September is almost over??

I said last time around that I would try and be better about updating but clearly that did not happen. So here is a quick update of what the last week has been filled with...

After finishing my rounds with ASRH, I moved over to working with some of the malaria projects that are funded by the NIH. Thursday April and I went to a focus group of mothers that was aimed at gauging acceptance of a rapid malaria test (RDT) that they are attempting to introduce in the community. We couldn't understand what was going on because the discussion was conducted in the local language but I was able to help women "sign" (thumb prints) their consent forms (most of the women were illiterate). It's interesting to see the way these groups work--usually there are a few women who are most outspoken and who, in addition to giving their opinions, prod the other women to speak up. There was much laughter and from what we could gauge it seemed the women were very receptive of the idea of the RDT. Friday there weren't any field visits going on so April and I had the day off. It was market day so once Ashley returned from her field visit we made our way into town to stock up on food and water for the week. We have finally figured out a route to take through the inner market to get to the plantains and oranges which is great because getting lost in there is more than overwhelming.

Friday night we didn't do much of anything which was nice. Saturday we got up and Francis drove us around to show us where the schools in the area are so we can pick one to volunteer at (something we have been talking about since arriving). After checking out the schools Francis drove us over to see the Tono Dam (about 20 minutes away) which was an amazing site. It is a gigantic lake surrounded by amazing scenery and the area was so quiet and peaceful. Once we get our bikes fixed (now there are 2 with flat tires), Ashley, April, and I plan on biking out there to have a picnic. Saturday afternoon we went over to the apartment of one of the Centre's employees to watch a movie (Ghanaians seem to LOVE watching movies). After the movie was over we headed to the local University campus to watch part of a talent show that was going on and which involved much dancing and rapping. It was a fun evening and it was nice to be out with some locals--if there is one thing people around here have stressed, it is the importance of seeing what local life is like. Sunday we didn't do too much and spent much of the evening with on again off again electricity thanks to storms (we have been having a lot of electricity outages lately and they are not all weather related...).

Yesterday I switched offices again and went out into the field with the Rotateq trial team. Rotateq is a vaccine that reduces the occurrence of diarrhea in children (esp. infants) and while it has been licensed in the US, South America, and Europe, trials are still going on in Africa and Asia. We drove to a clinic where, after picking up all the mothers and babies, the vaccine was administered (there are 3 doses given over a 2 month period). It was a day long even starting very, very early, and continuing until late afternoon. I was under the impression that administering a vaccine would be a quick and easy thing but somewhere between informed consent, the taking of vital signs, and physical check-ups (to ensure they are healthy enough to receive the vaccine) time seemed to fly by until the whole day had passed (I was told that often the days are even longer than the one I experienced). I really enjoyed having the opportunity to see a vaccine trial in progress and to learn more about the inner workings of these trials. Today I wasn't up to much of anything--we had a meeting with our supervisors to discuss what we want to do for our papers and projects while we are here. I haven't made any final decisions yet so I have a lot of thinking to do in the next few days.

This weekend we are planning on travelling to Ouagadougou to visit Aki and Emma (two other Georgetown students). Hopefully everything will work out--we have asked the girls who were here last year for advice about getting there and it doesn't seem all that difficult which is good. Other than that life here has been going smoothly and I find it hard to believe that September is almost over--I never thought that my time here would slip by so quickly. Well that's all for now and I apologize for not putting up any pictures this time around--the internet does not want to cooperate...

some crocodile fun...

from top to bottom: Ashley, me, and April with Nave; me sitting on Nave; all three of us on the watchtower rock at the slave camp; out for Ashley's birthday (Francis is in the yellow, Daniel's behind him)

So another week (and then some) has passed since I last posted on my adventures (I promise I will try to get better at posting more often!). I think we are mostly settled in now and we are definitely getting more and more comfortable with our surroundings. These past days have been pretty busy and I am glad for the mid-day break I have right now. Well here goes an update of what I have been doing...

