Friday, January 6, 2012

PEPFAR Field Activities (Nov. 8-11)

President's Emergency Plan For AIDS Response.
All 25 of us NRM trainees were split in to about seven groups, based on site location, for PEPFAR activities.  My group was made up of all o us in the Upper East Region, and part of the Northern Region group.  This ended up being the biggest group, comprised of Ran, Rob, Dawn, Barbara, Dennis, Megan, Linda, Diana and me. So Tuesday morning we all left our sites and started our journey to Gushie, a town about 45 minutes north of Tamale, where Katie would be hosting us for these HIV/AIDS activities.  All of us Upper Easters met in Bolgatanga to catch a Metro Mass bus to Tamale.  We met at the bus station at 8:30 AM, left at 10:30, and arrived in Tamale at about 2 PM.  Once in Tamale, we navigated ourselves to some taxis to get to the TSO (Tamale Sub Office), where we would meet up with Katie.  Rob painstakingly negotiated fares with two cab drivers for about 10 minutes.  I will keep it PG and leave out the profanity, but we do still have a good laugh when I remind him of the funny things he said when he was quite peeved. (Dan told Rob that the fare between the taxi station and the TSO should be 50 pesewa/person, plus a little extra for our luggage, which would have means it should have been about 3 cedis total per car.  Well both drivers wanted 5 or 6 cedis...yea, that did not fly with us.)
At the TSO we got a few minutes to unwind, and talk to some of the other PEPFAR groups that were meeting their respective PCVs at the TSO also.  And, thankfully, those who HAD to get to a computer were able to get on to the internets.  Once we met Katie, we went over the game plan:  go into Tamale to buy food for breakfast and luncd (dinners were already planned for), and then catch a tro to Gushie.  So we stocked up on oats, oranges, Milo and anything else we wanted.  Katie warned us that Gushie didn't have much food to buy. (Normally villages have a few chop bars, or at least vendors that sell food, but Katie was right, there really was nothing at all to buy at her site.)  I treated myself to a FanIce (really sweet vanilla ice cream in a plastic bag) and a chocolate milk (which wasn't a great idea since I haven't had much dairy since getting to Ghana..)
Amazingly, we all caught one tro tro to Gushie, and Katie negotiated a very good price for us, despite all of our luggage and pots and pans and food we had to carry with us.  We all stuffed ourselves in the tro, I got the very back right coner, next to an open window.  The breeze felt very nice as I watched the sunset out of the back window.
Katie's site was right on the highway that runs between Tamale and Bolga.  The guesthouse we stayed in was a few hundred feet off the road and Katie's house, which right on the road.  The rest of the community was on the other side of the highway.  Crossing busy, busy highways and roads is now a normal occurrence; at first it was a bit scary to cross the roads as cars flew past.  Luckily Gushie has speed bumps, so it was not quite as bad to cross the road as in some towns.  Katie's little living area was very nice- there was a room outside, screened off, that we cooked in, a small living room where we ate, and her bedroom.  The latrine was inside the compound, which required you to walk around the building to get to.  Most of the time we just urinated in the bush right outside here door.  We were promptly greeted my Katie's three small kittens- so cute!  Dawn and I went into cat-mode (i.e. baby voices, lots of lovin', etc...) much to the surprise of our fellow trainees.
The guesthouse was very big, even walled off with a security guard.  It was all set up to have electricity and running water...buuut neither worked, for reasons I don't quite know.  We were supposed to get running water while we were there, but it never did come.  So we walked around at night with our headlamps, and flushed the toilet with a bucket of water if we didn't feel like going outside or walking all the way to Katie's latrine.  We slept of foam mattresses on the floor, surrounded by piles and piles of dead and dying stink bugs.  The whole house was sprayed the day before we arrived, and we never really saw live stink bugs, so the place was sprayed very well.  Mmmm, chemicals.
