Packing Tips by Nava

Prior to leaving, one of the hottest topics of conversation was what to pack, what to buy, where do buy it etc. so I figure I’d share what made it into my bag and what got cut. I planned to continue on with travels after our time in Ghana so I packed light in a 40L REI backpack and found I was able to squeeze in everything I needed no problem. This did require doing laundry in the sink a few times but I had no problem drying clothing overnight on a line.

My clothing list included:

  • Bottoms (3 pants, 3 skirts, 1 shorts): 1 pair of linen pants, 1 pair of very light Northface pants, 1 pair of leggings (for travel days), 1 maxi skirt, 1 mid-calf Northface skirt, 1 nicer skirt (for church), and one pair of running shorts (for hiking and waterfalls)
  • Tops (6): 4 cotton target t’s, 2 Hanes cotton t’s (to be ruined and left behind
  • Shoes: One pair of runners and one pair of Teva flip-flops
  • Underwear: 5 pairs and 5 sports bras (much easier to wash and clean that regular bras)
  • 1 Rain jacket
  • 1 Bathing suit

Other things I brought along included:

  • Travel size bathroom stuff (deodorant, toothbrush/paste, REI travel shampoo/conditioner)
  • REI Travel detergent
  • Hand sanitizer
  • Mini medical kit and prescriptions – ibuprofen, antimalarial, anti-diarreals, band aids, neosporine, tums…
  • Sunscreen
  • Copies of insurance/passport/credit cards/tickets/immunization records
  • Passport/yellow fever card
  • Cash to convert at the airport – they had a good rate and if you’re heading to Volta, this is possibly your only opportunity to convert cash)
  • Electrical converter – we only encountered the two round prong kind (I’ve heard this referred to as British but not sure)
  • Travel towel
  • Baby wipes
  • Deet bug spray
  • Day bag
  • Journal & pens – I like small Field Notes, for portability and convenience
  • Kindle & charger
  • Phone & charger
  • Camera, charger, extra storage card
  • Cocoon Sack
  • Water bottle
  • Toilet paper/tissues

And food! I brought 16 bars and two bags of trail mix, chocolate and dried fruit.

All done it looked kinda like this:

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Tips and things I would change if I were doing it again:

  • Pants vs. Skirts: I’m really not a skirt person but found myself wearing skirts a lot because of the airflow they allow. The majority of our trip members shared a uniform of target t-shirts and old navy skirts which seemed to work really well and are very cheap. We also often unintentionally matched which was pretty funny.
  • Never needed any special shoes. Many people chose to bring older running shoes and leave them behind after our hike.
  • Bug spray: The wipes are awesome because they don’t count against your liquid amount and are easy to apply. If you’re going the liquid route, a normal size, normal deet content (like 35%) would have been fine for the bugs we encountered. I would recommend testing it before you go as Macy had a minor allergic reaction to using my bug spray! A few people went for the permethrin (spray for your clothing/sleep sack) but it turned out to not be necessary, at least for the time of year we were there.
  • Baby wipes and tissues came in handy often as you never know what/when/where your next bathroom will be and the wipes were helpful for wiping down your face or hands from the dirt. Hand sanny was nice as well but doesn’t do as much to help with the dirt.
  • Food: I really don’t love bars and luckily in the heat, we all just found that we were not that hungry until the sun went down. That said, there were often times during the day when I could just feel my energy crashing and then the dried fruit and trail mix was my go-to. If you’re going the bar route, I suggest mixing up the brands you’re bringing so that you don’t get burnt out on any one brand.
  • If you are a MasterCard user, we found that many ATMs were not accepting of MasterCard so be prepared with an alternative method or bring cash. Also maybe this will be different in a year?
  • If you’re going to Ghana through VCU OT’s program, ask people who went last year if you can borrow things such as sleep sacs, skirts, sink detergent etc. If you go the target/old navy route, you can really spent very little on what you’re packing.
  • Things I wish I’d brought: AFTER BITE! Only Rick had the foresight to pack this and oh man, did it come in handy. Also more dried fruit. And one old navy skirt
  • Things I wish I’d left at home: 1 pair of pants (traded for the skirt), 2 of the 4 little hand sanitizer (took up too much liquid room and didn’t use ’em)

