Sunday, August 17, 2014

Middle of the journey - week 2 in Ghana

Hi everyone! So I am back with my second post regarding my stay in Ghana. I got back home to Zurich two days ago but the experience in Ghana affected me so much that I have to continue the blog and capture a bit of what I experienced when I was away.

At the end of the first post, I left you by telling you that Jocelyn and I had come up with two mini-projects and we were able to see them through in the second week. I will focus on the hospital-based project, because that was really eye-opening and rewarding.

We were able to meet  both officers in charge for the family planning departments in two hospitals: Amasaman and Nsawum. I realized that talking to these nurses was a great way to have a glimpse into Ghanian society and beliefs, especially considering contraception and family planning in general. I was also surprised at how open the nurses were with us to share all of the relevant information. We spent a morning in each of the hospitals, which does not sound like a lot of time, but it was enough to give us information of the status of family planning in the surrounding villages. What was interesting and pretty telling was the fact that both hospitals gave us essentially the same information. It was good to have a bit of consistency in the information we found. Here are some of the impressions of what they told us about:

- How the nurses classify those who want to use contraception: One of the first things both hospitals told us about were the different ways to classify women who take contraception. First, you have the "delayers". These are the women who are potentially younger and are focusing on finishing their education or focusing on their careers and want to delay the possibility of having children. The next group are the "spacers". These are women who just want a bit more control on when they have children. They want a bit of a breather before having their next child. And the last group, the "limiters". These women already have upwards of 5, maybe 8 or even 10 children!...and they are looking a way to just limit the number of children they have going forward! I have to admit I was quite entertained by this classification. It makes so much sense and it isn't hard to extrapolate the reasons why family planning becomes so important - especially in a poor community like the villages surrounding Amasaman and Nsawum.

- General beliefs regarding the use of contraception: What was very interesting to learn is that Ghana is still a very male dominated society, and a very, very religious society on top of that. Even when it comes to HIV/AIDS, many people believe that someone who gets HIV/AIDS has a demon spirit within themselves, and cannot be helped. But the fact that Ghanian society is very male-dominated means that many women get contraception in secret. Many of the husbands do not even know that their wives are on contraception. It was interesting to learn that only back in 1992, the Ghanian government made it illegal for a husband to punish his wife for taking control over her body and using contraception if she desired. While it is illegal, many husbands believe that a women only wants to use contraception to be promiscuous outside of the marriage. Both of these hospitals go to great lengths to help women get the contraception they need without their husbands knowing. For this reason, the 3-cycle hormone injections are the most common contraception used. Many women come into the clinic every 3 months for their "refill". The nurses have an intricate system of using post-it notes or small cards with only the date of the next visit...so the paper is easy to hide from unsuspecting husbands...

- Availability and awareness of contraception: What was also incredible to learn is that contraception is available for extremely cheap. For a 3-month injection, the maximum that a woman would have to pay would be the equivalent of 27 cents!! The government actually subsidizes the large portion of the cost of contraception to make it affordable for the local communities. One of the things that these hospitals need help with is spreading the awareness of the availability of different contraception methods and truly dispelling the myths (for example, that using contraception would make a woman barren...). Education and awareness are incredibly important, especially when dealing with health issues. This applies to any health related topic: family planning, sex education, HIV/AIDS, etc.

This is where an NGO can make the difference, and act as the connection between the community and the services offered within the hospital. I would be lying if I told you that I didn't have a light bulb moment when realizing this...as mentioned in my post before, just making this realization and establishing the connection for AFAWI is really going to be the long-term impact that Jocelyn and I made while our time in Ghana.

After meeting with the nurses, I also realized is that work in these poorer communities can sometimes be heartbreaking. I also realized that no matter what, you cannot help everyone. That with limited funds (from an NGO's perspective), you need to make choices, and those choices are never easy. Do you use your funds to help very vulnerable children who need medical attention? Do you put your efforts towards ensuring that the maximum number of children who are healthier have access to education? Do you focus on education and creating awareness and supplying the women with family planning options, so that their existing children have the best chance of survival? Ideally, you would like to help everyone. But the reality is that you cannot. I struggled with this during my second week in Ghana. I don't have an answer to these questions, but I guess you just have to believe that even the smallest steps and even helping one child or family is where it begins and can make a difference.