Breakfast: oatmeal with currants that Barbara found in Tamale, oranges, tea bread with groundnut paste and jam.  Lunch: Indomie (like Ramen noodles), fried yams with groundnut powder from the vendor across the street, tea bread with groundnut paste and jam, oranges.  Dinner: the first night we had rice with a veggie stirfry, the second nice was a creamy potato and veggie soup and the third night was spaghetti with fresh tomato sauce.  Dawn's 30th birthday was on the last day, so Katie made brownies from scratch for her.  We put Hershey's chocolate sauce on it, and it tasted like heaven.  The brownies were made in the morning, so at breakfast you could already smell the brownies cooking...I thought about brownies ALL day.  And it was worth it, such a delicious meal.  Dinners were not quite American food, but they were definitely NOT Ghanaian food.  We all greatly appreciated the cooking, and it gave me some ideas of what I will cook myself once at site.
The first day of PEPFAR activities involved us going to the local primary school to teach the children about HIV/AIDS.  We split into groups: Rob, Ran and Megan took P5 and P6, Dennis and Linda took P3 and P4, Dawn and I taught P1 and P2, and Barbara and Diana took KG.  Dawn and I began our class by introducing ourselves, to the class of about 50 kids, and our warm-up activity was singing "Head, Shoulders, Knees and Toes."  Then we started asking questions like "How do you feel when you are sick?," and, "How do you want to be treated when you are sick?"  Then we described how HIV compromises the immune system, so your body does not fight infections very well.  We compared the immune system to an army, so when you have HIV, it is like your body does not have its army to protect it.  Then we asked the kids how you get HIV.  There are always some good answers, like "from sharing food" or "from shaking hands."  So we set them straight on those very, very common misconceptions, but who knows how much of what we said stuck with the kids.  There is lots of discrimination against those with HIV in Ghana, so a lot of our presentations focused on discouraging the stigma against HIV.  To do this, we ask the kids "How can you tell when someone has HIV?"  And then point of this is to tell them that you cannot tell, just by looking at someone, that they have HIV.  It is true that when HIV becomes AIDS, children say you can tell that a very sickly person has AIDS, but for our purposes we emphasize that you can not tell just by looking.
After we stated the facts of HIV/AIDS, at a very basic level, we had them make cards for people living with HIV/AIDS.  At first, the students just sat at their desks and looked at the crayons and paper, but eventually they started to draw their own pictures.  Dawn and I drew our own card, which many of the kids decided to copy, but some thought outside of the box and came up with their own cards.  After finishing their cards, they were free to play for the rest of the day.  Usually the school day goes from 8 AM-2 PM, but many times teachers do not show up to class, so the children just sit at their desks all day with nothing to do.  The P1 and P2 kids that Dawn and I taught did not have a teacher, so they had free reign all day.
Before Dawn and I taught our class, we watched Rob, Ran and Megan teach the P5 and P6 class.  This was very difficult for them:  Rob would ask a question, but no one would raise their hand to answer.  Then their teacher would tell them that they should participate because we are white people that have come to teach and they should take advantage of the opportunity.  Still no response.  This went on for a while.  Katie explained to us later why the participation was so low: in the Ghanaian teaching system, creative thinking is not encouraged, rather their method of teaching call and response, repetition.  Also, if you answer a question incorrectly, you get beaten, so students would rather not attempt to answer, than answer and get hit.  Our lesson plans were full of questions, but as the students got older, the harder it was to encourage participation.  I also learned that corporal punishment is not allowed in Ghana, yet it happens at all schools anyways.  It is ingrained in their teaching and parenting styles.
Since the P1 and P2 classes didn't have a teacher, (sometimes classes don't have teachers, or the teachers simply do not show up, but still get paid) the little ones would come out of their classrooms to look at what was going on, but then the headmaster would come around a punish them for not being in their classroom.  At one point the headmaster came to talk to me, and since I had introduced myself earlier, he knew my name.  He asked me if I knew Britney Spears.  I said that I know who she is, but I don't personally know her.  Then he said, "So you can sing?" And I said, "Oh, no, no, I can't."  Him: "Yes you can."  Me:  "No really, I definitely cannot."  And then I stopped talking to him.