 

Trip Reflections by Nava

Lauren helping Michael with his letters

Lauren helping Michael with his letters

1) Participating in this trip helped me think a lot about what kind of OT I want to be and what the role of OT (international or domestic practitioner) could or should be. Being back in North America, I am regularly reminded that one does not have to fly across an ocean or drive even 5 miles to find children growing up in difficult situations who need love and services. It only takes turning on the local news or opening up a web browser to come up with many ideas of how we could volunteer right at home to try and decrease the burden carried by our nations children and families. While it might not be as exciting as packing a bag and getting on a jet plane, regularly volunteering at a homeless shelter, shelter for victims of domestic violence, food bank, Ronald McDonald house, centre for immigrant services…these are all things that can be done here to promote occupational justice through use of the skills we have as OTs. They may not be in a different country but even local participation can provide personal growth opportunities like those we had in Ghana such as learning words in new languages, experiencing belief systems that are not your own, and practicing cultural competency. It is also a great way to learn more about our own communities and the parts of them that we may not see or know much about. These options allow for continued involvement which may allow the effect we have to be more long lasting and meaningful for us and for the people we work with. And we may even get to enjoy some sort of air conditioning while we’re at it.

Jo reading to Bright and Henrietta

Jo reading to Bright and Henrietta

2) I’m glad that occupational justice is a concept that is part of our curriculum and that it is regularly impressed upon us how important it is to practice in a client-centred manner. We could have headed in this unknown Ghana and tried to show them everything we know without listening and looking at what it is they need and want but I often heard myself and my trip-mates asking questions about what future trips to Volta could look like and how we could spend our time there in a way that we could actually help. No one had any easy answers but I think this trip was a great opportunity for each of us to really experience how valuable many of those general and obvious feeling concepts we talk about in class are. It can be challenging when you’re excited and have all these ideas of how to ‘fix’ things to remember the context and specific needs of the individual you are working with. This trip helped hit home the importance of these things for our future practice here in North America.

Girls dancing at Eugemont Orphanage

Girls dancing at Eugemont Orphanage

3) I’m really excited about the OT program that is being developed at the University of Ghana and what it hopefully means for the future of OT in Ghana. I hope that VCU is able to maintain a relationship with the program as is develops and grows. It seems like exchanges between our program and theirs could provide some wonderful cross-cultural learning experience and help to create a sustainable method of supporting the growth of OT in Ghana. The opportunity to do problem solving exercises with their students and get to know them over lunch was definitely one of my highlights of my trip. I was really impressed by their ability to explain to me what they feel their education is about and their fears and questions about what and how they will practicing in a few years.

4) Monkeys!

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Tafi Atome Monkey Sanctuary

What to do now? by Nava

After the experiences had in Ghana, it was hard to just leave and move on to the rest of summer. In the Accra airport I shared these feelings with Lily when realized we felt the same way, we figured we should work together and do something. We wanted this ‘something’ to follow-up but our experiences at study abroad students and as OT student trying to deliver services in a rural area. We spoke to our professors and decided to gather a few ideas that we could put forth as poster proposals for the National AOTA (American Occupational Therapy Association) conference next spring. With the due date two weeks away, we brainstormed a list and rounded it down to two topics we feel we can present information on that might interest the AOTA crowd. We will not know if either topic has been accepted until sometime in September but I thought I’d write about them anyway as the process of submitting these proposals has helped me process a lot of what we did and saw over the course of our trip prep and travel. The concepts we submitted are:

1: Compare participant and leader pre-departure goals with post-trip feelings of what was gained from the experience in both Accra and Hohoe through a simple survey of trip participants and by examining blogs.

2: Investigate the issues faced in delivering OT services and carrying out projects in the rural setting. Explore what we understand of why these issues occurred, and possible solutions for future trips. (language/cultural differences, available resources, time, relationships, etc.)

