – is its development and project sustenance to rest within the capacity of a handful of college kids who hold fundraisers when they’re not too busy studying for midterms? Seriously? Eunice’s kwashikor isn’t going to be a problem in January once our nutrition project has ended and now we’re trying to raise $10,000 for a lab. Or if we get enough money to keep the nutrition project going on a small scale AND a very necessary lab built, then are we to tell Michael’s mom that she still has to deliver her baby at home because I’m too busy going to the library to raise $20,000 to build a small place for deliveries? And the GHS isn’t going to take the initiative to answer her either. There are already a couple of maternity wards in Ho and they really can’t afford to build another. I’m not discounting my own role in all of this either. I would put off writing emails or reviewing a proposal for a night or two because I wanted to go out with my friends or study for that Bio test. Or decide not to hold any fundraisers during finals week or spring break. That’s the thing. I was a student first and foremost. And what I’ve come to realize, is that clinic development and community health are not the tasks or learning opportunities for 18-22 year olds when they have the time. If this were a developed health center that we could actually generate impact by project-based support then that would be one thing. But the Center is not in any measure ready for that.It needs a lot more guidance than "projects." br /br /So now that the agreement is to basically keep doing things the way we’re doing things. There is still no one who will be auditing the GlobeMed moneys and no one overseeing how the GHS is working with the Center. I don't really get how you can have a health center without any single entity overseeing it. GlobeMed oversees GlobeMed, and the GHS oversees the GHS. Sucks to be the HOPE Center and not be under the jurisdiction of either.div class="blogger-post-footer"img width='1' height='1' src='http://res1.blogblog.com/tracker/4560662317956479827-1137645601032356210?l=colleenfant.blogspot.com'//div
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13:01
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Colleen's Ghanaian Adventure
A bit about the basics of the HOPE Center and my own frustrations:br /br /The GHS provides the Center staff and their salaries. However, all staff at the Center are not “GlobeMed.” They answer to their paychecks as their very position at the Center is merely a temporary step until transfer to a less obscure, more substantial, sanctioned health center. In addition, while the Center is located among several needy communities, it is located on the district boundary and any district activities such as insurance reimbursement or drug procurement must be done individually for the 2 separate sets of clientèle. br /br /To be completely transparent, GlobeMed at NU provides $1200 a year for security, $600 a year for electricity (for now), and several thousands more for specific health “projects.” I’m not totally clear on how “health projects” can be isolated in single financial packages as even the few thousand dollars sent for the nutrition project will end in December and then there has been little to no thought put into the fate of malnourished children next year. We look for “sustainable projects” but, seriously, are we just expecting the GHS to jump in when we decide to stop funding certain things? (First of all, I think it is awfully presumptive for a group of college kids to ask the Ghanaian government devote thousands of dollars each year to a Center that was basically forced on them, even with good intentions). Or if not, yes, we built a farm, etc, and maintaining the nutrition program will be a good deal cheaper in the future; it still costs money. Health isn’t free, nor is it paid for in good intentions. br /br /The Center finances are currently divided as follows:br /br /Money is wired from Northwestern to the “GlobeMed Ghana” fund and we notify the district health director, head nurse, and our Center Director of its presence. The signatories – currently the Achana family – then withdraw the money and either give it to the head nurse to a) purchase the necessary items for “projects” b)put into the GHS’s small “HOPE Center/Miracle Life” acct. which handles drug and insurance costs, or c) is used to by the Director to pay electricity and security. br /br /So, the GHS makes sure that the Center is staffed, staff is paid, and drug and insurance costs are covered. That’s a huge cost, especially at a site that likely would not have been built as it was by the GHS. Did anyone ever stop to ask, “hey GHS, I have money to build a health center where I think there needs to be one – and yes there really is/was a need - would you mind committing your resources and time to keep it going since I can’t sustain it the long term?” Nope, it seems like that conversation went more like “hey GHS, what’s up, I just built this health center in between 2 districts without consulting you on what would be appropriate for the area. So now it’s your responsibility and I don’t really feel like supporting the ongoing costs there anymore since I actually can’t do that. Whoops! (throw hands in the air and make that “silly American” face). Sound good?”div class="blogger-post-footer"img width='1' height='1' src='http://res1.blogblog.com/tracker/4560662317956479827-1043609709416112894?l=colleenfant.blogspot.com'//div
