Accra Map - The airport runways can be seen at the upper right in blue and the clinic is at the far left at letter G. Each square on the map represents about 1/2 mile.
By the time fall quarter had ended at Rose-Hulman, I was looking forward to the trip with great anticipation. Dr. Patsy Brackin agreed to run the EM104 final exam so that I could leave a few days before the end of final exam week. Dr. Brackin also took care of turning in my final grades.
So on Tuesday, November 17, 1999, with the excitement of a great adventure and with the relief that comes with the end of the academic term, I climbed onto a jet in Indianapolis to begin the journey to Ghana. As with most modern air travel, this trip began in the wrong direction with a short trip to Dallas where I boarded a Boeing 767 headed for London. After a short layover in London I arrived in Amsterdam about 11:00 a.m. on Wednesday the 18th where I would spend a day before flying on to Ghana.
On Thursday morning I took a shuttle bus to the airport where I met Tomoko Kobayashi who would also join me for the trip. Tomoko is a Japanese woman who was a student at Indiana State University in Terre Haute and my family served as Tomoko’s host family during her year in the US. This would be Tomoko’s first trip to Africa.
The flight from Amsterdam to Accra aboard a KLM 767 includes a stop in Kano, Nigeria. We weren’t allowed to get off the plane in Kano. Altogether, the flight from Amsterdam to Accra lasts 8 hours and 45 minutes and so at about 7:30 p.m. on the evening of November 19th we arrived at Kotoka International Airport in Accra. Immediately upon exiting the airplane the warm and moist evening air made it clear that we were no longer in Europe or North America. Accra is located about 5 degrees north of the equator, on the prime meridian. Tomoko’s first impression of Accra was that it was hard to breathe.
If you would like to read more about Ghana, or see a map of Ghana, click on this link.
For months I had wondered what would happen as we passed through customs in Holland and in Ghana. We were taking a small amount of equipment and supplies to donate to the clinic. I had no intention to deceive any customs officials and we were bringing items with a very low dollar value for the purpose of donation to a charity and for no personal gain, but I had visions of corrupt customs officials demanding high "taxes" for our microscope etc. It turned out, in fact, that I passed directly through customs with no questions, no forms to fill out and no random inspections.
After we exited through customs, there was a huge crush of people just outside the door of the airport. There were dozens of "extremely helpful" porters all waiting to help carry our baggage. In fact several of the porters didn’t wait to be invited to help. I was fairly firm in suggesting that we did not need help with the baggage.
Just beyond the area with the porters, there were hundreds of people who were all waiting behind barricades for the arriving passengers. There was a lot of shouting and waving and it took us about five minutes to locate George but eventually we did see him. It was wonderful to be back in Africa and to meet my former classmate once again.
George had rented a car and we put the luggage in the trunk and
climbed in for the ride across Accra to the Atsina Charity Medical Clinic,
where George and his family also live. Kotoka Airport is on the east side
of Accra and the clinic is on the west side (see map below) but the distance
is only about 9 miles. About a half hour into the trip I mentioned to George
that if he was a taxi driver, I would think that he was trying to cheat
us by driving around in circles. At one point during the trip, Tomoko asked
George if there was some special event, like a festival, happening to account
for the large number of people on the street. George laughed and told us
that this was the normal number of people on the streets of Accra. A little
further into the trip we passed by a funeral, for which the main road had
been blocked. It took quite some time to detour past the funeral.
Accra Map - The airport runways can be seen at the upper
right in blue and the clinic is at the far left at letter G. Each
square on the map represents about 1/2 mile.
About an hour after we left the airport, we arrived at the Atsina
Charity Medical Clinic. This property, which we rent for approximately
$100 per month, consists of a fenced compound, including a main house,
an out-building, which was in former times the "boys quarters" (servants
quarters), a small guesthouse, a small shop at the front of the property
and the clinic building.
