Meet the housemates

Sounds like a line from 'Big Brother' but there are certain similarities: random bunch of people taken out of their usual habitat and living in each other's pockets for an extended period of time. The results are generally worth a mention. So, who are they?

Ali is Canadian, from Toronto, arrived at the same time as me and stayed 3 weeks. She is 27 and works in Human resources for a food company. She makes the snappiest decisions ever and can end up spending quite a bit of money in the process. Sometimes she regrets the decision almost immediately but never stews over it. Ali loves children and worked in an orphanage while she was here. She would have adopted all the local kids if she could.

Becky also started the programme at the same time. She is American, from somewhere near New York. She is 19, between semesters at university and had to put in some effort to convince her mum it was safe to come over here. I bet her dad didn't make flippant lion jokes!

Rebecca is Canadian, also from Toronto and was my room mate for my first 3 weeks until she left. She didn't snore, or at least I couldn't hear her over the noise of the fan. She is 18 and about to go to university to study political science. She had lots of pairs of flip flops, all of which broke in one day leaving her stranded in various interesting places. She looks great with braids, African style, and I have some fairly wild hair pictures from when they came out.

Emma is 26, originally from Wigan but defected across the pond to California some years ago. She got bitten regularly by the resident beasties and responds by swelling up impressively. Emma worked at a school while she was here.

Kristina is a critical care nurse back home in Boston and is working in the emergency care ward in Hohoe Hospital. She is totally appalled by their lack of hygiene or sense of urgency. She has taken it upon herself to teach the nurses the basics of emergency medicine and has rallied various members of the homebase to go and give blood since there wasn't any to save lives with. Should we tell our cook most people were turned away due to low iron levels?

Robin is from New Jersey, she is studying special education at university and is working in a school for learning disabilities in Hohoe. The kids, most of whom need 1:1 attention are in a class of 30 with one teacher. Robin sometimes plays scrabble with me but has been known to try playing 'words' like 'e-i-e-i-o' so needs to be watched.

Tim is 19, from Ottawa and has just been accepted into Toronto university to study economics. He is friends with nearly all the locals and knows all the short cuts into town and all the best places to go out. He has had the most exciting multicoloured hoodies made during his stay here.

Rik has also mastered the wearing of exciting hoodies. And bargaining for large and interesting souvenirs. He is 20, from California and hoping to set up his own business. He daydreams about the possibility of creating miniature animals and ponders the genetic implications of such a thing. I wonder whether his malaria pills are adversely affecting him.

Julianna is from Massachusetts and is studying nursing. She is actually working at two different placements - one in the labour ward at the hospital and one at an orphanage 'happy kids'. She is currently trying to 'renovate' or at least clean the kids rooms in her spare time - quite an exhausting task as I discovered at the weekend.

Marcella is 30 something, from Glasgow but would live in Ghana were it not for the temperature. She works in finance but is here working at an orphanage and teaching. She extended her stay for 2 weeks because she couldn't bear to leave the kids and is currently dreading the prospect of leaving Hohoe next week. It has been nice to have a friendly scottish accent around - even if it is from the west.

Brenda is also 30 something and is Canadian. She is a pig farmer and often uses her experiences as ammunition to bring the conversation downwards at mealtimes, possibly to ensure we don't all eat too much. She has the most exciting sleeve like tattoo on her arm and plans on getting another to match.

In true Big Brother style, housemates are evicted (well hopefully not, but they finish their programmes and leave anyway, albeit very reluctantly). and others are introduced - on a monthly basis. So, wait until next week for the sequel.....

see photos

Atoto bibi!

This is the most commonly used Ewe phrase in the homebase. It means 'pineapple is delicious' and alludes to the almost never-ending supply of fresh pineapple that is laid out for us - and really is delicious. As is nearly everything that we are served. Our diet, you might have picked up, is a little unvaried but probably one of the most healthy and balanced I have eaten for ages.

The lunch and dinner menu (there is no distinction) consists of:
Beans - nearly always
Chicken - nearly always, sometimes substituted with beef or grasscutter (a large rodent) all of which I have eaten without asking too many questions (the level of shock you experience may depend on how well you know me).
Fried plantain = often
Yams or potatoes - often
Pasta - occasionally
Rice - usually
pineapple - always
Watermelon - sometimes
Apples - never :o(

This last ingredient is possibly the only thing I miss - I have not seen an apple in Hohoe yet, although we did stock up on our way through Accra last weekend.

So there is an exhaustive list of what we eat. It is of course possible to buy other safe (packaged and tinned) food and even sweets if you look hard, which I do. There are no large food stores locally but there are market type stalls and small grocery shops - packed from floor to ceiling with an assortment of convenience food. One of these stores is called 'affordable', ironic considering that while prices in Ghana are normally very low, here you can pay the equivalent of twice as much as you would pay at home for a few familiar groceries.

