First week in Accra

16 Jan 2010 – 23 Jan 2010

Short version: hard travel, big time culture shock, crazy drivers, good accommodations, wonderful people, I think we will be OK.

16 Jan 2010 -23 Jan 2010

Long version: It has been a whirlwind week! We left the cold and smog of SLC on Saturday morning and arrived in the heat of Accra mid Sunday morning. Immediate sweat!! We were greeted by Mark and Sharon Stubbs, the physician and wife that have been serving as Area Medical Advisor for the past 18 months. They were accompanied by Arlon and Linda Petersen who provided a van to carry our luggage. We were taken to our temporary apartment where we rested for a couple of hours and then “toured” Accra.

First impressions of Accra: aggressive drivers, especially at the round abouts, dirt and garbage everywhere, hot and sweaty, lots of people, none of them white, lots of equatorial vegetation, especially palm trees and bougainvilleas, hot and sweaty, big potholes, lots of tro-tros (passenger vans carrying pedestrians), lots of incomplete construction (we’ve seen this in other countries; it seems to be the universal method of building, leaving rebar sticking up out of walls for “next years” addition), goats untended on the sides of the street, hot and sweaty (have I mentioned that?) We had dinner Sunday night with the Stubbs. We were expecting Ghanaian food, but instead had mashed potatoes, gravy, stuffing, carrots, and chicken. How about that? Come halfway around the world and eat an American thanksgiving dinner as our first meal in Africa.

On Monday we went to the Africa West Area complex next to the temple. We met a lot of people, most of whose names I can’t remember. We found the office in which we will be working. I saw an American missionary (my first patient) with three weeks of headache and backache, treated for malaria three weeks ago but still having head/back pain. I spent half an hour trying to decide how to further evaluate and treat him. We then drove to see some of the “medical facilities” in Accra. Ghana has a medical school. The associated hospital is Korle Bu, a facility built by the British during WWI and probably not upgraded/remodeled or even painted since then. Dr. Stubbs took us to various buildings at the hospital, all of which were very worn down. There is one CT scanner at the hospital with good quality films. The one MR scanner is down most of the time. We went to the ENT department to meet the head of the department, Dr. E.D. Kitcher. While walking across his waiting room (no air conditioning, everyone is sweating) I noticed and tried not to stare at a middle age woman with incredible mid face distortion, probably fibrous dysplasia, a young man with a parotid tumor probably 20 cm in size, and an older man with a draining right ear and total facial nerve paralysis. I did not see the boy that Marsha later described to me as having single eye proptosis. Dr. Kitcher was very cordial. (I had been warned ahead of time that the local doctors are always suspicious of the outsider white doctors who show up offering to help.  When I told Dr. Kitcher I would be in Accra for eighteen months he became very  emotional and asked  if I could possibly teach in the department.  What an unexpected response!)  His exam rooms were small, without much equipment other than a head mirror, speculums and tongue blades. He and his associates (?residents) see clinic all days of the week with patients on a walk in basis.  The doctors don’t go home until all patients have either been seen or have left to get home or back to work. At one o’clock in the afternoon I would estimate the waiting room had 40 – 50 patients (probably not all were patients, some were family members.)

On Tuesday we drove 25 km to Tema to the Missionary Training Center. We gave tetanus, meningococcal meningitis, and polio immunizations to 21 missionaries. We also placed TB skin tests. We stopped at the Accra Mall on the way home. Not surprisingly, the mall looks like most all other malls we’ve ever been in. It is fairly modern construction. There are clothing stores selling clothes to probably American/European patrons (you sure don’t see the clothes in the windows on the Ghanaians walking the streets), a general merchandise Target type store, an electronic goods stores, a Nike store, a book store,a  food store, etc. We bought several bags of food in the Shoprite grocery store. Great variety, but steep prices. Marsha bought a small pork roast for approximately $20 American. (The Ghanaian currency is the Cedi which exchanges at $1.00 US for $1.40 Cedi.) We came home and crashed – still getting over jet lag.

On Wednesday we again went to the Area complex in the morning.  We got our ID badges and did some more orientation. We spent the afternoon in the car, again driving around the city looking at important locations such as pharmicies, fruit/vegetable stands, grocery stores, the bank, and a few restaurants (most of these establishments are vague in my mind as to location—there are very few streets marked with signs; I’m told when you are lost if you ask one of the locals he or she will direct you to “go straight”, meaning he/she has no idea of directions or how to solve your predicament.)