I have to say that I learned so much in the second week. It may not sound like much but I can say that spending time with these nurses from these two hospitals really helped to broaden my perspectives. I also believe that Jocelyn and I made an impact by connecting the hospital services to the work that AFAWI is doing in the village of Mediah. I realized that the services of the hospital and the work of AFAWI go hand-in-hand, and we had a part in making the connection. That is something that will stay with me. But the reality is also true, that doing work in this part of the world is a long process, often slow, and sometimes you feel like you are trying to move a mountain...without much success, especially success that is not tangible only after 2 weeks. You have to hold onto the hope that your work in the limited time you were able to help would be of use in the future....

Apologies again for the really long post. I think it was important to capture the journey I went on myself. I will post one more post in the next week regarding my stay in Ghana....look out for that one, because that will be the "fun" post where I will try and relive some of the hilarious things Jocelyn and I experienced while traveling through Ghana the last week...a more light-hearted post if you will....

Until next time, ciao!!

Monday, August 4, 2014

Impressions of Ghana - Week 1

Hello to everyone! My blog has been inactive for about 2 years but I thought the experience I was going through now with three weeks in Ghana warranted a revival. This experience is worth documenting. It has been one week since my arrival in Ghana and already it has been a roller coaster of emotions and things that I have experienced, that it is hard to believe that this only happened in one week, and I still have two more weeks here.

So for starters, for those that do not know, my friend Jocelyn and I decided to take 3 weeks of our holiday to do a volunteering trip. We were keen to come to Africa, as that was a place that was unknown to both of us and thought we could make the biggest impact in the shortest amount of time. We started out wanting to go help my friend’s organization in Kimilili, Kenya. But the situation in Kenya worsened as we were finalizing the details of our trip, so another spout of research began to find a suitable substitute. We settled on Ghana without knowing too much about the country. We then decided to work for the Alliance for African Women Initiative (AFAWI). The work on the website seemed really interesting, where they had multiple projects working with vulnerable women and children with HIV/AIDS or establishing microfinancing projects or setting up a clothing cooperative where local clothing could be sold in order to raise money. We thought this was the perfect organization to host us for two weeks…So it was settled…Ghana it was to volunteer with AFAWI.

Honestly, one of the first impressions I had was the sheer lack of information before we actually got here. I know that sounds odd but after our application process where we were accepted into the organization, we didn’t really hear much from any of the other volunteers or program coordinator. All we heard about was how important fundraising was to any NGO or any activity that happens on the ground – and this through one email. We were asked to purchase t-shirts to raise money. I was happy to do so for myself, but I thought I would check out the organization and the work we are doing before I ask my friends and family to buy t-shirts and support this organization. I think that was the smart decision. I didn’t think anything of it until the week before we had to leave when I realized I don’t even know where we are staying and if there was anything special we needed to bring with us. After realizing that the email servers were down for a bit, we finally got the information we needed and were “ready” to go. 

So I guess our journey out here should have been indicative of the roller coaster we would face here….in short, it took us 28 hours to get to Accra from Zurich – a journey that should not have taken more than 12! There was a huge storm in Amsterdam (we were flying ZRH-AMS-ACC) where the airport was shut down for a few hours, so our flight from Zurich was 4 hours delayed! And the worst bit was that our flight to Accra left the minute we finally landed in AMS! And I have never seen AMS so disrupted and seriously such a mess. Luckily my frequent travels gave me some sense of what to do, so instead of waiting in the ridiculous queues, we called the Swiss help desk and got our flights rerouted. We were then booked on the flight to Nairobi and then onto Accra. How ironic that the airport we would fly through would be Nairobi, when Kenya was where we originally wanted to go to! We finally get to Accra and were so excited to be here and make a difference. I think that is so typical of people who go on volunteering trips – this expectation that you will be immediately be able to help and be useful. I think this was our biggest mistake…but more about that later.