Through the first topic, we hope to look into the different experiences had by each group to compare and contrast the outcomes and how each group feels their experience aligned with the goals of the trip as set out by the course syllabus. When we were all together for our last few days in Accra, it was clear that there were significant differences between the type of work done by each group. The Accra team completed very OT related tasks by working with students and teachers on things like positioning and wheelchair repairs in a school specifically for children with disabilities. They also completed a significant amount of Denver screenings at a school for typically developed children and helped write-up reports for those they had some concerns about. This experience (we expect) was likely very affirming for them in their choice of career and was a great experience for them to put to use the skills they’d learned in the classroom. For those of us in Volta, our time was primarily spent with children from the orphanage. While many of these children may have some psychological trauma in their pasts that contribute to behavioural or emotional concerns, with only two weeks in country, we were not able to focus on those areas. Our time was spent learning and absorbing the culture of rural Ghana life and its challenges. We developed relationships and asked many questions about what and how one could be an effective OT in this setting. From the survey results, we do know that participating in this trip was valuable for all members. We hope to find out more about which aspects were most valuable and most challenging and how they compare to the expectations of our professors to help provide insight for future OT study abroad trips.

Our second prompt touches on a topic that I’ve thought a lot about since our trip. There are many arguments for and against NGOs and ‘outsiders’ providing aid to developing nations. Regardless of what side you find yourself on, many practitioners are doing it. Just like we did, they choose to travel overseas, usually for a short period of time with the goal of delivering services and making a difference. Just as we did, many of them likely experience significant unanticipated  barriers to being able to provide the kind of care they imagined. When looking through literature to prepare this proposal, Lily and I found many articles regarding the systemic and structural barriers for delivering services in rural areas such as limitations to government funding and small numbers of practitioners, but nothing that touched on the face-to-face part of delivery. That’s kind of a lie. We found one article that touched on some of the language and religious concerns and got really excited and then realized it was by Stacey (our trip leader). But still, none of these articles proposed any suggestions for mitigating these barriers when in country or ways to prepare. This is likely because there is obviously no one-size-fits-all solution and the collection of formal research in this small area is likely difficult to acquire funding for. In this poster, Lily and I would like to share the knowledge we acquired through conversations with the Ghanaians we met, the reflections of our trip-mates, and consultation of literature across medical literature. We want to provide suggestions and ideas that we wish we had prior to our departure and hopefully help those interested in participating in this realm of OT seriously consider what they can do to prepare for such an experience.

As I said above, we wont know if we will actually have the opportunity to present either of these till September but regardless, the opportunity to go through the process of submitting was an interesting learning experience that will hopefully come in handy in again in the future.

Highs and Lows

To sum up my whole experience in Ghana, I thought it would be easiest to list my highs and lows of the trip. The highs majorly outweighed the lows (there were hardly any), so I’ll start with the lows first.

  • I got sick a few times, about 2 ½ to be more exact. I never figured out what this came from, but luckily each instance was short lived and I didn’t have to miss out on any part of the trip. This was my first time ever being sick on any sort of international trip, so I feel like I’ve finally paid my dues.
  • The projects I was assigned to co-lead with Lauren were transition services and vocational skills building. We did our best to prepare for our time in Ghana, but as I’ve explained more in other posts, what we had prepared wasn’t as helpful as we’d hoped. A variety of issued factored into this, but the upside was that we learned so much about the culture, education system, and people that we know what will work better next time.

Now for the highs… there’s too many to list in one post so I stopped with ten, but could go on and on.