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9:18
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Colleen's Ghanaian Adventure
After spending the last few days in Accra, I must say that it's good to be home in Ho. I was walking down the road this morning and a little girl stops me and says, "yeavou, br /give me toys." Yup, I'm back.br /br /The Africaso conference was incredible. I attended many interesting panels and presentations by: The VP of Ghana and assoc. Director of the Ghana AIDS Commission, The Directors of the "Roll Back Malaria" Campaign, 2 separate workshops on how the Global Fund works, and a QA session among 60 NGOs - about 1/2 of which apply as subrecipients for funding from the Global Fund. There were many workshops on the good practices of NGOs. We learned about program and project management, how to balance finances in a way that is accessible to donor organizations, how an effective NGO board functions, and so on. Basically everything I could have possibly wanted to know about how African NGOs function and succeed directly from the NGO leaders themselves and the leaders of NGO networks and donor organizations that flew in from Geneva. Pretty incredible.br /br /Despite feeling incredibly out of place - A. I was the only white, non-donor person there, B.I'm 22 fresh out of college and have only lived in Africa 7 weeks - It was a truly life-changing, unforgettable experience. Some of the highlights include:br /br /-talking about militancy in Nigeria over breakfast with a young woman who identifies herself with the militants, and I would honestly call one of my friends at the conferencebr /br /-over coffee (freshly brewed, non-instant) getting to meet the UNAID director of Maternal and Reproductive Health in Ghana. Oh, yeah, and she was extremely interested in what I am doing, gave me her card and insisted "I really do want to hear a lot more about it, it sounds incredible. Make sure you email me"br /br /-discussing "donor imposition" with NGO leaders who recognize this as something that is present both from international institutions AND from the NGO itself imposing on a communitybr /br /-Talking about the experience of being an ex-pat in Africa with Claudia from Chicago who has lived in Cote de Ivoire for the past 20 years and now directs part of the Roll Back Malaria Campaign through Johns Hopkins University.br /br /-Basically understanding much more about what it is like to run a real, grass-roots NGO in the field from those who run the top NGOs on the continent. Hearing what works, what doesn't work, how donors are actually perceived (not at all how I had imagined), how different NGOs interact with they're governments from Ghana, to Zambia, to Southern Sudan, to Ethiopia.br /br /-Finally, the "capacity-building" component that I got the most from was financial management and operational oversight along with organization oversight and governance. It was quite interesting to learn that most NGOs saw government as one of the only "sustainable" support systems yet most wholeheartedly distrusted government accounting, policy implementation, and government support of NGOs - in particular those from Ghana, Nigeria, and Cameroon.br /br /So I had a decent week. Now that I'm basically alone I'm starting to get a little bit too much in my own head and homesick - and I was supposed to be out of my current home today, but since its Ghana apparently the contract for my new place won't be ready until Monday. So I've got another few more days where I am. Here's hoping I don't get locked out again today.div class="blogger-post-footer"img width='1' height='1' src='http://res1.blogblog.com/tracker/4560662317956479827-6629148548861349863?l=colleenfant.blogspot.com'//div
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16:20
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Colleen's Ghanaian Adventure
From this morning through Thursday I am attending the Africaso (African AIDS Service Organiation)Capacity Building Conference sponsored by the Friends of the Global Fund Africa. The name itself is quite impressive.br /br /I wrote a proposal for Margaret's NGO that works a bit with HIV and mostly with Female Empowerment and Malaria. Her NGO was selected as one of 60 from 450 applications from around the continent. I've been talking extensively with a nun from Nigeria, the Ghanian director of social responsibility for a bank, a woman working with HIV patients in Southern Sudan, etc, etc. br /br /Some stuff is kind of ridiculous: during the "Project Management" workshop, we spent a good 45 mins arguing about the difference between project and program. No joke. And during the "Proposal Writing" workshop, we