Musings of a Development Worker

There were eyes in the window. 10 seconds later, a knock on the office door. I called out for the person to come in. Nothing. Eyes reappeared at the window, and I got up from my desk and opened the door. A man I had never seen before, probably in his 50′s, came in to the room. His clothes were loose and torn, covered in red African dirt. His face was unshaven, probably 3 days worth of growth, and lines creased his skin from age and wear. The man immediately dropped to his knees.

“What the hell?!” flashed through my head as I followed suit and got on my knees as well in reaction. The man started talking rapidly in Linkpapa, pulling down the neck of his ragged t-shirt over his left shoulder. The shoulder was oddly shaped, like a bone was jutting out or out-of-place in some way. He continued speaking in Linkpapa, oblivious to my indications that I didn’t understand a word of what he was saying.

But I had understood. “I know what this is” I thought as I quickly searched for a way to delay the inevitable internal dilemma I was going to face in the next few minutes. Pretending I didn’t understand, I convinced the man to get up off the ground and follow me out of the office over to someone who spoke Linkpapa. My mind was racing, and it was like someone had pulled the latch on the dam of mixed emotions that had been simmering for a while, causing them to flood into me while I tried to figure out what I was going to do.

This man wants money. I don’t know him, where did he come from? And he came directly to the office I’m in… it’s because I’m not black.

At that last thought, I immediately felt angry for being targeted and judged because of my color. “This is ridiculous, how can this man hunt me down for help just because I’m a foriegner?! Why do people keep doing this? I just want to be treated like a normal person.” Then I immediately felt guilty and arrogant for my attitude, but still you’ll see I failed to hold it in.

We walked over to one of the women standing outside who works at the office, and she spoke to the man and translated that he had injured his arm last week, and had spent all his money on seeing a doctor. He wanted some money so he can get food.

While she was talking, a small boy about 4 years old (I don’t know if he was with the man or not) latched on to my legs, trying to put his small hand in my pocket. I jerked away slightly, and he persisted, making hand-motions towards his mouth. At this point my heart was bursting with conflict. I decided that this time, I was going to just ask the questions I always kept to myself when asked for things.

The woman translated for me. “Ghana has heath insurance, how come you paid for health care?”

“I went to a private doctor. He took all my money.”

“Even if you get money from me now, you’ll get hungry again tomorrow. Then what will you do?” The man didn’t reply.

Is he even being honest? Again anger, then guilt. This little boy is really making me uncomfortable. Should I pay up? I have a few cedis in my pocket, and all they need is 50 peshwas. Whats in my pocket can probably feed them for a week. How did this man find me? It’s because of the color of my skin. Anger, disappointment with myself for my arrogant reaction, then guilt.

“See, I am wondering why you came to my office. Me directly. It makes me sad if it is because I’m a foreigner. Why are you not asking the other offices for money?” I went ahead and asked the question. The man looked guiltily at me.

Finally sensing my discomfort, the officer worker spoke to the man and told me to go back to my office and work. I walked away, clenching my teeth because I wanted to scream. I shut my office door behind me, and slammed my fist against the wall. I fought back tears of wildfire confusion.

How can I be so heartless? Why am I here, is it not to help people who need it? I eyed the flipchart paper and plans for the databank on my wall. Our plan for “sustainable” change.

How is all this right?

I think I made a mistake. I should have given this man some money. I shouldn’t have asked those questions. Angry at myself, I sat down and reflected. Later that day I wrote my last blog post: Closing the Loop.

—

I reflected on that last blog post. Something was really bothering me. I just couldn’t place my finger on it. But the feeling was there, like the sickly feeling you get in your gut when you know you’ve eaten something your stomach does not appreciate. Was it my tone? The way I framed my message… yeah maybe that’s it.

It’s how I started off talking about adhering to my values. How I spoke about the advocacy campaign, and went on to outline the work I’ve been doing. It’s almost as if I was trying to prove something. To show off. It was like I was saying “this is what accountability looks like,” and that I was doing something new and insightful. I wasn’t even able to properly talk about the things I wanted to. It’s like I was playing to external pressures, putting myself up on a pedestal for everyone to see.