Adjoa
and her apprentice seamstresses
George and his family live in the main house. The building which was formerly used for servants quarters is now used as a sewing school. George’s wife, Adjoa teaches a group of apprentice seamstresses in this building. Adjoa also runs the shop at the front of the house. There are many, many similar shops spread throughout the neighborhoods of Accra. In these shops one can buy drinks, some groceries, cleaning supplies, greeting cards, paper, etc. They are a kind of African convenience store. The guest house is really a large guest room with private toilet and bath. It is an upstairs apartment with an outside entrance. Behind the house is a garden with banana and coconut trees and behind the garden is the clinic building.
The
surrounding neighborhood of the Atsina Charity Medical Clinic
When we arrived at the clinic, Adjoa and George’s adopted 11 year
old daughter, Diann, were there waiting for us. Adjoa served us a glass
of water when we first arrived. It is a Ghanaian custom to offer water
to travelers after a long journey. Later we opened the luggage and I showed
George the microscope, microcentrifuge, glucose meter, needles, syringes,
sponges, computer, camera, . . George was a very happy doctor that evening!
l-r;
Adjoa, Lee and George behind George's desk at the Atsina Charity Medical
Clinic
Friday - November 19, 1999
I woke up around 6:30 a.m. After a good night's sleep in Amsterdam,
I had adjusted to the time zones really well and didn’t feel any significant
jet lag. Adjoa served Tomoko and me a breakfast of onion omelet, bread,
butter, orange juice, and coffee. Later we realized that George almost
never ate – at least we hardly ever saw him eat. Adjoa served us but she
never ate with us. This was a bit strange for us at first, but that is
the Ghanaian custom.
By the time we had finished breakfast, George was already seeing patients. George had told all of his patients that we were coming and that the clinic would be closed for a week during our visit. Despite the fact that the clinic was "closed," when people are sick, they still come. Each morning a group of patients was waiting at George’s front gate and he began seeing them before we had even finished our breakfast.
After breakfast, I sat in with George on one of his consultations. An
elderly woman accompanied by her two sons came to see George. This woman
did not speak English, but the sons could translate. George can speak 11
different languages, but there are about 80 different languages in Ghana,
so he can’t speak them all. George began by asking the woman how old she
was. After some consultation, the reply was, "the oldest son is 60 years
old." It took five or ten minutes of negotiation and everyone settled on
an age of 80 for this woman.
The
"waiting room" at the Atsina Charity Medical Clinic
It is perhaps important to note here that George treats every patient with the same respect that he would treat a wealthy patient. One of the guiding principles of the Atsina Charity Medical Clinic is that poor, sick people deserve the same respect as wealthy, sick people. Another guiding principle is to "listen well." George spends a lot of time with each patient; much more time than might seem necessary or efficient in a health –care delivery system in a more developed country.
After a visit of approximately a half hour, George determined that this woman very likely had a bladder infection that had spread to her kidneys. It was a problem that had developed over about a six-month period with no medical treatment. He wrote the woman a prescription which the sons thought that they might be able to get filled. One of the difficulties we have at the clinic is that George doesn’t really have a lot of medicine to give away. Typically he will diagnose an illness and write a prescription in the hope that the patient can find the money to get the prescription filled. Oftentimes a patient may have some relatives who can help with the purchase of the medicine. George asked the woman to come back in two weeks for a follow-up visit.
After seeing a few patients who had been waiting, Tomoko, George and I piled into the rental car and drove to the American Embassy where we registered as visitors in Accra. It is not a legal requirement to register, but George thought it might be a good idea to let the embassy know that we were in Accra in case of any "difficulties". I was a little surprised that George wanted us to register at the Embassy, and I hoped that he didn’t have any specific worries in mind, but only wanted to register as a precaution.
After leaving the embassy, we drove to the Village of Hope. The Village of Hope is an orphanage for street children of Ghana that is supported through the Church of Christ in the USA. There are several in the Greater Accra Region. Children who have no family and who are often living on the street, are placed in these villages which are modeled on the traditional African family with a mother, father, and perhaps a grandmother and auntie. A married couple might live in one of these homes and serve as parents to 16 Ghanaian orphans.
