community education

Every Tuesday a group of local volunteers meet underneath a big tree right outside the clinic. there are about 20 of them, mostly male. they discuss how to keep the communities informed and educated regarding health issues, then they drink coca cola and relax. i like these people, they're doing good things.

the first week i was here, an incredibly intelligent doctor from Kumasi (one of Ghana's biggest cities) and his wife, a community health educator, pulled up in a shiny truck. they were there to help lead the volunteer meeting and to suggest some itineraries and motivate everyone.

i walked in on the middle of the gathering, and squeezed on a bench between Secetry and a man i did not know yet. i wanted to listen to the doctor. he had an air about him, like royalty.

"Well hello my white lady friend." he stopped the meeting and focused in on me.

that was the last thing i wanted. my desire was to slip in, listen, and go back to the ward.

"Hello." i nodded humbly to him and his wife.

"Please, give us your name and where you are from."

"My name is Akua. I am from America, California to be exact."

Ghanaians use what they refer to as a "day name". Each day of the week has a corresponding name, one feminine, one masculine. Whatever day you are born on, you are given that name. This is tagged on to the many of the other names they receive, but the day name seems to be used quite often.

I think i was born on a Wednesday, so i have the name Akua, except that i am not African. But i didn't care, at that moment i felt like my Akua-self. (pronounced Ah-kwee-uh)

The fact that i introduced myself as this suddenly turned me into a stand-up comedian. I was going for a different sort of impression, more of the 'shy quiet won't look you directly in your eyes type', i wanted to try that out with the doctor.

Secetry immediately broke through and ruined my demure facade.

"Akua Keesssyy!!! AH! You are funny!" he looked around at all the volunteers. "She is a funny girl. Akua! She knows Twi. Speak Twi for us all." Then he slapped me on my back.

With the amount of energy Secetry has it is a good thing he is a small friendly man, he'd be in the way if he wasn't, or hurting people.

"Well, I don't know if-"

"Speak Twi! Speak Twi!" everyone was egging me on. I decided i was going to stick to the role i had originally planned upon.

"maybe later, i just came to listen, thank you."

The doctor looked at me. "Akua Kacie. Please. Give us your mission as to why you are at The Huttel Health Clinic."

I stood up, smoothed my dress, and faced the semicircle of faces which were staring intently at me.

"Good Afternoon. My name, as you now know, is Akua Kacie. You may call me either. I go by both. I am from America and I have come to Ghana to learn from Ma. I am studying midwifery and hope to be of some help to you volunteers also. I will be here for six months and then i plan to return to my home. I'd like to thank you for welcoming me and i look forward to the upcoming work we all will be doing together."

Everyone clapped like i was a famous speaker. i sat down.

Simple and precise. i felt good.

The doctor looked over at me and made a joke. "We should all be proud. The white lady, uh, Akua Kacie that is, has come over from America to learn from us!"

Everyone laughed.

If only they knew how much i do learn from them.

I nodded my head.

"Now" he said "one last very important thing." Everyone was still observing me, and i actually was beginning to feel a little shy.

"Yes Doctor" i said.

He and his wife looked at each other with secretive grins.

"You must tell us, are you married?" he asked.

"No, I am not."

"Well that is just fine! We have a son, our firstborn, about your age." the wife said.

i looked down at the grass and back up at them. i didn't know what to say. i smiled.

"meet with us after the meeting." the wife said. "we can talk."

i spent the rest of the meeting trying to combine their two looks; their faces, body structure, and expressions. i wanted to see if i would be physically interested in their offspring. after a long and thorough examination, i decided i would be. the wife had a smile that curled up towards the sky, sensual and pleasant. the husband was tall and had beautiful skin, the shade of a perfect cup of coffee. they both laughed freely and were smart. i was prepared to meet their son, even if it was only to see if my projections were close.

after the meeting we all walked over to the car.

"Akua, do you have plans for Christmas?" the doctor asked.

I hadn't even realized Christmas was approaching. I told him i didn't.

"Well then, you should come to Kumasi and spend the holiday with us. I will have this man call you to arrange the details." he pointed over his shoulder.

"Okay, that sounds great." i said.

They got in the car, and sped off.

The plans never worked out, mostly because Ma told me it was a bad idea. The doctor had arranged his friend to come and pick me up on a motorcycle Christmas morning, then ride me 1 hour north to Kumasi for the day, only to return later that night.

"You will be tired." Ma said. "They should have invited you for more than one day. Huh. You shouldn't go. You will be tired."

I thought for a bit.

"besides" she continued "have you ever traveled by moto-bike before?"

Memories of haphazardly speeding around Taiwan on scooters with my girlfriends flooded my brain.

"Yes." i said.

I could tell there was a perception shift from the way she looked at me. It was silent, but noticeable.

"well then do as you please." she said, she looked past me out the door.

I decided not to go. When i called the man and asked him if there would be a helmet for me, he made it sound like there was a slight chance he'd forget it, and that if he did it would be no big deal. He didn't sound like the type of person i wanted to be on the back of a motorcycle with, especially here. I cancelled my plans with the doctor, his wife, and their son and called Senam instead.

