Finding the Answer

November 2, 2012
Kasoa
Last day
It is 530 in the morning and I am awake already. I opened my eyes as soon as the slightest hint of sunlight peeped through the clouds. My eyes fell on what I have always seen first for the past 31 days: the slats supporting the mattress of the bunk bed above me, hazy through the mosquito net that surrounds me.
I know it but I can’t believe it: today is my last day in Ghana. I am so sad that I wish I had one more day, one more week, one more month —even though I know that one more than what I have, would not make it less difficult to let go. In another part of the world today, there are also people who await my return. But for us here, today was yesterday’s tomorrow, last week’s next week—the day we felt was too distant but like a seasoned thief has crept in to steal a day.
__
(As I write, P and D also wake up. D throws me this sad face, I throw it back and say no. P also throws me a sad face, says I wish you could have stayed longer, I throw it back and say I know. And I start crying. P squats down, wipes my tears and says we will never have someone like you again. I can continue to cry, but we have a full day ahead so I wipe my tears, try my darn best to be strong. L and U are still asleep and I don’t want to greet them with tears and puffy eyes. And this is just the beginning.)
Yesterday I was overwhelmed with generosity, the magnitude of which I felt underserving to receive. I went back to Ga-South Hospital to thank G and everyone whom I worked with, to say goodbye and thank you. After G and I had a picture together, we both went to A.M.’s office where she gave me her parting gift. I thought she was going to give me fabric as she had alluded to last week, but instead she gave me a white envelope. I thought it was a clothing pattern from which I can have a dress copied. I opened the envelope and found instead, money. I closed the envelope in disbelief, looked at her and said I can’t take this! She laughed and said I’m not bribing you, and it’s for the fabric you want to buy. Awww! She and I hugged each other tightly, thanking each other. I want to hug you tight but I don’t want to crush you, she said. I swallowed tears that were beginning to swell up.
I then went to the administrator, A.Mg, who is one of my favorite persons in the hospital, next to G. I tied up some loose ends with the HIV unit we are planning to build, thanked her for having me in their hospital. Before I left she and I exchanged the Ghanaian handshake, which consists of a firm grasp, an unhurried letting go and a flick of the middle fingers. With this I knew that we have come a long way from the day I first met her when we had the usual Western handshake. When you exchange a handshake with someone the Ghanaian way, it means I like you, we are friends. Before I left her room I said, I have been practicing to say this— nyame nhsia wo (God bless you).
G walked me to Mallam junction to board a trotro to Accra Mall where I was going to meet Tita N. G and I had one more hug and again I said, I have been practicing to say this— nyame nhsia wo. But to her I added, me fe wo papa (I will miss you very much).
___
I arrived at the Accra Mall much faster than I expected, having passed a different route this time (Madina-Lapaz route). Tita N called as I was crossing the street and said that she was wearing green. I didn’t think she needed to say it, because come on—there can’t be more than five Asians in one place, at the same time in a mall in Ghana. The instant I met her I knew that she was one of those. One of those kindred, fun-loving spirits with whom I just click instantaneously. We hugged, as if we have known each other for a long time. We had lunch at a Chinese restaurant in the mall, where we talked about her traipses around the world (Saudi, UK, Grenada, Malaysia, Philippines, Ghana), how she met her husband (a Ghanaian surgeon, retired now), her children’s impressive achievements, how she’s worried about them being too busy and single. She couldn’t wrap her head around how I can ride a trotro, because in her 12 years here she has not been in one. Isn’t it hot, she asked. If the traffic is at a standstill, yes.
She was so fun to be with, always giggling, always smiling. Even the taxi drivers would lighten up and go along with her jokes. After going to the craft market for last minute souvenir shopping, we went to their house in the Airport Residential Area, an area in Accra with buildings of modern architecture, gated and manned by security guards. Where homeowners talk about how difficult it is to find a trustworthy and hardworking housegirls, houseboys and guards. I just fired our boy, he was lazy! I got a new one, the son of a pastor who was able to tell me what Psalm 23 was. And on drivers: I didn’t hire this man—he was rather old, in his mid 50s; he had beads in his hand which you know what it means: he is chief. And you don’t want to have a chief driving you, you know that.
I met her husband and their two friends, both Ghanaians. The male friend was also a doctor, a neurologist who has made a home in Long Island, NY, Aburi and Accra. All of them had that same fun-loving spirit that just feels so light to be around with. Though I wanted to stay longer, I left at a quarter of 5 in the afternoon so I would be in Kasoa by sunset. Tita N walked me to the end of their street and saw me board a trotro. From that street I had two more transfers before I was finally on the trotro to Kasoa. It was during this transfer of trotrosthat I again received undeserved generosity. Unbeknownst to me, the first ride didn’t end at Nima where I thought I could take a trotro to Kasoa. Instead it dropped all of us at a market. A lady offered to go with me to Nima so she can show me how to get to Kasoa. When I handed a coin to the conductor, he refused it. The lady already gave him 40p to pay for herself and me. I looked at the lady behind me, my benefactor. She touched my shoulder and said please, it’s for the two of us. I was dumb-founded, surprised with her unexpected kindness.  She didn’t have to, yet she did. It reminded me of the Bible story where the Lord says, the poor though they give less, actually give more (or something like that).  I felt so very humbled with this selfless act. Her kindness did not end there however; upon reaching Nima she went down with me and brought me to the right trotro. There was only one space left, and she gave it to me. Whether she also needed to go to Kasoa or not I would never know. I thanked her, and asked that the Lord bless her heart.
This was when I again grasp that when we give, we get so much more in return. I thought of the time I paid for the fare of the boy who accompanied us to Kasoa from Ada Foah. When I did it I had no expectation of a reward, and yet— see how much more I received in just one day. Last night upon reaching home, I opened the envelope that G gave me. It was more than enough for a fabric. So now I had a dilemma: do I buy fabric as G intended, or do I donate the money to P’s church that is soliciting funds for construction? Inasmuch as I want to give things forward, I also don’t want to leave Ghana without a reminder of G’s generosity.
__
So today I can say: last night was my last trotro ride. And it was a long one too. Traffic everywhere. I was getting impatient, and I had to remind myself over and over again to change my perspective and just enjoy the moment. I still found it amusing that before the toll booth where tens of hawkers abound, is a sign that says:

                                    Mama Esther
                                    Back to Sender
                                    Tilapia for sale

