Forgot to Mention

We had 20 of the 26 health volunteers gathered together in the early morning. They were semi-punctual, something to appreciate in a culture that doesn't count minutes, let alone hours. The days lesson was the Heimlich maneuver. We explained that when a person is choking there is a very efficient method to dislodge the object in their throat, then, step by step, with pictures, simple sentences, and Simone pumping her fist into my stomach, we taught. After I finished my mock choke, and she saved my life, I was gently guided down to the ground and rolled over into recovery position.

Everyone clapped.

"Now" Simone said to the translator, "it is their turn to try."

A few men stood up and walked into the center of the circle. One very tall lanky man, Moses, a health volunteer who has bought my heart with weekly batches of sweet papaya, paired up with the littlest guy I have seen in Ghana. The little guy went behind Moses and reached his arms up and around his frame. His hands barely met. I tried to be serious but the group wasn't helping, pointing and laughing and slapping their knees.

Three sets of people were standing up, about to bravely attempt the Heimlich for the first time. They were timid to begin so we prompted them a bit. "You can start."

The men standing erupted into a slow motion, melodramatic, reenactment of a picnic time fiasco. Watching Moses I almost felt I was the chicken bone in his throat. The other two were just as good, heaving and flopping themselves forward, making us all uncertain of what would be their fate in the near future. The uncomfortable hacking sounds of choking, the desperate grabbing and clawing at throats, I began to wonder if some of the health volunteers, had been given a different opportunity, could have excelled in theatre, or movies.

I turned to Simone, and immediately we laughed. "Are they going to stop?"

She shrugged.

"Okay," I said to David, the translator, "tell them to practice what they learned now."

The choking scene gave way into the upchuck scene, which progressed into the object flying out the mouth and the each person, relieved, passing out into the supporters arms. Eventually, all of them ended up resting on their sides, with eyes closed peacefully.

When the session was over, and everyone felt they were competent life savers, we had a brief discussion where the curious (and confused) asked more and more questions. Why can't we stick our fingers down the throat and pull the object out? We heard self-induced vomiting is just as good as the Heimlich, is this true? What do you do if you are choking alone?

The questions are only the first course in a feast of spawned conversation and realizations of cultural differences. When Simone and I shared that generally Westerners don't eat fish bones and wouldn't be able to successfully crack a chicken bone, let alone chew and digest it, they laughed.

"As for we Africans" one of the feistier ones began "we like the bones too much! We crrrrrrack them, mmm, mmm mmm, and eat alllllllll. Delicious!"

"Yes, our teeth are strrrronnng!" He smiled and tapped on his side ones to prove. Ironically, this man was missing his front tooth.

The women watched and shook their heads, laughing at the men's enthusiasm over bones.

"Calcium." Someone said, and they all clicked their tongues in agreement. Then he asked, "If you people don't eat the bones, where do you get your calcium?" We made it simple and said "milk".

The very last comment, muttered by one of the shyer volunteers and translated by David, was this. "Usually when we are choking, we just cough for a short time and then we are fine. That is how we do it here. I don't think we people will want to be using this every time we feel to choke."

I could tell it was an honest expression, that he was conflicted in even speaking up, but that he just needed to share Somehow, in the entirety of our teaching, Simone and I had forgotten to mention this was for EMERGENCIES only, in life and death situations. The group was thinking we were advocating jumping up and running over to a person, gripping them from behind, and thrusting your fist into them every time they didn't swallow well.

When it was properly relayed this was a life saving technique a wave of understanding moved through the crowd.

Yesterday's lesson was on CPR, and it began like this.

"In case of an emergency..."