One of the things on the personal development side of things I’ve been trying to work on for the last year is humility. I identified it as something I was lacking. How did I know? It was just a gut feeling. I knew that I was not being as humble as I wanted to, and that it played a huge role in how I interacted with others. It really bothers me. Earlier this summer I defined humility, roughly, to be:

• Keeping a learning attitude. Opening myself up to understanding other peoples’ perspectives, values, and points of view. Being curious.
• Suspending assumptions when interacting with people, and not being quick to judge. Giving respect to others’ knowledge and experience.
• Recognizing and being honest about my mistakes and limitations, especially about my limited experience and knowledge. Allowing myself to be vulnerable by openly communicating these things.
• Something EWB’s Co-CEO once said that resonated with me: “Don’t confuse humility with modesty.” After some thought I concluded that modesty is often just a screen, an easy way to pretend to be humble.

I have been doing a fairly poor job of practicing humility since I came here to Ghana. I’ve been easily frustrated at work when things haven’t gone right. Many times I have felt like I knew better when some procedure was being undertaken that didn’t align with my ideas. I haven’t given people enough of a chance before dismissing them in my ignorance. I’ve often gotten irritated when random people ask me to give them things and make assumptions about me based on my “light skin,” not giving enough weight to the fact that in Northern Ghana it’s culturally more normal to ask for support from others. I’ve been fast at identifying barriers to development, cultural, behavioral and attitudinal, but until now I hadn’t explored “why?” enough and have been seeing them in too much of a negative light.

The above story with the old man in the office embodies some of these things that I haven’t done a good job of. It also is an example of decisions I have made in the moment that are not necessarily the best. I don’t know if what I did was right. I reacted emotionally and in-the-moment, something that happens pretty often when situations spring out of nowhere. Sometimes my actions lead to positive opportunities, sometimes they don’t.

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I have started making more of an effort to really keep a humble attitude. Today was an especially good day, and I’ve decided that I want to have conversations with a different person every day to really understand where they are coming from and what their ideas are. I have started to see links between systemic problems and the factors that create them, less as a result of culture but more as a result of circumstance.

The idea of being humble is crucial to development work. We’re working in another country, another culture. What are we trying to change, and what right to we have to change it? We have to learn and be open to compromise. Ultimately, behavior is often a huge factor in the work, making the debate even trickier. How do you justify trying to change the way someone thinks and acts? But then, without that how can development or change even take place? It’s important to feel empowered, but we also don’t have as much power and influence as we might think. It’s important to recognize that.

I know it’s very possible that I’ll slip up again, but I want to be conscious of it and catch myself. Opportunities and ideas are flowing like an open tap now that I’m 1.5 months into this placement, but time is ticking away threateningly at an even faster pace. Keeping a balance between learning, reflection, action, and innovation is going to become more and more challenging. I’ll keep you posted.

But right now it’s time to sleep. Brain: shutting down.

Closing the Loop

This has been probably the most difficult post for me to write so far. I’ve thought about it everyday for the past week, but just haven’t been able to write. I debated whether or not to even bother; it would be so easy to go on and write about some of the cool experiences and stories I have in mind. But I put my foot down on myself, and said “no, this is important.”

In Canada, many of you know I’ve been involved with EWB’s developing advocacy campaign over the past year (now called the ACT campaign). The premise of this political advocacy has been to push the Canadian government to deliver better foreign aid. Not only more, but better. This means foreign aid that serves poverty reduction, not foreign policy interests. It means foreign aid that is accountable to the poor as well as to the Canadian people, and open to trying new things to see what works. It means foreign aid implementing agencies (ie. CIDA) that reflect and understand the realities on the ground, don’t shy away from complexity, and don’t constantly change their focus.

Well, since I advocate for all these things and more importantly, I value them, it would only be right for me to adhere to them myself. I consider all of you my “donors.” You have supported me or EWB financially, or you’ve invested your time in me, or even just engaged with my blog. You are chapter members who’ve raised funds, friends who’ve helped me work through my thoughts, family who’ve kept me grounded. I need to be accountable to you, and I need you to hold me accountable to the people here in Ghana. So I want to give you an honest, REAL idea of what I’m doing here in Saboba. If it’s right or wrong, good or bad, that all depends on your personal opinion.

When I start thinking about all the stakeholders, the nuances, the detail of the complexity around me, things get really murky; the situation on the ground is a mess, and it makes my head hurt to even think about the interconnectedness of everything I’ve learned. So I stonewall when I try and put it into words. But here is my best go at it.