On the whole, Ghanaian food is something to be wary of, mainly due to its preparation. The regular sickness is understandable when you see food sitting in the sun all day or the meat, a distinctly rotten looking kind of blue, waiting to be added to the grill. The food at the homebase can be entirely trusted (John has to be the most vigilant cook going) but we are advised not to eat out unless a restaurant has a good track record. The safest option is probably vegetarian (if cooked) - more rice and beans then!

Orientation

"Go right out of here and over the raised stones, past the huts on your left and across the open space. The Geduld (hotel) is on your left then take the path towards the back of the houses and out by the water pump. Turn left onto the main road - pass the bank and sewing shop then turn off onto the mud track opposite the banana stall and round the trees where the goats were the other day. Stay to the left of the washing lines and go straight until you get to Miss Ghana . Take the main road on your left and keep going until you see it"

This apparently is how you get to the market! I should explain a few terms:
'straight on' usually means winding your way (not straight) between small huts and shacks where there are lots of options for 'straight on' and 'left' and 'right' are almost never firmly left or right. Landmarks are often quite camouflaged into the surrounding landscape and can easily be mistaken for a similar looking 'hut' or 'pile of stones'. Landmarks may also be mobile and can therefore not be trusted to be where you left them (there's a fairy tale in there somewhere) and missing one may leave you wandering around in the heat for some time. Thankfully the Ghanaians are a friendly bunch and will usually put you back on the right road, if not personally walk you to your destination (which may be some distance away).

Miss Ghana is the exception to the ambiguous landmark rule - she is a large gold statue standing at the junction of 3 main roads in Hohoe. The main roads are actually reasonably straight and recognizable as main roads despite being dirt tracks. They were resurfaced soon after I arrived - this did not leave a nasty tar smell or newly painted white lines, it just meant that huge piles of extra mud kept appearing on the roads like magic (totally destroying my main road landmarks) before being eventually rolled down onto the road and presenting the local kids with a great skiing opportunity in the meantime. It left us creeping along the sides of the road for a while, risking our cleanliness with the chance of falling into the gutter, in order to avoid getting stuck (literally) in the middle of the road.

Paving does not exist at all in Hohoe so anything big or fast moving will leave you spluttering your way through a cloud of dust: it's not at all great for contact lenses. Maps also do not exist, and neither do road names - I would love to see what a modern GPS system would make of it.

Physiotherapy in Ghana

I have procrastinated (yeah yeah I know..) in writing this post. I am nervous about portraying inaccurately or with bias, a hospital, department or health service that I don't fully understand. However I am writing to document and share my experience and here it is.

Like any service, physiotherapy is dictated by the needs of those it serves and by the resources that are available to it, and the physiotherapy department here (3 physiotherapists and a secretary) is meeting the needs of it's community in the best way it knows how to. However the staff are aware that this falls far short of what is really needed and a 'postcode lottery' doesn't even begin to describe the barriers to decent health care that many people face. Physiotherapy is only one example but in terms of accessibility and equality of provision it is probably fairly representative of most health care services.

Referrals are received from the hospital and local clinics. Patients may present to a doctor soon after an injury or onset of symptoms, or it could be days or weeks later. This is true for major traumas (such as open fractures or partial amputations) as for minor ones. The doctor may refer for physio or they may not. They often are not aware of what physiotherapy could offer, not a problem unique to Africa. The physiotherapy department itself does not have a waiting list: all patients are seen within a week of referral. This would be a fantastic situation at home - here however it simply reflects the gross under use of a department which is unable to reach the people that need its services.

The patients that are referred to physiotherapy present with many conditions common to us: a lot of stroke patients for example, though usually months or years down the line when neurological recovery is most unlikely and they are dealing with the effects of previous poor management. They also have children from a local special needs school come to use the facilities for exercise. The school has no name other than 'school for the mentally retarded and handicapped' ! Many of these kids also have a physical disability - the two I have seen both had a hemiplegia but I have no idea about the others as none of them had databases, problem lists or goals. Or notes in fact.

There are also a lot of patients with musculoskeletal problems: arthritic joint pain, neck or low back pain - as we see at home. The causes and aggravating factors vary a bit though. You probably wouldn't see on an assessment at home: "patient reports pain when carrying water on her head". Most of the patients are outpatients, although (according to the book at least) there are between 1 and 6 patients a month treated as inpatients.

The actual treatments are, on the whole, aimed at symptomatic relief and the conditions usually are chronic - many patients are not referred until a long time after initial onset of symptoms. Commonly used treatment modalities are heat treatments and massage, gait and stair practice, carried out routinely (reassessment is less frequent than I am used to), many patients attending twice a week. Active exercises are also given - usually using pulleys and the gym equipment available. Only 60% of the population are literate and many don't speak English so my prowess in stick men diagrams which require no explanation is being pushed to the limit.

