Don’t go looking for my latest snappy Tweet, funny Instagram photo, or Facebook banter in the next two weeks. I’ll be offline.
I might read a book. Bake a bread. Swim. Sleep early. Eat ugly food. Rest my right-hand thumb.
Inspired by Jemila of Circumspecte, and instructed by WikiHow, I will sign off from blog, social media apps, and all for two weeks or so. I am doing it as I want to experience my vacation with my children fully. I am doing it because I feel the chill of addiction. I am doing it because I am tired to the core. I have read that Social Media breaks make you happier, well, we shall see about that. I have a feeling I will rather than meeting a sweet sunset happiness, have serious withdrawal syndromes, like missing taking square photos of everything I eat and phantom grab for my phone for late night scrolling…
I will report back here mid-August. What happened? Did I really stay off? Did I miss it? What did I learn? Now, are you willing to join me?
Often, the news cycle in Ghana excites me and seemingly puts pressure on people in charge. So far so good. However, at times, the news feel like projectiles that blow up too close to comfort and just keep coming BOOM BOOM BOOM without breathing space to the point of me and other people going “what is happening to us?”, “WHY?” or similar while throwing our hands in the air.
This week, and its only Tuesday!, for instance we heard about:
All these problems are major, critical, and totally unacceptable. They all are not new, but historical problems that have not been adequately addressed. On radio this morning, the Korle Bu Hospital CEO Dr. Buckle said the surgery ward issue dates back to 2014 and the article on the identification card suggests the exercise begun in 2003, albeit is still not completed!
All these problems have multiple people (departments! ministries! experts!) working on them, seemingly not making much progress – or what do I know- but at least not solving issues! For instance the identification card was here highlighted in a forum organised by a media house and the World Bank – why not championed by the parliament or the authority created for identification, I do not understand. It seems the problems are too big to get solved by public servants or politicians? Or they lack the skill, funds, or political will?
If so, solutions to problems are likely linked to more citizen engagement. But how do we get there? How do we make sure we channel rage, direct energy, and funnel ideas for solutions – and not for apathy?
Personally, I have been very upset about the doctors strike now entering a month! I find it hard to gauge if the strike is well grounded. On the one side, earlier discussions on doctors and the work situation have haunted me; doctors fresh from university waiting more than a year for their first pay check, doctors in the rural hospitals working day and night in poor conditions with no extra pay and frankly just the statistics suggest we have an impossible situation on our hands, Ghana with 25 million inhabitants has 2,843 medical doctors. That is about 1 doctor per 10 000 inhabitants! To compare, Ivory Coast, Zimbabwe, Cameroon and Nepal are doing better! (according to WHO) and Sweden has 38 physicians per 10 000 citizens (says Global Health Facts)…
On the other hand, if you have sworn the Hippocratic oath, how can you go on strike and let innocent people suffer?
Yesterday evening, I started feeling ill. My throat was dry and my body was aching. Just a little while later, my cheeks suddenly felt very hot and I found my thinking slowing down and I just knew it – I have malaria!
The fear of contracting malaria was the biggest obstacle for me moving here. I had heard about dying children, the importance of profylaxis from travel websites like this and could not make it fit with what my Ghanaian friend talked about as “a cold, nothing worse”. The first time I had malaria, was also the first time I was back in Sweden after almost a year in Ghana. We travelled from a 30 degree celsius tropical night to a bright and crisp winterday of about 10 degrees below zero! I thought it was pretty normal to feel cold! That time, because it took me almost a week to understand my symptoms, I was hospitalized from “severe malaria” and learned about how the parasites multiply exponentially leading to that you can get very ill quickly after you fall sick.
Fast forward five years, I have had malaria a couple of times (for instance in May 2010) surrounded by much less drama – Now I am too thinking of it not much more than of a cold, well the kind you need to take medicin for. However, although malaria is no more a serious problem to me, malaria is a serious problem to Ghana. In 2007, UNICEF estimated that every year 3,5 million Ghanaians get malaria and 20 000 children die from it, that is 25% of deaths in children under 5 years, although newer numbers suggest 33%. Sadly the cost of treatment or distance to a health facility will be the cause of non-treatment. Another interesting – and devastating – aspect of malaria is the hidden costs. UNICEF says:
• A malaria-stricken family spends an average
of over one quarter of its income on malaria
treatment, as well as paying prevention costs
and suffering loss of income.
• Malaria-afflicted families on average can only
harvest 40 per cent of the crops harvested by
• In endemic areas, as much as 60 per cent of
children’s schooling may be impaired as a
result of repeated bouts of malaria.
• Malaria-endemic countries are among the
worlds most impoverished. The cost of malaria
control and treatment slows economic growth
by about 1.3 per cent a year in Africa.