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Check out my original post outlining my placement: Nuts and Bolts

The Premise:

The six short-term volunteers, including me, are embedded in six districts in the Northern region of Ghana. EWB is partnered with a big Danish development initiative called the Local Service Delivery and Governance Program (LSDGP) that aims to put development in the hands of the district-level of government, rather than the NGOs. They’ve been active for quite a few years now. The core of LSDGP’s strategy is two-pronged: a) to strengthen districts’ leadership, accountability, and ability to provide services (ie. capacity building) and b) to consolidate donor money into a district discretionary fund (DDF), where money (a total of ~60 million USD and rising) is distributed to districts based on their performance (which is evaluated every two years). The criteria used to evaluate districts’ performance right now centers on processes: financial auditing, planning and execution, monitoring and evaluation, leadership and organization. This will slowly evolve, once the districts improve, to measure actual development indicators: medical and water coverage, income levels, etc.

This way, the districts can decide what is best for them, and the key developmental issues can be addressed by the Ghanaian government themselves rather than the hundreds of NGOs operating independently who don’t necessarily understand the problems.

If anything is unclear, feel free to ask me many many questions by commenting. I’ll use my next post to answer them all.

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The Premise II

EWB has been working in governance in Ghana for over 5 years. Our strategy developed from supporting water and sanitation teams, to supporting planning processes at district level governments.

Why? People in rural communities, especially the ones further from the cities, are extremely vulnerable. Low sanitation & little access to clean water –> causes disease –> incomes and livelihoods suffer. Low or inadequate access to education –> less opportunities for work –> livelihoods suffer. There are many such issues, you get the idea.

Our working theory has been that if districts’ government can use evidence and see the importance of tracking information about what’s happening in their communities, they can a) plan projects and activities that tackle the key issues and b) can provide NGOs with information on which communities need what, and direct their services to where they’re most needed.

Even I find it difficult to see the connection sometimes. It’s so difficult to work when you know you will never see how and whose lives you’ve impacted, if at all.

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Let me just lay out some of the challenges

I’m supposed to be working with the District Planning Officer. Saboba doesn’t have one, and hasn’t since the end of last year. The budget officer, also involved with planning, does not exist here in Saboba. Half the office is empty on Fridays and Mondays, as people travel to Tamale to visit their families. In addition, the government & NGOs call officers over to Tamale for workshops and trainings all the time, so you’ll almost always spend 3-4 days trying to get a hold of any one person. People make a lot of commitments: “let’s go to the area council offices tomorrow” “yes lets meet at 3″ “I’ll call you when we’re ready to go.” But people either forget, plans change, or they get called away to Tamale. I plan my time based on people, but get shot down 80% of the time. The frustration is fiery, but now I’m just used to it; doesn’t mean I’ll stop trying.

There are some pretty big ones I’m not listing, because it’s just better if I describe some of the pretty ridiculous situations I’ve been in. Watch out for that in upcoming posts.

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The different government departments (Health, Education, Agriculture) are located in separate buildings up to 1.5 km from the main district office I’m in. Because really no one was engaging with me at the district assembly, I started spending a lot of time with the decentralized departments. Let me tell you, this is where things are HAPPENING. The staff at the departments are working hard, even on Saturdays, to deliver services to the communities. They are under-resourced and stretched thin, but man they care about their job. I’ve been spending time going to different communities with them, to really understand how they work and what the problems are at the grassroots.

—

What I’m doing:

• Building a Centralized Databank: This is my big deliverable for LSDGP and EWB. How can we have a effective planning system when information is… everywhere? There is no place (and no one) who has information on the district! Using my relationships with the departments, I’m gaining an understanding of the key issues faced by the district. I’m building the databank with participation of people in the separate departments as well as the other volunteers over email. I am adopting each section to the data the departments already have and collect. That way, it’ll be easier to use it. The volunteers in the other districts  give feedback as well, and are adopting the databank to their districts.
• Engaging the district leadership: This is critical to the success of anything. The top-down nature of government in Ghana means that if the District Chief and District Director see the importance and value of the work, the chances of success go up. I’m trying my best to build a relationship with them, and give them weekly updates on my work. Also, I really want someone at the assembly whose sole responsibility is data, and who will come with me to all the departments (and continue after I leave) to keep the databank updated. Patience, the person I’m hoping for, is already working with me sporadically but this is not her job. She wants it to be, and the leadership wants her to be working in the planning office; getting it done is another story.

Some of the other volunteers have developed a project monitoring database, that I’ll be implementing with the engineering department in Saboba.

All the trainings, the databases, the work that the six of us are doing, LSDGP will (hopefully) eventually roll out to all 20 Northern Region districts. In time.