I have passed by this sign at least ten times and I still can’t understand what ‘back to sender’ means.
Switching my mindset worked at times, but when the heat inside the trotro irrefutably transformed into beads of sweat, the frustration came again in a wave. I must have cursed in at least three different languages, a hundred times in a span of two and a half hours. Upon reaching the Kasoa signage, I decided that I have had enough. I went down and walked for about a mile and a half, meandering my way into the strolling night crowd.
The old market at the junction, though still bursting with energy had a subdued tone to it now it was dark. One step here, one step there, a twist of the body here another twist there. With each step I take there was always something being sold.
            One step to the left:              toothpastes (layers of them)
            One step to the right:           rechargeable lights
            One step to the left:              black shoes, bright shoes                
            One step to the right:           loaves of bread (only 2 cedis)
            One step to the left:              dried fish
            One step to the right:           CDs, DVDs (I always see Dingdong Dantes)
            One step to the left:              phone credits
            One step to the right:            roasted plantains
            One step to the left:              cellphone chargers
            One step to the right:           lotions shampoos soaps
            One step to the left:              keychains posters balloons
It was almost a rhythmical dance, made complete with scattered music and pungent smell, the inevitable human interaction: a bump on the side as we simultaneously twist, sweat on sweat, skin to skin.
I walked until I was too tired, and at that point luck fell down on me and a trotro unloaded one passenger, which made space for me. As I was boarding though the driver sped on almost knocking me off. I and the other passengers cried, EYYY! If Ludo was around, this would have been the perfect time for him to say, action movie.
___
Upon mentioning Kasoa to Tita N, her face distorts with mixed disbelief, mild repulsion and vicarious fright. We only pass by Kasoa on the way to Cape Coast, and…oh my god. How is it there?
Well, it has been home. It is where I have lived with 7 other people (Laura, Una, Portia, Doris, Josephine, Franklin and Wisdom) in the last 30 days, sharing the same food, under the same conditions of intermittent power and water, exchanging life stories, dancing and laughing, drinking, merrymaking under the bright moon and inside the candle-lit home.
I recall the first night I was here and how disgruntled I was at the dim light, the mattress, the toilet, the shower. Everything just dissatisfied me. And yet as the days went by my eyes have grown accustomed to the light (although I did change them eventually), my back has started to like the foamy mattress. And the toilet and shower? Luxuries compared to others.
And with this I grasp that our ability to adapt and accept things as they are and live within them can be a two-edged sword. While it can certainly help us thrive in a new environment, it can also blind us and desensitize us. Numb us even.  The HIV/AIDS patients and staff at Ga-South come to mind. They have been, for the past years now, making do with what little they have: a table, a chair, a hall, a room sometimes. But is this how they should remain? The enemy of good is better. And the challenge, I think, is for us to be able to oscillate readily between these two vital capacities so that we can accept things with peace without being too anesthetized to some realities that need to be transformed.
___
This trip is what you make of it. A previous volunteer inscribed this on the wall at the back of our house. I saw it on my first week and has been the one gentle reminder that has stayed with me throughout my stay here.
I think, I hope, that I spawned love. Love for the work that I do, love for people, love for discovery, love for the kind of travel that transforms you inside and out. I hope I did, because that is what I certainly received. That is what I will bring home with me.
Shortly after P sees me cry this morning, she sends me a text message:
Hi love, you are amazing! You are so much fun to be around! You are so fun and adorable you were like a big sister to me but I can’t believe that you are leaving, I’m so sad, Portia.
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When I woke up this morning and saw for the first time the sun rise from beyond, a song emanates from me. It is the song that the Ateneo College Glee Club used to always sing when we leave a place and move on to the next.
Morning comes and I must go; day is breaking yonder
After all the places I have been, now I’m going home.
I have been to seek the sky, to travel on the highway
And the time has come, I don’t know why
I am going home.
Where is the answer to so many questions
I don’t know, so I begin another journey
Where is the meaning for my world
I see the answer now.
Though we came by different roads, now we walk together
Stay beside me all our days, strangers never more.
Through the cool of summer rains; by the heart-side fire
Here I’ll be with you when nothing remains
I am home to stay.
Love is the answer to so many questions
Now I know, and I can stop my endless wand’ring
Love gives the meaning to my world
I see the answer now.
Love is the Answer. . .       Love!
(by Raymond Hannisian)

Indeed:
Love is the answer. It gives the meaning to my world.
The sunrise this morning
                 

Firsts and Lasts

October 31, 2012
Kasoa
Today was a day of firsts and lasts.
The first delivered baby in Ghana.
The last visit to the maternity clinic.
The first group lesson on Azonto dance.
The last trotroride to Bajwasi.
You have to understand: I am trying not to be sad here.
___
This morning was all about perfect timing. M, L and I went together on a trotro toward Bajwasi to see the Margo Maternity Clinic. It is a small, private, for-profit clinic run by Margaret (I guess I should call her Auntie Margaret, as a sign of respect), a nurse midwife who still practices. It is a gated compound that houses six discrete buildings:  on the left side are the screening room, waiting area, injection room/recovery ward/wards a and b/pre-labor ward/labor ward/consulting rooms; on the right side are the dormitories for the midwives and I guess, Auntie Margaret’s home too; on the center is the dispensary or pharmacy, facing a shady mango tree under which we first found Auntie Margaret and greeted her and told her of our intentions for the day.
We wanted to see a baby being delivered. I have seen it multiple hundreds of times before, but seeing how a baby’s head starts to show, teasing excited spectators outside, always gives me tremendous joy. I don’t grow queasy about it until the baby really descends with magnificent pushes from its mom and its head crowns, the labias are pulled apart like a woman bellowing out in laughter and staying in that position. I grow queasy because I know it is painful for the mother. I feel it, and I know it is more than painful. It is at this moment that I always feel in awe of all the mothers who deliver vaginally. If every one of us would see the torture that women go through in child birthing, we would appreciate our moms more. Men would have greater respect for women. With every inhale the baby’s head retracts, and with every exhale and PUSH, PUSH, PUSH (!) it swells again. Whenever I see this, I think: this is why we are all inexplicably and undeniably linked to our moms, why even the elders, whose mothers have long gone, still call out to their moms in trying times. Because child and mother have shared the same harrowing pain, and have together breathed to live the same exhilarating miracle, the bond is never severed. It is a friendship that is borne of shared adversity, of parallel labor, and ultimately of communal triumph.
As soon as we walked into the labor room and saw a hint of the baby’s hairy head, we stayed. M and L looked uncomfortable and curious. L remained on the side for the most part, seeming hesitant. I goaded her to come nearer especially when the head was definitively crowning.
___
So this is what happens: baby’s entire head pops out of the vagina and hangs in the introitus for what seems like forever. I knew there was something wrong, the way the head just hung like that, with that ashen color.  Typically when the baby’s head comes out the rest of its body just follows rather easily. This baby was not typical. The cord was wrapped around its neck. The midwife immediately but calmly uncoils the cord. I quickly scan the room and search for gloves. I know it— I would need to attend to this baby. Just as I don a pair of gloves the baby is set loose, its shoulders slide out, then its torso then its pelvis then its tiny feet. IT is a HE. He is a boy. I love boys. I smile.
He doesn’t cry. He is pale. And limp.
I rush quickly to the bedside, grab the suction bulb and start sucking away all the muck from his mouth and nostrils. First he gasps, and then he gives out a faint hint of a cry. Encouraged I suck out more and with my left hand dry him vigorously and stimulate him.
He cries. It is definitely a cry. I almost cry—in delight; in relief. He is alive. The first baby I helped deliver has made it to this world, has opened his eyes.
___
After quickly scanning him for his APGAR scores, I brought him to the counter by the wall to further dry him and examine him. Counted his toes, 10. Counted his fingers, 10. Checked his anus, patent. Checked his palate, approximated. Checked his chest, belly and back, what needed to be robust was and what needed to be straight was. He was perfect. Re-checked his heart and lungs, beating and breathing. He was alive. That thought kept repeating itself in my head. Alive. Alive. Alive.
Only later on did I realize why it mattered me to that much for him to be alive. It was because he was the first baby I delivered in Ghana. Heck, the first baby I have delivered ever, on my own. On my own, without anyone looking over my back. Holy cow. The baby and I made it. It is an exhilarating experience.
We asked his mom, the superstar of the show, what his name is going to be. ‘I don’t know,’ she said. M said ‘well, how about MJ for Michael Joseph?’ Michael Joseph is the name of her yet unborn nephew. He is set to be born today in the States. So we turned to his mom, ‘we have given your baby a name. Michael Joseph,’ we said.
Me and MJ
Later at night when we went back to the clinic, one of the midwives said, ‘oh Michael Joseph and his mom have left for home this afternoon’. We asked if he was indeed named Michael Joseph. And the answer? Oh yes! Woohoo. Would it not be great if two Michael Josephs in different continents shared the same birthdate?!
___
Apparently, according to one midwife whom I spoke to this morning, they never have sick babies in the clinic. I find it hard to believe, but I hope it is true because babies here are just secondary priorities. I saw with my own eyes how they almost ignored a limp, pale, non-crying baby. Now, it might have been because I was there; but— the first reminder they gave me as I brought the baby to the counter was, ‘here take this cup, this is oil; use this to clean the baby.’ Second order was to put the baby on the scale, then measure the head, the chest and the length. Nobody asked me how the baby was doing; only if the baby was already clean.
You can always clean a baby anytime; but for me I would rather clean a living baby over a dead one. I had to remind myself to accept things as they were and to just adapt to the circumstance and make do with what I had and what I didn’t. 
Being a doctor for kids, I worry when there is not even a stethoscope in the room, nor a suction machine, nor an APGAR (a brief scoring system to see if a baby is doing well or not in the first 1,5 and 10 minutes of life) scorecard on the wall, nor a lamp for heating, nor a thermometer. I think this is appropriate worry, no?
____
This afternoon we went back to the clinic, this time with Una who was going to work with us for the first time in 6 days since being sick. We were hoping to get timing as perfect as the one we had this morning. On the way to the clinic, which is a good 30-40 minute ride from our home base, this was what I saw:
It’s nostalgically beautiful.
When we arrived at the clinic, the midwives were gathered in a circle near the wards talking amongst themselves. They called us and as inclusive as ever, they invited us to join their circle. When we finished our introductions and basic getting-to-know-yous, and after they clarified that condoms here are referred to as condoms and that romantic is just a brand, someone noticed U dancing in her seat. ‘You are dancing,’ she tells U. U says she was. I took this as an opportunity to ask for a dance lesson so I say, ‘actually we are all trying to learn Azonto dance.’
‘Ahhh!! Azonto!!’ They giggle and rise from their seats, immediately goading us to rise and dance. Music starts to boom from a cellphone and we have fun.
Me trying the Azonto