Function is addressed but often the physical and functional requirements of a task are not really broken down so compensatory mechanisms are practised until they become established. As it was put on my recent Bobath course "if you take something away, you have to give something back": these patients unfortunately are often struggling fruitlessly to obey a command which is impossible for them.

The problem for many people is distance - they may be required to travel long distances to attend physiotherapy and there is no alternative - physiotherapy is not offered in local centres and there is no community outreach. People who are fortunate enough to have wheelchairs at home usually do not bring them into the department as they have no means to transport them - they tend to be carried in from the taxi. The proportion of non ambulant patients is small - I imagine we just don't see the majority.

Facilities and staffing obviously present difficulties: ferrules on the whole are worn through, wheelchair brakes don't work, there are no specialist seating systems, standing frames, splints or basic materials. However the biggest need in this community is probably education. People don't understand their own health conditions, they don't know when to seek help or where to go; even within hospitals emrergencies are not treated with urgency and preventable morbidity (and mortality) is not prevented. Socially, a physical disability in childhood is seen as a curse on the family and usually the child is kept hidden away in the home. Last week an 8 year old girl, who is unable to sit or stand independently, was brought into the department - nobody in her community knew she existed and she was not known previously to the health service.

The Ghanian physios are lovely to work with: they are happy to answer my questions and ask for my advice and input. It is still a difficult line to tread though, being a volunteer and working within your own profession where decisions are made very differently and where sometimes you do not agree with the choice of treatment. I am given a lot of freedom to treat patients as I wish but I am mindful that my way of doing things will not necessarily transfer practically to another culture. Not would it be accepted easily or quickly. As we are all reminded on beginning the programme, I am not here to change the world, only to share experiences and promote understanding and respect across cultures.

Internetting

The world today is an amazing place. In a town that often has no running water and where many of the houses lack roofs or walls and washing machines are unheard of, you can still walk 20 minutes down the road and login to find out what the rest of the world is up to. It is one of the few activities I can do here that is at all familiar - even sleeping, showering and laundry having taken on new meanings (I have never before had such neatly ironed underwear or spent so much time at the well).

You do need plenty of time however: my own internet connection at home invariably doesn't work as fast as I'd like it to but here it is not uncommon to wait 30 minutes for a page to load (or not load at all). Best to go armed with a book. Emmason, the internet place, is a room with over 20 computers in it and a small office. It is very cheap - about 1 Ghana Cedi (approx 60p) for an hour, but you don't achieve much in that time.

If you do get onto your chosen site, typing becomes the next challenge: the keys are usually sticky and do not always produce the expected effect. They frequently swap places with other keys and this week my apostrophe disappeared completely. I had not appreciated how handicapped you can be without an apostrophe!

There are a couple of fans on the ceiling which cover quite a few of the work stations but if it is not working or you are at the wrong computer you just have to sweat it out. There really is considerable dedication required!

Most excited to find free internet available last weekend at our hotel in Lake Volta I hoped to catch up on a few e mails without having to watch my money as well as my time slip into the cybervoid. However, after maybe an hour of enduring the small electric shocks that jumped from the computer when you got too close to it, several episodes of shutting itself down when the plug was jiggled too much and waiting at least twice as long as you do at Emmason even, my enthusiasm was waning.

The weekend in Cape coast was more fruitful internet wise -there was a cafe next door to our hotel which advertised fast internet. I went on Saturday morning to enquire about opening times.
"we open at 2pm"
"great, and what time are you open until?"
"we are open 24 hours"
!
It was indeed open late though and my scepticism was unwarranted - it was excitingly speedy: every page loaded within a minute and the only hiccup was a solitary power cut!

Trip to Cape Coast

"Are you taking the tro tro?" Akos asks. "You should take the van"
I explain that the equivalent of 100 pounds each for a taxi for the weekend was a bit steep so we had decided to rough it instead (and tro tro is the ultimate in roughing it transport wise). Sounding increasingly worried she reminds me that 11 people died in the tro tro last weekend on the road that we are about to take. And that this wasn't an isolated incident. Having deliberated at length about it previously we were reluctant to rethink our financial priorities and change our plans, but much as I like Ghana, I would like to keep my chances of returning to Edinburgh as high as possible. I was not alone so, wallets feeling decidedly lighter, we stayed in our spacious air conditioned van (we had accompanied Emma, who was leaving, as far as the airport in Accra) and as we crawled through the traffic, were already starting to feel the benefits.

Unfortunately the van doesn't do anything to make the traffic any better and it took us a good 2 hours to get out of Accra and on the road towards Cape Coast. Had we chosen to we could have used the time to do a spot of shopping: people walk up and down between the rows of traffic selling food and drink, clothing and even shoes out of the boxes on their heads. They seemed to get most of their custom from the tro tros which don't stop for comfort or refreshment breaks, but we also had a lot of people approaching our windows. Mostly we just smiled and waved at them, unhelpfully buying nothing.

