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My trip to Ghana was much better than what I expected – actually it was one of the best times of my life. I spent 2 weeks there with a group of 11 Americans – an ophthalmologist and his wife, two nurses, a retired anesthesiologist, another nurse, a dentist couple, an engineer and 3 college students. The couple who organized the mission has been doing this kind of work for 7 years full time. They went to Haiti, Zambia, Nigeria, China, Cambodia, Rwanda and this was their 6th time in Ghana.
We flew to Accra, the capital, than traveled North at night to a town called Abetifi, which took about 3 hours. A group of Presbyterian ministers greeted us at the airport, and then we had to drive to their house so the exact same people can greet us again, properly. In Ghana people are very formal, there were many welcoming and farewell ceremonies, long introductions, speeches, etc. – but somehow these were still not too boring. Before we left, there was a long prayer so we’d arrive safely – I figured this was instead of safety belts, which they do not have. At 1 pm we arrived to our first lodging, where it was pitch dark, there was no water or electricity and it was pretty cold. (1600m up in the mountains.) I wrapped myself into the curtain as there were no blankets. I started to get worried as I knew that the place we were heading to was going to be at a much poorer area. Next day the Presbyterian ministers served us a huge breakfast and we left to our final destination, Donkorkrom.
This town is on the so-called Afram-plains, isolated from both East and West by Lake Volta. Before a huge dam was built in 1965, there were only shallow rivers, but now it is the largest man-made lake on the world. Afram-plains can be reached only by ferry from either East or West, so it is isolated and therefore a relatively underdeveloped area in Ghana. After crossing the lake, the scenery visibly changed: Instead of concrete and wooden houses we saw mostly adobe houses with grass roofs scattered along the road. After 3 hours drive we arrived to Donkorkrom. It is a large village with very few concrete buildings, only unpaved roads, animals (chicken, goat, dog, sheep) running around everywhere, including the hospital. I was relieved to see that in the rooms the hospital provided us with we had running water (not hot, but the weather was warm anyway), electricity and pretty decent beds. We quickly got used to the ubiquitous and huge cockroaches, mice, spiders, ants, etc in our rooms. The food was excellent, lots of fresh vegetable and fruits – I quickly realized this was not going to be a place to loose weight. Noone got sick from the group, but we drank only bottled water.
Next morning we were told there would be a welcome ceremony and prayer in the hospital-this was not a solemn, boring religious ceremony what I expected but a large band welcomed us with loud music, singing, dancing and clapping. (The prayer was brief and in Twi, one of the local languages.)
Then we started to work. It was basically the same every day: We saw the patients – they were screened before so us, the doctors examined only the very sick ones. Those who needed glasses went straight to the local eye-nurse who distributed them. We brought the glasses too, there is no place to even buy them there. We signed up those patients who needed surgery (mainly cataract-surgery) and then performed the surgeries. (I was alternating with the other doctor daily between clinic and surgery.)
It was my misconception before I started to do this kind of work that all these third-world countries need for eye-care is an ophthalmologist who can perform the surgery to make people see. Actually, surgery is just a small part of the whole operation. First of all to organize the patients – to make sure they know that we are there, to organize their transportation, their stay, lodging, feeding, etc – is extremely difficult and requires several months’ effort before we even get there. Then to make sure we have all the necessary instruments and supplies for the surgery and carry all the stuff there is not too easy either – if we lack even one thing, the surgery cannot be performed. Then to train and organize the nurses and laypeople to help us…. Then the language-problem. In Ghana English is the official language but only educated people speak it, very few of our patients did. There are 70 local languages; our patients spoke 4-5 different ones. The hospital provided 5 translators – local teachers, all of them intelligent, hard-working young men – who worked with us every day and translated whatever was necessary. Not everything got through – we removed one of the eyes of a patient because it was blind and very painful – the next day he said the pain was gone but why was he not able to see?
The whole operation was a team-effort, it would have been impossible to make it work without our helpers from the US and Ghana. We saw nearly 1600 patients and performed 76 surgeries, mainly cataracts. Most people were totally blind before the surgery – there is no ophthalmologist (or any other specialist) nearby. The closest one is about 5 hours away, but it is not free, and most people cannot afford to pay for any kind of eye-care.
The local hospital has about 30 employees, a few clinics and wards, an operating room, a pharmacy and a lab, even an old X-ray machine. It has minimal supplies, but it is surprising how much they can achieve with so little. It has only one doctor, who trained only for a year after med. school before coming here. He takes care of everything; he is an internist, pediatrician, OB/Gyn and surgeon in the same time. (No malpractice issues here!) The most common problems are malaria, typhoid bowel perforation, difficult births/C-sections and induced abortions.
We had some time after work to do other things. One day we visited the local school. Education is free and compulsory till age 15, and most kids go to school. (Except on Thursday as it is market-day.) But there are very few teachers; the average class-size is 40-45. The classrooms are wooden huts with dirt floors, and there are no books to learn from. (They have notebooks and pencils.) We saw 4 classes, but only one of them had a teacher in it, in the rest the kids were “studying” on their own. The instruction is in English, but most children do not speak it very well.
We also visited the local orphanage, which was built from money donated by a chain of Presbyterian Churches in the USA. It was pretty shocking – the babies were laying on the concrete floor in their own excrement– no diapers, as there is no washing machine. There was a horrible smell, not a single toy; the children had no stimulation at all other than being fed. Finally our group gave enough money for them to buy a washing machine – I am not sure if it’ll help, as they also need more caretakers.
We visited a few different churches (Pentecostal, Presbyterian, Catholic– they are definitely much happier places than in the USA or Europe! There is music, dancing, singing, clapping, praying aloud in all of them, they remind me of a disco, not a church!
My most interesting experience was when we visited a local shrine in Abetifi, which is the house of the missionary who brought Christianity to this town at the end of the XIXth century. The chief of the town and 4 “elders” welcomed us and there was a long ceremony and speech about the missionary. Then they showed us the most valuable part of the shrine, a dark room with the local “fetish” (it is a great privilege to see it) – which is a small God, something wrapped in clothes. There were many offerings – oil, sherry, eggs, all kind of foods – in front of it. They said it was the God of the missionary – they mix the local beliefs with Christianity absolutely nonchalantly.
The trip was great in many regards, but the best part of it was to get to know the people of Ghana. They are unbelievably honest, extremely helpful, friendly, natural, gracious and dignified. I did not the feel the resentment at all towards us as “stinking rich white people from America”, which is so common in other 3rd world countries. The young men, our translators we got to know very well. They are all very serious-but friendly in the same time- work and study very hard, do not drink at all (nobody drinks, it was really weird), do not smoke or womanize – very untypical!
A surprising thing is that I started to love this country, the US – which I have had a pretty ambivalent relationship with – much better since my Ghana trip. I think there are not too many other countries where I could afford these missions, considering the time, energy and cost involved.
I hope I’ll be able to return to Ghana next year – it is a big dilemma, I love the place but there are so many other places to go to!