Group lesson

Girls having fun
___
After calming down from the dance, we heard a car pull into the driveway. ‘We have a case!’ C excitedly tells us. U, who just pulled out her packed dinner and was about to start digging in had two people telling her different things: ‘eat!’ ‘No, don’t eat yet!’ I said I didn’t think the baby would come out within the next 5 minutes. Seconds later, two men came in carrying a frail looking, middle-aged woman by her armpits. My eyes immediately go down to her belly and the first thing I say is, ‘but she’s not pregnant.’
Apparently they also accept non-pregnant patients. As this woman was. I let the nurse and the midwife attend to her first and only went to the woman’s side when the nurse said she couldn’t get a blood pressure. The moment I was at her side it struck me how sweaty she was.
I felt her pulse rate and I didn’t have to count through the full 60 seconds to know that she was tachycardic (has a fast heart rate). At 15 seconds she was already a 30-40. I still went ahead and attempted to get a blood pressure though. Three times I tried and I could not get anything.
Sunken eyeballs. Skin tenting. Cool, clammy arms. No blood pressure. Fast heart rate. S***, I thought, this patient is sick. Immediately I ordered for the woman to be laid down on a bed, given an IV fluid bolus. This patient is clamping down on us, I told the nurses, we need to assist her heart to pump blood. I went to the dispensary with the nurses and together we picked out IV fluids and medicines to give. They asked me if I could do the IV insertion. I said yes, but when I realized that this woman had only one or two chances for an IV insertion and that the family may not be able to afford a second IV kit (should I fail), I asked the nurse to do it instead. The unfortunate thing about training in a hospital that is well staffed is that residents like me don’t get enough opportunities to do simple procedures like this, and even when we do there are non-resident trainees and PAs and NPs who sometimes fight tooth and nail with us to get it. So a simple procedure like an IV insertion, once a natural skill I had, is now lost on me. Hopefully I will have a chance at redemption.
After 1.5L of IV fluid boluses and 2 hyoscamine injections, the woman regains an acceptable blood pressure of 90/60.  Whew! Now I can wipe the sweat off my armpits. She lived! Like my baby this morning, she was alive.
I cannot even begin to explain how rewarding it is for me to feel that the work I do, actually matters. That what I know, can save a life (and what I don’t know, can fail to). My heart swells just thinking about it. What utter privilege it is to be able to care for people, to be able to touch them in ways that probably go beyond the present moment. An utter privilege.
As doctors it is frustrating to be unable to practice ‘right Medicine’ each time because of the unavailability of services or financial limitations. Tonight after the woman regained her blood pressure, the nurse and I had a discussion about the IV fluids. The outgoing nurse told her during their sign out that it was ‘ok not to give the 4th IV fluid for 30 minutes because she has already received 3 bags.’ Don’t ask me where they got the 30 minutes. I reasoned that the woman still needs the fluids. The nurse, hesitant to carry out my orders, finally says ‘but the family will need to pay for the 4thbag.. does she really need it?’ I look at her in the eye. I say I truly understand but I ask, ‘how much is her life?’
I know how it is to lack, and I always explain to my patients and sometimes to nurses like the one tonight that I am not one to order labs and medicines unnecessarily. I always say that I apply the same principle to myself. I give thought to each order I give, fully aware that these orders don’t act in isolation.  A patient, a relative will have to pay for each centavo, sacrifice upon sacrifice, blood upon blood.
___
L and U meanwhile busied themselves practicing BP measurements on each other. U learned it in school, L learned it from me this morning. U did it several times on L that by the end, L’s arm had indentations.

‘My heart is beating!’

Writing orders

They came with me to the labor room when I did a cervical examination on a woman who has been laboring since this morning. It has been at least 7 years since I last did a cervical exam on a pregnant woman, so I had to ask the midwives for assistance to help me measure the cervical opening. 4-5cms of thick cervix was what we estimated. I regretfully told the girls that it was impossible for the woman to give birth within the next 30 minutes, and that we would have to leave the clinic without having a delivery tonight.
R, one of the midwives, insisted that L and U come back. She reassured them, saying, ‘don’t worry before you leave here you will come to something.’
I thought her choice of words was spot-on. You will come to something.
On my last few days here, this has left me thinking. Indeed, what have I come to, what have I arrived at?  
­­­On a day of firsts and lasts, I know that whatever virgin place within me I have arrived at and whatever sacred truth I have come to since coming here — I have been changed.

