Goodbye Muddah, Goodbye Faddah

Or rather......Goodbye Ghana! Goodbye Doris Duke Foundation! Goodbye Relaxing/Exciting Year Off!

Yes that's right everyone. If you hadn't figured it out by the fact that I haven't posted in almost 2 months, I'm officially shutting this blog down to head off for greener pastures known as "My 4th year of medical school."

I was really, really sad to leave Ghana in May, because as anyone who has travelled can probably attest, it feels like no matter how long you are in a place, you feel like just as you're really, truly settling in, your departure date arrives. And so with some sadness and good-byes, I hopped back across the pond to New Jersey.

I've been super busy with reorganizing my life in the US and wrapping up my year of research. Happily, part of this included attendance at the annual Doris Duke conference in Dallas, TX. It was my first trip to Texas, and provided a bit of a step-down in terms of the weather from Ghana. Ghana = 100 and humid; Dallas = 100 and dry. I also got to see at least 4 men wearing cowboy hats over just 48 hours, eat venison at a local steakhouse, listen to an old bearded man play Johnny Cash at a local dive bar, and.....oh yeah present my research to the other fellows. There were about 100 of us in total and (nerd alert) I actually really enjoyed hearing about everyone's work and future plans. But to counter our collective nerdiness, the Doris Duke fellows (and even some faculty! Mt. Sinai and Iowa, I'm looking at you!) also proved pretty adept at drinking beer and playing FlipCup. Hooray!

So yes, I'm now tucked back into the wonderful world of New Jersey, preparing for my fourth year and a residency in Anesthesiology. If any of my future adventures land me back in Africa (or Latin America, or Asia, or....well you name it) you can bet on this blog being resurrected. Till then, thanks for reading!

Tower of Babel

A lot of students study abroad in Ghana because it is considered an "English-speaking country," as opposed to its "Francophone" neighbors Togo and Cote D'Ivoire. But in reality, the predominant languages used in Ghana are neither English nor French. And once I venture out of the city (or to the pediatric ward where patients have come from more rural areas), I'm suddenly out of my language comfort zone. African countries are in reality dominated by hundreds of local languages. In Ghana, the primary tongues are Twi (pronounced like "Chree"), Ga, Ewe, and Afante. If you don't speak one of these languages, you're at a disadvantage in all sorts of situations (and can't even understand the radio, sadness).

I was quite surprised at the dominance of these languages. On the wards of Korle-Bu, I actually need a translator to provide my study patients with informed consent, and Ward Rounds can be a complete mystery. However, I love languages and was optimistic about picking up some Twi. Two things have made this task especially difficult:
-I haven't been able to track down any Twi books all year.
-Most people speak to me in English if they can, as a courtesy.

However, thanks to a spunky soda vendor at the medical school who insists in talking to me in ONLY Twi, and getting quite angry (in an endearing, yet intimidating way) when I forget her lessons, I've made some progress! Today, on the sidewalk, I was super proud of the following exchange, accomplished entirely in Twi:

Me, speaking to an older female vendor: "Good morning, your dress is very beautiful."
Lady: "Thank you! What is your name?"
Me: "My name is Meghan, and yours?"
Lady: "My name is Gifty."
Me: "I'd like some peanuts."
Lady: "Ok. Good-bye!"

I know. Not so impressive, maybe. But exciting for me!

Addendum: The small boys in Kokrobite (a beachtown near Accra) also love teaching me Twi. Although with them it's more of a contact-sport language lesson. They perform a simple act (i.e. sitting down, jumping) and say the accompanying Twi word. Then I repeat the word and make them do the task. Once I learned a few words, it was like a giant game of Simon Says!

Chale (Ghana-ism #3)

Chale (pronounced Chah-lee), is a common West-African nonsense word. I've encountered it in conversation with Ghanaians, Nigerians, and even in an autobiography from Sierra Leone (note: A Long Way Gone is an amazing story of a child-soldier from the Civil War in SL, and requisite reading for anyone going there. Plus, it's an easy read. But I digress....). Chale can be used in almost any context, and it might be easiest for me to just point out some examples:

Taxi driver: "This ride will cost you 5 cedis."
Me (being very Ghanaian): "Ah! Chale! That is too much!"

Boy watching football in my hostel: "Chale! Did you see that goal?"