spent at least 30 mins discussing why the sample proposal we were given was not the same as every single other proposal that everyone had written for their own NGO. I guess what can you really expect when you cram 60 leaders in a room who all generally think that what they're doing is great. Which it is. br /br /Some stuff has been incredible. Engaging in a casual debate about the roles of women in society, and in the workforce and government over coffee with 2 men from Nigeria, one of which runs a female empowerment NGO, a Nun, Margaret, and northern Nigerian woman (who's basically trying to do the exact same VCT/infrastructure project as me!) was one of those surreal experiences. The feeling of a)I actually have something meaningful to contribute, b)this is an incredible, interesting, global conversation, and c)I absolutely love being able to casually hang out, in a low key setting, talking about things that I really care about!br /br /Ah. so happy right now. as much as I am getting slightly terrified and homesick, I love it here and feel so incredibly comfortable doing what I feel is the exact right thing for me to do right now.br /br /more on the conference later...
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9:25
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Colleen's Ghanaian Adventure
So, you match up students with the HOPE Center to work for a year or two. A student goes there for 9 months. But then what? Pass the work off to someone else who gets to learn everything anew? Meanwhile the partner isn’t starting over every year or so – they’ve got continuity. br /br /Saturday I visited an HIV support group based organization in Alfao (2 hrs away at Togo-Ghana border). They asked us what were we there for. Our answer – development work – bring in HIV testing, strengthen the local health infrastructure for our brothers and sisters in Ho. Response: “great” but with the implicit question of “yes…. But why are you here.” Implicit answer: “to learn for my project.” That’s crap. I come, take knowledge and they get what, a smile, a friendly and respectful incident. Yes, I’m not really taking anything from ‘them’ but what I ‘get’ is almost immeasurable. br /br /At the HOPE Center I partner with them for a few years, work my butt off raising money, worrying, etc, doing stuff for ‘them’ that is arguably admirable. Then I leave; go to medical school (which ‘they’ will have almost directly helped me get into). The partner is still here in Ghana, working. Sure, other students will take over my role, but what about my personal accountability. Many of the people I’ve met here constantly refer to development volunteers who have come before as friends. But most people come, do something ‘sustainable’ and then never come again. (by sustainable I mean possibly sustainable in terms of infrastructure, but not so in personal relationships) Sure, their experience may make them better “advocates for global health” in their future endeavors, but what the hell does “global health” mean in the clinic or community. I can’t just make friends, coworkers, or confidants during my “year off from real life.” Right now I see that ‘real life’ as one that has me working with my MD/MPH on a similar project at a similar clinic. But then, what did the HOPE Center mean to me? A great experience? A sweet anecdote for medical school interviews? That’s such a disingenuous load of crap. br /br /People here always ask, how long are you staying? Or, when are you coming back? Those answers are almost always semi-dishonest like “hopefully next year (that is, of course, if I’m not too busy in my real life)”, or boldfaced lies, “I love it here! I want to stay! (since I can easily leave whenever I want and return to my real home).”br /br /We come here and people are so generous to make a role for you in their existing systems. It’s as if ‘they’ see us with this important and formative role – building a school, clinic, something that will have a genuine place in that continuum of permanent existence. But, as much as we tell ourselves that is how we will also see our experiences, I feel like the experience is just going to become anecdotal to whatever real life and job we end up with. The center will exist for years to come, and there’s really no way to forget the specific people who were here to make that happen. But it will be easy to lose that equitable personal exchange. Show me someone who continues involvement beyond the occasional email or keeping up with Center activities and actually keeps working with the Center in a way that’s not just a side activity for the future. A student partnership basically allows us to no longer feel responsible to the partner past graduation. Maybe it’s the fault of global systems (whatever that cop out, scapegoat means), that this disconnect will inevitably take place. Or maybe its just because we see ourselves as better people for having taken a time – a week, a month, a year – to “do good” and we’re simply expected to no longer be truly involved once we’ve taken what we needed from the experience.