The van doesn't make the roads any better either. It may be that its suspension is better than that of the tro tros (which I have yet to travel on) but it still has some monster potholes and speed bumps to contend with. In fact (and you may empathise or snigger depending on who you are) if you are female and planning on travelling in Ghana any time soon, I would recommend a decent sports bra! And possibly a helmet.

We eventually arrived at our hotel late in the evening - about 9 hours after leaving Hohoe. It was basic but clean enough (just) though worryingly the large fan hanging over the beds, when switched on, appeared to be about to swing itself violently off the ceiling. I am also not sure that the loose and exposed cables hanging out above the shower would pass their safety check back home. The following morning, as we walked along the small street outside our hotel, we met some of the locals, one of whom was wielding some large knives and looked about three years old!

We started the day with a canopy walk and a short stroll through the rainforest, and spent the rest of the day (amidst numerous classes of schoolchildren and other tourists with the same itinerary) learning about Ghana's participation in the slave trade at Elmina and Cape Coast castles. We also attempted to explore the local surrounds though this wasn't easy as we were accosted frequently by people attempting to sell us things we didn't want or demanding money for one cause or another. The smell of fish and the heat were quite overpowering in Elmina and it was a relief to retreat to the van.

Back in Cape Coast we stopped for dinner and took a walk along the beach to work up an appetite first (I'm fairly sure it did not serve this purpose). The first hundred metres or so of beach contained a few budget hotels and some boats (the touristy bit!) and was followed by a stretch about the same distance which would have looked idyllic (sun, sea, palm trees etc), had it not been absolutely strewn with rubbish and screaming of the poverty that is typical of the area. It was inhabited it seemed by a family of pigs wandering freely in the sand and foraging amongst the waste.

The children on the beach mostly swimming in their underwear, though some swimming fully clothed or wearing nothing at all, came running over to talk to us or demand we take their photo. It was around this point that the sea pounced and we spent the rest of the evening soaking wet. And smelling of fish - yuk!

Sunday was spent en route back to Hohoe. We drove through the university before heading back - it seemed a bit out of place with its manicured lawns, smart buildings and smartly dressed students on their way to the on- campus church. Anyway, we arrived back in Accra a few hours later where we went to the market and spent more money than we had intended to. It is a very un- british way of shopping: you find yourself literally chased or dragged into the various stalls (unless you run fast in the other direction) by people overly anxious to rip off the tourists, who they will not accept are not loaded with spare cash.

"Just come and look at my shop...I want to show you something..."
"No thank you" I repeat firmly. 'Looking' is turning out to be expensive.
"Not to buy, just look....it is free...I give you a good price...I want to give you something to remember you by..."

There must be some kind of inter- stall etiquette since whilst you are looking at one, you seem to be relatively safe from other attacks, but once you leave you are immediately pursued again. I became more accomplished at bargaining as time went on: the trick I learned is to not care too much about the thing you bargain for and be prepared to walk away. Also to start with as ridiculously low an offer as they start ridiculously high. Not foolproof though: I fought hard for some material to what was a fairly good price and then found the guy shortchanged me in quantity. The hazards of being a white tourist :o(

We also stopped at the shopping mall which felt a bit more like what we are used to - especially when we wandered up to visit the cinema and food complex. Until, that is, the electricity failed and everything shut down. That wouldn't happen at home!

Where's my camera?!

Sound familiar? It might if you have ever been on holiday with me. We took a trip to Likpe caves today (skiving work into the bargain) but as I carefully put aside the things that I wanted to take with me, I found that my camera had walked off. I decided that my current housemates were unlikely to have hidden it from me so I proceeded to search - everywhere. This included the toilet, shower, washing line and freezer. Though I am not particularly prone to using my camera in any of these places, you do start to question your own sanity after a while. So I joined the others in the van at 7am, feeling slightly disgruntled, amidst many helpful offers of alternative cameras and suggestions as to where I could have left it.

The trip was great - it was a moderate walk up a mountain (thankfully mostly shaded) and lots of scrambling in and out of caves (one of which was full of bats, totally deterring Ali from going anywhere near it). It was right up my street and I could have climbed around the caves all day. It even came complete with rope swings and trees to climb. It could have been hard work had it not been done at Ghana speed (the guide was very concerned that he did not go too fast for us. Which he really didn't!).

We arrived back just in time for lunch - chicken and beans and pineapple. Oh and the camera? I found it in an altogether sensible place, right on my shelf where I left it :o)

Weekend at Lake Volta

Six of us took a trip this weekend to Lake Volta. We hired a van (with air conditioning - whoop) and drove west for a couple of hours in monsoon like rain through a load of small towns and villages. All the potholes (and there were many) filled up to provide us with very exciting swampy driving conditions and though I took a book I found that the scenery on the whole was much more entertaining.