My roommate Ama, on the phone in our room: "...Chale! No way! Tell me what happened!"

No one seems to have any firm definitions for Chale, so I'm loosely considering it a sort of benign expletive that's flexible enough to be used happily, out of frustration, or with anxiety. But in general it's a fun word, and makes any visitor to Ghana feel a tad more native.

Hey! Chale!

Taking a Walk Downtown....

So despite the fact that I've been updating this blog so regularly throughout March (*pats self on back), the fact remains that most of Accra still has little to no internet access--including the entire compound and surrounding areas where I live/work. Instead, I've been demonstrating my utter devotion to blogging by coming downtown to the Vodafone Internet Center, which has a high-speed connection all the time. This is usually a quick taxi ride, less than $1. In traffic, however, it can take up to an HOUR. Ack! The other day I surveyed the bumper-to-bumper traffic and decided that it would be much more fun to just walk home. (This later horrified my roommate, who worries for my safety, but really, Ghana is a wonderfully safe place, and it was still light. Or at least sort of light.)

So off I went down High Street, walking through historic Jamestown past old prison forts and watching pickup football games as I went. I really think any city can be better appreciated from the 'a pied' approach, and this particular walk was awesome.

Obrunis don't usually cruise solo down High Street at dusk, however, and I attracted lots of funny stares and "Hi Obruuuniii!" calls as I went. Soon, I had a literal parade of children following me. All I needed was a flute to complete the Pied Piper look!

One little girl, Princess, took a particular liking and held my hand as we walked.

"Where are you walking?"
"To Korle Bu."
"Ah! All the way?"
"Yes. Look, traffic is so bad that I am passing the cars!"
"Ah yes. But......you will come visit my house on the way?"

And for once, I accepted a friendly street-side invitation and detoured off through a small encampment to Princess' home. Anyone living in Camden or Newark might be horrified by this story, but I've really begun to appreciate the genuine generosity of Ghanaians and didn't feel at all threatened by the situation. I was still quite the scene however, and had to use my best Twi skills to greet everyone we passed.

We reached Princess' home, just 2minutes off of High Street, and she introduced me to her parents. Her house was small shack with a curtained-door, and inside her parents sat watching a football game on TV. There was no light other than the television's blue flicker, and the entire home was about 4x8feet. Hairdressing materials littered the shelves, among random food parcels.

"Nice to meet you! Princess invited me over to say hello. You are a hairdresser?"
*Nods, shakes my hand
"Very nice. Princess, where do you all sleep?"
*Princess points to the floor
"All together here?"
*Nods
"That sounds nice. Well it was nice meeting you! I'm off to walk again!"

The entire interaction lasted only about 5 minutes, but I was overwhelmed by a few things:
1. Princess' parents weren't surprised at all that their daughter had brought an obruni to meet them, and greeted me as if I lived in the village as well.
2. The home was small. And at least 3 or 4 people would share the floor that night. The same floor that serves as a salon during the day.
3. They had no lights, but they did have a working television.

Gave me some perspective on life in Ghana. Made me realize that I should never have complained about the size of my dorm room in college. And that being able to watch football on your own television is a huge status symbol.

It seems that lately I am finally putting aside some of my American tendencies toward suspicion and defensiveness, and embracing a bit more of the Ghanaian friendliness. And it's wonderful! The rest of the walk to Korle-Bu was similarly enjoyable. The children couldn't walk the whole way, but our parade lasted at least a kilometer. Several pedestrians later helped me cross the Korle Lagoon and, upon nightfall, get a taxi the last several kilometers.

I'd just like to suggest that anyone living in a (relatively safe) African city take the time to occasionally walk. Really walk, over a long distance. It's one of the best ways to meet real locals, appreciate the scenery, and slow things down a bit. And it sure beats traffic.

Bathroom Humor

STORY ONE
At a bar in downtown Accra that I've frequented over the past few months, there's a sign on the bathroom door that confounded me:
Please do not put toilet paper in Toilet. Use waste beans and help keep this place clean.

Me thinking to myself: Waste Beans? What the hell are they? (looks around bathroom) Is this some sort of new technology I'm missing? Wait, I'm in Ghana. Can't be new technology....

Me outloud: Waste beans, hmmm, waste beans....waste beeeeeaaaanssss......oooooh... WASTE BINS!