  • As part of the Volta group, I was able to see both urban and rural Ghana. Since there were so many differences between the two, I felt that I was able to learn so much more about the culture just by comparing Accra and Hohoe.
  • Our driver, Vincent, was amazing. He kept our time in Hohoe and Accra running smoothly and always looked out for us (he also helped me keep track of my back pack which I somehow always lost in our tro tro). On our last night at the orphanage, Vincent came and sat with our group while we were hanging out with the kids before they went to bed. One of my favorite kids, Luke, had been talking to me about our flight home and was getting sad for us to leave. He wanted to know when I would be back again, and I was having a hard time figuring out how to tell him that I didn’t know. This turned into Luke asking me about age and how big he would be when we came back. Thankfully, Vincent stepped in and steered the conversation towards how old Luke could become. He told him that when he got to 100, he would be walking with three legs, and then picked up a stick and showed him how to walk with a cane. Luke couldn’t believe this, and then picked up the stick and walked around like and old man. It was nice to see how the younger kids looked up to Vincent. This little moment became one of the more memorable parts of the trip for me.
  • Getting to know the children at Eugemot was the core of the trip. We all had planned different projects and also worked with children at the school for several days, but the majority of our time was spent at the orphanage. Almost all of the kids spoke English, so it was easy to get to know all of them. We helped them with handwriting and health education, read books, played soccer, worked on fine motor skills with loom bracelets, and talked with the older kids about their plans for the future. It was impossible not to become attached to the kids and I think we all miss them more than anything else.
  • Our day trips to Mt. Afadjato and Wli Falls added so much to the trip. Mt. Afadjato is the highest mountain in West Africa and by far the steepest mountain I’ve ever climbed. Parts of the trail on the way up were so steep that we were using our arms to climb more than our legs. From the top, you can see Togo in one direction and a sweeping view of Volta in the other, so it was worth the effort. Wli Falls is the tallest waterfall in West Africa. We were able to take about 20 of the Eugemot children with us. Many of them had never been before, so this was a pretty big event for them. The force of the water falling from 70 meters up was so great that we had to turn around and walk backwards as we got closer. Luke loved playing in the water and wanted to come with me when I walked under. He had been identified as sensory seeking on a previous trip, so this might explain why he was the only young kid to make it under the waterfall.
  • On one hand, it was disappointing that my projects didn’t work out as planned. But this opened up many learning opportunities, which will hopefully end up helping groups who go in the future.
  • Speaking of learning opportunities, in Volta, we spent a good amount of time talking with the older Eugemot kids and Mama’s daughter, Yvonne, over dinners. I doubt we would have learned half of what we did if it weren’t for these conversations. Yvonne had been to the United States to work at a summer camp, so she had a lot to offer on the differences between our two countries. We talked about everything from Ghanaian social policies to veterinarians and clothes for pets in the US (it’s starts to seem excessive when you’re in a country that hardly has adequate health care for humans). She summed up the disability culture differences between the US and Ghana perfectly by saying that we both have the same problems, but on different scales.
  • Bright, who I wrote about in a previous post, crushed my plans to not become attached to one kid at the orphanage more than others. He provided our group with endless entertainment. I’ll think of him every time I hear someone say ‘Jesus Christ’ or get my haircut. His nickname, Mr. Sassypants, was well deserved.
  • Through this trip, I realized how much I didn’t know about classmates who I’d been around constantly for an entire year. Traveling helps reveal layers of personality in a way that not many other things can (I mean this in a good way, promise!). Our group meshed well and made the trip that much more enjoyable.
  • Our hotel/nightclub in Volta was a definite memory maker. It will be hard to forget eating my fried egg and rice for our first Volta dinner under nothing but the light of a miniature spinning disco ball with Slumdog Millionaire playing in the background. We put an end to this sensory overload by unplugging the disco ball and using cellphones as flashlights. We really had nothing to complain about with our hotel though, which was much nicer than what most of us were expecting. We even had hot water for showers most of the time. The cute lizard that liked to hang out with us when it rained was a nice touch too (sorry Macy).
  • When we came back to Accra before leaving to come home, our group was able to visit the New  Horizons School and see the work the Accra team had done there. New Horizons is a school for children and adults with disabilities. The Accra group was able to work the positioning of many of the students who used wheelchairs. The used duct tape, foam, towels, and other supplies from our MacGyver kits to make the children more comfortable. They also fixed up the wheelchairs themselves. It was awesome to see that the group had made such an immediate impact on the children’s lives. Later, we were able to help with training the school staff and University of Ghana OT students on safe transfers. The staff loved this and wanted us to watch them practice to make sure they were doing everything properly. This put our long days of class at Theater Row into perspective.

There’s not nearly enough room here to list all the highlights of our trip. If you’re thinking about going next year, hopefully this post has helped to convince you. It’s worth it!