The accommodation of the settlements varied from mud huts with roofs of hay and leaves, tin and corrugated iron buildings, wooden houses or small stone one room buildings. Occasionally we passed bigger and more expensive looking houses interspersed with long stretches of green land. We frequently spotted smoke and flames in the woodland which definitely did not look like deliberate or controlled bonfires.

We arrived after about 2 hours at our hotel which was so luxurious after a week in Hohoe. It came complete with swimming pool, lake (obviously) and crocodiles. Yes, really crocodiles - though thankfully not in the lake or swimming pool. And monkeys, snakes, parrots and other unidentifiable animal species. I'm not quite sure what the purpose was in keeping them - they were barely on display and nobody was charged for seeing them. The animal's accommodation, it has to be said, was not great and not allocated particularly fairly either: there were 2 monkey cages, one was fairly big and had many monkeys with lots for them to do while the other one was a small bare cage with a solitary monkey in it. The naughty cage perhaps: he certainly didn't look too impressed with this arrangement.

We spent the weekend mostly sitting around the hotel and pool. Quite a challenge for me in fact. I went out for a walk around the lake which is enormous for a man made effort. It wasn't really very successful as I couldn't get near the lake without trampling through peoples' back yards and it was unnerving to have people stopping me to request my photo every few minutes simply for the colour of my skin. Feeling a bit like a tourist attraction I retreated to the hotel where we took a short boat ride around the lake. All the locals living at the edge came out to wave at us or were already there washing or bathing in the lake. They didn't seem to mind the regular intrusion of tourists on their doorstep.

Lake Volta is a fascinating place to be if you are not afraid of bugs or lizards. Everywhere you go you see tails disappearing into bushes or feet scuttling along the walls or ceilings. There are tiny green and brown lizards, including one residential in our bathroom, and much larger colourful (red, blue and yellow) ones. Definitely one of the highlights and compensation for the stifling heat, but despite much perseverance I never did manage to convince one to stay still so I could watch it close up or take its photo. It is a close thing in terms of amusement value - to watch the lizards or to watch Ali as she spots one, jumping out of her skin or leaping out of her chair. She may have found it a long weekend.

Meal times have also proven quite amusing. The menu for a start is hilarious - here are some examples:
'midnight hunted snail chosen for your motionless in charming garlic sauce'
'grilled fish conceived in terbanut sauce'
'chicken thighs with jealously hocked on a skewer'
'chicken ripped in strickey bacon ona town of paprika roasted potato'
'napolitan sauce fine march to panne'
'fried egg worshipped with flame grilled black peppercorn'
'a forest of bacon rained in brown sauce'
'or the classic bangers and mush!

Definitely a few things lost in translation.

Ordering the food is the next challenge: I adventurously ask for one of the Ghanian dishes.
"that is out of stock"
I try again with another dish
"that is out of stock"
Plan C: do you have......
"No we don't have that"
I order a plate of vegetables.

I am not the only one having trouble. Ali, following her previous encounters with the food has opted for chips but is still struggling with the ketchup which just isn't Heinz. Emma picks all the visible chillies off the top of her pasta but has to request a box to take away all but a few mouthfuls, while Rebecca valiantly conquers her vegetarian pasta dish, picking out the bacon and getting through 2 litres of water to take out the sting. Becky's meal seems ok today but all the bugs flying around have given her the air of somebody suffering with tourettes. All most entertaining.

It's off to work I go

I'm going to talk shop for a bit so you may switch off if you wish but I have been asked what it is I am actually doing out here. Last Tuesday I began my 6 week placement in Hohoe hospital, which has 600 beds (can't confirm how many of these are actually in a ward) and 3 doctors (!), and where I am scheduled to work in the mornings, Monday to Friday. Officially it is on an observational basis but unofficially who knows?

First I met with John, the hospital director who informed me that considering my interests and background, I would be based for the 1st 4 weeks in the physiotherapy department, for the 5th week in the emergency ward (A+E I think that means) and for the last week in the children's ward. So, a good start I thought. Then I was given a brief tour of the children's ward and A+E before being introduced and deposited in the physiotherapy department.

Physiotherapy, by all accounts, is the nicest and best equipped department in the hospital. It has a large gym area with a couple of treatment beds, parallel bars and weights machines, exercise bikes and stepper. It also has a separate area with cubicles and some electrotherapy equipment and a large waiting area. Much better in many ways than I expected. And there are even fans to keep the temperature down.

The department suffers from the same problem as everywhere else however - transient running water. I eventually discovered some soap (shampoo!) in the kitchen but it took me longer to track down the water - collected in buckets - to wash with. Might need to modify my finely tuned and practised hand washing technique then.