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10:37
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Colleen's Ghanaian Adventure
I posted new pictures if anyone's interested.br /br /This past week since Jon and Nikita left has been very busy. On Monday, mother's began coming to the Center to be interviewed by Sarah for the nutrition center that will begin this coming Monday. Since the GlobeMed money came in, all of the cooking supplies have been bought for the Center. Beginning next week, mothers will bring children that are underweight or are having difficulty with complimentary foods will be able to come to the Center and learn how to prepare and introduce a variety of balanced foods to their children. Every mother in the program was given a day to come and some, those children that are severe cases, will come more often than others. The nearby village of Ando has been pretty incredible. Two of the mothers stayed all afternoon at the Center helping us sort through the beans, roast groundnuts, and peel the groundnuts. We are now all prepared to begin on Monday.br /br /Yesterday Dr. Eleeza stopped by the Center. We are almost ready to create and submit the Laboratory proposal to GlobeMed. After some stressful and expensive phone calls home we got a potential budgetary figure from the NU students to base the Laboratory proposal on. Hopefully Monday we will have something finalized to send to the NU students. But its Ghana, so by Monday, I mean it'll probably be done sometime before Friday. Its pretty incredible how much just being here has catalyzed the program development at the Center. When GlobeMed received the potential 3-year plan from Margaret and Dr. Eleeza in February the top 3 goals were: Nutrition Project, Diagnostic Laboratory, and HIV testing facility. Right now all of the goals on that list are in the works.br /br /My individual work on the VCT is also going well but slow. It's really good that I'm staying for as long as I am because I realize how incredibly long it takes to build up that level of comfort and discretion that I'm going to need to bring in this VCT. It's really great that the GHS wants to put one at the Center and I get to have a role in making that a reality, but I think that in terms of my contribution, I'm starting to realize that I can be more useful if I am able to look into how to make this VCT more incorporated into the Center for it to be successful. The direction that I think I will be heading in (and I think I get to spend this weekend hashing out a revised "project proposal" for my fellowship) will be in examining how HIV testing fits into the overall scheme of sexual and reproductive health and how that will look for actual program design and implementation at the Center. I think it will be important to not just have HIV testing at the Center, but if we're testing for that, I'd like to look into other STD prevalences, testing, and treatment alongside overall sexual health. The trick I think, and I haven't really figured this part out yet, will be to bring in overall sexual health in a way that's not just women since the Center already has such a strong emphasis on women. We shall see how that goes.br /br /Three other new developments. First, Sarah and I met with the program director at Future Generations International, and he agreed to help me when the VCT is established. His organization provides support groups, ARV access, and is looking into income-generation and nutrition for HIV+ people - so basically the perfect collaborator as long as he proves to be genuine. In addition, tomorrow at 6:30am Sarah and I are meeting him and we will be going to an HIV support group in Aflao (2hrs away). So that should be very interesting. The second thing is that Margaret's NGO, Strength of Women, got accepted to attend the Friends of Africa Conference sponsored by UN fund for AIDS, Tb, and Malaria in Accra in 10 days. This is such a huge honor for her. They called her yesterday when we were in the car and she was so happy. Yelling, smiling, and hugs all around. I'm so happy for her. And the really exciting part is that I get to go with her! The last bit of good news is that after spending pretty much every afternoon here at the internet cafe submitting 21 miserably long secondaries for medical school I finally started getting some interview invitations! Now I've just got to beg them all to schedule during my 6 week return to the U.S....br /br /Sarah leaves on Friday and then I'm officially on my own. I actually pretty excited for that. A bit terrified, but excited. This afternoon we stopped by a student hostel near the university where I will likely be moving to. By myself. I'm looking forward to learn more Ghanaian cooking, have my own room, getting myself around, and finally being able to put my specific "project"tasks and needs first. Not really looking forward to overwhelming loneliness or having someone to talk to about the experiences of being a yeavou in Ghana.