From now on, I will refer to all garbage cans as Beans. And chuckle. hehehe.

STORY TWO
This past weekend I was joined by a Princeton friend, Ariel, who's living in Liberia for a year. Ariel did the Peace Corps in Mali, so she's pretty excited about West Africa, and it was awesome to have an enthusiastic travel buddy. We headed off to Green Turtle Lodge on the Western Coast for some R&R deserted-beach style.
30 minutes down the beach from Green Turtle is the tiniest, cutest little village, and we went there on Saturday to buy cheap water. As with any small African village in Ghana, we were greeted by a crowd of children as if we were huge celebrities. Soon, Ariel found herself a cute baby to play with. No one can resist the offer to play with cute village babies. Believe me.
Soon, however, Ariel started laughing and telling me how the baby had made a huge fart. Sure was comfortable in her arms! But the next thing I knew, there was a strange gooey substance running down Ariel's beach wrap......
SHE GOT POOPED ON.
This of course caused a commotion in the village as everyone laughed at the Obruni's misfortune (I was probably laughing the loudest, Ariel second), and the mother whisked the baby off and ushered us into her house to clean Ariel. All in all, a successful visit to the village!

I want to take you as a friend

(or....Ghana-ism #2)

The title of this post is something any visitor to Ghana will hear on a DAILY basis, from taxi-drivers, waitresses, street vendors, and passing children. Well, passing children will probably just yell "Obruni!!" at you, but still. They'd probably say it if you gave them the chance.

West Africans are known for being especially friendly, and Ghanaians are the prototype. When they say they want to take you as a friend, they mean it! Giving out your phone number will result in them calling you 10,000 times a day to "chat," "see how you're doing," or invite you to their wedding. Seriously.

I like to take my time in getting friends, and usually treat strangers with a healthy dose of skepticism, so this approach has freaked me out several times. I've learned my lesson though. Unless I actually want a new Ghanaian friend, I just tell them that I reserve my number for "work only." And in response to the question, "But when will I see you again?!" I say simply, "You'll just have to pray we meet again." Ah, the power of prayer.

Sad News

Jos, Nigeria
(taken from msnbc.com)
http://www.msnbc.msn.com/id/35759877/ns/world_news-africa/

"At least 200 people, most of them Christians, were slaughtered on Sunday, according to residents, aid groups and journalists. The local government gave a figure more than twice that amount, but offered no casualty list or other information to substantiate it.The violence in three mostly Christian villages on Sunday appeared to be reprisal attacks following the January unrest in Jos — when some 300 people, most of them Muslims, were killed, Red Cross spokesman Robin Waubo said. State officials did not comment on the cause of the latest attacks.

Plateau State spokesman Gregory Yenlong said Sunday's toll could be much higher. "Soldiers are patrolling and everywhere remains calm ... We are estimating 500 people killed but I think it should be a little bit above that," he said.

Death tolls have been highly politicized in previous outbreaks of unrest in central Nigeria, with various factions accused of either exaggerating the figures for political ends or downplaying them to try to douse the risk of reprisals.

On Sunday, the bodies of children tangled with each other in a local morgue, including a diaper-clad toddler. Another young victim appeared to have been scalped, while others had severed hands and feet. One woman victim in the morgue appeared to have been stripped below the waist, but later covered by a strip of black cloth.

Jos has been under a dusk-til-dawn curfew enforced by the military since January's religious-based violence. It was not clear how the attackers managed to elude the military curfew early Sunday.Acting President Goodluck Jonathan said security agencies would be stationed along Plateau state's borders to keep outsiders from coming in with more weapons and fighters.

"(We will) undertake strategic initiatives to confront and defeat these roving bands of killers," he said in a statement.

Ghana-isms

Two days ago, March 6th, Ghana celebrated its independence! This is a pretty big deal, as Ghana was only born 53 years ago. It was the first African country to achieve independence from Europe, under the leadership of “The Big 6”:

1. Dr. Kwame Nkrumah
2. William Atta
3. Emmanuel Obetsebi-Lamptey
4. Dr. Joseph Danquah
5. Edward Akufo-Addo
6. Ebenezer Ako-Adjei

It’s hard not to learn about these guys when you visit Ghana, because
- they’re on all the money, and
-the major roads/roundabouts in Accra are named after them.
So if you don’t know where Nkrumah circle or Danquah circle is, you’ll be lost as well as poorly-informed.