After finishing up with IPT-i/Urban Malaria I moved to work for three days with NDSS (Navrongo Demographic Surveillance System). The NDSS gathers census-like data on the entire population of the Kassena-Nankana District where the NHRC is located. Much of the work done here relies on data collected by NDSS as it can be used to find study populations for the various research projects. In other words if, for example, a study was to be conducted on malaria and pregnant women, the project team would turn to the NDSS to determine who amongst the local population is pregnant and can thus be considered as a subject. My first day with NDSS I went out with WM (staff at the center go by what they call code names) and Francis to the eastern region. We stopped at various field workers’ homes to collect their data from the day’s interviews. Because everything here is so rural the field workers live in the communities they are responsible for gathering data from and so senior staff from the Centre must check to make sure the workers are completing their work. Thursday (my second day with NDSS) I went out with Daniel (another NDSS worker) and WM to the west where we went to check up on a field worker while he was conducting interviews. In order to find where in the community the worker is the team stops at the worker’s house and checks forms they leave outside to see which houses will be visited that day. Once there is a general idea the team then goes to the area of the community and asks around to see which compound the worker is in. While this worked for finding the first field worker of the day, it didn’t work for finding the second so much of the morning was filled with driving and asking without being able to locate the person. It was a little bit frustrating but I got the impression this happens often and I was content enough to sit back and enjoy the amazing scenery (the west is hillier than around here). Friday I went out with WM and Francis in the morning to collect field worker data and in the afternoon I got to sit in on a field supervisor meeting.

Friday was also Ashley’s birthday so that night after some much needed showers (we had been without running water for 2 days because the water tank servicing our apartments had burst) we headed out to dinner with Francis and Daniel. It was a nice celebration at an outdoor restaurant with an amazing view of the stars and plenty of bugs to eat us up. Saturday we decided to travel to Paga, a town about 10 km north of here. After hiring a taxi (the first of many adventures) we headed off to our first stop, the Zenga Crocodile Pond. There are two crocodile ponds in Paga and according to all the locals the animals never harm humans—they believe that they are totems and that the spirits of ancestors reside in the crocodiles. When we got to the pond we were told that we would need to purchase chickens to lure the crocs from the water. After our purchase we headed down to the water (where people were doing laundry) and using two of the birds the guys running the site managed to get two crocs out of the water (which didn’t phase the women doing laundry at all). But after feeding them the birds they decided that these crocs weren’t big enough to take pictures with (they looked plenty big to me) and we headed off to look for Nave, the oldest (at 89 yrs) and biggest croc in the pond. We found him in a little side pond after using the last bird to lure him out. The guys then proceeded to show us various poses for pictures including squatting over the croc, holding its tail, and sitting on him. Needless to say it was a little bit terrifying but Nave didn’t seem to mind the poking and prodding and calmly posed for pictures with us. Ashley, April, and I thoroughly enjoyed ourselves although none of our parents were too pleased to hear that we had been sitting on playing with crocodiles.

After the croc pond we headed over to the Pikworo Slave Camp, which had served as a stopover/rest area for slaves being brought from Burkina Faso and Mali before being taken down to the coast. The area was a stony hillside where our tour guide showed us places like the dining area (where food was served in holes bored into the stone), mass graves, the lookout tower, etc. It was very interesting but also sad to see. When we finished up at Pikworo we headed back to Navrongo where it was market day. We braved market to stock up on food for the week and then managed to get stuck in a rainstorm on the walk home. Our cooking is getting better although we eat a lot of rice and noodles and fried plantains. We are slowly but surely finding foods we like including the amazing bread that you can buy fresh on the side of the road (it’s called sugar bread and April and I are capable of devouring a loaf between the two of us in a matter of hours). Sunday Francis invited us to attend services at his church (non-denominational Christian) where he was scheduled to preach. Francis picked us up and we got there at 9:30 (services started at 9:00 but the church wasn’t full until around 10:00). There was a ton of singing and dancing and then Francis gave a really great sermon. When all was said and done the service had lasted over 2 hours. Sunday afternoon we were lazy and April and I took a bike ride which had a few mishaps (including a flat tire) but it was nice to get a little bit of exercise.

Monday I switched over to working at the Adolescent Sexual and Reproductive Health Project. My first day there I went to a meeting at the Ghana Educational Services office in town where they were discussing teacher training for the ASRH curriculum that is taught in schools. Yesterday I got to go about 40 km south to Naaga, a very rural community that is one of the ASRH intervention sites where we facilitated a beekeepers meeting. One of the parts of the ASRH project is a livelihood component. The idea is that by providing certain people in a community with a means of income ASRH can then use these groups as a way to get messages across to the beekeepers who are then supposed to spread information on ASRH throughout the community. Well that’s all for now—I have to go check in to see if there is a group headed out to the field. Hope everyone is well!