The volunteer group had planned to take the Holiday season off, and meet the second Tuesday in January. We would start community education on that day, by splitting into groups and visiting the local villages looking for cases of a local disease called Buruli, and referring those people to the Kumasi hospital, to be treated by the Doctor. The Doctor had promised a bicycle to whoever referred 20 cases. Over 40 cases got a motorbike. I was shooting for the motorbike.

Secetry informed me that i was to tag along, and instead of working with Buruli awareness, i was to speak with the communities about personal hygiene.

i agreed.

The Monday before we had planned our outreach i sat in the office and had a little chat with Secetry.

"So, what exactly am i supposed to say?" i asked.

"Oh okay. Well you should inform them about personal hygiene." he said.

"Yes, I realize that. But to what extent and under what parameters."

"Well see, talk to them about how they should keep themselves during pregnancy and how they should care for their bodies. Things like that. Ya." He was extra jumpy.

Maybe i should talk with Ma, I thought.

"Okay, thanks" i said "I'll go and talk with Ma to see if she has any advice."

"That's right. Yeah, good idea."

I walked over to Ma's office, thinking surely the village women know how to wash themselves. Did i need to inform them of the basics, or go deeper? If i needed to go deeper, what would that be? I really had no idea. I was wondering if my friend Mickeys advice would go over well here... "Wash as far as possible, then wash Possible."

I sat down at Ma's desk.

"Ma... tomorrow we are going to the local village and i am supposed to talk about personal hygiene. What should i say?" i was sort of begging for an answer. I knew it was going to come out reluctantly.

"oh well, inform them to keep clean."

This sounded influential. Me walking miles to tell people to KEEP CLEAN!

"what else?" i asked.

"tell me what you have prepared to say."

i hadn't prepared anything, and she knew it.

i shook my hands around letting her know i had nothing to say.

she laughed until she had to let out the familiar deep coughs to catch her breath.

"okay. if you haven't prepared anything then i will have to tell you."

that was precisely why i was sitting there.

"first you need to tell them what they should be carrying with them when they come to deliver."

i pulled out a pen and paper.

"they need 3 cloths, old but clean." she went through the list slowly and repeated everything twice. "they will need 2 dresses for their baby and 2 blankets. tell them to bring a nightgown for after they deliver. they will need to put on something clean. tell them to bring pads if they can afford them."

i kept writing. i was glad she finally cracked.

"you should inform them to clean themselves before they come to the clinic."

my mind flashed back to the last woman who had come. she was gorgeous, and dirty. her legs were dusty and there were little slick lines running down her calves, like she had walked through some sprinklers and let it dry on the way over. i kept looking at her feet, so worked and rough, while she layed there in the birth trance. i thought of America, and the feet i might see there one day. manicured and soft, probably.

"yes, they need to be clean. and when they go home they should bathe themselves and their babies two times a day."

"two times?" i was surprised.

"it is the Ghanaian way, yes, i said two times. it is our custom."

"okay! two times!" i jotted it down and circled it for the dramatic effect. Ma liked that. She knew i would relay that important information.

"Please let them know they should take the drugs after discharge. We will give them medicine to prevent infections. They need to take what we give to them and come back one week, 1 WEEK, after they deliver. Just to make sure their uterus is okay, and the baby's cord is not infected."

I got it all down. "Is that all?"

"Lastly, tell them they should not give themselves enema. Do you know enema?"

She said it like enema was an old friend of mine.

"Yes I know enema." i said.

"Tell them to not do that, rather they must sit on hot water two times daily."

"Okay, i will tell them." i assured her.

"two times daily that is, once in the morning and once in the evening."

She gave her long slow nod, breathed deeply through her nostrils, and then coughed it all out. She patted her hands on the desk a few times and asked me to repeat it to her. I did, quickly and fluently.

"So you are ready. Tomorrow you will go with the volunteers." it was a qualifying statement.

I was a health soldier and i was sent out on a mission, and Ma was commissioning me. my motto: NO ENEMAS! I left her office without saluting, even though i felt i should have.

I went back over to Secetry and we passed the morning hours by him teaching me my list in Twi.

"Ohhhhh! Kessy, you are good! Thank you. Thank you. The people in the village will like you! You speak Twi verrrrrrrrry well."

I returned to Ma's office to show off my new vocabulary. I spent about 5 minutes trying to say everything perfectly, the whole time saying it loud enough so she could hear me over her roaring laughter. Efreeyeh was there too, keeping her lips closed tight, but still letting out just as much enjoyment as Ma.

When i was through i stood and looked at Ma, scanning for approval.

"Ohhhhhhhh" she sighed, recovering. "they will laugh at you too much. You should have Secetry speak the Twi."

I agreed. It was a mouthful for a person only used to a hefty phrase here and a light conversation there. "I think that will be the best way" i said "if they want to understand, that is."

i couldn't imagine in America, taking a foreigner seriously if she was trying to educate me but couldn't stress the correct syllables of Enema. i was looking forward to the upcoming adventure, even if i was laughed at.