What’s next?:

• I want to organize two workshops, co-run by Patience and I, in July and August once the databank is complete. I want to use my relationships with the departments to get officers (and hopefully directors) of each department to attend, and learn how to use the database. To learn how to find the information they need. And MOST IMPORTANTLY, to learn how to make the data visual and easy to understand. How to use data.
• I want to spend July and August visiting the departments constantly, helping them use the database, refining it to their needs, and building up their computer skills.

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Now you see, even if I’m completely successful, all I’ll have done is put another piece in place needed to strengthen district processes. Will it be used? Will it serve the people in the communities? I came here to work against “poverty,” didn’t I? Who am I helping? I don’t know.

This is the nature of the beast. I go home to the village I’m living in, and I continue to see their challenges. I certainly won’t see anyone’s livelihood improve before I leave, and I probably won’t see it at all. It’s not an easy thought. It’s sad, it’s demotivating, and it’s real. I knew that is what I was getting into, but it doesn’t stop me from shedding a tear before bed once in a while. But I’m a small small small part of a process. 20 years from now, I believe that people in Saboba will have better health care and education. 20 years from now, I believe that the district government will function better and the people will be less vulnerable. Will that be attributed to me? HELL NO. Will it be attributed to EWB? Maybe a little bit. But ultimately, it’ll come from within. Change, will come from within Ghana.

But do I still believe in what we’re doing. Yes. Saboba is not an ideal placement, the other volunteers are having more success engaging district officers, but ultimately we’re all just putting those small pieces into place. What’s next?

EWB’s strategy, our next step for Governance in Ghana, it hasn’t been developed yet. The other volunteers and myself will be part of developing that. When things are not going well, I spend a lot of time with different people in Saboba. The more I can really understand the issues, the more I can flesh out the system, the better equipped I’ll be to contribute to the larger strategy. We have many problems, even in our approach; but we have been and are moving in the right direction.

So this placement. This web of craziness. It’s not the end for me. I’m beginning to see more and more, as hard as it is to justify and accept, that this placement is an investment in me. It’s an investment in my future impact. It’s an opportunity for me to sink deep and understand the entire massively fucked up system of NGOs, committed workers, corruption, money, cultural limitations, and the impoverished people who’re left without support. I can already see that my career in development is just beginning. Yes, career. Whether it is in Canada or overseas, I don’t see me turning away from this. Not anymore.

But I think this is enough writing for now.

ASK ME QUESTIONS. BE CRITICAL. DON’T HOLD BACK.

Rural Realities III: The ‘F’ Word

“In Saboba here, people are sending their children to school more and more. It is become a big focus.” Yousif was responding to my question around what people in rural communities are striving for.

It was getting to 10 pm. Yousif and I were half-sitting on our bikes, stopped at the side of the dirt road just outside of Saboba town. The dim glow of the last streetlamp of the town cast long shadows where we stood, and frogs (and other critters) could periodically be seen moving in and out of them. The faint odor of burning wood hung in the humid air from when people had been cooking dinner mere hours ago. I was heading back home, but it was really late. Yousif and I had gotten caught up in a long discussion (since 7 pm) on poverty, Ghana, development, what people in Saboba aspire for themselves, their challenges, business… the list goes on. We disagreed some, we agreed some. Yousif is so far one of the only Ghanaians with whom I’m completely comfortable openly discussing sketchy topics, and probably the closest local friend I have to date.

To give a bit of background, work has continued to be an uphill battle. There are challenges too many to count, and my brain is on overdrive trying to find opportunities to make a difference. Things are moving in a positive direction, though, but by the end of each day I’m exhausted. Anyway, I had spent the day visiting communities with Ghana Health Service; they were administering a community-based program on child malnutrition, focused on reducing infant mortality rates. I’ll talk more about that in my next post. Either way, the day had been long and as always exposure to the villages sent me on a roll thinking about the work EWB is doing, the work I am doing, and who/what we are working for. Regardless, I was in a somber mood by the end of the day when I as-usual stopped by Yousif’s roadside egg-and-bread business to say hi. This is how our discussion had started.

“Why education? What will that do for them?” I probed, voicing a thought that had been on my mind for a while.

“How many days are there in a month? 30. or 31. But there is always an end, okay? Has there ever been a month that hasn’t ended?” Used to the amazing Ghanaian way of explaining things, I played along. “No. It always ends.”

“It always ends. Yes.” Yousif repeated. “Well at the end of the month, okay, you collect your salary. You know that every month you’ll collect it. That is what happens when you have education. Saboba here, we’re a farming community. That is what we do. But what happens if your crops die? That is a man’s income for the year, okay. He doesn’t collect a salary.”