One Week Mark

So I have officially been in Ghana for one week but it seems like I have been here for ages already--I can't decide if this is good or bad. These first days have been a whirlwind of activity. We got into Accra late on Monday night and spent Tuesday getting phones, exchanging money, and getting to see some of the city. It's not so much a nuclear city as it is a very spread out urban hub. We (April, Ashley, and I) were taken around by Isaac, who used to work at the Navrongo Health Research Center (NHRC) but has since moved to Accra to become the NHRC liaison there. It was during this outing that we had our first true Ghanaian meal which consisted of goat and tilapia in a very spicy stew served with fufu which is a dough like substance that is generally made from cassava. That same evening we were told by Dr. Liese (a Georgetown professor) to stock up on the "European" food in the buffet at the hotel because it would be the last we would see for a long time.

Early Wednesday we flew up to Tamale, a 1 hour flight, and then had a 2 hour drive from there to Navrongo. Despite being squished into the backseat of a pickup (a very common mode of transportation here) we managed to take tons of pictures of things we have since realized will be surrounding us for the next three months. Everyone in Ghana has been so welcoming, and that includes the staff here at the NHRC. Before we even stepped foot into our apartments we were greeted by various people all offering helping hands and words of advice (i.e. always close the door quickly unless you want wall geckos everywhere). We have two separate apartments--Ashley is at one end of the 3 apartment block, April and I at the other. They are spacious living spaces--living room, kitchen, bathroom, and bedroom (complete with bed nets!). After unpacking, briefly meeting one of our supervisors, and getting our internet set up, we had a quick bite to eat in the guest house here with a Ghanaian soap opera playing incredibly loudly in the background.

Dr. Liese said good-bye the next morning and we have been on our own since. Later Thursday afternoon Rosemary took us to market (market is every 3 days) where we bought some yams (which we attempted to cook later...it was disastrous), some tomatoes, amazing bread, spices, rice, and even pasta. She gave us a good introduction to the market although none of us are ready to brave it on our own yet. Friday was our first set of field visits. Dr. Williams (one of the supervisors) sent each of us to a different project and we were told to tag along with the teams. I was with urban malaria/IPT-i (another malaria program). That first day I went to Bolgatanga, the next biggest city, about 30km away with 3 of the workers here. We visited a number of compounds, first checking to make sure the Community Based Agents (CBAs) were doing their jobs of testing/treating malaria and then to a few compounds where children had been treated to see how things had gone. It was, needless to say, a little overwhelming.

Over the weekend Dr. Williams took us to Bolga where we did some grocery shopping and wandered around after which we ate lunch at a local restaurant. That evening, Francis, who works with the Navrongo Demographic Surveillance System (NDSS), showed us around town a bit, pointing out where we can get toilet paper, the cheapest bagged water, etc. and he also drove us by the Catholic cathedral which is beautiful (entirely made of mud and 100 years old). Sunday was a lazy day. Yesterday (Monday) I was back in Bolga doing visits similar to the first day--this time I was slightly more comfortable with things. Today I went to Paga (home of the Paga crocodile ponds and last town before Burkina Faso) with one of the field workers. She was interviewing a young mother about her experience with IPT-i (which refers to 3 doses of anti-malarials given in the 1st year of life and shown to reduce occurrence of malaria during the first years of life). The worker then showed me the crocodile ponds (I think we are headed there for the true tourist experience on Saturday) and took me to the border to show me what that was like.

Despite things being so very different here, I have to say that there hasn't been any huge culture shock--more culture confusion. When a Ghanaian is welcoming you to their home or country or whatever, they say "you are welcome" which the first few times confused us immensely because they were saying you're welcome and we hadn't said thanks. Other things we have learned: African yams are not at all like "yams" in America, cold showers can feel great when taken after a particularly hot day and not all stove tops light themselves, to name a few. Overall, the experience so far has been great and I can't wait to see what the next weeks bring (hopefully an end to our perpetually upset tummies!!).