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8:15
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Colleen's Ghanaian Adventure
It's called grasscutter... and it's actually not terrible, even if it looks it.br /br /The internet was down for the entire Volta Region of Ghana for the past week, so things have been a bit difficult.br /br /Yesterday, we had a big finale-type meeting with the district health director, Dr. Eleeza, where Jon and Nikita presented on the IT at the HOPE Center, the progress of each of the programs, and began the discussion of the Center's future since they will be returning to the States on Thursday. What was decided, (and I'm sure for all of you GlobeMedder's you'll hear much more about this in the future), was that we will continue to work on this Nutrition project, as the money for phase 2 has just arrived, and then we will continue to raise funds for a laboratory. Long term goals would likely include out patient treatment areas, beds, and places for deliveries. (But of course, no work will be done on those now, as it is important to focus on achieving these present tasks beforehand.. but a bigger picture is at least nice to see) The guy who deals with medical laboratories for the region came to the Center today to get a tour, figure out which space will be best suited for a lab, and now we are just waiting to hear back from him on what types of equipment will be appropriate for the Center and what the budget breakdown will be. Since it's Ghana, and things operate on "Ghana-time" Sarah and I will be stopping by his office at the Regional Hospital on Thursday to check the status of that information and keep him from forgetting us.br /br /Bringing in this laboratory should make a real impact on both the services available to the Center's clients, and increase the number of clients. Not only that, but since I'm going to be hear, instead of just building a laboratory as a singular project, we'll be able to work out the lab within the context of some of the ultimate goals of the Center. The lab will have the capacity for HIV testing, and is being placed in an area that will take into account the placement of counselors for pre and post HIV testing. Even if the counselors aren't put in immediately, its good that we're starting to think ahead.br /br /It seems also, from my limited time and research here, that this "VCT" that I'd be spearheading will likely be one part of an overall increase in reproductive health services. So in addition to the HIV outreach, there would be outreach for safe sex, getting STD tests, and perhaps some gynecological services. (Apparently the only place to get Pap smears or mammograms is Accra!!) But we shall see how it progresses with flexibility and resource availability.br /br /On a personal note, I pretty much love it here. Getting used to always feeling a little bit dirty, and not always having some task to do has been a little bit difficult to become accustomed to, but I think I'll get used to it. I've already gone through 3 books... one of which, as a side note, The Fountainhead - one of the best books i've read in a long time. Cooking has been fun, learning and trying different things... much less convenient than in the US! It's been really interesting to sit and try to listen and watch different people and things. br /br /(I hope this post was less whiny than my previous long one... as much of the frustration I felt at the time has been replaced by more positive goals and thoughts. And I'll try to post some pictures soon...)br /br /br /I hope everyone is doing well,br /br /Miss you all,br /Colleen
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12:45
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Colleen's Ghanaian Adventure
The water's back on in the house, the internets been good at the cafe, no power outages, I'm almost done with med school apps.br /br /Nikita and I did some community asset-mapping fieldwork today. Which is a glorified way of saying we did a lot of walking around and asking nosy questions. We very randomly went into an office to make a copy of something for an education NGO and ended up in this pretty awesome HIV awareness group. They hold support groups, do stigma-reduction outreach, get people ARVs and much more. So things are looking up! It was a great contact, and it's incredibly exciting to see what will come of it and what the HOPE Center will be able to do. Get excited. I definitely am.