George had heard about the Village of Hope when the pastor in his church announced that a child had died at the Village of Hope. As time went on, several children had died at these orphanages, so George asked the pastor why the children had died. He found that the children had died from treatable illnesses because the orphanage had no money for health care. They couldn’t afford to take the children to see a doctor.
George volunteered to serve as the health-care provider for three Villages of Hope and since he began seeing these children last spring, no more children have died. Normally, George does not have a car and so he rides several buses and a taxi or two to the Village and finally walks the final miles. It takes about a half-day to reach a Village and another half-day to return home. This means that about three days of George’s time, out of every two weeks are taken up by visiting the Villages of Hope.
On this day, we had a rented car so it only took about two hours to reach the Village of Hope. The trip included some "diversions" which took us through some rather nasty looking puddles and streams. In one case we passed a truck which was stuck in the mud in one of these "diversions." When we reached the orphanage, the children were still at school and the mother, father, grandmother and auntie greeted us. We saw an extremely well organized home with extremely tidy, dormitory style sleeping quarters, running water and electricity. The Village of Hope was very close to the coast and standing not far from the house you could look out to the sea.
We sat under banana trees in the cool shade feeling the ocean breeze
on an extremely warm Ghanaian afternoon. Suddenly, a swarm of children
in tidy school uniforms came noisily down the drive excited to see that
Dr. Atsina had come to visit. The children stood in a group and one by
one they introduced themselves in English. English is the official language
of Ghana, but not the native language of most Ghanaians. It is the language
of all education in Ghana and it was the language that is used at the Village
of Hope.
The
children at the Village of Hope. George is at the back on the left.
Next, after a short consultation the children announced that they wanted to sing a song for their visitors. It was like a scene from the "Sound of Music" as these sixteen African orphans, dressed in school uniforms, reminiscent of the Von Trapp Family Singers, sang a beautiful rendition of "All to Jesus I surrender." It was such a moving experience that sometimes the memory can bring tears to the eyes of a 42 year old, American, engineering professor. Poverty and sickness exists in Africa, but music and laughter exist also.
A
smile at the village of hope.
After the song, George examined several of the children who had complaints
and wrote prescriptions for various rashes and other minor complaints.
He also examined several children as follow-ups to previous treatment.
The children all seemed to be relatively healthy and happy.
Dr.
Atsina examining his patients at the Village of Hope
As we were preparing to leave, George asked the children whether they remembered what he had promised to bring them on his next trip. You could feel the excitement mount when he asked, but the children were a little bit too shy, or perhaps simply self restrained, to shout it out. Finally he pulled out a bag of candy, which he gave to the oldest child (a 16 year old girl) and told her to pass out the candy later that evening. She should give one piece to every child and two to every well behaved child.
On the way back to the ACMC in Accra, we had a drive that seemed to
me, at the time, almost beyond description. We drove once again through
the Ghanaian countryside, back through the diversions, and dirt roads.
We drove with few apparent rules, continuously honking. Sometimes we raced
down two lane paved country roads with little or no shoulder and occasional
cars passing three abreast at speeds near 80 mph. Sometimes in small towns
we saw a total gridlock of cars and people moving at speeds so slow as
to be nearly imperceptible. Cars were bumper to bumper and people were
everywhere reminding one of a cross between the Fourth-of-July on the Mall
in Washington D.C. and rush hour in the Tokyo subway. At one point we saw
an accident that had completely stopped traffic, but we took a detour through
a gas station, jockeying for position with the other cars trying to make
the same detour. Through a mixture of skill and daring, George somehow
managed to get our car through that mess and back on the road to Accra.
Traffic
in a village near Accra.
We returned to the clinic to a delicious dinner of rice and chicken, with spices that I could not quite identify. We also had fresh pineapple, boiled cabbage and pop. We took a nice walk around the neighborhood after dinner and discussed the future of the Atsina Charity Medical Clinic. I told George that it is such a wonderful story that eventually, we will probably see a book and a screenplay. We joked about James Earl Jones playing Komli-Kofi Atsina in the movie.
Saturday, November 20,
1999
Sometime around 4:00 a.m. I woke up to the sounds of a shouting mob.