Trials and Tribulation with Health Education by Nava

The lesson plan I was assigned to work on with Jouette was health education. Before leaving we planned a few different sessions that we hoped to be able to adapt for different age groups in different settings as we had no idea what age groups or in what setting we would be working with kids in before we left. We prepared these short sessions so that they could be grouped together in a variety of combinations with ice breakers and activities. As many others talked about in their posts, we did not anticipate the differences between American and Ghanaian culture in how classes are taught and how students are expected to behave. All of our plans involved student participation and that is where we experienced our biggest hurdles.

The classrooms for 7 and 8 year olds that we spent most of our time in had ample room with desks and chairs for each student and a large blackboard up front. The children mostly behaved according to the expectation that they would sit in their seats and perform rote memorization of the lesson.The lessons we observed consisted of the teacher explaining something and the students repeating it back. We didn’t see any examples of students being asked to provide answers demonstrating comprehension or critical analysis.

Kids at orphanage practicing handwriting

Kids at orphanage practicing handwriting

Jo and I created mini lesson plans on personal hygiene, basic emotions and coping skills, relationships and appropriate physical behaviour, smoking, and healthy eating/food pyramid. Most of it was geared towards the 7-9 year age range with the ability to simplify for younger kids or grade it up for 10-15 crowd. We also put together role playing and information on relationships and consent aimed at more of a teenage audience. We only had the opportunity to execute these lesson plans with the 7 and 8 year olds and decided, after teaching them the hokey pokey, to break them up into three groups. The groups rotated between three stations each lead by a pair of OT students that covered oral hygiene & taking care of your skin, emotion health and coping strategies, and how to stop germs.

After completing all the rotations, catching our breath, we headed back to our hostel on the way, had a little debrief of the experience. At each station, students had been responded with silence to simple open ended and we always eager to repeat a suggestion provided by us ‘teachers’. They appeared to listen and be somewhat engaged when learning about oral hygiene, skin care, and germs but were rather disengaged on the topics of emotions and coping strategies. The children to regularly perform teeth brushing of some sort and wound care but still struggled to tell me about it when prompted. Emotions seemed to be foreign concepts to them. The only responses they were able to provide were that they were sad when they “got beat” – a common parenting practice in Volta. Talking about putting names to feelings and the idea that one would discuss feelings with a confidant only brought blank stares and wiggly feet.

An interesting contrast to this experience was how the children behaved out of school. There was one 13 year old girl we met in the older classroom when some of my group-mates were teaching transitional skills who seems pretty quiet and disengaged. A day or two later when we visited a village to conduct interviews with mothers, she approached our tro tro (van) and chatted with us for probably about 30 minutes. She had so much to say and answered questions about what she wanted for her future, her favourite activities, her family, etc. She bounced around as she asked us tons of questions about our families, our favourite foods and shared her story. This was a drastic contrast to the personality she displayed in school. She was clearly bright, active, and inquisitive. Meeting her outside of the school context provided us with an interesting idea of how students adjust their behaviour and attitudes based on the expectations in the classroom.

The Volta School for the Deaf

On our last day in Hohoe we were able to visit the Volta School for the Deaf (VSD) for a quick talk with the headmistress and a tour. As we drove up to the school, I felt like I was on the set of the show Lost. The architecture and design were very original, with the academic part of the campus arranged as a five hexagonal rings of rooms that were raised off of the ground on a platform. We made our way through the school to the office where we sat and talked with the headmistress about the structure of the school and the children they serve. VSD is the only school of its kind in the region. It is a residential school supported by the government and serves 302 students ages four and up in kindergarten, primary, junior, and vocational school. These students come mostly from the Volta region, but some come from as far away as Accra. The school calendar operates around three, three-month terms with breaks in between. My understanding was that all the students are educated using the same core curriculum as students in typical Ghanaian schools. On our tour of the campus we looked in primary level classrooms, the computer lab, and vocational areas of the school. Students in the vocational school can specialize in areas such as batik, woodworking, and weaving. The school also has it’s own pig barn, but I’m not entirely sure of all of its purposes.