—

Farming. Agriculture. It is the lifeblood of rural communities. Most of the people living in ‘poverty’; 80% in Northern Ghana; they are all farmers. Even if you have a job, you still farm. That is the main livelihood.

I had decided before I came here that I’d spend every Saturday really digging deep into rural livelihoods. It’s fundamental to the people here, it’s fundamental to development in many places in the world, therefore it’s fundamental that anyone wanting to work in development understands it’s realities.

One Saturday my host father Elijah and I went with a couple of guys from town to his groundnut farm. It was just “close” to the house, as in we walked for 45 minutes to get there. Once there, Elijah negotiated with the guys to have them weed his farm for him. They eventually settled on a price of 230,000 (23 new Ghana Cedis ~ $18 CAD) for the one acre of groundnut. In July, just before the rains become heavy, Elijah will harvest his groundnuts.

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“Ey!” My host sister pointed at my hand. She shook her head vigorously, pointed at my hand again, which had stopped mid-way through cracking a groundnut. She picked another one with her hand, and in one swift move demonstrated how it should be done. I mimicked her, and after a few tries my technique improved.

It was around 8 pm, my second night in Saboba. The entire family, including me, was sitting in a circle around a massive bucket of groundnuts. Last year’s harvest. We were cracking them and dropping them on the ground, shells and all. After we were done for the night, the kids swept all the nuts into a bucket again. They would be laid out in the morning, and the wind would blow away the shells. Then they could be roasted, and sold in the market for 10 peshwas (7 cents) per handful.

—

“Amir! Will you accompany to farm?” Last Saturday we trekked to the groundnut farm again, but this time Elijah had acquired 100 small mango trees from World Vision. “I want to plant a mango farm.”

Mangos are a huge cash-crop in Ghana. They sell for up to 70 peshwas each (about 50 cents) which is pretty decent.

“The trees, how did you get them?”

“We wanted Mango trees here, so the village we asked for them.” 10 families in the village had gotten 100 mango trees each from World Vision. I don’t know what program this was part of, but I plan to investigate.

So Elijah and I planted the trees. For each we dug a hole about 2 feet down into the earth, placed a small tree in, and packed the soil in again. The trees had to planted in a grid, about 8 feet apart from each other.

“Won’t this affect your groundnuts?” I asked, since we were planting on the same field.

“No, I won’t grow them after next year. I just plow.” Following a few years of farming crops, the land has to be left fallow, so that the nutrients can replenish.

At one point we came across the collapsed remnants of a burnt tree that had been hit by lightning. I hesitated, uncertain if we should plant a tree right next to it. “Don’t worry,” Elijah reassured me. “It’s dead, Dana will use it to make coal and sell it.” Bewildered, I dug into the earth reeling from the knowledge of yet another income source.

We planted 91 trees that day. Elijah’s mango trees will start to fully fruit in five years. His oldest daughter will be entering senior school next year, followed closely by his second daughter. That money from the mangoes is gonna come in handy.

—

—

I have tried to compile a list of the ways the family makes a living. I’m confident there are many things I don’t know either, but for interest’s sake check this out.

Elijah and Dana’s Income Sources:

• Farming two acres of maize, cleaning it, milling it into powder for T-Zed and selling it at the market or to merchants from Togo who come across the border often.
• Farming two acres of neera. Don’t ask.
• Farming one acre of groundnuts.
• Farming one acre of yams. Then either selling it just like that, or drying and powdering it for T-Zed.
• Making firewood or coal for cooking
• Selling the fully-grown Guinea Fowl, once they hatch kids. Then the cycle repeats.
• Selling cows, similar to the Guinea Fowl. Cattle is the optimum investment here, as you can double your investment when they have calves. If your cattle dies, though, your entire bank account just died.
• Making food (various) and selling it at the market every six days.

Big Expenses:

• Fertilizer, seed, and inputs for farming
• Hiring tractors to plow the fields every year <– expensive
• School fees, textbooks for the kids
• Bread, tea; I think they may be only buying this because I’m living with them.

—

Elijah is an innovator. He is smart, sharp, and dedicated to doing the best for his family. “Think, before you do!” he says. He always has something new on the go, new ways to support his family. Is he living in poverty? Maybe. I don’t know, because I haven’t really figured out what that damned word means yet. But I can say this: Elijah’s story is not uncommon. There are hundreds of thousands of people in Ghana, sub-saharan Africa, and the developing world as a whole who are in the same situation. They are striving to do better, to innovate, to grow. There are risks: floods, fires, drought, disease… all risks out of anyone’s control that can obliterate large percentages of farmers’ incomes. But there is potential by the spades.