I am a pretty sound sleeper and I don’t wake up easily, so these noises
that sounded like angry shouting in an unidentified language were somewhat
disturbing. The noise sounded very nearby, as if it were coming from the
street not far from my bedroom window.
I lay in bed, contemplating the situation. Certainly, I thought, George and Adjoa must be able to hear this disturbance and they would come to get me, if something important was happening. I lay there sleepily but somewhat frightened and eventually feel asleep. When I awoke, the neighborhood was quiet and it was another beautiful, clear blue morning in Accra.
At breakfast, we asked Adjoa about the disturbance. At first, she didn’t seem to remember it. Tomoko had also heard it and was also worried. When we described the noise, Adjoa told us that it was a worship service at the neighboring Pentecostal Church! … at 4:00 a.m. on a Saturday morning!
Breakfast included a hot cereal called Tom Brown. Tom Brown is a combination of millet and peanuts and is usual eaten with sugar and milk. It was delicious. We also ate hard-boiled eggs, bread with cheese, juice and coffee.
After breakfast, George and I started up the laptop computer and George began learning to use the computer. George is highly educated, and one of the most intelligent men that I have ever met, but he doesn’t have much computer experience. He finished his doctoral dissertation at Iowa State just a few years before personal computers were in common use. The concept of "point and click" was a bit troublesome. Throughout the coming week, however, George would make tremendous progress in his computer skills.
George’s son, Junior, also came home briefly on Saturday morning. He came home to have a shower since there was temporarily no water at the boarding school where he lived about an hour away.
Although the clinic was officially closed, four more patients came on Saturday morning. Two patients had malaria and one had gonorrhea. George prescribed mefloquine for the malaria cases and gave them free samples of chloraquine. Some malaria is chloraquine resistant so it is not very effective, but mefloquine is very expensive and costs about $10 per pill in the USA.
Julie Fine and I both took mefloquine once a week as a prophylaxis (preventative) during our visit, but Tomoko took a daily dosage of chloraquine. Mefloquine is also a bit controversial because it causes some fairly serious side effects in a very small percentage of patients. Those side effects can include paranoid delusions in a few extreme cases. In any case, I have taken the mefloquine on two different trips and have never suffered side effects. I have also not contracted malaria – thankfully.
For the young man who was diagnosed with gonorrhea, George ordered a lab test to confirm the diagnosis. This means that this young man will need to go to the main teaching hospital in Accra and pay for a lab test. It the diagnosis is confirmed, George will prescribe a medicine to treat the gonorrhea for which the young man will also need to pay. This case is not an emergency, but left untreated the young man will die over the next few years.
In the afternoon, we went to visit the mausoleum where Kwame Nkrumah is buried. Kwame Nkrumah is considered to be the father of independence in Ghana. He was the first President of Ghana after they received independence from the British in 1957. Ghana was the first African country to be ruled by a black African. It was also the first African country to receive its independence from European colonialism.
After leaving the mausoleum, we drove along the ocean. We saw many fishermen and their dugout canoes from which they fished. We also drove to the university at Accra where George taught physiology after he first returned to Ghana.
On the way back to the clinic from the University, we stopped at a second Village of Hope. This time the parents and children were not at home. They had gone to a reunion with the children at the village that we had visited on the previous day.
Dinner on Saturday was a spaghetti like dish with carrots beans and ground beef sauce. We had more boiled cabbage and pineapple. After dinner Tomoko and I took a walk through the streets of Accra around the clinic and bought a couple of drinks for a bit more than $1. Guinness malt tonic is a non-alcoholic, sweet, malt beverage; is imported from Europe and seems to be quite popular in Ghana.
Saturday night I heard no more "rioting," but once during the night there was a sudden cacophony of dogs, chickens, roosters, and birds that was so loud and sudden that it woke me up briefly (for less than a minute or so).
Sunday, November 21, 1999
Sunday breakfast consisted of tomato omelet, bread, cheese, oatmeal,
juice and coffee. More patients arrived on Sunday morning. Normally the
clinic is closed on Sunday but some patients who tried to come on Saturday,
returned on Sunday morning and George "couldn’t" turn them away.