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11:27
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Colleen's Ghanaian Adventure
definitely going to be a long post. you've been warned.br /br /It's almost the end of week 2 here in Ghana. Nikita and Jon will be leaving in about 10 days, and Sarah leaves in about 3 weeks. Lots of our discussions recently have been centered around the big picture of the HOPE Center. What is it really doing? How different, really, is it from other NGO projects that we constantly criticize for being unsustainable or irresponsible. Is it our motivation that makes us different, even if some of the outcomes of the Center are no different than other NGO practices. Or to actually do something better, is it not the means or motivations that matter, but the outcome. If so, then what of us. Not in the long term of goals and visions. but right now in the immediacy of a person's health. br /br /Right now the HOPE Center is a beautiful building full of incredible promise. But the actuality it is that 2-5 patients come a day. Most of the staff sits around because without patients they don't have anything to do. Outreach has been good, but it still has not made quite the impact of actually getting people to come to the Center. Over a year in existence and basically all the Center can treat is malaria (whether it actually is malaria or not), and family planning. The "sexy" word in global health is "community-empowerment" or "community-ownership." How can the community "get behind" the Center when most of the times that they walk the mile and half to get treatment, they just get referred out to the district or regional hospital. We were in Ando this Friday for a Nutrition Workshop and there were about 10 adults at the talk. It was a great talk, and I completely agree with the goal of education as the catalyzing force behind health. But, it seems like the community is struggling with the apathy for seeking out health services because they've constantly been disappointed.br /br /Now I realize that sounds pretty pessimistic. And it is supposed to. We keep talking about great goals and laying out plans. But today, in the exact present tense - crazy Anthony from Ando should not have to keep getting his open sores treated by HOPE Center Nurses sporadically. And all of the children should not have to wait until a group of inexperienced foreigners come from abroad with their pride and their money to give them dewormers. Many of their parents can't afford the health insurance, and are too disenfranchised to walk to the HOPE Center when the kids need treatment because, in all likelihood, they'll just be sent away to the hospital anyways and they probably can't afford most of the treatments there either.br /br /So what then. That seems to be where I get stuck. We raise a few thousand dollars to put in a lab. The we bring in other communities with the VCT. Then we raise a few more to build a maternity wing. Then we get a doctor a few days a week. And then and then. Each of these steps could bring in more people. Or they may not. Maybe people in the communities will get sick of going to the Center that has a few more services each time, but never all of the ones they may need. Or they may just come to the realization that it is a more efficient use of their time to just go to the hospital and forego the unnecessary referrals. Or, since much of what it seems they have experienced int he past is either inconsistent"duffel bag-type medicine" or the inaccessible resource poor, big hospitals - then what? And what of sustainability. We keep saying that the GHS will take on more of the costs for services and we'll become project-based. But they're resource strapped too! When you barely have enough doctors at the district hospital, it makes absolutely no sense to post a doctor at the HOPE Center that sees a handful of patients a week.br /br /I'm always one to advocate for taking things slowly and stepwise. Walking before running and what have you. But I am having a hard time comprehending all of these small financial steps in the grand scheme of this Center. In (my) ideal world, the HOPE Center could become like Miracle Life - a private clinic that serves fairly affluent people in Ho. This clinic seems quite like a normal, private, primary care practice that would be in the US, except with more outreach because its Ghana. It has a doctor, it has nurses, it has a system and services, it has a nice and accessible building. The problem, though is that its expensive. How can we make the HOPE Center more like that, but keep it accessible to the poor. Part of me wants to say let's raise a crapload of money and put in a lot of services at once. You wouldn't build a random nurses station in the DeKalb, IL USA countryside. You'd just go ahead and build a full clinic. It wouldn't be half-way completed with a nurse and a few anti-biotics but not much else. It would be tailored to what the community actually needs and built once the resources were in place.br /br /I know that's ridiculous, because it is clearly a resource-strapped imperfect world, and let's just face it - we're not in the US and apparently it's "naive" to expect the same healthcare and I'm really just trying to hash out these ideas for myself. I also still very much think that small, thoughtful impact can be a great approach as well. Now comes the challenge of reconciling all of the negative thoughts with the positive ones (which I've pointedly left out of this post. probably for the sake of dramatic effect, but mostly just to give some organization to my own thought processes and sort through the positives and negatives separately). What now, what now, what now. the question remains where is this balance of healthcare and where does the HOPE Center fit in ....