“Your kids should look at what you have, and think nothing of it because they can do better. If this happens, you have been successful.” This is how Yousif describes it. I can think of many people in Canada who dream of the same thing.

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I want you to think about something. I want you to think about Elijah the next time you see a sad picture of someone in “poverty” plastered on a donation card or poster. I want you to think of innovation, persistence, and brightness when large NGOs beg for your pity money using shallow images. I want you to think about the smiles and laughter I spoke about in my last post, when presented with a pathetic picture of a “poor” child on TV.

These images of poverty… they are skewed. I can put on ragged clothes and look desperate for a camera. Elijah wears old clothes when he farms; obviously, you don’t want your good clothes to become dirty! Hell, in Canada I looked horrible at the end of the day when I was working as a painter. Does that represent who I am? What I do? No. No it doesn’t.

My Engineers Without Borders colleague in Malawi, Duncan McNicholl, has started a photography project to dismantle this inaccurate and degrading image of “poor countries.” Check it out here:

• Perspectives of Poverty
• Balancing Perspectives

Yes, life is hard for people in Ghana. Yes, public services suck. Yes, people are more vulnerable. But they are not beggars on the street wanting handouts from the “developed world.” Do they have to be, to attract our support? Are we unwilling to help people who are striving to better their lives, rather than drowning in sorrow? Why are NGOs consistently using this disgusting method of imaging? Why does it work?

That’s for you to decide.

Through the Looking Glass

May 29th

It was Saturday. I had spent the morning washing my clothes, followed by weeding the farm with the guys who live in the compound. I spent some time reading, and then went with along with Elijah – my host father – to his groundnut farm to negotiate a weeding deal. I learned tons, more to come on that later. Regardless, it was my first real “day off” in a long time, especially since I had gotten here to Ghana.

It was 4:30 now. The sun was beating down relentlessly, the still air of afternoon fighting the inevitable cool of the evening. I lay on the series of wooden planks outside the family compound, under a thatched shade, where people usually sit. I was writing in my diary, processing the millions of things that were running through my head: what I’d learned in the week, a check-in on my goals coming into this placement, how I was feeling and why…

Children ran around, playing a game where they were selling rocks to each other, pretending it was food, using leaves as money. Periodically, they’d expect me to buy some rocks, and exchange some leaves. I smiled. It was quiet. I was reflecting, restrategizing, and of course sweating buckets.

I walked into the compound, telling my host mother and host sister, Dana and Ana, that I wanted to help them prepare food that day. “Will you teach me?”

“Will you learn?” Like that, we drew up two small wooden benches and we got to it. I knew I would be more of an observer than anything, because even though I know how to cook in Canada the sheer mechanisms are different here. Sure enough, my most valuable contribution was probably airing the coal in the base of the cooking stand, feeding it oxygen so it erupts into a small flame over which the soup bubbled.

We laughed and I got laughed at, a usual occurrence I’ve long gotten used to. We made jokes, half of which got lost in translation either ways. The three-year-old Janet was up to her usual antics, and we all laughed at her dancing with the baby, Jethro. We laughed at my FAILED attempt to stir the T-Zed, the staple maize-based food in Ghana (see picture).

After all was said and done, the food was ready and the sky was darkening as the sun set in the direction of Saboba town. I peered over the compound wall, and saw vast green fields shuddering in the breeze that had finally come. A chill ran through me, not from the temperature but from the gut feeling of the natural beauty that was before me. It was that romantic image of Africa everyone talks about, the one that misses all the details, but yet is just gut-wrenchingly awesome in it’s power. A feeling of content brew in me.

“Why are you smiling?” Dana snapped me out of it, but ever so slightly.

“At home, in Canada, I do the same.” I tried to explain. “I always spend time with my mother, or my aunt, when they are cooking. Just like I am doing now.”

It was true. A nostalgic feeling was cursing through me, and I instantly felt… at peace. I knew this feeling; it was one I had been missing for a long time. It was the feeling… of home.

—

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The Week Before May 29th.

Frustration, worry, and confusion were dominant in my thoughts when I put up the post Echoes and Dust during my second week here in Saboba. I now know it was a product of culture shock, being overwhelmed at the task before me, and the realities of working in development. Things are more on a roll now. Apart from the above, though, the frustrations were also a product of the fact that I wasn’t feeling so good. I had a persistent headache, was constantly tired, and had some digestive issues.