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 (Inside the academic area of campus)

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 (The dorms)

From what we saw, the school seemed to be very well organized and structured, but we also weren’t able to experience the school with the children present. The headmistresses explained that students were not allowed to come back to VSD for the start of the new term because the government hadn’t given them enough money to pay for the children’s food. A quick Google search shows that the government had actually withheld grants to all special schools in Ghana for the term because it wanted the schools to pay for their own supplies and utilities. The impact for the children is drastic. The deaf community is still marginalized by stigma in Ghana. The headmistresses explained that, in many cases, children’s parents and family members at home don’t know sign language and may not be eager to learn. Students who are lucky enough to be placed in a residential school like VSD may end up developing their entire social network around the school. This leaves them without an easy way to communicate when they’re at home, so all of the students look forward to their time in school. Besides the lack of social connection, a disruption like this one obviously affects the quality of education. If this situation had occurred in the US, there would be a public outcry, but unfortunately, the headmistress’s tone didn’t make it sound unusual for Ghana. Luckily, according to another Google news search, the government board in charge of special school education held an emergency meeting soon after we left Ghana and decided to grant funding for the children to return and finish the term.

On a more positive note, when the school is up and running, it helps to support itself through the work of students in the vocational school. A Peace Corps volunteer helped VSD open the “Our Talking Hands” store on the main road running through Hohoe. They sell the students’ work and even have an online Etsy store (https://www.etsy.com/shop/OurTalkingHands) where you can find pillowcases, batiks, table runners, purses, wood carvings, and even some Guinness bottle cap earrings.

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 (Murals on the walls in the academic area)

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 (Thanks to Meghan for all the pictures!)

 

Some Differences between Rural and Urban Ghana

As part of the Volta group, I was lucky to be able to experience both rural and urban Ghana in one trip. The capital city of Accra and the small town of Hohoe were so different that I might have believed they were parts of separate countries if I didn’t know better.

Our flight landed in Accra on Monday night in the middle of a thunderstorm. As we drove through the city to our hotel, we passed many impressive buildings with modern architecture. Many of us were surprised by the quality of these buildings and the streets, which was about all we could see, but as soon as the sun came up Tuesday morning, we saw more of what we were originally expecting. From our hotel window, we saw shorter buildings of all different colors and states of repair. In the city, the sound of car horns and roosters was constant. Drivers there use horns to communicate their presence to other drivers or pedestrians when going around turns or trying to pick up taxi customers. This took a bit of getting used to since horns are usually associated with rudeness and road rage here. I was also amazed by the number of business signs lining the roads in Accra. They were plastered to the sides of buildings, lined up on poles, on roofs and billboards, and generally in-your-face. I never expected to come back from Ghana with an appreciation for sign regulations in the US.

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 (Thanks to Jodi for getting pictures of the signs in Accra!)

We left for Volta Tuesday morning, so we weren’t able to see much of the city, but it was nice to watch the changes in scenery on our six hour ride up to Hohoe. The landscape of the Volta region was drastically different than Accra. I wasn’t expecting to see so much green, which was awesome compared to the inner city feel of the capital. The town itself also gave me a much different impression of Ghana as a whole. All together, it was more of what I had envisioned Africa to be like. One main paved road ran through the middle of the town with a few smaller roads sprouting off along with lots of dirt roads. The main road was lined with shops selling everything from soap, toilet paper, and food, to winter jackets and pots and pans. There were many fabric stores and seamstresses who made the traditional Ghanaian outfits we saw most of the people wearing. The clothing choices in Hohoe were more traditional compared to Accra, where many people wore jeans and other western style clothes. Many shop owners named their stores with religious sayings. This also seemed to be popular in Accra. Besides the smaller specialty shops, we also saw many churches, several government run primary and secondary schools, chemical stores (their pharmacy), banks, a few other hotels, small food shops (one was called the “Decent Food Shop”), and other random businesses.