Nkrumah is the man you’ll hear the most about, because he served as the first president of Ghana. Like Ghana’s George Washington. Not only is he memorialized in the major circle of Accra, but there was also a museum and monument park built in his honor.

So, in honor of Ghana’s independence, the next few posts will be about unique “Ghana-isms” that I’ve learned while I’ve been here. Anyone spending more than a week in Ghana will probably hear at least some of them…...

Are you sure?

This may seem innocuous, but it isn’t used in the expected context. For instance, no one will ask you if you’re sure you want chocolate versus vanilla ice cream. Rather, they’ll catch you off guard like this:

Taxi driver: “So, are you German?”
Meghan: “No, I’m American.”
Taxi driver: “Are you sure?”

As if I don’t know where I’m from? Let’s try another example:

Medical student: “So why are you here in Ghana?
Meghan: “I’m doing research on HIV in the Children’s Block.”
Medical student: “For how long?”
Meghan: “8 months”
Medical student: “Are you sure?”

Hm. I hope I have my departure date correct. Since I’m the one who booked it!

I don’t exactly know what Ghanaians are going for when they ask this question. But they do it frequently. Maybe it’s just an icebreaker? Or maybe they have better ideas for me. I’m secretly a German girl who’s here in Ghana for 3 months. I’m slowly learning to face facts: Ghanaians are always right. Once you accept that, the rest of the Ghana-isms become amusing rather than frustrating. Woohoo!

Ask the Ethicist

So I haven't posted for a month. A MONTH. I hereby apologize to all of you out there depending on blog updates to procrastinate from your usual life, but in all honesty, internet access here in Ghana has been total craperoni for the past few weeks. The only way I'm on right now is because my advisor lent me her mobile modem for a few minutes, so this has to be quick. Stay posted for more updates (hopefully) soon!

So as some of you know, I'm conducting a chart review of all the pediatric patients that Korle-Bu Retro Clinic has started on Antiretrovirals since they became available in Ghana. This means that I spend long loving hours in the medical records room sweating, getting dusty, wading through occasionally flooded corridors, and loving my job. ;) But seriously it has really helped me learn more about the clinical management of pediatric HIV. Repetition! Repetition! Woo!

So yesterday I came across a patient's chart with a sealed envelope inside. It contained the VCT (Voluntary Counselling and Testing) results of the patient's father. Now, I am collecting parental data, and want to know if the patient's parents are HIV+ or not. My ethical question for today, dear readers, is:

Would it be ethical to open that sealed envelope in order to get my data?

On one hand, the data is in the patient's chart, which is all confidential. I have been granted access to this confidential data, and am protecting it appropriately, so I am entitled to view everything in the folder.

On the other hand, if the patient's father himself has not yet opened this envelope, then perhaps this is his passive way of saying he does not want to know his status. In a way, the patient is voiding the fact that the test was ever done, and I'm not entitled to expose him (myself, or anyone else) to his data.

In the end, I couldn't take the risk of violating the father's privacy. I left the envelope sealed, left my data entry point blank, and decided that only a patient can be the one to unseal their own medical records. The envelope's presence in the chart was not reason enough for me to view its contents. Weigh in! Let me know what you think!

Lady Volta @ Swank

For all of you who haven’t been religiously reading each post (“Never! We read every single word Meghan! Even about colons and poop!”), last September I was lucky enough to meet two really cool Brits: John and Becks. Both of them volunteered for three months in Ho, a town in the Volta region. John was involved in construction work, which honestly I don’t know all that much about, but Becky is a jewelry designer, and worked with local craftwomen. Jewelry? That sparked my interest!

Becky’s work consisted of revamping the local women’s jewelry business, to improve their advertising, sales, and profits. She’s already a seasoned pro at jewelry, running her own website of self-designed creations at http://swank.bigcartel.com/. During her time in Ho, she got to trade styles with the women, and add a little bit of her own flavor to some of their jewelry. The final product? The 2010 Lady Volta line.

Becky helped the women design the line, and showed them the benefits of online business by posting the collection on her website (The women were initially skeptical, and didn’t want her to make them their own site.). In one week, she more than doubled their sales. I myself fell victim to the Lady Volta line, and may or may not have bought, well, quite a few of their pieces.