I was sure it was all psychological, and that it was the heat. Regardless, when I was talking to my EWB coach Dan he told me to get checked out at the local clinic in Saboba anyway. I don’t like bothering with doctors, but as the saying goes among us volunteers: “a fart is never just a fart in West Africa.” I agreed to get checked out as a precaution.

—

My friend Yousif and I ventured over to Saboba Medical Center, which is also a hospital. His kid, named Fortunate, was running a high fever, so we all went together. I got my health ID card, got a file made, and spoke to the other people seated in the outdoors waiting area waiting to be seen. There are really a few (maybe 3-5) qualified doctors at the hospital, one of them an enigmatic, rude American ex-pat who I had an argument with. I don’t pick fights with many people, but this woman just pushed me over the edge. And I wasn’t the only one; the entire hospital staff is vary of her, but staffing issues mean they have no choice.

Either way, because it was morning there wasn’t much rush at the clinic. I was seen by an elderly Ghanaian doctor who barely heard what I was saying, but told me to get a blood test and a urine test. I went over to the lab room, and after giving some blood I went around the back of the building give my urine sample. While the technician performed the tests (yup, I was standing right in the lab) we talked about medicine, and his work. He did the test for Malaria: negative. Typhoid: negative. I sighed, these were useless tests. They were only being done because I was a foreigner. They did the litmus test on the urine: all normal. I took the lab results (scribbled on the back of the requisition) to the doctor. He, without listening to me again, gave me a prescription that’ll “take care of all my problems.” It read:

• Ciprofloxacin –> broad-spectrum antibiotic, also used to treat Typhoid. there was no way i was taking this for no good reason.
• Doxycycline –> preventative anti-malarial. ridiculous. a) i didn’t have malaria. b) i am already taking an anti-malarial.
• Potassium –> why the hell would I take potassium?

Needless to say I crushed the prescription as soon as I walked out, and did not buy-in to the ridiculous money-making drug dispensary the doctor wanted me to buy from. I was kind of pissed, because it literally was just a stamped-on carpet-bomb method of medicine! What if I was a patient with something actually seriously wrong?! What if I did not know what those drugs were, which most people walking into that clinic don’t; if you’re not sick with the right thing those drugs are bad for your system!

Yousif and I talked, and he said “we don’t have a choice. We have this, or we have nothing.” He was referring to the medical care, specifically for a Northern Region district. “Who wants to work here?”

He was right. In Ghana there is no incentive for doctors to come work in the rural communities. After medical school, you get placed; but because there is such a shortage most doctors can pretty much dictate where they serve. And why wouldn’t you work in a big city? Tamale, Kumasi, Accra… As a result health care available there is actually pretty decent.

Meanwhile, the people on the outskirts… they are left to fend with completely inadequate medical care.

Yousif told me generally people who get seriously sick will either die, or travel far to get good health care. He said that many times people can’t afford it. He told be about the times surgeries went horribly wrong at Saboba medical center; I won’t go into that.

On my way to Tamale for a meeting last week, I was sitting beside a coworker. Her daughter was puking her guts out with Typhoid. “Are you going to the hospital for your daughter?” I asked

“No, I’m going to Kumasi for a check-up. I have breast cancer.” Kumasi is 400 km from Saboba.

—

Ghana is really pushing to improve. I know development will reach these areas, albeit slowly. Unlike the US, Ghana actually has affordable government health insurance for all their citizens.

But I want to point out some things about Canada:

In Canada, you get paid more for working in a rural area. Your student loan is forgiven if you serve in an under-served community. In Canada, social welfare takes care of the sick. Most mentally ill people are supported, not marginalized and thrown onto the streets. In Canada, an ambulance will come get you in 3 minutes if you’re ill. There will always be doctors at the hospital, and priority will be given to the most grave situations.

We have many problems in Canada; I’m not denying that; but take this moment to really appreciate what we do have. Take this moment to count your fortunes, and be thankful of where we’re living and the systems in place to catch us when we fall.

Rural Realities II: A Day in the Life…

A few months ago.
Toronto, ON.

“8:45 am! SHIT!” For the umpteenth day in a row I was going to miss class. “No, not this time!” rang through my mind as I slapped the snooze button one last time on my alarm that morning, jumped out of bed, and bolted to the washroom to get ready. I sprung on the tap, washed my hands and face, brushed my teeth, and got back to my room to quickly get changed. Grabbing my backpack and locking my room door, I ran down to the kitchen and threw slices of English muffin in the toaster; in the meanwhile I packed the lunch I had made for myself previously, and had stored in the fridge. My muffin popped out, I threw some jam on it, wrapped it in a kitchen towel and put it in my backpack. Out the door, on my bike, ripped down to school. I walked into my Stats class by 9:10.

