1 July 2010

This woman walked through the traffic which had slowed near the 37^th Hospital tro-tro station.  She had a shopping bag in her right hand and was holding her daughter with her left hand.  She had her baby on her back.  And she had a suitcase on her head.  She was obviously going somewhere on a trip.  Gives new meaning to Carry On Luggage, doesn’t it? 

I jokingly tell people that when you live in Africa you become part of the food chain.  I am now a believer.  I woke up last Thursday and noticed that my left cheek along my jaw line was sore.  I couldn’t see anything so I didn’t think much about it.  It felt tender when I shaved.  By mid day I noticed that I had welts along the jaw line toward my chin and a lot of itching.  I still couldn’t see much in the mirror.  I started putting hydrocortisone cream on the welts.  By Friday morning I had more swelling and the beginnings of an area of central necrosis (tissue death.)  It’s pretty obvious that something chewed on my cheek Wednesday night.  I have now developed a central area of hard swelling that is very painful.  I asked one of the African doctors I know what he thought about my “bite”.  He was not very impressed and shrugged his shoulders, as if to say “you’re worried about that little weeney bite???”  I’ve done my medical reading.  I’m sure I’ve got a Tumbu fly larva growing in my cheek.  We’ll know in 10 – 12 days when the larva matures and can be extracted from the wound.  If it’s not a Tumbu fly larva then it must have been some aggressive flesh eating spider.   This is what my "little weeney bite" looks like after a week.  It is very uncomfortable.  

Speaking of the food chain in Africa, being consumed by others is not limited to animals.  It also exists in the plant kingdom.  This next picture is a little hard to see but it is a kapok tree with a parasite tree wrapped around the outside.   We saw this near Wli falls.   Our guide indicated that the parasite tree is called a “blackberry tree” (that’s what it sounded like to me) and it grows on the outside of the kapok tree, wrapping around it and eventually cutting off the kapok’s nutrition, killing the tree.  The outside of the kapok tree remains intact and provides structural support to the parasite tree.   The parasite tree then grows supported by, but not competing with, the kapok tree. 

Last Thursday I spent a half day at Korle Bu in the ENT clinic.  It was a little slow because I think everyone, including myself, didn’t really know how it would work out.  I met many of the staff, most of the faculty and one of the residents – way too many names to remember.  The female nurses/staff are called either “sister” or “auntie.”  (Does one graduate from sister to auntie with age or experience?  I don’t know.)  I couldn’t catch what they called the nursing students who seemed to be everywhere. 

I have described the Korle Bu facility before.  The clinic is on the second floor of a building built by the British at the close of WWI.  It doesn’t appear to have been remodeled since its construction.  To get to the ENT clinic one walks up a front set of stairs and turns to either side to an outside waiting room, covered but open to the air on three sides.  There is a small enclosed financial office.  (Remember, you pay before being seen.)   There is a portable reception desk at the end of the waiting room near two doors that lead to hallways with five examination rooms per hallway.  The examination rooms are small and cramped with a patient, a doctor, a nurse and several nursing students.  The examination chairs are straight back sitting chairs.  The examination lamps are bare bulbs on goose necks.  The doctors use head mirrors with bands so worn that they are covered with duct tape.  The clinic had an operating microscope but I struggled to get it working.  It really needs a lot of lubricant.  The joints grind with movement.  I am not discouraged, though.  The staff make up for their facility/equipment limitations by the enthusiasm for their work and their willingness to learn.  This is a picture of Dr. Kitcher, the department chief, on my right, and Dr. Jangu, the faculty member that I am to train in otology this next year, on my left.  Dr. Jangu will be in charge of teaching otology when I leave in a year. 

It was raining lightly on Friday morning.  We thought we’d wait for it to stop before we left the apartment to walk to the car to go to work.  The rain picked up.  So we waited.  An hour later we were still waiting for the rain to stop.  I stood in our front doorway looking at our balcony.  I couldn’t step off onto the balcony because there was a pool of water on the balcony and I didn’t have galoshes.   It made me remember my predecessor’s (Dr. Mark Stubbs) recommendation that I bring shoes that can “get wet.”   I thought he meant shoes that could tolerate walking across pavement when it is raining, not wading through pools.   The rain eventually slowed enough that we could tip toe across the balcony to the steps and get on our way.

While I was standing in the doorway watching this downpour I took some pictures of my garden.  I need to first show a picture of my tomatoes with their new cages.