The profits from this particular line go to the women of the Volta region, to support their ongoing business and to help bolster their business skills. I’ve noticed that there is a lot of opportunity for teaching managerial skills and business tactics in different parts of Ghana, especially the rural areas. The Lady Volta line is a great example of how partnering successful small-business people with interested groups in developing nations can be incredibly successful.

Anyway, I encourage all of you to check out the collection on her website. It’s a great way to support people in a relatively unknown area of the world, and well, the jewelry is pretty awesome.

Football in Africa

Football, aka soccer, is huge here in Ghana. Well, to be honest, it’s huge in all of Africa. You know those amazingly fast, lean Kenyan marathoners who kind of look like they were raised by antelopes or cheetahs because there’s no other way they could be so fast and make it look so easy? Well those are just the castoffs from the football team, who figured they might as well take up another sport to pass the time. They’re the JV. So you can imagine, football is pretty huge.

This year has been a particularly exciting time to be a football fan in Ghana, because we’ve been playing like rockstars. The Black Stars (That’s the name of the national team. Check out Ghana’s flag on the left side of the screen. Ahh, now you see where the name comes from.) not only won the Under-20 Championships in October (insert crowd roaring), but also advanced to the finals of the 2010 African Cup of Nations (insert crowd going beserk). Unfortunately, we lost to Egypt, but still….(crowd sighs)…..Huge year for football!

I’m hoping this means Ghana will advance to the finals in the World Cup, and I can show off all my newly-learned knowledge about the players. But in the meantime, there is still lots of football to be watched! Some tidbits I’ve learned and talked about over the past 6 months:

-Most Ghanaians cheer for Chelsea when they watch European football on television. This is because Michael Essien plays for Chelsea, and he’s Ghanaian! He’s also on lots of billboards here in Accra selling everything from FanYogo frozen yogurt to fruit juice. Very popular guy, that Essien.

-The African Cup of Nations, held in Angola, just finished two days ago, but it had quite a dramatic course. The Togolese team came under gunfire as they boarded a bus in the 2nd week of the tournament, and three players were killed. Several others were injured. (check it out on the BBC here: http://news.bbc.co.uk/2/hi/8449319.stm) Understandably, the team withdrew from further competition. Or, I guess not so understandably. The Cup of Nations administration suspended Togo from entering the tournament for the next 2 years because forfeit is against the rules!
(http://blog.seattlepi.com/worldsoccer/archives/193046.asp?from=blog_last3)

What?! You would think that a murderous attack might make the “exception” list……TIA…..

-For all of you living under a rock recently, the 2010 World Cup will be held in South Africa. When I visited Johannesburg, I talked to anyone and everyone about the upcoming tournament and festivities. Surprisingly, the population was split: Black South Africans were overwhelmingly excited, while white South Africans were largely indifferent or even unexcited. Concerns ranged from the economic (“We won’t ever make up the deficit that building these stadiums is costing.”) to the social (“A tourist might get attacked and that will hurt our global reputation.”).

-The World Cup’s theme is “We will be one in 2010.” It’s posted on billboards all over Ghana, and I’ve heard lots of people comment that it will be nice to have such a widely accessible sport played on African soil for a global audience. So I was surprised when I read this article: http://www.guardian.co.uk/football/2010/jan/12/world-cup-2010-south-africa-apathy
I guess the apathy stems from lots of things: no money to travel, no cultural support for the idea of a 'holiday,' and the fact that most people might prefer to watch the games on the local village TV with all their friends and family then in a foreign country. Still, it'd be nice to visibly see the continent's (supposed) support for the games.....Food for thought I guess....

Morning Rounds 4

I hope you all didn't think I'd forgotten about Morning Rounds (posting about cool cases) because I haven't! Just been (obviously) busy with other stuff and wanna make sure to keep you interested. Sooooo...with that said.....let me tell you about the patients I saw today!

A team from Cincinatti Children's Hospital came to Korle-Bu this week for a whirlwind surgical mission of pediatric colorectal cases. The patients were already prescreened and prepped by the Ghanaian team so that the Americans could maximize their time here and complete as many cases as possible. I got wind of this mission and requested to tag along for a day. Thankfully, they were very gracious and welcomed me with open arms.