On Thursday morning Dr. Stubbs and I went to C&J Hospital to meet the director, Dr. Phillip Amekudzi. The hospital is small but is supposedly one of the best in town. The hospital is a good resource for our missionaries because it is the only one that allows the church to pay after treatment instead of the policy at the other hospitals which require payment to get in and for each item or treatment rendered, such as drugs and meals. Dr. Amekudzi is willing to help us in all medical situations. If he or his associates cannot take care of a missionary they will arrange for someone more qualified to assist. For lunch we went to Champs, not the same as the sports bar in the US. We had Mexican food. Isn’t it great that one can always find Mexican food throughout the world (except in Mexico)? I closed my eyes while eating the enchiladas and I could imagine I was in Boise eating at Chapalas except for the language, which we have been told is Twi, a local dialect spoken by all the natives except when they are addressed in English and then they switch to a semi-intelligible British English. We took the Stubbs to the airport on Thursday night. You do not leave your car while unloading passengers. Locals are standing nearby ready to boot your car. (Enterprising business, they watch you to see if they can get a boot on your car at any time while you are unloading. It requires a bribe to get it off.)

On Friday morning we moved into our permanent apartment. It is probably 900 sq. feet. It has a small kitchen with an oven and a microwave. It has a generous sized living room and balcony (we’re on the third floor) and two small bedrooms with an adjacent bath off each bedroom. The second bedroom is set up as an office. The living room and bedrooms are airconditioned. The kitchen is not. The furnishings are comfortable. We have satellite TV which doesn’t work at the moment and slow internet (dial up speed) which works intermittently. We didn’t have internet in the office all day on Thursday. We were told that it was out for the entire country. I am amazed at how this announcement caused such little annoyance for everyone I met. I guess you get used to such inconveniences. In the afternoon we drove again to the MTC in Tema. We gave second dose immunizations for hepatitis to twenty one missionaries and read TB skin tests from Tuesday. There were five positive who will now go to an X-ray facility and get chest films to make sure they do not have active TB. I had been warned that up to fifty percent of the native missionaries are skin test positive. Fortunately very few demonstrate findings of active TB. All of the missionaries positive on skin test are warned, extensively, about symptoms of activation during their life time. It is unfortunate that they are not offered treatment for latent TB (nine months of INH) but it has been tried in the past and none of the missionaries are compliant with daily treatment. Any of the missionaries with findings of active TB undergo sputum testing and three drug treatment if positive.

On Saturday we drove with another couple from the states to see where the famous Ghanaian batik fabric is dyed. It is quite difficult to describer this facility. It is in a series of outdoor shelters with dirt floors, black from years of smoke, and very greasy. Multiple pots, three feet in diameter, are sitting over open fires heating a mixture of water/oil and wax. It is very smoky. Natural dies are added to the mixture and the artists apply the heated mixture to large bolts of white fabric by hand using big foam blocks which have been carved into patterns. The patterns are all done by sight with no measurements for accuracy. Multiple patterns are done over top of each other. When finished the long bolts of fabric are then placed on beds of rocks on the ground to dry. Once can purchase fabric here at the “factory.” You are escorted to a room at the front of the complex, very small and very dark (no lighting inside) where the fabric is piled in stacks. The selection changes daily. Most of what we saw was primarily brown/yellow/orange/green monochromatic varieties of various repeating geometric designs. Marsha did buy one piece which was a dark purple with a central design of contrasting colors. We then drove about ten miles to two “retail stores” (two of many located around Accra) which are open shanty on the street. We met Esther who owned both stores. She was delightful. She is a large woman who was wearing a dress of the beautiful fabric she displays on her walls. We were her only customers for about the twenty minutes we were at the stores. The variety of fabric was a visual delight. Marsha picked out two pieces of fabric and purchased enough for a dress from each. Esther called her “tailor” who measured Marsha, which consisted of looking at Marsha long enough to remember her build, taking four quick measurements, and then deciding upon the style of dress to make. We bought the two pieces of fabric (Marsha said it was less than half the price it would have been in the states) and left one with Esther for the dress. We will pay for the dress when Esther calls and says it is ready. As we left Esther hugged each of us. We then returned to the apartment and spent the rest of the day trying to organize ourselves and trying to get communication up and running. We could not get the internet to work.  Skype video would not work. We did eventually get  Skype audio with the computer in the kitchen in Boise. We ended up making several phone calls to family. We’ll try Skyping on the internet in the office, which we are told is faster.

Summary of the first week: we’ve made it through it! Many times this past week we have found ourselves looking at each other questioning whether we can do this, but we then contemplate the situation for a moment and quietly nod in agreement we can. We are confident that we will be able to find meaning and fulfillment in our daily lives once we can get beyond the sights/sounds/smells of our surrounding and the inconveniences of living here – having to wash every fruit and vegetable (and eggs) and all the dishes in Clorox, having internet which works sporadically, having to drive with white knuckles, and getting used to the heat – the oppressive, moist heat of the day, and night (it changes very little at night.) What has given us encouragement this first week is the sincere greeting we have received from each of the Ghanaians we have met. They are a loving, kind people.


I doubt that future entries will be this long but I have had a personal need to get this first week into a written record. I am going to attach some photos of the first week.