Since we knew that we would be making the trip to the airport to pick up Julie Fine in the evening, we didn’t do much on Sunday. Around 7:00 p.m. we began the 1 hour trip to drive the 10 miles or so to the airport. It’s not really possible to go inside the Accra airport to meet an arriving passenger so we waited in a crowd of people outside the airport for about 45 minutes waiting for Julie to arrive. She did arrive safely of course and we were truly glad to see her when she emerged from the airport.
We returned to the clinic around 10:00 p.m. to a supper of a thick chicken vegetable soup and we sat up and talked past midnight. George told many stories about his life, a number of which I had not heard previously.
George also told a story from his school days in Accra, when he had no place to go during the breaks. A classmate invited George to store his belongings, at his house, but the classmate's mother would not agree to letting George stay at the home during the break. Happy to have a place to store his belongings, George roamed the streets of Accra, sleeping in the shade by day and walking the streets at night. George considered it to be too dangerous to sleep in the open during the night.
George and Adjoa met when George was in high school in Accra. Adjoa
came from an educated family. Her father was a physician's assistant who
assisted a foreign doctor from the West Indies. Adjoa’s parents didn’t
like George much. Eventually they fell in love, but in the meantime, George
had left Ghana to study at the university in Hamburg. Adjoa made plans
to study French, in Paris, and told her parents that she wanted to do that.
Instead, she went to Hamburg and married George! Many years later, Adjoa’s
parents learned to love George like a son and George and Adjoa’s father
eventually became very close.
George
and Adjoa
When Komli-Kofi Atsina arrived in Hamburg to begin studies at the university, he began by studying German. He was able to pass the German proficiency test after only six months in Hamburg so he began to study physics.
George also had become quite enamored of his ability to find jobs and make money in Germany. He often went to the student union, where a job board was located. On that job board, a person might advertise that they would like to hire a college student for two hours to move some furniture on a certain day. George told me that he was amazed, "They actually paid me MONEY for things I would happily do for free, and they sometimes even gave me something to EAT!" The money became more and more appealing and eventually George found a job unloading ships at the harbor, and his studies began to slide. The money seemed so wonderful – money, money, money!
Finally, one day George found himself working THREE shifts at the harbor, unloading bone meal. By the third shift George was completely white, covered from head to toe by this fine white dust. He had also neglected to put on the mask that he was given, to prevent him from inhaling the powdered bone. Sometime during the third shift, George collapsed and woke up in a Hamburg hospital three days later.
During this three-day period, Adjoa, who had now joined George in Hamburg, had no idea where her husband was, or what had happened to him. Eventually, the Hamburg police helped Adjoa to track down George who recovered after a week in the hospital. After a week in the hospital, George had learned a valuable lesson that would stick with him the rest of his life. All the money that he had made and all that he had saved was completely used up by his stay in the hospital! George decided that it was time to get serious about his college education.
He was too embarrassed to return to the physics department at Hamburg, so George enrolled in Mechanical Engineering. Some years later George would become the first foreigner to earn the mechanical engineering degree from the University of Hamburg in the standard five years that it took the German students.
George told these stories beyond midnight and I think we might still
be there listening if Adjoa had not insisted that George stop, so that
Julie, who had just arrived on the African continent a few hours earlier,
could get some sleep.
The
clinic guestroom where Julie and Tomoko slept.
Monday, November 22, 1999
On Monday we got up and ate breakfast, as had become our custom. Breakfast
on this day would consist of hard-boiled eggs, a corn porridge with a slightly
sour flavor, fresh bread, cheese, coffee and juice.
George had several patients waiting on Monday morning. Once again, he had explained that the clinic was closed during this week, but still the patients came and waited patiently. One patient on this morning was a small three-year-old girl brought by her parents from about one hundred kilometers away. They had begun their journey about 5 a.m. that day. The little girl was diagnosed with malnutrition. These are problematic cases for which George can educate the parents, but it is a difficult case to treat if the parents do not have money for a proper diet. Proteins (meat, cheese, and eggs for example) are expensive and many poor people in Ghana suffer from malnutrition.