Initiatives such as the (American) president’s malaria initiative are trying to roll back malaria and Ghana has recently had successes in distributing mosquito nets and giving pregnant women precautionary malaria treatments (I took them, myself), but are they enough? When you see open gutters being constructed as I write this (a prime breeding ground for mosquitos) and trash everywhere (another favorite place where mosquitos breed) – it feels like we are going backwards rather than forwards.
In the weekend a relative called my friend and in an upset voice conveyed how her five year old son had been severely bitten by a stray dog. She had of course rushed her child to hospital and he had been attended to, his wounds cleaned, but now she needed money for Tetanus shots for her son. The cost was 200 GHC ($100) .
Average annual household income in Ghana is about GH¢1,217.00 whilst the average per
capita income is almost GH¢400. With an average exchange rate of GH¢0.92 (¢9,176.48)
to the US dollar prevailing in June 2006, the average annual household income is
US$1,327 and the average per capita income is US$433 (Section 9.8). There are regional
differences with Greater Accra region recording the highest of GH¢544.00 whilst Upper
West and Upper East regions had less than GH¢130.00. Urban localities had higher per
capita income than rural localities.
All patients with a bite should receive a tetanus shot, given the risk of tetanus after all kinds of bites, not just those of dogs and cats.
Note the figures above are averages (and from 2008, but the dollar estimate is likely still relevant). I think they show that a Tetanus treatment, though needed after a dog bite, might be out of reach for the average Ghanaian and those earning less – as it costs the equivalent of a monthly household income. Not everybody can pay that or find someone who can, especially on short notice which a dog bite situation requires.
In this case, my friend said, no problem and handed over the money to the upset, but now grateful, mother. The woman who called my friend was lucky to have a relative with that kind of money in pocket. But should children’s lives depend on luck?
Since I returned to Ghana with our daughter, I have gotten many comments about me breastfeeding her. Most often, I am met with surprise, raised eyebrows and reassuring comments such as “you have done well!” Many of these reactions seem to come out of the misconception that “white people do not breastfeed”. Nothing could be more wrong!
In my native Sweden, there is extensive education on breastfeeding both for parents-to-be in preparatory courses and at the hospital when your infant is just born. Breastfeeding is highly encouraged, and initially 97% of mothers breastfeed. When the baby is 2 months 88% breastfeed partially and 69% exclusively. At 6 months the share of breastfeeding mothers is at 65% (Statistics from Swedish national board for health and welfare for children born 2009. Additionally, there is stats for babies’ breastfeeding of 9 months as well as 12 months!)
Surviving Life in Sweden blog (written by an American in Sweden) has some experience on breastfeeding and is surprised how openly Swedish mothers feed their children:
“In Sweden, the attitude toward the boob is different. Seriously, they are everywhere – in often very non-sexual ways – and it’s not a big deal. You will be stared at if you wear a nursing burka USA style. If you are shy and your child will oblige lay a small cloth over your shoulder/baby – but nothing dramatic. And no – it’s not because Swedish ladies want the world to see their boobs, it’s because they just wanted to keep their baby fed and not be chained to the house all day.”
I guess this goes to say that when it comes to attitudes on breastfeeding, there are also differences in the Global north.
Moving onto the attitudes to breastfeeding in Ghana: some of the Ghanaians I have talked to about this topic have informed me of a new trend in Ghana where Ghanaian mothers do not breastfeed their children. Some not at all, some very briefly.
I was surprised when I heard this, had I not seen many mothers feeding their children in Ghana? When water security is a problem, why not breastfeed? I decided to do some research and realized this is not a new trend, but a major health problem for Ghana. The Linkages Project summarizes the situation like this:
“Nearly all mothers initiate breastfeeding in Ghana. However, sub-optimal breastfeeding practices begin on the first day. Only 25 percent of women initiate breastfeeding within the first hour after birth. Approximately 20 percent of mothers nationwide practice exclusive breastfeeding for the recommended period of the first six months. The low rate of exclusive breastfeeding is largely due to the introduction of water and other liquids at an early age. The Ghana Health Service estimates that sub-optimal breastfeeding practices contribute to about eight percent of infant deaths or about 3,300 infant deaths each year.”
The good news is that education really seem to help. The Linkages Project reports big jumps in numbers of breastfeeding mothers after sensitization.The Breastfeeding Week (!) might also help bring awareness. So education seems to be step one.
But one friend was insisting that also well-educated Ghanaians refrain from breastfeeding. Can an explanation to this behavior can be found in the relatively short Ghanaian maternity leave of three months? Compare with the recommended breastfeeding time of 6 months and you see the discrepancy.
Or are there other reasons? Vanity (“I do not want stretched out breasts”), corporate miseducation (“formula is better”) or something else?