The beds (plinths) are nicely presented with a sheet, the purpose of which is lost on me. Normally as I understand it, a sheet protects a bed so that it can be used by more than one person as only the sheet needs changing in between. The thing is that while these beds are properly wipeable, the sheet is not. And is changed only once a week.

The hierarchy within the hospital runs with the doctor at the top and the patient quite firmly at the bottom. This appears to be the case in the physiotherapy department also to a degree. I was shown around the department on my first day where there were patients being treated in most of the cubicles - in varying degrees of undress. We wandered in and out of the cubicles and for once I was disappointed (and embarrassed) to find that my anonymity, to the patients at least, remained intact. It was also the first time I have known a physiotherapist show less than the usual basic courtesy to a fellow human being. Almost as schools are run here (kids are regularly disciplined by way of the cane), obedience and conformity are attained (by one therapist, certainly not all of them) through fear. Patients do not always understand the treatment they are given or the goals they are being steered towards.

Healthcare in Ghana works on a pay as you go system: All treatments must be paid for although people can buy insurance which will cover some treatments but not all. Just over half of the population, probably, have insurance. The patients seen in the physio department that have insurance are given a patient number. If they don't have insurance but pay for their treatment they have a different type of patient number, though still a unique identifier. If the patient has neither insurance nor means to pay, they are treated but not given a number. They are not recorded in hospital data and they remain invisible to audit!

Shopping on your head

I will remain forever in awe of all these amazing Africans sauntering along, doing their shopping or carrying out chores with the most incredible, large, heavy and/or precarious items balanced on their heads. I have watched mesmerized as crate loads of food, large basins of water, furniture or even sewing machines go bobbing along, sometimes for long distances, on somebody's head. We had an African dance evening a few days ago and a lad of about 8 or 9 stood and watched for a good half hour or so without thinking to remove the large plate that was sitting on his head.

Babies are not carried on heads - they sit piggy back on backs inside a piece of cloth - regardless of how small they are. Anyone who would be in a pram or pushchair, or who can't walk the required distance, qualifies for the cloth trick. It is very clever and looks most amusing from the front - a small foot sticking out on either side. I haven't yet seen anybody with twins!

"Ndi" (good morning) you say as you meet somebody, (at least if it is the morning) and shake their hand. This is accompanied by finger clicking - the louder the better. I have not quite mastered this art yet - I sometimes think I've got it and it passes uneventfully and then an African I know a bit better will inform me that I still need to practise.

And you don't even need to get near to the person to get the greeting wrong. I have taken to making sure I am carrying something in my left hand just to keep it occupied and stop me waving with it. I have never waved so much or so often at so many different people - mainly kids, but it absolutely must be done with the right hand. It doesn't do, and is in fact quite rude, to get it wrong and wave with the left.

I just hope the locals are gracious enough to forgive my naivety.

Waterworks

Every blog needs a bit of toilet humour to lower the tone and I'm not going to make this one an exception. Especially when there is so much material to feed it with.

I might have alluded to a few flushing regulations and some shower limitations: The water pressure is certainly temperamental, meaning that sometimes there is running water and sometimes there isn't. If you are the sort of person who needs to stand in the shower for 5 minutes before your hair even gets wet then the trickle that comes from our shower in Hohoe might have you there all night. Although if the trickle runs out completely the alternative option of sticking your head in a bucket might actually be quicker.

The toilet is to be flushed sparingly - that is, only when contents are of a solid consistency (toilet paper is not allowed in the toilet at all).

"If it's yellow, let it mellow, if it's brown then flush it down" requests the polite notice that sits above both of our toilets. Of all the amusing toilet etiquette that is to be found in public restrooms, this is one I had yet to experience.

You can imagine the toilet is not always the nicest place to pass time. Just as well most people don't use it that often - the sweating (or perspiring or 'glowing') seems to do the job quite effectively the rest of the time.

If you do decide to flush the toilet, thereby advertising your bathroom activities to all around, then make sure there is nobody in the shower - the bathroom doesn't multi-task. Must have been a male plumber.

The streets of Hohoe

Since I can't attach the smells or sounds, or the heat or dust to this post (in fact the blasted blog won't even let me copy and paste), it is difficult to share the experience of living here. But I'm always up for a challenge....

There are kids everywhere, playing in and around the wooden and tin huts that line the road (the road being a wide, flat dirty mud track). They wave and call out 'yevu' (white person) to you as you walk past. This is not an insult - they just want your attention and it always feels such a privilege to have their interest. They are so excited about cameras when they see them and clamour to have their photos taken, posing angelically and jumping up to see their faces on the screen just as the photo takes, so you end up with a fuzzy blur.