We also hooked up the new printer that Julie had brought. I had been pretty concerned about whether we would have the correct drivers for the printer and I had downloaded them from the internet before leaving for Africa. It turned out that the driver disks and the printer all worked flawlessly.
Close to noon we left for the town of Cape Coast where we learned more about the history of Ghana at the Cape Coast Castle. Portuguese explorers built the castle in the 15th century around Columbus’ time. It was captured and occupied by several European countries and finally by the British. It was used as a trading outpost for gold, ivory, cocoa, and slaves.
Later, during the 18th and 19th centuries, the castle became primarily a storehouse for slaves. It was their last stop in Ghana before departing for the "New World." Slaves were confined in two large underground dungeons. The dungeons were dank, unlighted rooms and the slaves were forced to live under inhuman conditions for up to a month before they were loaded onto a ship. We learned that approximately 30% of these slaves went to the United States and others went to Caribbean countries and to South America.
On our return trip from Cape Coast to Accra, we drove through a huge thunderstorm. The defroster did not work on our rental car and the windows fogged up pretty badly. George rolled down his window to help defog the windows, while Julie wiped the windshield with a rag. Sitting in the back seat with the driver's widow open, was pretty similar to sitting in the shower. Just when I thought I couldn’t get much wetter, rain began pouring in through the leaky sunroof. The roads were also pretty badly flooded in spots, so we were relieved when the rain ceased after about twenty minutes.
Back in Accra, we had African cuisine at dinner on Monday evening. We ate plantains, a spinach and fish casserole in a yellowish sauce, pineapple and orange juice.
After dinner on Monday George, Adjoa and their three visitors took a walk around the neighborhood near the clinic. George and I talked about tropical disease in Ghana. Malaria and typhoid are the two most common diseases that George sees. He sees patients with these maladies nearly every day. According to Dr. Han Willems, a Dutch friend who is the Director of Research for the TNO-PG (Applied Scientific Research - Prevention and Health) in Holland and who has worked as a physician in Africa, typhoid is less common but it may be endemic in the area where George lives. This means that it may exist within the population of a certain region at a higher rate than one might normally expect.
Left untreated, both malaria and typhoid are normally fatal. Malaria can be treated successfully with mefloquine (brand name Lariam) but it is expensive (and can also cause some fairly serious side effects in a very small percentage of the people who take it). George normally gives his malarial patients a free injection of chloraquine, a different, far cheaper, and less effective treatment and writes them a prescription for mefloquine (the pills are about $10 each). Chloraquine is more like 10 cents a dose and it causes far less serious side effects, but some malaria is chloraquine resistant.
Cholera is also deadly, kills quickly and is highly contagious. The patient dies from dehydration. With treatment and rehydration, patients can recover fairly quickly.
AIDS is a serious problem in Ghana and George normally refers these patients to the Kumasi Teaching Hospital where he received his medical training. Since there is no routine testing for AIDS, George wouldn't usually see an AIDS patient until that patient has the full-blown disease. At that point, George can't do much for him/her. He has only seen a few AIDS patients this year.
Tuesday, November 23, 1999
For breakfast we had "Tom Brown," tomatoes, meatballs (ground beef
with onions), bread, butter, jam and coffee. Perhaps not what many
Americans eat for breakfast each morning, but delicious nonetheless.
After breakfast, I took my hand-held GPS outside and turned it on for the first time. For fans of geography, who might be interested in such trivia, the Atsina Charity Medical Clinic is located at 5 degrees 33 minutes N latitude and 0 degrees 16 minutes W longitude. That means it is almost directly on the prime meridian (directly south of Greenwich, England) and just a bit north of the equator. Furthermore, it is located 5,814 miles from Terre Haute, Indiana (as the crow flies - an extremely vigorous crow capable of flying long distances) at a heading of 136 degrees (i.e. southeast, 90 degree being east and 180 being south).
While I was playing with the GPS, Tomoko and Julie were visiting with George and helping him to learn some of the basics of using the spreadsheet on his new computer.