Hearting Ghana

October 30, 2012
Kasoa
On a night w/o power nor water
I am almost getting tired of having both power and water outage. Especially when this means melted ice cream packs and stinky bathroom. U said it is hard to tell if she is dehydrated because of all the accumulated urine in the toilet. I suggested that she watch the stream of her urine instead.
But moving on. I watched with bated breath, the unfolding of Hurricane Sandy back home. I am happy that DC (where my plane will land), MD (where my parents are) and PA (where our Filipino house is) were all spared from destruction. Since I am aware of how ‘lucky’ I can get with transits, I am also hopeful that my flight out of Frankfurt will not get pushed back (as it is I already have an 11 hour lay over during which I cannot leave the airport because I have no German visa) and that by the time I arrive in PA we have both power and water (because I need a break).
I still find it hard to believe that I am now tangibly talking about departures and flights and such. Having only 2 full days left here in Ghana, I feel the nostalgia seeping in. Now every place I have frequented, every habit I have acquired, every food and drink I have ever consumed since coming here have attained a certain finality to it. Today was the last time I would go to Country Side Orphanage. Today might have been the last time I would buy chocolate at Mama Joyce’s. Today was the first and last time I would carry 15L of water on my head. Tonight might have been the last time I would receive lessons on Azonto dance under the moonlight. Yesterday might have been the last time I would eat red-red. And who knows, tonight might be the last time I would not have power nor water (power of positive thinking). And pretty soon I will say, today was the last time I rode a trotro.

Today for the second time I played doctor to the children at the orphanage. It was refreshing to talk to teenagers and tweenagers this time around, because they could talk and tell me if they had health concerns. My favorite was a 15 year old boy whose concern was not being able to wake up at the time he wanted. He said he would like to wake up at 4am but has difficulty doing so and wakes up 1 or 2 hours later. I asked why he would want to wake up at such an hour, and he said it was ‘for learning.’ He puts me to shame, this boy. It must have been at least 7 years since I last woke up early in the morning to study. The closest I have come to this is staying awake during a night call to study. I don’t think it counts, because with this you don’t rouse yourself from one of human’s most satisfying delights. You just stay awake; you do not awaken yourself. It turns out that he sleeps late at night (10pm). I explained that his body needs at least 8 hours of sleep each night and that waking up at 6 when he slept at 10 is just his body’s way of saying — I am the boss, listen to me let me sleep.  I then asked him if he was good in class (I hoped he was, to give justice to his efforts) and he said yes. His classmates corroborated this. He said he would like to be a medical doctor when he grows up. I chuckled and said he was starting early; indeed, I said, doctors are sleep-deprived.  He apparently is the top in his class, but he did say that he and his friend compete with one another so that sometimes he is second to him. He said it so lightly, I had the feeling that for him learning is a fountain of fun and play.
Another favorite is a 16 year-old girl who was complaining of having menstrual cramps. I asked her what she takes when she has it and she said, ‘banku.’ (mashed cassava and corn)
Again I was amazed at how nice their teeth were! None of them had bad teeth. None. Like I said I think it is because they don’t eat candies nor drink a lot of soda here. Though their diet is carb-heavy they themselves are not heavy. Today was the first time I saw an obese teenager. He stood out. It took every ounce of my will not to stare at him.

With Joyce (nurse), Uncle Joe, Mama Emma, Uncle Anes

Ordinarily in the States I would talk about sex with my teenage patients. Here though it seems odd and out of place to do so. They all seem so unadulterated. As an example, our helpers reportedly asked one of the girls if you can get pregnant by swallowing sperm. They also wanted to know what the color and taste of it was. I think this might have been when they read parts of Fifty Shades of Grey that one of the girls brought here before.  I don’t know if they also asked about S&M stuff, which I think the book is heavy on.  If they did, it would be like getting a PhD before getting your high school diploma.
Condoms here are referred to as romantics. I think this name is too presumptuous. It assumes that all sex are motivated by romance.  But at any rate, can you imagine summoning a romantic in the middle of sex? Saying it is too long and tedious. I wonder if it’s one reason why condom use is not common here. I remember one female patient with HIV whom I spoke with. She confessed that she had not informed her partner yet about her HIV status (can you imagine; it is almost criminal to withhold such a thing).  Initially she said they always used condoms. Finding this hard to believe (I know that patients lie. I know the fail rate of condom use), I quizzed her again and again. Later she admitted that maybe sometimes they didn’t. It makes my head spin, how people can be so stupid and imprudent.
___
Unbeknownst to me until tonight, the Azonto is a dance style that Ghanaians have popularized. It involves a twisting movement of your feet and legs while gyrating your hips. In the meantime, your upper body remains free to rave in different combinations; sky’s the limit. My favorite one at the moment is the Azonto style they rendered on ‘Chop my Money,’ Akon and P-square’s hit and hip single that is so catchy everyone here’s into it.   So tonight to while the time away I asked J to teach me the steps. J is the girl who lives with us and whom F sends to school. And so in the darkness of power outage, the two of us were dancing in our front porch to the music blaring from P’s cellphone. I tried hard, but in the end I felt like a white dork next to J who looked very cool.
By now I think you might have sensed how I have hearted Ghana already. Ghana, the land of trotros, Azonto, romantics and plantains; of peace, easy brotherhood and religiosity; of haggling and colorful fabrics; of beautiful smiles and straight spines.
It will be difficult to leave.
  

Doctor for Kids

October 29, 2012
Kasoa
Having finished my hospital work last Friday, I have this week free to do other types of medical volunteer work.
And today I played doctor for kids.
The location was at Country Side Orphanage, no doubt the best orphanage I have been to in Ghana. It is located on a 28-acre property, bordered by lush virgin forests and run by well-hearted individuals (Mama Emma and Uncle Joe, and another Uncle Anes) for whom I have high respect and admiration. It has dormitories (clean, non-cramped), classrooms, kitchen, wash area, library (well-stocked, quiet, conducive to learning) and best of all—a health center with a good stock of essential medicines and equipment as well as 3 big beds where sick kids can take their respite. This alone beats the HIV (non)unit at Ga-South Hospital where I worked. My next favorite place was the animal farm where all profit goes to the orphanage. It had a poultry, a piggery, a goatery (? Haha, I don’t know how you call it), peacockery (?) and a tilapia pond. Though I’m not a fan of four-legged animals, I must admit that I found everything charming. Including the pigs. I enjoyed observing the different animal behaviors: how the peacocks ‘gackak’ the moment you direct sound to them (almost like mirroring); how the lambs just herd together—walking in one direction, turning their heads at the same time and gazing at the same aim; and how the pigs just act like pigs—smelly and pink, gross and fat. Oh the piglets were so cute with their curly tails!

Pig tails!