In Ghana, everything works on GMT – Ghanian Maybe Time. For those that are Indian, you will understand this because it is very similar to IST – Indian Standard Time. Everything happens in its own time and there is no hurry to get anywhere. The program coordinator told us he would pick us up from the airport, but we had to wait 1.5 hours from him at the airport. That isn’t the bad part. The other thing about Ghanians, the men especially, is that they are super “friendly”. So from the moment we exited the airport we were approached by so many different men who wanted to help us get to our destination. One guy approached us immediately and offered his phone so we could call our program coordinator…and of course he wanted a tip for that. But in the 1.5 hours we were waiting for our program coordinator, we were approached by multiple men, many who wanted to marry us. No need to worry. This is very common for Ghanians to give marriage proposals to all of the Obrunis (which literally translates to “white person”. I guess any non-Ghanian is an Obruni….no matter what technically their skin color may be). 

The drive from Accra to Ofankor (where we were staying) reminded me so much of India. I would even venture to say that parts of India (what I know of Gujarat) are more developed than Accra. As I mentioned earlier, I didn’t know much about this country before coming here. But the dirt roads, the simple stalls for businesses, the traffic, the commotion on the streets, it all seemed so familiar to me. What is striking is that I didn’t see many of the Western restaurant or store chains that would see in India. Of course I didn’t have a chance to explore Accra to the fullest, but I remember thinking that I didn’t see commercialization like you would see in India. Accra, which is the capital of Ghana and therefore the most developed city in the country, seemed quite undeveloped to me. The population of Accra (including its surrounding areas) is around 4 million people. That is a relatively small capital when you compare to the likes of other African capitals like Nairobi or Johannesburg.

We finally arrived to the AFAWI Headquarters. I do not know what I was expecting when I got here but I was not expecting to live in a hostel type of situation. I kid you not, we are living with 4 volunteers to a room (with bunk beds), with a shared shower (with no hot water) and a shared toilet. Of course this is ok, I just did not know what to expect when I got here. There was only one other volunteer here when we got here – everyone was out in the field. What we also did not realize is that our program coordinator runs this organization on his own. He is the only permanent staff; everything is done by volunteers. At first, you do really think, “oh man, this is going to be great. We will have a real chance to get involved and make a difference. And the work of volunteers is that much more valued and appreciated.” Since we were a day late in arriving, our program coordinator was quite keen to sit us down and go through our briefing. We were not even able to shower after 2 days of traveling. We were served lunch and then immediately needed to start working…During our briefing, our program coordinator gave us an overview of the house rules and then walked us through each project. The project we are working on is called ECCACHILD, where we help vulnerable women and children in the community to get the care they need. A lot of the work revolves around HIV/AIDS and sex education in the community. What was so striking is that the lack of education in the community regarding these topics. Of course, as you hear about the situation about these women and children in the community all you want to do is get out there and help in any way you can.