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 (Views from the top of Mt. Afadjato in Volta)

Villages in Hohoe tended to be in clusters farther away from the center of town. Some houses were made out of concrete and others were made with mud or bamboo walls. Many of these villages looked just like the stereotypical shots from TV commercials. We saw many more children running around freely in Hohoe than in Accra. The same goes for the goats and chickens. Sometimes it seemed like there must have been at least one goat for every person in Ghana.

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Our two groups also had very different learning experiences in the two different cities. The group in Accra gained valuable practice working in more concrete OT related areas like positioning, Denver screening, and wheel chair maintenance. In contrast, the Volta group spent less time working on concrete OT projects and more time learning about the culture and challenges in Ghana through talking with locals and maintaining connections for future trips. Although we weren’t able to work with any disabled children like the Accra group, we did spend a significant amount of time building relationships with the children at the orphanage. This was a highlight of the trip for all of us. Both experiences were equally as valuable, and I’m sure we would all love to go back and switch locations to experience the other city (time to start fundraising now?).

Mr. Sassypants

Meet Bright:

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Bright, who we affectionately nicknamed Mr. Sassypants, is a 3 ½ to 8 year old boy who lives at Eugemot Orphanage with his older sister Melody. I went to Ghana knowing better than to “pick favorites” amongst the kids, but Bright’s sassy attitude and goofiness made that nearly impossible. Bright constantly entertained our group with his antics and funny ways of talking. Some of his favorite activities included: napping, making traditional Ghanaian dishes out of mud for us to share with “our people”, swinging, “cutting” Meghan’s hair with his teeth while riding on her shoulders, beating on things with his plastic spoon, and generally getting into trouble (he also loved being tossed up into the air and caught by Nava, but apparently would have liked it more if she never caught him on the way down). For all of the entertainment Bright provided, he gave us equal opportunities to learn about Ghana and how some children grow up there.

When you first see Bright, you would assume that he is between three and four years old. His height, baby belly, and large head for his body all match this age range. After listening to him talk, you’d probably be impressed by his vocabulary, considering his apparent age, which included the appropriate use of the phrase “Jesus Christ” and other sassy sayings. However, if you ask Bright how old he is, he’ll say give you an answer anywhere between seven and nine. This actually became a joke within our group (and still is). Other children and staff at the orphanage also told us that Bright was between six and eight years old. We were well aware that many Ghanaian children, especially those in rural areas and in orphanages, suffered some lasting effects of malnourishment. Malnourishment during infant and toddler years can result in stunted physical and intellectual growth and immune problems. We thought it might be likely that Bright was older than he looked for these reasons, just like many of the kids at Eugemot are, but seven or eight years old seemed like too far of a stretch. Eventually, someone explained to us that when Bright and Melody came to the orphanage, they were so malnourished that Bright needed blood transfusions and almost didn’t live. This helped us make more sense out of the age issue, but it was still hard to be entirely sure.

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 (Some pictures to give you an idea of his size)

 A quick solution to this dilemma, if we weren’t at an orphanage in rural Ghana, would have been to pull Bright and Melody’s file from the office and check their ages. Unfortunately, this is much easier said than done. From our perspective, it seemed that record keeping in Ghana was less than accurate. If his birthday were listed in his file, it would have been hard to tell how accurate it was. This, along with the fact that less emphasis is placed on the actual birthday and age of children, leads to confusion about ages for many of the children at the orphanage. Bright was not the only one who gave different answers for his age depending on when you asked him.

Not knowing the exact ages of children makes it difficult to determine how they’re developing compared to their age group. We ran into this problem when conducting a few Denver screenings on some of the youngest children at the orphanage. We made our best attempts at estimating their ages before we began the screenings, but the outcome of the entire test is altered if the age is not accurate. This, combined with possibly being some of the few white people the children had ever seen and the language/cultural barriers, made developmental testing at the orphanage very difficult. Although Bright’s screening probably wasn’t very accurate due to the confusion about his age, it was very helpful in pinpointing cultural differences that could be accounted for when creating a Ghanaian version of the screening. For example, when shown a picture of a cat, many of the children identified it as “bush cat”, and when shown a picture of a horse, most children identified it as a goat.

