I'm Back

Hey All.

I'm back in Ghana. As per tradition, rather than updating via mass email, I will try to occasionally post a few thoughts here. Don't miss the links embedded below...

I'll only be here for the month of January. I am lucky enough to have gotten sponsorship from the new Yale Pediatric Global Health Track to do a quick project at Korle Bu hospital - the major teaching hospital here in the capital, Accra. In addition to spending time on the wards, I'm doing a quick project with the pediatric housestaff to improve access to and familiarity with available electronic medical knowledge resources. Basically, there are a variety of resources, such as electronic journals, databases, and decision support services which are can be obtained for free if you are a practitioner in the developing world. You just need to know how to jump through a few hoops to access them. Luckily, with the help of the Yale Medical Library, I have learned how to jump, and I plan to teach these skills. But more on that some other time.

First, because I believe that appropriate orientation is important for truly understanding your environment, I have put together a little google map with a few of the sites important to my life in Accra. Enjoy.

Here is the textual update.

Living situation:
There aren't a lot of places that rent rooms by the month here. As such I've ended up in a little apartment complex owned by a large Ghanaian woman named Auntie C, and occupied variously by her extended family, and a variety of Obroni. The expats here are an interesting bunch, working variously for the Korean embassy (he's Korean), a carpet business (he's Pakistani), the Goethe Institute (one guess...), a company that runs toll booths (he's also Pakistani), an NGO focused on fostering a transparent democratic process (also German), and their own start-up film-making business (brits). It's a nice little social spot, where not infrequently someone takes it upon themself to cook a big dinner and the crew sits together on the porch for dinner and a chat.

The hospital:
There will be more on this in later posts, so suffice it to say that Korle-Bu is the largest teaching institution in one of the most developed (though still very much developing) countries in West Africa. As such, it is characterized by the contrast between advanced pathology, scarce resources and leapfrogging technology (malnourished children with advanced cancers, payment required prior to lab work, sparse facilities for provider hand hygiene, Wifi access in part of the Pediatric Block, and a broken (but present) hospital MRI machine). As for interesting pathology there is plenty. Have you ever heard of Cancrum Oris? Neither had I. I was in the Emergency Room today -- which is, in fact, a room -- and I was impressed by the rather gory wound on the face of a wholly calm 2 year old. He had lost the majority of the soft tissue overlying his right jaw, with the exception of a twisted, blackened bit of lower lip, which exposed his lower arch of teeth and mandible. My first thought was electrical burn, given the charred appearance of the remaining lip. The resident with whom I was working found this to be a novel idea. It was, in fact, Noma - necrotizing stomatitis, not seen in the US or western Europe since Auschwitz. It was impressive. If you have a strong stomach, consider searching google images for "Noma". As the resident said - 'We see that here.'

Other tidbits:
I have to say -- the experiences that one has walking and running through various corners of the world never fail to entertain. For instance, you might think that I would have remembered past lessons prior to going running down the beach along the southeastern edge of Accra. Alas, I have been reminded.

Something one could never wholly prepare for, however, are the hilarious variety of reactions that one gets as a white man in Africa. Once, jogging down a farmer's path in the humid, hilly and verdant central Ghanaian Ashanti region, I so confused a local woman that she grabbed her small child and sprinted terrified off the path into the forest (I hope she found her way back). At other times, I've run with crowds of merry Tanzanian school children in tow. I've heard many a cat-call , and when my hair is long not infrequently been likened to Jesus. I was even once called Osama bin Laden - I have to assume it had to do with the long beard, although--let's be honest--the beard was bright red and attached to a really white guy.

But regardless, the media-fueled power of racially-based free-association never ceases to amaze, and I have perhaps never been as amused as yesterday when, walking the few blocks home from the local Tro-Tro stop, I heard the unmistakable, half-comical, gritty tone used to yell random things at foreigners, as a Ghanaian man called me:

Chuck Norris.