Look at them gaze in one direction

The tilapia pond

After touring the facility, Uncle Anes helped me settle down in the community gazebo. This was where I was going to play doctor to toddlers. It was adorable how they were lined up so neatly on the benches. None of them with a mom. Aww, I thought, my little patients!
Look how good my little patients are seated
My mini patients waiting for their turn

With all the shrieking, I had to close my eyes to shut out the noise

I was going to see only the toddlers, but the next thing I knew older children started lining up too. I don’t know how many I actually saw, because at some point my scriber left. It was at least 40. 40 in 2.5 hours. See how much a doctor can do without the burden of documentation? It was awesome.
I was expecting to see a lot of skin infections, scabies and maybe even lice. I only saw 2 serious tinea capitis (fungal infection on the head) cases, 1 contact dermatitis and maybe 5 or 6 hyperkeratoses of the extensors. I listened closely to the ones who were having runny nose and were coughing, making sure they didn’t have some crackly sound in their lungs to suggest something more serious. Clear lungs all.
I mean sure they had big bellies and were generally small for their age — an effect of micronutrient deficiencies and playing chronic hosts to parasites—but they were pretty healthy. Even their teeth were white and surprisingly free of caries. I thought they had better teeth than the kids I have seen in the States. I think it is because Ghanaians do not have a sweet tooth. Meaning, they drink less soda and eat less candies.
As I would examine their genitals, those who were either waiting for their turns or had their turns already would mill around and above me, hoping to get a glimpse of their friends’ privates and then giggling and shrieking endlessly when they did. I don’t remember as a child getting at all excited about seeing my playmates’ things. I think maybe bathing with my brother (which I did until both of us started to be aware of our differences) was enough to desensitize me to the mystery of the pototoy. And then of course I had my own, which enough said, bored me already. But I guess it can be funny watching your playmates and friends look uncomfortably self-conscious. Until it is your turn and then it isn’t funny anymore. When the older boys started to take their turns, they asked me to tell the girls to go. Of course, the girls stayed. I would have stayed too, especially if those same boys stayed and watched for my turn.  But this is coming from someone who as a child raced on foot and bikes with boys, climbed trees with them and who often came home with fresh wounds. As a young child I would not be outdone.
___
Tomorrow I will again go to the orphanage and see more children. I am excited. Truly, I am Med-Peds through and through!
I love my work. I really do. And I adore the spontaneity and innocence of children— and the runny noses, boogers, shrieks, clinginess and dirt that come along with them.  

Revelations

October 29 2012
Kasoa
It’s late afternoon. It’s my almost-favorite time of day here in Ghana, when the cool breeze meets and greets the warm afterglow of the sun. I like to sit and lounge at our front porch at this time. Right now there is on my right the young round moon that has risen. I have a feeling it is going to be a bright night. If we lose power tonight, I suspect the moon will radiate enough light to illuminate our street.  I bet you tonight is also a night of brilliant stars.
We do not usually see the sun set from here at our home base, and I think it’s partially because we do not seek it. Living in a city sometimes makes you think less of these ‘usual’ revelations of nature. And although Kasoa is not as big as Accra, it is still riddled with the price of city living: traffic, noise, dust. Distractions. Today though I did see a glimpse of the sunset when I went to examine the patch of land that is now teeming with plants of cabbage and yam, where W only a couple of weeks ago planted their seeds. I didn’t see the half arc of the orange sun as it was sinking, but I saw a suggestion of its descent: the silhouette of an unfinished building with stairs that led aimlessly to an unsupported landing. With the sun behind it, the contours of the building stood out more—as an unfinished structure.
Unfinished. It strikes me now why I chose this word. In describing the building, am I also describing our selves here? Am I describing myself and how, even with the tiny revolutions that have taken place within me since I got here, that I am still unfinished? The thought relieves me, because in the state that I am in I would be aghast if I were already finished, and if all my questions were already answered. We each have our own stories here— where we came from, why we came to Ghana, the things we know about ourselves, and the many more things we don’t know and what comes after Ghana. None of us know for certain: L may or may not go to Tanzania and who knows what after that; Lu does not know what to do after Ghana and Australia; what he knows for certain is that his previous job was just a job and it was time to move on (I have to applaud him for his daring); U will go back to school but is unsure of what she will end up doing, And I?  At my core I think I know what to do and it is more a question of gathering courage to do it than being certain.
___
Today, M, a new volunteer arrived. F said she is older than any of us (how refreshing for me, who until now had been the oldest in this household).  Before she arrived, we were all curious about her— what does she do? How old is she? Where is she volunteering? Will she keep to herself? Is she fun? Questions that I am pretty sure U and L also asked before I came. I didn’t want to share my room (I am territorial this way), especially with all of my things strewn all over. But when F asked if I could share the room, I said yes. What is one to say anyway? Truthfully though I really do not mind it, except for the fact that now I cannot just undress and scatter my mess. I guess it’s to prepare myself to go back to the Filipino house where food, bills and mess are shared among four. In the meantime our questions about M are still unanswered. She has been sleeping since the time she arrived. I think it’s jet lag.
P, though she has not met M yet, has been worried about her since dinnertime. She has asked us countless times now why M has not awakened yet, and if she’s not hungry. ‘But she must eat!’ I asked P if she wakes up at night because she is hungry. She said no. I offered the analogy, but it left an impression for only 2 minutes and it was again back to her ‘but she must eat!’ In the end, to abate P’s worry I composed a note to M saying:

‘M—P is worried that you might feel hungry when you wake up. Your dinner is on the kitchen table. It is yam and cabbage stew. It is very good. There is also pineapple in the fridge. It is on a plate. It is all for you. P hopes you eat. By the way, P is one of our cooks. You will meet her tomorrow. 

                                                                                                -Ross and Una
                                                                                               -Portia                                                                               
P.S. (I add this when P hands over a bag of water to me)
This water is for you. This is how we drink water here. There is more in our room. Feel free to take some. 

P seemed happy with this note, but then she started to worry about M not seeing it if the power would go out. Exasperated, U suggested to her that if she wanted she could keep a vigil by the dining table and wait for M to wake up. I added that should power go out, that she should shine a light on her face using my torchlight. You know, just to be sure M sees her.
The only thing I have said today to M was hello I’m Ross, because I and U had to go back to the hospital. Last night as we were leaving Aburi, U started to feel symptoms I thought were very suspicious for malaria. When she had the fever last night and again this morning, there was no question about it: all my plans for today (which included meeting up two acquaintances in Accra and going to Church for the first time this month) would have to be put on hold especially since everyone was going to Church.
The first hospital we went to was Kasoa Health Centre. It was a government hospital with a system that was similar to Ga-South, where I have been working. So first U had to buy a folder for registration. What’s peculiar about the folder was that on the first page, most of the spaces were left blank save for U’s name and age and her religion which the clerk assumed was Christian — the clerk didn’t bother with U’s contact info, emergency contact person, status and insurance. The second step was to pay for the consult fee. The third step was where it gets cloudy: one sits down on one of the benches outside to wait for BP/Temp/HR screening; there is no specified order – there is no one who calls your name, there is no number to track. Patients have to keep track of their place in the sequence by themselves. Once you succeed in this step, then you queue to be seen by a doctor (though in U’s case there was no doctor). If lab work is ordered, then you go to the lab (in U’s case there was lab work ordered but no lab service available). If medicine is ordered, then you go to the pharmacy (in U’s case the medicine was not available).
Because neither the doctor nor the lab was available, we decided to walk to the private hospital nearby. It was not much better. Doctor was not in yet, and so was the lab technician. We were told to come back 3 hours later, when the lab tech was expected to be in. Ayayay.
Anyway, U’s blood smear did not show evidence for malaria but as a precautionary measure she is getting treatment for it. This of course makes me paranoid— though I dislike putting on that darned spray, I have been applying it liberally nevertheless. Just in case. I counted my malaria pills tonight and realized that I missed one pill. It should not kill me. Again, like I said— doctors make the worst patients!
__
Yesterday, three of us (U, Lu and I) went to Aburi. It is a hilly town in the Eastern Region just one hour from Accra. We got there by taking a tro-tro from Tema Station. On the way we rode with other obronis, all of them girls. U and I suspected that they have not been in Ghana for long, judging from how they hesitated to go into the tro-tro and took time to decide where exactly to seat themselves.
Aburi has two popular spots (and by ‘spot’ I don’t mean bar, like how they mean it here): the Aburi Botanical Garden and the Rita Marley Foundation/Studio 1. Unknown to us, the gift shop of the RMF was brought down by fire several months ago and is now closed. This brought down the spirits of Lu, who is a staunch fan of Rita Marley’s deceased husband, the ever famous and influential Bob.
The Aburi Botanical Garden has impressive flora. Upon entering the compound (5 cedis for Non-Ghanaian adults), you will see a line of tall trees standing straight along the main walkway. There were at least a hundred more trees and plants that looked foreign and interesting, but of course I didn’t bother to know their names (I never liked botany). It was enough for me to look at them from afar and appreciate their beauty.