The first case I saw was a colonic resection for Hirschprungs Disease. Hirschprungs Disease occurs when neural crest cells don't migrate properly to the colon during the embryonic period. In layman's terms, this means that the developed child doesn't have the proper nerves in the rectum, and they can't poop! This can become seriously problematic as the stool remains in the colon over time, causing bacterial infection and distension. Eventually, the child will die. So correction (removing the part of the colon without nerves) is essential. The patient was only 18 months old, but Hirschprungs is something you ideally correct as soon as possible (even right after birth). The surgeons were able to do the entire procedure transanally, as opposed to doing it through the abdomen. This means an easier recovery period and less pain for the patient. I haven't seen this procedure before, and it was absolutely amazing to see the surgeons pull (just pull!) the colon out of the anus. Just trust me on this one.

The Hirschprungs-affected colon looks totally different from normal healthy intestine. It had a 'stretched-out,' leathery appearance, whereas the normal parts looked smooth, pink, and glossy. Now, usually during this procedure, the surgeons will pull out all the Hirschprungs colon, and then do frozen pathology sections to make sure that they've reached the margin of diseased v. normal tissue. But here in Ghana they can't do frozen sections intraoperatively, so the surgeons had to just send tissue to the pathologist and rely on a gross visual analysis to make sure they'd resected enough colon. For all the medical students out there, the pediatric surgical fellow asked me what the pathologist would be looking for at the margin of diseased v. nondiseased tissue. I'll put the answer at the bottom of this post.

The other procedures I was able to see and learn about were fistula corrections. Female babies can be born with a variety of congenital fistulas that connect the urethra, vagina, anus, or any combination therein. This can mean, in some cases, that they only have one opening for all three organs! Incredibly, some of these disorders remain undiagnosed in Ghana, and the surgeon had even done a congenital fistula repair on an 18-year old woman. I was particularly impressed at how quickly he could work: He repaired a rectovestibular fistula in just 1 hour, right before my eyes!

I had never really considered Colorectal Surgery as a career before, but seeing this team at work really intrigued me. The quality of life of these patients (and in cases like the Hirschprung's patient, the life expectancy) will be dramatically improved after just one surgery. That's pretty amazing.

For those interested, the pathologist analyzing the Hirschprung's patient's tissue will be looking for 3 signs that indicate diseased tissue:
1) aganglionosis
2) hypertrophied nerve fibers
3) abstainment of Acetylcholinesterase

If all 3 of these signs are absent, the tissue can be considered healthy.

Earthquake Hoax

KNOCK KNOCK KNOCK.

Frantic knocking. Check my watch. It’s 4am. Stumble out of bed to the door, and find a stranger standing there, already knocking on my neighbor’s door.

“There’s going to be an earthquake. You have to get out of the building.”

Ama and I walk outside together, confused, a little scared. Outside I see all 80 or so students who live in the ISH, milling about in their pajamas. The especially studious ones are hunkered down with flashlights reading microbiology (there’s an exam at 9am, and yes they are that intense), while the rest just mirror my own dazed look. I look around for the night porter who woke us, expecting some sort of announcement. He’s nowhere to be found. I realize that if there is an earthquake, we are missing people. Do we attempt to find them now? Do the porters have a roster for the dorm? Who is leading this safety effort?

The questions could go on and on. And if GoogleEarth had passed over Accra (or southern Ghana) between 2am and 5am Monday morning, it would have captured the entire population milling about worriedly in the streets. The rumors were:

“It’s going to be a 9.6!”

“It’s an after effect of the earthquake in Haiti.”

“The BBC ran the story this morning and the radio is carrying it now.”

Ghana is an area known to have mild earthquakes, so no one could be sure if these rumors were totally true or false. And unfortunately, no one was actually providing any data. We didn’t have access to televisions or internet outside. The radios I heard out of some cars weren’t confirming or denying the rumors. Everyone was just passing on the story they heard via cellphone from “a friend” or “my family.” I started to doubt the whole thing when I heard the followup rumors that "Cosmic rays are going to hit Earth from Mars!" and got really upset that the person who felt the need to wake 80 students didn’t have the leadership to actually inform us of his sources, his information, or any school-wide evacuation plans. I work at a hospital here, and I thought there would be more disaster-preparedness within a medical organization….

Around 5am, we finally decided that everyone was just spreading rumors rather than fact, and went back to bed. Apparently around the same time, a government official came on the local radio to assure the general public that no earthquakes had been identified in the local region. The next morning, everyone was pretty jovial about the whole thing. Laughing at the way rumors can spread.