I made the cages two weeks ago of tree branches and string.  Pretty clever, huh?   The second picture is my tomatoes with their rain gear on. 

A couple of follow up comments on the World Cup.  If you didn’t know it already, Ghana beat the USA on Saturday.  Probably ho hum information for most Americans.  Not for the Ghanaians.  The victory is immense.  Everyone is talking about it.  It represents the little country beating the world power, despite the fact that in reality the USA is not a team to be feared in international soccer competition.  It’s not like Ghana beat Brazil.  One of the guards here at the apartment complex tried to extend his condolences to us for the USA’s loss but he couldn’t express it in English.  Each time he tried he would get part way into a sentence, stop, think about what he was trying to say, grin and then blurt out “Ghana won!”   

I have decided that my last blog was inaccurate when I tried to describe the intense EXCITEMENT of soccer, I mean football.  I feel it would be more proper to describe the emotion of the game as intense ANTICIPATION.  There is a lot of heart racing waiting for the favorite team to score a goal.  It’s a lot like deep sea fishing – each time you cast out your line you know that you are going to catch a huge salmon. Your heart begins to race with anticipation. When you reel in your line with nothing on it you are only briefly disappointed.   You immediately cast out the line again knowing that you are definitely going to catch the big one this next time.  The World Cup matches are the same emotion.  Each time the team brings the ball into scoring position you know that they are going to score.  When they don’t you know that they will do it the next time they have possession.   I wonder how many soccer fans fish for salmon.  It would be an interesting study.  Not really.

I was disappointed last Friday night watching Brazil play Portugal.  In case you don’t know (and you would have to be an alien from another planet to not know) Brazil is considered the best soccer team in the world, or maybe the universe.  They are the New York Yankees of the soccer world.   In fact I understand that their motto is the same as the Yankees:  melhor o dinheiro pode comprar equipe (that’s Portuguese for “the best team money can buy.”)  When Brazil plays there is always a lot of hype.  Just like the Yankees.  The sports channel carrying the World Cup here in Ghana advertised this match between Brazil and Portugal as “the best of the first round, don’t miss it.”   Marsha and I didn’t miss it.    It sounded like it would be a good Friday night date.  We settled onto the couch at the beginning of the match and could immediately feel the intense ANTICIPATION of the game.  The ball went back and forth many, many times.  Each time Brazil had the ball we knew that they would score.  Ninety four minutes later, when the match ended 0 – 0, we decided perhaps we should have played Nertz for two hours instead.  Or gone salmon fishing.  What a disappointment.    I must admit, however, I really love the Brazil team.  Who wouldn’t love a team that has a goalkeeper named Julio Cesar, and stars that are so good they go by single names such as Lucio, Josue, Nilmar, Robinho and Kaka (he was red carded in the Portugal match – bad boy)?  And get this, they are coached by a man named Dunga.  Not Mr. Dunga, just Dunga.   (I am going to suppress any impulse to make a comment about the names Kaka and Dunga.  It would not be appropriate to laugh at the best soccer team in the universe.)   It would be hilarious if Brazil had a little guy with pointed ears named Yoda.  Think of the fear they could provoke in their opponents.   "Just use The Force, Luke, I mean Lucio." I think the Yankees need to follow the example of Brazil and let their Super Stars (the $$$$$ players) wear uniforms with single names on their backs such as AROD and DEREK.  

I fear that I am giving you the wrong impression that Marsha and I sit in front of the TV, or play Nertz, or go salmon fishing, all the time.  We don’t.  We actually watched only the first 20 minutes of the Brazil-Portugal match and then did other things, periodically checking the score, which obviously didn’t change.  We will be cheering for Ghana this coming Friday in their match against Uruguay.  I will be wearing this hat while cheering for the Black Stars.

I mentioned a month ago the availability of fruit – the mangos, the papayas, the pineapples, and the bananas.  We do enjoy easy access and affordability of such fruit.  We count it as a blessing each day.  Right after I made that blog entry Marsha and I were in Shoprite and I noticed they had fresh strawberries and raspberries.  The strawberries were Ghc 23 ($15.86) for a medium container and the raspberries were GHc 8 ($5.51) for a small container.  We both stared at the strawberries and raspberries.  Daily mangos, papayas, pineapples and bananas are wonderful but for us June and July are synonymous with strawberries and raspberries.  It’s not summer without strawberry short cake when the strawberries are freshly picked and cooled and the whipping cream is just the perfect texture and temperature, Marie Callender strawberry pies, and homemade vanilla ice cream with fresh raspberries.  Yum.  Just describing it makes me salivate.  We bought the raspberries.  Why not, it’s summer isn’t it?  We temporarily forgot that every fruit or vegetable you can’t peel or heat to boiling you have to bleach.  This is what raspberries look like after soaking in a Clorox solution.

