Tuesday, 19 February 2013

Akwaaba! (Welcome!) by Rachel Gaudry

Welcome to our blog! Or, in Ghanaian terms, Akwaaba! In the next following weeks we'll be posting a variety of blogs to share our experience in lovely Ghana. Our hope is that through our recounts and reflections you'll also share in a part of the adventure, and hopefully learn some new things, just as we have. Before all of that though, let us give you some background on the country and share a bit of our experience so far!

Ghana is situated on the Gulf of Guinea and bordered by three former French Colonies, Burkina Faso to the North, Cote D'Ivoire to the West, and Togo to the East. There are 10 different regions throughout the country, with Accra being the capital city. With a population just over 24 million people, Ghana's urban centers in the south are densely populated, and continue to grow rapidly.  The northern regions however, are declining in numbers as many individuals migrate towards the south in search of employment. The contrast between the north and south regions in terms of socioeconomic standards and access to health services are concerning, and the subsequent implications are profound. As this is an issue of great importance, more explanation and discussion will be present throughout our following blogs.

Although English is Ghana’s official language, there are huge varieties of dialects and ethnicities scattered throughout the regions. The vast number of tribes gives a Ghana a diverse and rich culture. Following English, Twi (pronounced ch-wee) is the most common spoken language. Our single word attempts at speaking twi to our hosts remain a great source of entertainment for them, as well as a wonderful way for us to connect and build relationships with the Ghanaian locals. One interesting example of Ghanaian culture is the significance they place on Schnapps. As a product of the Dutch, the importance of Schnapps goes back to the colonial era in which this alcoholic beverage was associated with power. Subsequently, it remains a prestigious beverage among Ghanaians, especially the Chiefs. The role of traditional cloth (wax print, fugu, kente) also holds a rather complex and extensive role as the type, color, style are all determined by a variety of customs. For example, to remain in good social standing, both men and women must have a set number of cloth outfits in their wardrobe for various events. In fact, if an individual has not attended an appropriate number of funerals, it is suspected that the individual does not have enough cloths to keep up appearances.

Ghana gained independence from their British colonial power on March 6th, 1957, making them the first independent nation in all of Africa. As a result, Ghanaians take great pride in promoting human rights and politically stability, and are recognized by the international community for their strong peacekeeping role. Kwame Nkrumah, one of the men who negotiated Ghana’s freedom and the country’s first president, is well celebrated and loved by the people. The most recent election occurred this past December with John Mahama gaining office after receiving 50.8% of the vote. With such a close race, an investigation was undertaken to ensure that the results had not been tampered with. Following a rigorous examination, the Supreme Court declared the election fair and the results valid. Many outside observers view Ghana’s adherence to an organized legal system as a display of their democratic maturity.

In 2003, Ghana launched their public healthcare system, the National Health Insurance Scheme (NHIS), as a way of reducing barriers to accessing health services. Even with 15% of their GDP going to health spending, the system remains under-financed and variable in quality. Other challenges the system faces include regulating traditional medicine, staffing shortages, and lack of resources.
Many of the major causes of illness and death are preventable if only there were more access to clean water, immunizations and primary healthcare. Although progress in these areas is slow, there are improvements, and the nurses and doctors work tirelessly to make the most of what is available. From our experiences so far, we have witnessed an unprecedented number of long-standing hypertension cases, accompanied by secondary conditions such as strokes. Other common health problems include malaria, gastroenteritis, hydrocephaly in infants and maternal deaths. After our first two weeks, we’ve noted a number of differences between our two cultures on topics such as patient-healthcare provider interactions and the management of death and dying in the hospital setting. As we rotate through our various clinical placements – medical emergency, trauma/surgical emergency, pediatric emergency, general pediatrics, female obstetrics and gynecology, polyclinics and our week in the village of Apemanim – we will continue to acquaint ourselves with the various similarities and differences between our two countries, and build on the strengths of each.

We hope that you’ll find our blog both educational and enjoyable to read. Our goal for both ourselves’ as individuals and as a group is to take what we’ve experienced in our practicum, and to apply it in a more meaningful and in-depth way. Through critically reflections, we are able to share both our thoughts, as well as challenge others to gain new ideas and knowledge in what it means to be both a nurse, as well as a global-oriented citizen. 

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