Still, I never found the situation funny at all. It showed me how quickly a situation can escalate due to lack of information, confusion/panic, and rumors. I’m relieved that no one was actually hurt in this massive evacuation, and amazed that cell phone rumors can carry quite so far. The whole experience showed me how disaster management can become, well, a disaster. This ‘earthquake drill’ also demonstrated just how wonderful certain things are:

(1) fire drills

(2) 911

(3) Check, Call Care!/CPR

(4) Stop, Drop, and Roll

(5) Only YOU can stop forest fires!

A little infrastructure, a little preparedness, can go a long way. I mean, the chances of me being set on fire are pretty slim, but I still know what to do: Stop, Drop, and Roll! (phew!) I hope that here in Ghana, we all take a few moments to think about how we will react better the next time a real, or imagined, disaster comes our way.

(And now to provide sources I wish someone had provided Monday morning...)

Articles on the Earthquake Hoax:

http://news.bbc.co.uk/2/hi/africa/8465619.stm

http://news.myjoyonline.com/news/201001/40680.asp

Mt. Kilimanjaro!

I love warm weather, the beach, etc. But as some of you may have already heard, the Ghanaian heat and humidity is nothing to joke about. I’m still getting accustomed to sweating 24-7, and chug at least 3L of water daily. Good for the skin right? But as the holidays approached I decided it’d be nice to have a White Christmas, or at least a Cool Christmas. Taking inspiration from Toto, I decided there was no better getaway than 6,000m above the Serengeti: climbing Kilimanjaro!

Mount Kilimanjaro is in northern Tanzania, and at 5,895m (19,340ft) it stands as the highest mountain in Africa. Also the highest free-standing mountain in the world, if that means anything to you. Most importantly, it is the only one of the seven summits that a hiker can climb by simply walking up the mountain. No technical skills or ice gear required. I signed up with ZaraTours, an operator out of Moshi, Tanzania, and asked to be placed in a group on one of their 5-day Marangu Route hiking expeditions (the shortest and cheapest climbs available). Then I joked with my family that I’d either end up joining a group of burly German mountaineers or camera-toting Japanese tourists. Little did I know…

I arrived December 24^th in Moshi, Tanzania, the tour operator’s base and met my group. And almost burst out laughing. Japanese Tourists!

(pictured: Keen, Megumi, Me, Mayuko, Toshi; not pictured: Quian, Tara, Ryan)

Day 1: climbing to Mandara Huts (2,720m)

(me, all set to go!)

We set off towards Kilimanjaro on Christmas morning, for an 8 kilometer hike through rainforest to the first camp. Hiking with us was a crew of approximately 20 people: 3 guides, 15 porters, and 2 cooks. This is pretty standard for how most tour groups. Our guide started off on the trail with us and immediately taught us the meaning of “Pole Pole,” the Swahili slogan of Mount Kilimanjaro.

Pole Pole means “Slowly, Slowly.” Climbing to over 19,000 feet is no joke, and doing it too quickly can cause Acute Mountain Sickness (AMS). Because it’s an accessible mountain, and tourists tend to undertake it without adequate preparation, hiking Mt. Kilimanjaro account for 50% of AMS worldwide. Pretty scary. Complications of AMS include pulmonary edema, cerebral edema, and death. In fact, comments I heard in the days leading up to my trip included:

“Please don’t get cerebral edema and DIE.” –my mother

“I made it halfway and then threw up blood, so they made me descend.” –girl at busstop outside park

“Only 4 in my group of 8 made it to the peak. One guy got stretchered down.” – tourist at the border

Needless to say, these comments made me a little nervous. But hiking behind the guide “Pole Pole” style alleviated most of my fears the first day. We were literally hiking in slow motion. Picture a three-toed sloth. Or a turtle. Now imagine it in slow motion. That’s Pole Pole.

(me and our main guide, Abdi)

Day 2: Hiking to Horombo Huts (3,720m)

We woke up the day after Christmas and had a hearty breakfast to fuel our 12k hike to Horombo Huts. The Japanese tourists made the morning extra cheery by whipping out their iPod and portable speakers to play Christmas carols on the trail. So funny. Some hikers coming down the mountain were even wearing Santa hats. A very good morning.