They also love our plastic water bottles and will take them from us, if we let them, to fight over amongst themselves. The locals drink unfiltered water from plastic bags with chemicals added to kill anything in it - hopefully that doesn't include the locals themselves! We are advised firmly not to drink this water and likewise the food that is cooked on grills at the roadside and spends the larger part of the day sitting in the sun.

Apart from food and sweets, the huts lining the streets sell books, fabric in abundance, bags, or services such as hairdressing and dress making. Dress making incidentally is a roaring trade as most people (including many of us at the moment) have clothes made rather than buying them off the shelf. There are several places with signs advertising internet access, most of which provide no such thing - they just draw people in. There are a few cafes, which have a couple of tables and a few chairs. Better not to go in groups of more than 4 or 5.

The smell in Hohoe is distinctive and always present. Possibly it is just the accumulated smell of different types of rubbish burning or having been burned (and of the goats and sheep wandering around everywhere) but it is not usually unpleasant. Probably much like the smell of hops in Edinburgh, it is a smell you become accustomed to and either like or dislike according to it's association.

Monday saw us through the rest of our orientation, a trip to the bank (somewhere to be visited as often as possible by virtue of its air conditioning) and a visit to the market. The market is closely packed with stalls and stalls of fabrics and local foods among other things and there are people everywhere. There is NOT room for cars to drive through but that doesn't stop them. Pedestrians absolutely do not have right of way and cars will often not even slow when they wander into the road, the likelihood of death by taxi being far higher than that of becoming lion food!

Cultural shift

At 1am the tour of the house was brief and once the toilet flushing regulations and bucket showering facilities had been explained, I was finally free to crawl under my mosquito net and sweat it out for the night, with the assistance of the friendly fan. The noise and 'blowyness' of it was well worth the relief it provided although the very edge of the top bunk, I reflected, was probably not the most sensible or safe place to position oneself for the night.

However, I was still there when I woke the next day, so all was well. After breakfast (pineapple) I joined some of the other volunteers heading off to one of the catholic churches in town. I don't think we even came close to arriving in time for the start of the service and it had not finished when we left quite some time later. It was conducted entirely in Ewe, the English version having happened at what must have been the crack of dawn, so to be honest I didn't have the foggiest what was going on. Despite this though it was interesting to watch and pretend to participate in, and it was the liveliest catholic mass I have ever seen.

It was perhaps the hardest part of the day though - I could have stood with a beacon on my head and not felt more conspicuous or out of place. Or wished more that I were back in Bellevue where things are familiar and I know what people are saying :o( We walked back at Ghanian speed for lunch (chicken and beans and pineapple) before our first lesson in Ewe and our orientation to the programme and the country. This took us nicely to dinner time (chicken and beans and pineapple).

First hours in Africa

It was my favourite part of any flight where you make the descent and the detail of the landscape below gets more and more elaborate until you become part of the world of which only moments before you had been a distant observer. I am not a particularly infrequent flyer, ashamed as I am to admit it, but the experience this time was somewhat surreal. As though the size of everything was reduced from a distance (as normal) but the perspective was lost so that I appeared to be flying into a miniature world. Perhaps this was just my initiation into a totally surreal few days.

Stepping off the plane was a bit like walking into an overheated room that hasn't had any air for a while. It was 9pm and the sweaters I had been wearing all day were definitely no longer needed. I wonder whether I will be putting them on again before I come home....

After a long wait in the customs queue at Accra airport, I met my chauffeur, Prosper, and we headed off on our three and a half drive to Hohoe. The closest experience I have previously had to this was driving long distance in Australia where the roads were long and straight with no buildings for miles and the journey was slowe only by the possibility that a kangaroo might appear in front of you any any moment. The 'kangaroos' came in the shape of goats and pedestrians and cyclists meandering across the road. I'm not sure whether bicycle lights have made it across the med yet.

The difference with this drive from Accra was that there was plenty of civilisation, if not buildings, and that Prosper was absolutely not slowing down very much. The gap between our car and the car in front was the kind of proximity that embarrasses me when I have parked my car and leaves me walking away surrepticiously in case onlookers think I have actually just crashed .

The road was probably the Ghanian equivalent of an A road. I have no idea whether or not there is a speed limit but the randomly placed speed bumps did a good intermittant job of suddenly slowing us down. The speed bumps were worn down more in some places than others so by swerving around you could take out the sting and avoid having to slow down so much. This unfortunately meant that sometimes we fell off the road altogether.

There were frequent barriers and police checks - apparently car worthiness and driver competence are inspected routinely. They did sometimes seem to function only as glorified stop signs however, as there was not much checking going on.

The dilemma I found that presented itself during this drive was whether it is better to keep one's eyes open (a task that was becoming increasingly difficult in any case) so that you had a few seconds to prepare yourself in the event of a crash, or to shut them and remain blissfully ignorant of any impending disaster. I opted for a combination of the two, firmly reminding myslf that since I was not in control of the car I may as well stop worrying about the potential outcomes.

