I'm writing this from Accra airport, just before I board a flight to Nairobi. I've said goodbye to the friends I've made over the past couple of weeks and I'm ready to start the second leg of my adventure. Ghana has amused, enraged, amazed, disgusted, mesmerised and baffled me. I arrived here with no expectations which was definitely the sensible thing to do. In some ways this is a surprisingly developed country; but it is almost medieval in many others.
I still struggle to comprehend that the average Ghanaian doesn't have hot water, but does have a touchscreen smartphone. People are happy to buy uncovered meat from a bowl balanced on top of someone's head who's walking alongside an open sewer, but would be appalled by blemished clothing. I've seen thousands of vehicles (most have been broadly road-worthy, but some I've been in were most definitely not) driving on mud roads littered with rubble: in the UK these would be 'dirt tracks'. Ghana feels like a country where all the ingredients are there to fully develop, but there is something stopping that from happening. I've not spent long enough in the country to have an opinion on if it's an issue of governance, motivation, religion or simple contentment, but few Ghanaians I met were troubled by this.
Christianity plays a huge role in this country, complete with all the contradictions and hypocrisy religion brings. As I've written before, businesses everywhere allude to Christianity (my most recent favourite being the 'God Is Love Chop House'). The attitude of 'God works in mysterious ways' is embedded in healthcare, and the mindset of there being a higher power in ultimate control is reflected in road safety. (On the way to the airport our minibus came within inches of being in a multi-vehicle pileup; my tolerance of crap driving has increased since being here, but I thought I was going to die. That's 4 out of my 9 lives spent!) I've seen hospital staff judge unmarried and/or very young mothers, but not consider the part of the Bible which tells them to help these same people. I'm not sure exactly which part of the Bible this is, I've never read it, but I think that's meant to be the overarching theme...?
Possibly the strangest thing to bother me in Ghana has been the nation's approach to their environment. For a country which relies on natural resources for the majority of it's income (cocoa, gold, fruit, tourism) it's incredible how neglected the environment is. Whilst I'm no member of Greenpeace, I care a lot about recycling and sustainability. Within my first couple of days I asked how I could recycle the bottles and cans I'd been drinking from; there was no recycling bin in the house, and no-one could tell me where I could find a public point. Frankly, most people seemed confused by the question. I'm not sure there's any public service to remove household waste, either. I couldn't say for sure where this ends up, but personal observation makes me assume it's probably at the side of a road. There is also a large degree of aspiration to the West; not re-using things is seen as a sign of affluence.
As for my experience as a midwife living in Ghana... it's been a totally mixed bag. I got used to the basic way of living quite quickly: living without hot water and 3G didn't bother me. I can't pretend the perpetual lateness and disorganisation didn't annoy me, but you just learn to expect it. Initially I felt vulnerable in public as an extremely white person in a society which has received little migration, but once I acknowledged that people were only pointing and shouting "ABRUNI!!!" at me because white people are rare in Western Ghana it stepped down from 'intimidating' to 'irritating'. I've done things I never thought I would do: hitchhiking (tro-tros), walking through a jungle, meeting the chief of a rural village and stroking crocodiles - all have been great fun.
I struggled a lot more at work, and I'm still not sure I could explain the rationale for many (most?) of the things which happen inside Ghanaian hospitals. Hospitals were far better resourced than I was expecting, but donations from well-meaning benefactors arrive without instruction or training, and are therefore almost useless. It was the deficit in care and compassion which shocked me the most, and I don't think that will change for a long time, simply because the staff I encountered were amused rather than intrigued by our notions of patient respect, dignity, choice - and even consent.
Overall it's been a great trip, although not one I'd repeat in Ghana, and not one I could have completed if I didn't have a house of likeminded frustrated medics to return to for evening de-briefs. I believe improvement in healthcare is possible, but it has to come from within the country: Western technology and practices will only be utilised once medics in Ghana understand, and appreciate, evidence based rationales for adopting them. It was a once in a lifetime trip (and it will definitely be just the once!) made far better by the Work the World staff and other students. I've met a great bunch of people, made some great memories, and ticked a few things on my bucket list.
Ghana, you've amazed me in ways I didn't think were possible,
Love Emily x
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