Despite the raspberries being expensive (24 cents per berry) and Clorox turning them into mushballs we savored each one, eating them, slowly, one by one, letting the flavor magically transport us to a warm summer evening at home, out on the back patio, with a favorite summer dessert.   Enjoy your strawberries and raspberries.

I’ve got to close.   Anyone who has lived in Accra knows that you cannot consider yourself a veteran of the city until you have been to Makola Market.  We went to the market for the first time last week.  We took Florence (she cleans our apartment weekly; we have become good friends.)  It was raining.  The sights and the sounds and the smells are overwhelming.  The rain amplified the smells.  I would try to describe our experience but it is impossible to put it together in words.  We needed to purchase two items.  Florence guided us through the narrow streets, the cramped stalls, the mass of people, and took us to the first vendor who had exactly what we needed.  We stood in the rain and listened to Florence argue prices with the vendor.  After a minute of animated argument I produced the exact money to support Florence’s offer.  I showed it to the vendor.  He stopped arguing and took it immediately.  The second vendor didn’t have exactly what we needed and promised he would have the item in 48 hours.  Florence indicated to the vendor she would return in two days and pick up the item.  I paid for the item and we returned, once again through the narrow streets, the crowded stalls, and the mass of people to our car.  Inside the car I asked Florence if it was safe to have“prepurchased” the second item.  She didn’t pause with her response.  “Yes, he knows I can find him.”  When we got back to the apartment we took our shoes off to clean the red mud and our clothes off to wash them.  It had been a surreal experience.  Only a video recorder on my shoulder would have been able to capture this experience (and it would have missed the smells.)   I don’t know if I can ever put together words to describe it.  I think I’ll ask Florence if she would go back with me sometime and obtain permission to take pictures of the market.  Not when it's raining, though.

Last item:  we had another experience this week that makes us true Ghanaians.  Once again, anyone who has lived here will understand.  I’m going to call it Ghanaian Car Weaving, or Motor Macrame.  We’ve come across it before, but this was the first time we were in the center of it.  Here’s how it works.  (You’ll need to visualize this in your mind.  Think of an intersection with two streets perpendicular to each other.  The street you are on has a stop sign.  You are stopped.  The street perpendicular to you has crossing traffic without stop signs, and the traffic opposite you has a stop sign.   Can you see it in your mind?  Add to this mental image narrow two way streets, potholes, and  minimal shoulders.)  We were the first car at this intersection.  We stopped with two cars behind us.  One car was opposite us, similarly stopped.  Three crossing cars were coming toward the intersection from our left, and two cars were coming from our right.  I decided to wait for the cars to my left and right to pass.  The driver behind me decided not to wait.  He wanted to turn left so he pulled from behind me thinking he could beat the cross traffic. He started into the intersection.  At the exact same moment the car opposite me thought he could beat traffic and shoot across the intersection.  The initial move in Car Weaving requires that two cars come to a stop facing each other in the middle of an intersection.  This is what happened.  The car pulling out from behind me and the car opposite came face to face in the intersection and stopped.  They started honking their horns.  The second move in Car Weaving is to add the opposite sides.  You can easily imagine how this happens.  The first crossing car to my left pulled up to the stopped cars, and started honking his horn.  The first crossing car to my right did the same thing.  The crossing cars behind each of them tried to go around the stopped cars by moving into the opposite lane or onto the shoulder only to find their paths blocked.  They started honking their horns.  And then a third car behind me figured he didn’t want to miss the action so he pulled around me to the right and tried to skirt the intersection, only to find his path blocked.  At this moment there were 10 cars in one intersection, all stopped, and honking.   Honking must be the antidote for driver stupidity.   It took several minutes for the Car Weaving to untangle.  We were the first at the intersection and the last to eventually cross it.  But what the heck.  We had just experienced Ghanaian Car Weaving.  People riding the bumper cars at an amusement  park pay money for such an experience. 

Have a good 4th of July weekend.  Wave those flags.