In order to give a full picture of the roller coaster of emotions that we went through when we got here, I have to dedicate some time to the organization itself – how it is run, the things I learned about small NGOs. There is one part of the work we are doing and the other is part of the NGO we are working for. I do believe that these go hand-in-hand at some point, but I also think it highlights the reality of the situation and is definitely worth mentioning because it was such an eye opener for me. As mentioned earlier, AFAWI is a very small organization, that has only one permanent member on staff – our project coordinator (PC). What I immediately realized is that this is more a family-run organization. The brother-in-law is also the IT guy. The younger sister is the one that cooks our lunches and dinners for us. When I say small, I really mean small. When we were going through our briefing, the project coordinator told us that the project we are working on is very sensitive due to the really bad health status of some of the children and women we would be visiting. This organization had identified a list of very vulnerable children and were funding their medical care. Most of these children are orphans and don’t have access to the care they need. This organization essentially uses its funds to make sure these kids can get treated appropriately. He thought it would be difficult for us to develop relationships in such a short amount of time. I do not disagree with him on that point. He told us that he didn’t think that there was much we could contribute in the field for the two weeks we would be here. He continued to talk about the importance of fundraising and that without funds, the work in the communities could not continue. Given what this organization is doing, it is clear that without funds there is only so much you can do.  The PC thought that we should sit in the office and find a way to fundraise for the time we are here. The thing is that we didn’t fly all the way to Accra to sit in an office and come up with a fundraising idea. I could do that from Switzerland – I didn’t need to be here to do that. I wish that the PC had mentioned this to us before we arrived. We would have been able to potentially help some of the other projects where we would have been able to interact with the local communities. The other thing that became very apparent is that the PC did not have a real clue of what was going on in each project. What I realized is that there was a clear lack of project management. That makes things very inefficient and very difficult for new volunteers to jump right in. You have a situation where volunteers come all the way to Accra from all over the world so eager to help, but an organization that is not organized enough to ensure that the human resources available are used to the best of their abilities. The other interesting thing is that most of the volunteers are in their early 20s, most finishing up university or their masters. You do sense a real lack of work experience. I think even if it is an NGO, you need someone leading the ship in the right direction. You need someone who can run the activities of the NGO like any for-profit organization. You need someone who understands project planning and is able to keep control of the activities you are doing. This becomes even more important when the NGO is very small. I think the idea of inviting volunteers from around the world is really amazing. There are so many people who want to help, and this is a great way to do it. But even if they are volunteers, they need to be managed appropriately. So I guess the first impression I had is that the PC had no clue about what was going on and didn’t know how to use the skills that Jocelyn and I bring to the table. We can do so much more than put together a business plan for a fundraising idea. To be honest, we both struggled with this fact. We wanted to do something more meaningful and really get into the community and help first hand. Don’t get me wrong, fundraising is super important. But it is a bit chicken and egg as well. How do we fundraise for something that we have not seen for ourselves? How do we put our weight behind something that we do not even understand what is happening? With a few days out in the field we can see what happens, we can really get behind the cause. I guess our first impression left a sour taste in our mouth. We definitely did not want to be in an office for two weeks! I could have stayed in Switzerland for that and been much more comfortable, that is for sure!! So as you can imagine, we already had our thinking caps on because we knew that we would not sit here for two weeks in front of a computer.

One of the best things about this experience so far has been the other volunteers we have met. As mentioned, most of them are almost 10 years younger than us, but it doesn’t matter. You realize very quickly that when you are experiencing something similar together, you bond in a way that is incredible. We have volunteers from Australia (actually from Mexico), UK, and even another Swiss here. I honestly believe if it wasn’t for the other volunteers, Jocelyn and I would be even more frustrated than we were. Luckily we had people who understood exactly what we were going through and also believed that we should not be sitting in the office in front of a computer. Very quickly the other volunteers recognized that we both have a lot more to offer than just coming up with a business plan for a fundraising idea. What I also realized is that every volunteer experienced the same frustrations with the organization that we did. That there was no clear project plan and that there were a lot of days spent doing nothing. It seems such a waste of valuable resources that are all here to help….

Jocelyn and I definitely had our wheels turning because we were not going to sit in an office for two weeks! So the next day we decided to sit down and talk to our PC and make it clear that we have more to offer and we came to Accra to work in the communities. What you also learn is that if you don’t ask for anything you don’t get anything.  At first, we were given the opportunity to help another project on gathering information on sex education and awareness of HIV/AIDS in the community. Great! We can go out and talk to people and understand their level of education. That is perfect. We did go out Wednesday evening to help with interviews in the field. That was very interesting, and exactly what Jocelyn and I were looking for. Just being able to talk to the people. After that, the PC was at least open to get us in the field either Thursday or Friday where we would be with one of the other volunteers to get information on kids in the community on whether they were in school or not. Cool. Finally we were able to go out and meet people for our project. In the meantime, you do realize that there is a lot of administration work that the organization needs, and they do need help to document the work that is done in the field, create databases, etc. So Thursday was an office day where Jocelyn and I worked on creating a database of all the children that had been interviewed so far. It is amazing how basic Excel skills can come in handy in an organization like this. We didn’t mind spending one day in the office because we knew we would be out in the field on Friday.