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11:46
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Colleen's Ghanaian Adventure
after posting about subjective experiences yesterday, I thought I'd post a short entry about life since arrival.br /br /We arrived safe in Accra at 6 last Wednesay and the 4 of us with Joseph drove to Ho that night. The very next morning we went to the HOPE Center met and talked with the staff about what we would want to do while here and then Margaret quickly shuttled us off to meet with the district health director, Dr. Eleeza, for about 10 minutes. Thursday we went with the nurses on an outreach program (see previous entry) and Friday we had a staff meeting about the projects. This week is where all the real work begins. My temporary companions are working on: analyzing nutrition data (Sarah Mihalov), asset mapping and a media project (Nikita Kohli), and the electronic records system (Jon Shaffer). They will all leave me behind in late August and Early September.br /br /The water's been out since Friday at the place we're staying, so I haven't had a real shower since then and today is Monday. The electricity went out in the whole city too on Friday, alienating us from internet and connection with anyone back home. Its back on now, although it shut off in the internet cafe earlier today while I was in the middle of faxing in a med school application.br /br /Things are different, but not so much, I feel very comfortable here. It's so much more relaxed, open and friendly. I could definitely get used to this.
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8:46
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Colleen's Ghanaian Adventure
The title of this entry is a quotation that has been running through my mind for the past few days. I saw a movie before I left and in it a character asked "what is the point (of helping) there are thousands more where that one came from" and the response was; "but here is someone we can help." The last several days have been both eye opening and confusing to say the least. I have often ended each day more thoroughly confused than I had begun it.br /br /There is another NGO in Ho that connects youth from around Europe to various service areas in Ho. One morning at the H.O.P.E. Center, the nurses embarked to the village of Ando to provide check-ups on all of the children and provide them with Vitamin A, de-wormers, anti-malarials, and wound dressing. About 15 European youths joined up during the visit. The "yevous" or "whites" almost overwhelmed the locals. It was clear that the villagers were benefitting from this treatment, and the other NGO also brought along 2 doctors to address more serious cases. However, the issue arose when it came to money. The European NGO provided all of the funds for the drugs and then in return, the youth volunteers got "medical experience." Something about this transaction really rubbed me the wrong way. While in the end, the medical services provided were clearly beneficial, and all of us being there were able to provide the manpower to help the nurses examine the children for wounds in a timely fashion, it was disorganized and it seemed almost as if this other NGO was imposing on the GHS. They came in with their own agenda of what to do, and did it with what I saw as very little respect for the health workers. The 15 Europeans took themselves to this rural village in taxis without even waiting for the nurses to properly introduce them to the chief. The group brought 2 doctors with them, but did not let anyone know ahead of time so that the GHS could properly prepare. In addition, this NGO goes to the GHS to get some of their volunteers placed and even though Margaret explicitly told their leader that the HOPE Center did not need any volunteers the next morning everyone arrived at the Center to find a lost, aimless volunteer waiting to be told what to do.br /br /So this is where I am conflicted. While there are strong positive outcomes from their presence which I admire, I was angered by the way that it was gone about.br /br /We spent yesterday touring the many villages in the area that Joseph has worked with and it was core-shaking to see just the desolate poverty, the bloated bellies, and the red hair because there was literally NO medical access of any kind. At night, the four of us who are here would sit around and discuss just how difficult it was to see and how it made us felt - and that has been really helpful in Ghana, actually being able to talk about all this stuff on a real level with people who are having similar experiences. It will be hard