After eating lunch we rented mountain bikes from Ghana Bikes, a company that rents out bikes and offers different tours in Aburi (and beyond). They also offer hiking. It is located very near the South entrance of the garden. We almost missed it had we not seen their sign. There was no discernible store where the sign was. Apparently the store is on the second floor of the house next to the sign. It was being manned by I think, a husband and wife (and child) team. They do not own the store however.
Since it was already past 2pm, we decided to take a short route with reasonable terrain. We all declined to wear helmets, a decision I would somehow later on regret as we were going down almost-vertical roads and seriously rocky tracks. I and U barely managed to bike the terrain. I think half of the time (I am exaggerating) we just carried our bikes until the ground was more flat and ergo, manageably safe. When we reached a swamp we left our bikes. There was a small bridge that we all  were able to luckily traverse without falling. On the other side were cocoa trees. Our guide, who all this time was wearing black pants, black shirt with gray vest (totally appropriate for the weather and the occasion), reached for a semi-ripe cocoa and opened it for us to see. It opened up like a lobster. The meat was white. It almost tasted like guyabano, nothing like the chocolatey taste I have come to know and become addicted to. Whoever thought of making sweets out of cocoa was genius. I suspect it was borne out of accident though, as most discoveries are.

Our well-dressed guide

Cocoa

Stopping at a village

The track we used on the way back was more manageable than the one we took coming. We had to go through a small river crossing with our bikes and thankfully my Vibrams held steady. Some leaves would often get stuck in between the toes of my Vibrams though. By the time we reached the road, all of us were drenching in sweat and screaming in thirst. I wanted to pour the cold water all over myself, but instead I just drank it with so much greed. After this stop we had to power through the almost-vertical road again. On the first part I carried my bike up (no shame in that), but on the second part I was able to gather up enough will, muscle and lung power to bike up, catch up with Ludo and go past him. The reward was looking back at how far we have come. And of course the freshly cut pineapple prepared for us by the storekeeper at the end of our trip was another reward.

The queue for the Accra-bound tro-tro was long and it took us almost half an hour, maybe more, before we found ourselves in front of the line. Being in front of the line didn’t matter, because when our tro-tro came the people behind us muscled their way through and went ahead of us anyway. The conductor directed me to go to the front seat. As I was hoisting myself up and Ludo was getting ready to follow me, a man told us, ‘only one!’ My eyebrows shot up. Tired of all the s***^, I said no, there’s two of us and we were first, so we take this seat. Argh. We should not have to do that. But again, when in Rome you do as the Romans do! That is how you survive.
When our driver crashed our tro-tro against a cab that was parked in front of us, I was not surprised. The way that he impatiently careened in and out of traffic and honked at other cars, it was bound to happen. So first hand we were witness to how a Ghanaian car accident is settled: it’s almost comical. First our driver goes down angry, shouts at the cab driver for being parked improperly. Then the cab driver shouts back (if you ask me, our driver was at fault). Then our driver gets something (a bottle and a towel) from the tro-tro and then starts wiping the cab’s damages (really? You could wipe off a rear light crack?). Our conductor comes around the tro-tro and opens the driver’s door. At this point both L and I thought he was going to start driving the tro-tro as a compassionate gesture, but instead this is what he does: he changes the radio station. L and I started bawling with laughter— surely, changing the radio station was the most important thing to do in the scheme of things!
__
We did lose power tonight, and I was right: it turned out to be a bright night with a full moon in the company of brilliant stars against a dark velvet sky. In the company of the giggly Kasoa family, this was perfection.

A Ride Like No Other

October 23, 2012
Kasoa
It’s early morning. All three of us got up at our ‘official’ time for working out. None of us actually did. I have chosen instead to write about last weekend. It was a trip that has already gone to the timeline of my personal history as something I will always remember. It has joined the ranks of that time in Santorini when I roamed its winding roads on an ATV on my own; that dive we had in Pangasinan when my ears almost split and I felt the aftermath of a big wave after a fisherman dropped a dynamite while we were at work; that revolution in Venezuela which I unknowingly flew into and in which I pretended to be part of the Press (to get better pictures), and in which I inevitably got tear-gassed along with the rest of the crowd; that time in the border of France and Switzerland when I boarded a packed train without a ticket (I absolutely needed to get on that particular train) and got away without paying it as I turned away from the ticket officer just as the train stopped definitively; or that day in Amsterdam when I boarded a tram without money in my pocket to pay for the fare (I was hoping not to get noticed) and the kindness of the conductor (who noticed me) and let me go with a wink. Ah, the glory of unplanned traveling. There are plenty of moments such as these that crowd my mind now, but — here is what happened just this past weekend and why it deserves a place in the stalwarts of my travel timeline:
Location: Ada Foah
Starring: Laura (an old star in my stories), Ludo (a Swiss French guy, also a volunteer and now our pal) and me. There were also goats. And children. A lot of them.
I think the first challenge was to figure out how to properly say Ada Foah. Without saying it right, we ran the risk of taking the wrong tro-tro and ending up at the wrong place. After several tries and coaching from locals, we finally managed to say it without butchering it too much. The stress is on the 2nd syllable. You have to say the 2ndsyllable with a downward note (a ‘re’ instead of a ‘mi’ if you’d like to think of musical tones). The ‘da’ sounds like ‘duh.’ ‘Foah’ is said as ‘fo’ not ‘fow’ or ‘foo.’
See, this was important to figure out because apparently there are 3 Adas. Big Ada, Ada-Kasseh and Ada Foah. Travel time by tro-tro is approximated to take between 1.5-2.5 hours from Accra, depending on traffic. To our pleasant surprise, our trip fell well within this range. What took a tremendous amount of our time was the trip from Kasoa to Accra (an unbelievable 3 hours!). From Kasoa we took a tro-tro to Kaneshie Market. From there took a taxi to the Tudu station where we found another tro-tro that was headed to Ada Foah. The fare from Tudu station to Ada Foah was only 5 cedis ($2.50).
Putting up our feet after a cramped 2 hour drive to Ada
We found our guesthouse (Ezime Guesthouse) without difficulty. It was conveniently located in the corner of a busy junction, and was a 10-minute walk to the beach and 20-minute walk to the river. Having seen photos of the place in their website, I was quite excited to see it for myself. We have been jipped once in Kumasi when we thought the Sports Hotel was as nice as it looked like in their website. Ezime, however, lived up to expectations. It was elegantly simple and thoughtfully casual. It had 5 rooms, with each room accommodating 2 people although they make room for a 3rd person by bringing in a mattress (which didn’t come with a fee; we were told to only give a tip for the caretaker). Being the money-scrimpers that we were, we were in agreement to take just one room (60 cedis per room/night, inclusive of breakfast). The balcony at the back had very comfortable seats and was also tastefully decorated. Having meals there was a challenge, as we had to share it with flies; although I noticed that they were less conspicuous during breakfast. At lunch they were just pests. I am not sure if the reason we ate so quickly at lunch was because of the pesky flies or because we were chasing the sun before it decided to set. Either way, by the time we finished our barracuda spaghetti we were all clutching our stomachs. It really is never good to eat too fast too soon, but after waiting for 2 solid hours for lunch we couldn’t help it.  Back home when something we order at a restaurant takes too long to arrive, we joke about how the cooks might still have had to catch fish from the sea or pluck the vegetables from the earth. It was almost true—our lady cook did have to buy vegetables and the barracuda from the market. Who knows if they also made the pasta from scratch?