At about 1, we were finally done for the day.  After a lazy afternoon, Katie took us to greet a woman in her village who just had baby.  We were supposed to to to the baby girl's naming ceremony, but I guess that was not in the plan.  In Ghana, they have naming ceremonies about a week, sometimes more, after a baby is born.  We all had a chance to hold the baby (I declined though), and the mother brought out henna ink which they produce themselves, to paint our feet with.
On out second day in Gushie, we planned an HIV/AIDS fair.  Beth, the new PCVL in Tamale, came to help us.  She seems nearly fluent in Dagbani (the local dialect), so it was fascinating to watch her interact with the village.  Katie rented some big speakers, and we even had a DJ with a pretty impressive set-up- computer and all.  We came up with games that we would play with the adults and children- water balloon toss, relay races, bread-eating race, dizzy bat/carry things on your head races and corn hole.  For prizes, we gave the children toffees, and the adults condoms.  Katie told us that the people in her community go CRAZY for free condoms, so we always had someone guarding our huge bag of condoms.
All the games were successful- the kids had a lot of fun and everyone enjoyed themselves.  We were happy that a lot of people showed up; Katie says you ever really know how many people will show up to events or meetings you have.  The music had all the children dancing; it is so much fun to watch them!  The area was very dusty, so as the dancing went on, we were all covered in the red dust.
After games, we had two Ghanaians demonstrate how to put on a condom, then we were treated to an HIV/AIDS drama (Ghanaians love putting on dramas).  It was very entertaining, even though we couldn't understand it.  The dancing continued late into the night, and there was also an HIV/AIDS movie shown, but lets face it, I was tired, so I went to bed instead of watching something I wouldn't understand anyways.
Our experiences at PEPFAR were very interesting and useful.  At some point I plan on doing activities in the schools in Kongo, so having a chance to teach firsthand and see the Ghanaian teaching system in action was very valuable.  Putting together the fair also seemed like it worked well-people enjoyed the games and prizes and dancing.
The following day, it was time to leave Gushie to travel to Techiman to have our off-site technical training.  Gushie doesn't have any tros that specifically stop there, so Katie told us we'd have to hitch rides on whatever passes through- truck, tro or taxi.  Luckily, eight of us caught one taxi to Tamale.  Needless to say it was a very cramped 40-minute right.  Dawn sat up front with the existing passenger, then four of us squeezed int he back row, and the rest were in the trunk.  All of our luggage was piled on top.  Once in Tamale, by some small miracle, we all caught the same tro to Techiman and it left within 10 minutes of us getting to the tro station- by far the least painful tro experience I have had in Ghana.
The ride took about 4 1/2 stops.  I'm getting good at not having to go to the bathroom on these long trips.  Rob, Ran and I were in the very back of the tro, which at first wasn't so great, since the back is usually where its the most cramped, but once it started to rain, and water poured through the holes in the roof and through the windows into the middle of the tro, sitting in the back didn't seem so bad.  Rob and I were fascinated by the dramatic change in environment and weather.  At the start of the day, if you were to have said we were going to see rain, we wouldn't have believed you.  We got used to the days being very hot and sunny and dry and dusty in the northern regions.  As you drive south, it becomes very lush and green, even cloudy and rainy, humid...and for a minute there, as it started to rain and the windows of the tro were still open, we felt a little cold.
At the Techiman tro station, we crammed into a couple taxis to the hotel.  I was pretty hungry, so I bought some boiled eggs out the window of the taxi.  At the hotel, I walked down the street and bought some red red (beans in lots of palm oil), with gauri (a type of ground grain), and some fried plantains.  Back at the hotel I washed it down with a beer.  Delicious.

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