Thankfully the outcome was that we arrived safely at our destination. The CCS homebase resides at the end of a long and bumpy mud track, along which each turn, most disconcertingly in the dark, feels as though we are veering off the end of the road. The homebase is a comparatively large and impressive building within the community although reasonably basic by western standards. It is not so far removed from those of our neighbours as to isolate and separate us but probably does a lot to protect us from the huge cultural shock that we could experience if we truly lived as some of our neighbours do.

Preparations

All good assignments are written the night before, somebody once told me. I personally find the mere thought of writing a sensible 2000 word essay within 24 hours of the deadline is enough to raise my blood pressure significantly - I am not a natural risk taker. There is truth in the saying that one uses the time that is available, and it is true that many hours could have been saved by me had I left things later to organize, but I do think that on this occasion I took that lesson a bit far....

I enrolled in Cross Cultural Solutions (the organization sending me to Africa) within days of the cut off (presumably because this is the absolute minimum amount of time that planning will take). I spent large amounts of money on enrollment and flights and the privilege of being jagged repeatedly with needles - in the same spot where the bruise remains from the week before. And I began a course of tablets that give you indigestion and can apparently compromise your sanity. Then I stuck my passport in the post and prayed that my visa would arrive in time.

 "God is never too late" I was told reassuringly. And more alarmingly a minute later... "He is never too early either". Funnily enough it was the second half of this piece of wisdom that kept me calm as I half expected my visa to arrive, in true essay style, within 24 hours of the deadline. Thankfully God did not heed this advice and I received my passport and visa over a week before I needed it.

Then I set about the trivialities. This had me learning how to sew a buttonhole via step by step instructions from my mother over the phone (mum, I still haven't done this yet!), phoning from the camera shop to find out what kind of camera I own (yes I have had this camera for a long time but it might be worth pointing out that I have yet to set the time and date properly so that it doesn't keep resetting itself) and writing my will in case, as my father delicately put it, I get eaten by a lion.

Items such as a Ghanian travel guide, local currency and mosquito repellant have so far been neglected. I did however, as I might have gloated about afterwards, go into a bookshop and buy 3 books in the space of 10 minutes without any prior decision making time. I believe that even people with a natural ability to make decisions could be pardoned for the inability to make this claim.

I spent this afternoon running (yes, really running) around town trying to find a post office or bank or in fact any other institution that might have any idea how best to access ones finances in Ghana without spending them in the process. Having waited in line at several post offices and watched several different members of staff read the travel card instructions and wonder aloud about the charges and tell me they only had euros and dollars and they didn't know which one they used in Ghana, I had given up. Trusty old visa then....

How to not procrastinate

"So, Philippines, how's Africa going?" David, my Africa mentor enquired for not the first time. And not for the first time my stomach lurched uncomfortably as I confessed that actually I had my head firmly in the sand and had done nothing about it. David had taken it upon himself a year or two ago to keep me accountable to my decision to go out to Africa to work for a while. The original plan had been to go out for a year or so to work but as I started thinking about this I discovered I wasn't really ready or motivated enough to do the amount of uprooting necessary to get myself, on a long term basis, out of Edinburgh.

However I am extremely grateful that I was not allowed to let it go and in the end decided that I would go on a shorter trip. I booked the time off work back in August and set about making arrangements through an organization that had interviewed me and promised to help. After much impatient waiting I received a contact from them in November for a hospital in Tanzania.

Then they pulled out of the proceedings leaving me to organize things independently. Having found out through independent agencies what was required, I e mailed the Tanzanian hospital to request they filled out the required forms. And I waited. Several e mails and a few months later they e mailed to tell me I had left things too late and they would not be able to accept me :o(

Hence a trip several years in the 'looking forward to' has now been planned from start to finish in the space of a month! This is, after all, the year for not procrastinating as I proclaimed to anyone who would listen when I made my resolutions at New Year, hoping that some accountability to my friends might spur me on.

Now, on the whole I like to know what is going on in internet society without getting my nose too wet by offering my mood or food preferences or any current 'status' other than to unwittingly advertise when I am on line. I am also quite disinclined to regale an indifferent world with my daily trivialities. And  to that end I had firmly intended to remain strictly a pew warmer in the goings on of blogs and social websites.

However, with a trip to Ghana looming, the poor recipients of my mass e mailing may find themselves wishing that all this (possibly interesting but personally irrelevant) information were stored somewhere handy that they could read at their leisure and not trip over in their in boxes. So here is Flip'in Africa: a phrase that in fact I hope not to feel the urge to use too often. I will do my best to update it when there is stuff to update it with, and to make sure it does not outstay it's welcome - in my life, let alone yours.