Present Day.
Saboba, Ghana.

“Cuckkoo! Cuckkoo!” “Qaaannkk!! Qaaannkk!” Roosters. Crows. Laughter from the women working early in the morning. My consciousness surfaces from a light sleep. I bring my watch up to my eyes and hold down the “light” button to be informed it’s 5:15 am. My alarm, set for 5:30, has not gone off yet; I sigh. I’m drenched in sweat. My t-shirt, without which I would be devoured by insects, is soaked through in most places and sticks to my skin as I peel myself off my bed sheet. I duck out of my mosquito net, put on shorts, and walk out of my mud hut.

Everyone else in my host family is already awake. It’s market day today, and my host-mother Dana is sitting with a massive (about 1 m in diameter) metal bowl crushing and mixing powdered yam with maize. The family would sell the mix, fruits of their farming and labor, in the market all day. I seek out water in the basins of an adjacent mud hut, filling half a cup quickly before someone from the family troubles themselves to help me. The water has already been carried from the borehole, about a 10 minute walk away, to the compound by the women of the house before 5 am.

I grab my tooth brush, go out of the compound, and brush my teeth with the water in the cup. It’s already 5:30 am. I need to go to the toilet; I grab toilet paper from my room, and sleepily trudge my way past several compounds and through an acre of fallow farm land. There, in the middle of the field, there is a “toilet” in the form of a concrete slap on a hole, and a reed that surrounds part of it. I stomp on the block to scare away the lizards and salamanders, and settle in among the fleas to do my business.

I walk back to the house, look for soap in my room, grab some water again, and fumble clumsily to wash my hands while pouring water from the cup. 5:50. Now I go for my run; in West Africa, nature will hurt you unless you take care of your body. Guaranteed. I run to the river – the Ghana-Togo border – and back. It’s 6:20. I take a bucket shower, I won’t describe the logistical issues around getting dressed. It’s 6:40. My host mother prepares tea for everyone and eggs for me on hot coals, a process that takes a good 20-30 mins (eggs are not what the family eats for breakfast, they are not accustomed to it; they eat left overs from dinner; but as much as I’ve argued they refuse to let me do the same). It’s now 7:00. I grab my stuff, and my bike, lock my door, and set off for town on the dirt road. The bike wheels are perpetually deflated, and it’s hot so I go slow. I stop in town several times to talk to and chill with people I know, and by the time I get to work it’s just before 8.

—

The contrast is pretty crazy eh? 20 minutes in Canada to 3 hours in Ghana? Granted, I don’t run or shower in the mornings in Canada. But I don’t fetch water or cook in Ghana either. The message is, things here take time. More importantly, they take human power. Our lives in Canada, they are so mechanized. Water is at our fingertips. Our food processing (like Dana was doing) is done in big machines in factories. We have fridges and toasters and light. Here, things wear you down. Many people rest in the middle of the day: it’s simply too hot, the work is laborious, and people work hard. They still have a blast doing it, and enjoy their lives; but it’s still taxing on the body.

—

I ate at my coworker Thomas’s house the night I arrived in Saboba. Apart from his wife and three children, his late brother’s children and other members of the family live with him too.

“In Ghana,” he says, “if your family sends you to school and you start to earn, you are obliged to take care of others in the family.” He tells me how people are quite regularly in and out of his house, and in fact at any given time there are no less than 10 people living in his house. He is also sending his kids to school, and has paid for several of his brothers to go to school as well – he comes from a family of 27 children.

“Ah! You’ve done well!” I say, reeling from the thought. Even when people are successful in making some money, it’s many-a-time spread around to benefit the entire family. This is one of the many factors that contribute to the slowness of economic improvement in Ghana; wealth is diluted. It’s a good thing, it’s an admirable thing, it’s a difficult thing.

“Hmm..” Thomas continues, “education is a risky investment here. You see, even after university the jobs are simply not there for people here. A farmer won’t send his children to school, because then who will work on the farm? And what money will school bring? So sometimes a family will send one child to school, and if he does not make money it’s seen as a wasted investment.”

Thomas explains how he strongly believes rural villagers must understand the importance of education, and send their children to school. After this conversation, though, if I was a farmer struggling to make ends meet I don’t know if I would choose to send my kids to school…