On Tuesday, we decided to make a trip into Accra to buy souvenirs.
We first checked the exchange rate. George had brought along enough
cedis to purchase all of our souvenirs and then we were able to reimburse
him in dollars later. The rate was about 3400 cedis = 1 dollar.
We first made a trip to the "Multistore" where we bought postcards and
a map of Accra. Then we took a trip to the post office where
we bought stamps. The cost of mailing a postcard to the US from Ghana
is 550 cedis or approximately 15 cents.
The
streets of Accra
After leaving the post office we walked to a craft center, a large outdoor complex where vendors sitting under tents sold an assortment of mostly hand-made goods. You can read further about this market at the following link:
According to this link by interKnowledge Corp, "Accra is an excellent place to meet locals and buy native Ghanaian art and craftwork, especially at the Arts Centre. Visitors here can find practically anything: sculptures, game-skin drums, exotic beads, and superb examples of the colorfully expressive Kente cloth. The Makola Market, also abundant in goods and bargains, is a fine place to experience a true West African bazaar."
We spent hours bargaining for souvenirs, with George doing most of the bargaining and complaining that he had to pay "tourist" prices since it was obvious to everyone that we were not Ghanaians. I had the feeling that it might have been easier to make the things we purchased than it was to buy them! Tomoko, Julie and I would have happily paid more, but George bargained, and bargained and bargained to save us a few dollars. He mostly wore them down, but he definitely wore me down as well.
After an afternoon of shopping we returned to the clinic and had a delicious dinner consisting of rice balls in peanut soup with fish and mutton. We also ate watermelon for dessert. George had more patients waiting to see him after dinner. He had two patients in the morning who were followups from an earlier visit. They were elderly people with pneumonia.
Wednesday, November 24,
1999
Omelets with tomato and onion were on the menu for breakfast on another
warm Ghanaian morning. We also ate bread, cheese, grits and papaya.
Coffee, butter and jam completed the breakfast. I always enjoyed
the breakfasts which Adjoa prepared for us.
George told more stories about his background on Wednesday morning. As a baby, George had been abandoned by his mother and lived initially with his father. In later years he would be raised by other villagers. As a baby, his father had tied him to the back of a bicycle each day, rode off to work and laid the baby in the field where he worked. At the end of the day, George's father would tie him to the back of the bicycle once again and peddle home.
George told us how, as a child, he had begged door-to-door at Christmas. As George told this story, one had the impression that it was a rather positive experience for him, and for the other children who begged door to door. He received generous hand-outs and food was plentiful for several days. He also claims that in more recent years, handing out money, rather than food, has become more common.
We talked a bit about George's eating habits. We had rarely seen him eat during the week that we visited. I think he sat down to a meal with us only once or twice and didn't eat much. During his life, George has never been in the habit of eating three meals a day. Normally he will eat once a day, occasionally he doesn't eat at all during a single day. He told me that even when he was a student, living in Ames, Iowa, he didn't eat three meals a day.
On Wednesday morning George had more patients waiting for him. For example, three of his patients included a woman with bone cancer, a man who is an alcoholic, and a man with TMJ syndrome (temporo-mandibular joint syndrome).
In the afternoon, we took a drive through the Ghanaian countryside and
passed through and by a number of villages. Some of the villages
were extremely primitive, with no nearby source of clean water. The
villages usually consisted of a grouping of mud huts with thatched roofs.
Sometime the villages contained buildings with sheet metal roofs.
Typical
village in the Ghanian coumtryside
We revisited the second Village of Hope, which we had visited on the
previous Saturday when nobody had been at home. This time we were
greeted by a huge crowd of children, along with the mother. We had
a pleasant, but relatively short visit. Since our visit had been
unannounced, I believe George was concerned that we may have surprised
the mother who had not had sufficient opportunity to prepare her sixteen
children for visitors. As we were leaving, the mother presented us
with a large bunch of plantains that had been grown at the Village of Hope.