to grapple with this when I am alone in a month.br /br /The devastating poverty is what contrasted with some of the really bad NGO work that exists. There is so much need and room for growth, but I guess every little bit that is done with good intention helps? I really hope that we are able to go about things differently and at least make baby steps in renovating this imposing, hierchical Western NGO "aid" that comes here rife with racial and social prejudices.br /br /That whole blog post may not have made much sense, but thats only because my thoughts havent really materialized yet about how I feel. Now time to go work on the 15 or so secondaries for medical school that are also pressing on my mind.br /br /love and miss you all,br /Colleen
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16:12
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Colleen's Ghanaian Adventure
Welcome to my new blog for my upcoming African adventure! My flight for Ghana leaves a week from tomorrow, Tuesday, August 4th at 8pm from O'Hare. After a brief stopover in Germany, I will finally arrive in Accra (the capital city) at 6:30 on Wednesday, August 5th.br /br /I was lucky enough to receive the Mind the Gap fellowship through the Northwestern University Center for Global Engagement to spend the next 9 months in Ho, Ghana working on an HIV project at the H.O.P.E. Center. I was linked to the Center through my work with the NU student group GlobeMed. Several years ago, NU GlobeMed students, with the help of Evanston Lighthouse Rotary, raised money to finance the construction of a rural health Center on the outskirts of Ho, Ghana. By working with Joseph Achana, a Rotarian from Ghana, the Center became a reality when it finally opened in April, 2007. Since then, I have been working with GlobeMed at Northwestern to support the Center and raise money for health projects. What is great about the H.O.P.E. Center is that it focuses on education and outreach. The current scope of the Center includes maternal and child health, immunizations, prenatal care, family planning, and malaria treatment and outreach. Recently a comprehensive malnutrition-reduction program was added to the Center through program design by Margaret Asante, the head nurse at the Center, and fundraising by GlobeMed students.br /br /When I arrive in Ghana, I will be working with the Center staff and the Ghanaian Health Services (GHS) to research, design, and implement an outreach-based HIV testing and prevention program. Around Ho, the prevalence of HIV is about 4%, and the GHS has recently instituted a "100% tested" policy, to encourage everyone to get tested. Working out of the Center will be such an amazing opportunity to be able to get firsthand experience of how these programs are created and put into place, but to be able to use the resources that I have to hopefully make a real impact.br /br /To get ready for this exciting time I have been preparing for quite some time. I spent a few days at BeHIV, an HIV testing and outreach Center in Chicago, learning more about the realities of HIV testing. I helped stuff many condom packets for outreach and helped visitors get testing. There were two main things that I learned. One is to realize how stressful the experience can be for people and how important it is to have these kind of services easily accessible and private. The second was how important it is to be knowledgeable and as welcoming as possible. At BeHIV, people call with many questions, so it's really important to know not only about the process they will go through, but also be able to present them with as many opportunities as possible. One of the best experiences I had at BeHIV was answering the phone and being able to speak with someone and help them locate any other hospitals, clinics, and services that they might be able to use. I can't say enough great things about BeHIV and how important all of the amazing things that they do. Everyone there was dedicated, friendly, and kind and I had a great time during my brief stint there.br /br /Both the Center staff and the GHS have been very receptive of this HIV project to be launched at the H.O.P.E. Center and Margaret has been key conecting me with the people who I will need to work with.br /br /I am very grateful to everyone who has helped me so far, GlobeMedders, CGE'ers, and family and friends who I adore and will miss. I'll try to post regularly about the process of the project, but I'll also have email, a href="mailto:colleen.fant@gmail.com"colleen.fant@gmail.com/a so please make sure to stay in touch with me while I am away! Wish me luck!br /br /Colleen