This extra holiday cheer was pretty helpful, because the hike to Horombo Huts was not only long, but it poured cats and dogs the entire way. I had been warned about hiking during the rainy season, but whew! I was getting the desired winter vacation!

(me in the rain with some cool vegetation)

I also spent the day marveling at the porters. These men carried loads of up to 30kg, mostly on their heads, and literally ran up the trail ahead of all the tour groups. Some NGOs in East Africa are actually focused on protecting the health and wellbeing of porters, because the physical strain of the job is so intense. I absolutely could not believe their strength, and urge anyone looking to get in insane physical shape to take up a porter job in Tanzania…..

We finished the day at Horombo Huts, 3,720m above sea level, which is pretty high. Some people in my group started to feel the effects of altitude, getting headaches and feeling nauseous. Thankfully, I felt fine.

(me and Quian)

Day 3: Up to Kibo Huts (4,700m)

Day 3 promised to be the most intense of the trip, because we not only had to hike 9k to Kibo during the day, but we would set off for the summit at midnight. We were nervous!

We hiked through Alpine Desert, large expanses of red sand with sparse dry bushes. Combining the scenery with lightheadedness from the altitude and it kind of felt like walking on the moon. This would have been really neat if (1) it weren’t pouring, pouring rain the entire time; (2) I hadn’t been so focused on conserving energy for the summit. I guess you could say I was really getting in the zone; and (3) Our group was too tired to talk at all. No using the iPod in the rain…. Combining the effects of these extra factors, I like to refer to Day 3’s hike as “The Trail of Tears.” Please don’t misinterpret the sentiment. I was having an awesome time. Just in a Trail of Tears kind of way. Maybe you had to be there....

Happily, when we arrived at Kibo, it was SNOWING! White Christmas Woo!!!

(arrival at Kibo)

(me and Kitentia, another of our guides)

(getting ready for the summit)

Night 3: UP TO THE SUMMIT

We left Kibo at 12 midnight for Uhuru Peak, the TOP of Kilimanjaro. Hikers leave in the middle of the night like this because it assures that the mountainside will be frozen and easy to walk on. It was still snowing, and yes I was still elated. I never knew I was such a closet winter weather fan!

We started the ascent with all 8 hikers in our group, but unfortunately, only 30 minutes later we lost one person. Mayuko started vomiting from the altitude and a guide escorted her back down the mountain. After that the 7 of us continued on. Hiking in the frozen night was so different from anything I’ve done before. We needed to wear headlamps to light the way, and when I looked up, all I saw was the black night and twinkling stars. The incline was so steep that sometimes I mistook hikers’ headlamps ahead for stars. (After some thought I decided not to look up too much; hiking toward the stars seems kind of demoralizing.) We carried our water in our jackets because the night was so cold that anything in our backpacks froze. And we intentionally panted every few minutes to make sure we got enough oxygen. Our guide sang us Tanzanian songs in Swahili to keep us energized. Amazing.

At 7am (somehow I hiked for seven hours and barely realized the passage of time), we reached Gilman’s Point. This appears from all angles to be the top of the mountain, and from here we watched the sun rise.

Not to be distracted, however, I had my eyes on a ridge to the southwest: Uhuru.

Our group was starting to falter, however. Two people didn’t feel they had the energy to continue on across the ridge, and we had to buckle down and Pole Pole together.

(the group walking across the ridge to Uhuru. That's Tara in blue getting some support from our guides.)

8am: UHURU PEAK! The Roof of Africa!

Day 4/5: "Oh Yea, We Have to Go Down..."

Climbing Kilimanjaro was amazing, one of my absolute favorite activities so far in Africa. If anyone's interested in going back to do it on a different route, count me in! Just remember, however, that after climbing for 3.5 days, your guides expect you to descend the mountain in 1.5. This means that after hiking for almost 24 hours to reach Uhuru, we had to essentially run down 42 kilometers. Fast. Unfortunately, we lost another group member doing this. Toshi needed a stretcher to reach Mandara. But the hike down did give me the opportunity to see all the beautiful scenery again. Let me emphasize this: Tanzania is bee-yoo-tee-ful.

(rainforest trails by Mandara Huts)

(exiting the park

And if you can't climb Kilimanjaro, you can always drink it!

And that’s it! 1 summit down. 6 to go. Everest anyone?