We also saw some issues with Bright in school. He was usually in a classroom for children who looked like they were in second or third grade, but sometimes could be found in the younger classroom, or just roaming around outside. This is where he liked to run around banging on chairs, desks, and people with his plastic spoon while the other children were working. The lack of structure in this particular classroom was evident when Bright was there. It wasn’t clear if the teacher knew which class he should actually be in, but either way, his needs weren’t being met. The class didn’t seem to have many supplies, the desks were too large for almost all of the children, and it wasn’t clear how involved the teacher was (this may have been off because of our visit). This situation was less than ideal for someone like Bright who needs extra supervision and structure.

Bright has already been through his fair share of challenges and still has many more ahead of him. I’m thankful for everything I was able to learn through him, but will remember his sassy and goofy personality more than anything.

A Little More on the Ghanaian Education System…

 When we left for Ghana, I was expecting to see the country and its culture through a lens of OT and disability culture, but I was surprised at how many issues could be traced directly back to education. We saw many differences between the Ghanaian education system and our own, and some of these differences were beneficial, but many were problematic enough to impact the way we carried out our projects. Some of these issues were smaller in scale like long walks to school and unreliable transportation for the Eugemot children. Others were more systemic, such as the design of the secondary education system.

Some of the immediate problems we noticed were at the Eugemot School. The orphanage and the school are on separate pieces of land about 3.5km apart (that’s about a 43 minute walk for an adult, thanks Google Maps). Eugemot sometimes has a bus to take the kids to school and back but it was being worked on when we were visiting and didn’t seem to be very reliable in general. The kids make this walk regularly, but it’s hard for the younger ones who ended up staying home one of the days the bus was broken. When the kids do have to walk to school, they’re likely to be hot and tired by the time they get there, which creates some obvious challenges for learning. This situation is normal in many developing areas, especially rural ones.

After spending several days at Eugemot’s school, the Peggy Good School of Hope International, we became more familiar with the style of education. The school teaches kindergarten through junior high school students from the orphanage and the surrounding community. We spent most of our time working on handwriting skills and health education in an elementary classroom with students ages four/five to eight. The most obvious challenge we ran into was the style of learning by rote. Good memorization skills can be helpful, especially for the preschool aged children we saw at the school, but when children are only asked to recite something they have memorized in class, this creates problems with independent and critical thinking. Lauren and I ran into this when trying to talk to the younger kids about their emotions for the mental health aspect of Jouette and Nava’s health education project. Our initial approach was to begin with questions like, “What makes you angry?” and “What makes you feel better when you are sad?” This was met by blank stares in nearly every group that came to our station. Obviously part of this had to do with the language barrier and the fact that Ghanaians tend not to show their emotions, but we also noticed that the kids were hardly ever asked open ended questions. If they were asked a simple yes/no or true/false question they could easily respond, but most were not used to vocalizing their own thoughts in front of all of their peers and adults. This problem was still evident in the junior high class. When the older kids were asked questions about preparing for college and writing formal essays, we were met with more blank stares.

The high school and college system has a different set of challenges for students, which was covered in an earlier blog. To recap, students have to test into high school as well as college. If they are not admitted they can still attend a vocational training school to gain skills for a particular job. Students who pass are placed into high schools depending on their entrance test score. They must select an elective track to study in addition to the core curriculum. After high school, students take the WASSCE to enter college. All students are tested on the core curriculum subjects, but they also have to select an elective area to be tested on. This should pertain to the area they want to study in college, but the design of the system pressures students into taking the exam on their high school elective area. It’s hard for a student who did not study a particular elective area in high school to get into that program in college. This means that many Ghanaian students have already chosen their basic career path by the time they’ve entered high school. This system restricts opportunities for discovery and experimentation.

This post can only scratch the surface of education challenges in Ghana. Many schools still use corporal punishment, lack textbooks and other resources for students, offer low teaching salaries, and have very high student to teacher ratios. It’s important to note that even in the US, many of our schools have the exact same problems. Fortunately, Ghana has recently begun working on education reform bills, which specifically target the lengthening of different phases of education, lowering student to teacher ratios, increasing the quality and quantity of technology training, and restructuring the high school system.