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!!