The Common Room
It was a quiet 10-minute walk from the guesthouse to Ada Beach. Three black goats greeted us on the way, all of us walking on orange soil. Just before we enter the mouth of Ada Beach, I see this almost abandoned-looking white and blue-washed church on our right. It is eerily beautiful, as all structures that are near to the sea always are. Like a witness with old eyes it stood proudly. Its bell, which seemed to be as old as the building itself was housed in a tower with a rusty roof that seemed to be trying to be present but was almost absent. On the front lawn is a sizable patch of cacti. In the glow of the early afternoon sun, the thorns looked almost friendly I wanted to touch them. I was starting to get enamored when Ludo called out to me loudly from the beach, reminding me to ‘take pictures tomorrow!!’ He had a mission that commenced from then on — to find a good bar and join a party, you know just like in Kokrobite.

At Ludo’s command I walked with anticipation towards the beach to join him and Laura. It was one of the most breathtaking sights I have ever had. It reminded me of the beach I and my family went to in Chincoteague, Virginia the summer before my sister left for the Philippines. White, powdery sand that tickled every nerve on my feet. Giant waves that swelled and shattered again and again, creating an almost heavenly haze above and beyond, cooling the air around us. With my eyes closed, the blare of the city, the dust of the traffic and the long wait at lunch were all of a sudden behind me. The sea does this, doesn’t it? It quiets everything down, almost as if your being at that precise moment is all that matters, and that defined moment is all you really have.

We walked almost to the end the end of Ada Beach to look for Cocoloco Beach (where we thought there was going to be a bar).  Asking for directions from different strangers who didn’t know much English was fruitless, and after dawning on us that we would not find Ludo’s utopia that afternoon, we decided to head back. 
One of Ludo’s many attempts to get directions to Cocoloco 
As we settled on a spot some kids started to inch their way towards us. At first they were shy, hesitant. They were observers of the obronis, giggling and nudging each other. It took them only minutes to warm up and approach us. The gate opener was when I went up to them and requested to have a photo with them. Then they were all over us— stroking our hair, climbing over us, sitting on our laps, hugging us, borrowing our sunglasses and posing as models. And the best of all? Dusting the sand off our back, off our legs and arms, shaking off the sand from our towels and folding them neatly. I felt like a movie star. My favorite was Gloria, a girl who looked like she was probably 2 years old.  She warmed up last and when she finally did, oh joy—she was the most stunning child. Big, bright eyes, each corner of her face so perfectly chiseled on a canvas of chocolate-colored skin. Sitting up very straight on my lap she looked like a princess-in-the-making.
First they were far away and shy

The gate breaker

Me and my favorite girl, Gloria

Stunning!

Closer and closer!

Our models

Dusting off sand 

See what I mean?
By 7pm we were again ready to eat. The only question was where. After 3 weeks here I knew that this was not going to be a simple matter to settle. Eating at the guesthouse was not something we initially considered after the two hour wait we had at lunch. So we thought of eating at Manet Paradise Resort that was reported to have an excellent restaurant. But, as our luck would have it the resort was being renovated. Plan B was then Cocoloco Beach Resort, but to get there we would need to ride a motorbike, which seemed to be Ada’s local version of a tro-tro. I laughed at the idea of riding a motorbike at night with a man I didn’t know from Adam. So that was immediately scrapped off the list. Next in mind was Brightest Spot, a popular restaurant and bar that was around 10-minute walk from our guesthouse. Seeing that the road leading to it was dark and after encountering a very strange local (he insisted that Laura said she and I were both Europeans, and got angry when Laura denied ever saying it; this was the local who said we shouldn’t be afraid of him because he was the UN’s ambassador of goodwill), we decided to head back to the guesthouse and re-consider our options. We then re-thought of eating at our guesthouse to save us the hassle of searching for a restaurant in dark alleys and riding motorbikes. But again this idea was killed when N, one of the caretakers of the guesthouse, said that unfortunately he couldn’t take orders anymore because the cook has left for the night and would not be coming back until the following morning. So really, that left us with two options: going to bed hungry or walking to Brightest Spot. N made it easier when he volunteered to walk us there. I gladly took his offer. I always try not to be proud and accept help when it’s offered.  
The Brightest Spot’s strongest point for me was serving food in under 30 minutes. In GMT (Ghanaian Maybe Time), this timing was phenomenal. As we sat down I asked the waiter for the menu. He smiled, bowed to us lightly and said, ‘Yes. We have a menu.’ I said if I could have it. Smiling and again bowing, he said, ‘Ah, but I am the menu.’ We have chicken and chips. Chicken with rice. Fish and chips. Fish and rice.’ Four items. Knowing now what they mean by ‘fish and chips,’ I opted for the fish (tilapia) and rice. N, whom we invited to join us for dinner, at the start was so shy around us that he would not eat the chicken with his hands. As he warmed up he was already using his two hands and finishing up the chicken until only clean bones were left. N was 18 years old. He was still in Senior High School. After school he works at the guesthouse. He was planning to take up accounting. He was the only boy in a family of 5. His father passed away when he was young. I said, ‘when you grow older you will be the father of the family.’  I think he liked the idea because he smiled and laughed. I was starting to like him, until he took the 1 cedi out of the 2 cedis we were going to give the waiter as a tip. We were standing up when he noticed that there were 2 cedis on the table.  ‘You left this,’ he reminded me as he pointed to the bills.’ I said it was for the waiter (who we thought was excellent, as he was able to recall our orders without scribing them, give our orders on time and was very amiable).  ‘Ah, then I will get one,’ was what N said as he casually pocketed 1 cedi.  Incroyable.
Ludo and I, seeing that the night was still young decided to head over to the bar just opposite our guesthouse. I don’t know how we did it, with his limited English and my more limited French, but we drank and talked until we were the only ones left in the bar. It was quite an interesting crowd, composed mostly of young men. There were some women but they were very few. One guy walked in dressed as a woman and started dancing like a girl. If it were not for his baritone voice and muscular build I would have taken him for a girl the way that he moved his hips as he danced. And I’m pretty sure I wasn’t tipsy that night.
Coming from our Kasoa home base where there are only the most basic of necessities, our air-conditioned room with soft mattresses was a bright promise. We all expected to have a good, restful night. Mine for the most part was, except that it was 22 degrees (Celsius) inside and our flimsy blanket was not properly suited for it. I kept waking up to cover more body surface area. However, compared to Ludo I had an outstanding night. Poor guy, mosquitoes feasted on him all night. At 3 am he woke me up and asked if he could have some insect repellent. I got up, took out my 100% DEET spray (the one that I suspect is not good for your skin if it ruins your nail polish, your watch and your wrist pad) and with two squinting eyes sprayed some on his back that already had innumerable wheals (I am exaggerating; he only had maybe 10?).  Later on I heard him repeatedly slapping the wall and clapping his hands. Feeling his misery I suggested that he move his mattress on the floor next to my side of the bed where I thought there were no mosquitoes. For some time he was quiet and I could sleep too. Then later on I sensed him moving. I asked him what it was this time. He was too cold. Apparently it was not only I who was feeling the chill. Putain, I heard him mutter several times.
But as they say, each morning has new mercies. And the following morning indeed we were blessed with good things to remember forever. I didn’t realize it then (as we often grumble at unexpected twists of events) but looking back now, when the heavens opened its belly to rain down on us it was its way of washing us of the night’s miseries. Had I known then, I would not have covered myself so greedily and instead I would have lifted up my head and stuck out my tongue to taste the delicious wash-down.
To be honest though, it was initially a bit discouraging to see the dark clouds as we walked out of the guesthouse. It was only our hardiness that made us take the first step out of the gate, instead of retreating back into the oyster of our house. When we felt the first, the second and the third and especially the fourth credible raindrops, we quickly ran for cover under the tree. Ludo and Laura were both seated. I preferred to stay standing. As I was looking down I saw that Ludo’s fly was halfway open. ‘Are we friends?’ I asked. Confused he replied, ‘Yes of course.’ (Meanwhile Laura was wondering where this was leading to.)  ‘Ok so don’t be embarrassed when I tell you that your fly is open.’  He looked down, laughed and said ‘ah but I really pulled that down because it was so hot!’
WHO DOES THAT?! So hilarious this Ludo. I cannot even imagine how pulling your fly down halfway would air-ify you. I would take out my whole shorts if I needed to. Oh, but not him. Eventually he zipped it up. Peer pressure.
E, our guide and owner of Not Now boating company – so named because 15 years ago when they started their business they could not think of a name yet; hence: Not Now— picked us up at the tree and walked with us to the river where his boats were located. By the time we reached the boats the heavens close up its belly and the rain stopped. There was a faint rumor of sunlight whispering in the distant sky. By mid-day this rumor transformed itself into big news and we were sweltering under its heat.
E and their boat, also called Not Now