After returning to the clinic, our Wednesday dinner was African cuisine once again. We ate a white-colored potato-like yam, eggplant and fish in a reddish-brown sauce, watermelon and juice. After dinner George saw several more patients in the evening before we took our routine walk around the neighborhood. On this evening I asked George about the wildlife in Ghana. Upon inquiry I found that a number of snakes exist in Ghana including the black cobra and the boa constrictor. Other wildlife which is present in Ghana sounded fairly similar to the wildlife in Tanzania, which includes baboon, antelope, buffalo, crocodile, monkey, warthog, lions, elephants, giraffes, waterbuck, hippopotamus, zebra, . . .
Thursday, November 25, 1999
Thursday would be my final day in Ghana before heading back to the
US. We arose to another wonderful breakfast of corn porridge, sausage,
bread, watermelon butter and jam. As usual George was already seeing
patients by the time Tomoko, Julie and I got out of bed and had breakfast.
When the last patient had gone, we sat in the cool shade in the waiting
area outside of George's office and discussed the future of the Atsina
Charity Medical Clinic. This discussion continued into the afternoon
and I was able to put down on paper a general outline of our vision for
the clinic. That vision is detailed below.
As the afternoon came to a close, we ate one last meal at the ACMC before George drove Tomoko and me to the airport. (Julie would stay another day and leave on Friday evening). For our final meal we ate plantain fritters, chicken and tomato stew over rice, pineapple, ice cream and cokes. After this wonderful meal was finished, George saw a few more patients and finally had to send away the rest of his patients and ask them to return the following day, so we could leave for the airport.
I flew back to America after spending a day in Amsterdam and after a
short visit with my friends, the Willems, in The Hague. Tomoko flew
to London and Julie would spend another day in Accra before flying all
the way back to the USA in one long trip. The images of Ghana and of the
Atsina Charity Medical Clinic are very strong in my mind. The images
are sometimes wonderful; the singing children at the Village of Hope or
George telling stories of his past long into the night. Sometimes
the images are terrible; a young couple who brought their young daughter
to the clinic who was slowly dying of malnutrition or the mental images
of slaves being warehoused in the Cape Coast castle. I have memories
of a warm and humid equatorial climate coupled with memories of a cold
and rainy day in Amsterdam. I remember some unexciting hours spent
reading and relaxing at the clinic and some terribly exciting moments driving
on the Ghanaian highways. I suppose it was more than I could really
take in over such a short period of time. I'm looking forward to
going back.
George
at the airport.
The mission of the Atsina Charity Medical Clinic is clear -- to provide medical care to the poor and destitute of Ghana.
George operates the mission based on a few important Guiding Principles --
The clinic is a Christian mission.The vision-
At the clinic George treats poor people the same way he would treat rich people.
He treats everyone with respect.
He listens well.
George asks patients to pay based on their ability to pay. (There are some difficulties included with this principle).
In the relatively near future, we see the possibility of hiring one or more nurses so that George can get some help in handling the patient load. This is perhaps our highest-priority short term goal.
I can also imagine sending American medical students to Ghana for a "rotation" during which they work at the clinic for three to six months learning about tropical medicine and lending a hand at the clinic. I have already spoken with two medical students who are interested.
Eventually, I hope we can hire an additional doctor or doctors. Perhaps it will be possible to begin a fellowship program and put another doctor through medical school. We have done it once for $70 per month (for approximately six years). Perhaps others will also want to follow this model and put an additional doctor in the clinic.
Our vision of the future of the ACMC is a clinic with improved laboratory facilities. A clinic that is well supplied with some of the lower cost medicines.
Our vision of the future is a clinic which continues to provide medical care to the Villages of Hope. In as little as fifteen years it is not inconceivable that we would see our first Village of Hope "alumnus" finishing medical school and returning to help out at the Atsina Charity Medical Clinic!
I suppose that the ACMC web page will never be finished,
but this is pretty much the end of the description of my 1999 Thanksgiving
visit to Accra. If you have questions or comments, don't hesitate
to send me an e-mail:
Lee.Waite@rose-Hulman.edu
Return to the
ACMC web page.
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This page was last updated on December 22, 1999
Copyright 1999, Atsina Charity Medical Clinic Inc.