Friday was the big day where we were going to be able to go out and meet people and interact with them directly for our project. This was an interesting experience. We were three volunteers with a local translator. We spent 4 hours searching for particular families. We were only able to find one and interview them. And this is when it hit me. That work in these communities is often very slow and very frustrating. It is not like these families living in these vulnerable areas have permanent addresses or are easily found. The point is that they do not have anything to their name…so tracking them down is extremely difficult. And of course none of them speak English. So you need a local translator who is guiding the way. I finally realized how difficult the work is for an NGO in these types of communities. Everything is so slow. Everything is difficult. If it were easy, I guess more people would be able to help in a structured way. I also realized that this work is tiring and frustrating on the side of the volunteers because it becomes harder to see the impact you are making. You really need to stick with it and have patience like you wouldn’t believe. When you realize this, you are able to accept the pace at which things happen, and I started to feel a bit empathy for what AFAWI was going through….

After this experience, Jocelyn and I realized that the way we will be able to make an impact is to come up with our own mini-projects within our overall project. We realized that if we wanted something to happen and our experience to be much more interactive that we would have to come up with an idea and run with it. Because of the lack of the project planning and the pace at which things happened, we also needed to be realistic about our expectations of what we could accomplish in 10 days. After a bit of brainstorming, we came up with two mini-project ideas that we will execute this week. The first. We will do some PR for AFAWI this week by interviewing the local community about what they know about the work that AFAWI is doing and what are their impressions of it. We want to understand what the locals feel about this work. Of course we know the work is important but it can give another perspective when you hear it coming from a local. The second project we will execute this week will be to interview nurses and doctors at two local hospitals to get an assessment of the type of services they offer when it comes to family planning. We want to understand the challenges that the health care system faces in serving these vulnerable populations. For me, this is extremely relevant. This is what I do for a living and this will help me understand how health care is delivered to these populations. I am excited to start these projects this week. In the end, Jocelyn and I realized that in the 10 days that we are here, we are able to help the best by gathering local insights and information so that AFAWI can make better decisions in the future. This is the impact we can have. We need to keep the bigger picture in mind and we need to understand that our contribution will go a long way in the future. Maybe we won’t be here to see the impact, but we know that this will make a difference eventually. Once we settled on these two ideas, we pitched them to the PC with formal proposals, and now we will be working on these two things this week. I think this second week has the chance to really be inspiring and can give us the experience we were looking for.

So our experience here isn’t all work…there is a bit of fun mixed in too! This past weekend all of us (meaning 6 volunteers) made our way to Ada Foah, a village near the Volta lake region. We were invited by some nurses that we work with to come and join the village festival. This was incredible. It was a celebration of the harvest. All of the local tribes came with their village chiefs and performed dances and there was an awesome street parade afterwards. It was really incredible to see. We definitely stood out like sore thumbs but it was well worth it. We then stayed at a hostel type of place near the ocean…was nice to have a bit of a break from the city and enjoy the sounds of the ocean. No matter where you are in the world the sound of the ocean can be so calming. I guess it should be mentioned that since Jocelyn and I are traveling with the other volunteers, most of whom are students, our travel plans are very, very basic. We are definitely back to basics. Traveling with the locals in tro tros (the local bus system). Staying at places where there isn’t really running water or electricity. Trust me, every sense of mine is getting an experience! The smells, the sights, the sounds…everything is a shock to the system. I think it is really good to sometimes remember the basics. It makes you appreciate the things you have back home. And you also realize what little you can do with, which isn’t a bad lesson either.

I should apologize for the long essay of a post. There are so many things I wanted to capture just from our first week here, and I wanted to share all of that with you. Part of the reason for us coming here was to experience all of these things. They don’t mean anything if I cannot share them back with my friends and family. I will definitely have more experiences to share after this week as Jocelyn and I actually execute our mini-projects. I am sure we will have more impressions and ideas to share. I am sure we will have our share of frustrations and light-bulb moments. I will post again next week. Until then, see you soon!


PS – I will post pictures on Facebook once I am back home!