A hint of sunshine just in time
We were brought around the fishing villages, the estuary (where Ada Beach meets the Volta River) and Crocodile Island. We settled ourselves for 2 hours in the beach camps, where a patch of small huts is lined up along the shore that sits between the river and the sea. It is a form of accommodation in Ada that one can opt to have, for only 20 cedis a night. But given the lack of electricity and running water only a few actually stay (mostly it is young backpackers who stay). Their doors are painted with national flags. Realizing that I most probably would not find my flag painted on any door, I posed beside a hut that bore the Japan flag. I might as well, right?
Konnichiwa!

Restrooms

The huts in the beach camp

I and Ludo swam for a bit in the river, as the sea on the other side had waves that were too strong for swimming. Laura chose to chill on a hammock. I debated on this but I love water too much to resist its call especially once it glistens silver under the blue sky. Ah, the cool water was a joy. It was hot and cold making love and reaching a climax.
Our lunch was not without some drama. Again. I ordered ampese with tilapia (I think this meant stew cooked in red palm oil). Laura ordered tuna salad, thinking it was the most simple and fool-proof food to order. Ludo ordered chicken with Jollof rice, I think. My order was correct (and was delicious). Ludo’s didn’t come with a chicken. Laura’s never came. ‘Oh,’ the server said, ‘we don’t have tuna salad what would you like to have?’ Furious and hungry (never a good combination), Laura ended up ordering a piece of chicken, resigned to her fate. When the bill came, it seemed like she was going to vomit out all her food when she saw that her chicken, after all the hassle and bustle, cost 8 freakin’ cedis. I think the person who enjoyed her chicken the most was the girl who sat down with us and watched us eat. She devoured everything.

Ampese with tilapia, plantains and egg
As we had to hurry back to the guesthouse if we wanted to stand a good chance at getting a tro-tro, we agreed to ride a motorbike. Ah, the best decision ever. Getting up and propping my legs in between the seat was a challenge as I was wearing a dress. But once that was taken care of, everything fell into place and as we rode through the village I managed to let go of one hand and reach for my camera and take infectively happy photos of myself (or more accurately, my shadow), Laura and Ludo (or more accurately, his back). These are kinds of photos that imprint memories in your mind forever.

Waiting for an Accra-bound tro-tro in Ada Foah was our training in patience. Ada Foah is not frequented by tro-tros as much as the other cities we have been to. I think we waited for a good one hour in the junction before we found the one. As we were waiting, a man with two good-sized goats came. The goats were tied with a rope. The man at first held the rope with his hand, then when he had to make use of his hands to eat and drink, he tied the rope to his foot using a loop. The ingenuity of men. Ludo and I conjured a make-believe story about how we would ride with the goats for 2 hours to Accra. We both snickered at the thought that we assumed was incredulous.
A thing is only incredulous until it turns real. As I stepped into the tro-tro and climbed onto the back end, I froze in what could only be described as unguarded alarm as I had this vision:
Oh yea– a goat under my seat
You have to understand: I don’t eat meat not because I love four-legged animals. As an example, I can admire a beautiful dog from afar but I would be the first one to run for cover once it approaches me. Upon seeing the goat’s legs under the seat I was going to sit on, I grabbed Ludo’s arm and told him to go ahead and take my seat. I said in panic, ‘there’s a goat under the seat!!’ He looked at me in puzzlement as he nonchalantly scooted to the seat. When he himself realized that there was a goat under him, he looked at me in panic too and said—look!look! I said, ‘that’s what I was telling you, and that’s why I wanted you take the seat!’ Then he laughed and said, ‘ah but I didn’t understand you! What is goat?’ I double-checked behind us and true enough, the goat owner was putting the second goat under my seat this time. At any rate, he thanked me for my thoughtfulness. Our goat ride, once an incredulous make-believe story, was now a true, living reality. We could not stop giggling as two living things would episodically kick and make sounds under our very seats. 
We made it home after only 3 hours of travel, which I thought was impressive. I was psyched to travel for 6 hours, but thanks to the high school boy who led us to the right tro-tro in the right station, we got to Kasoa comfortably in time for dinner. We rode the biggest tro-tro I have ever seen. The green light was almost psychedelic and hypnotizing.
There are days and trips that pass you by—those that do not leave an imprint on your mind nor create memories. And then there are those days and trips that, by virtue of unforeseen chains of events that are both side-splitting and heart-tugging, impress on your core forever.
This was one such trip.