Kara Hoppe’ Blog

The market day in Ankaase is every Wednesday. I did have a short break, in which a local took me to the market and I bought Kwado- bananas. I not only got a little bunch like in the US- but an entire banana branch (about 50 bananas). However, they are also much smaller than the ones in the US. Other things available to buy- giant yams, cocoa yams, avocado, many different spices, dried fish (with a lot of flies and atrocious smell,) Kente cloth, second hand clothing and shoes, and much more. This coming week we hope to spend a little more time exploring the market.

Thursday- I spent a bit of time with Dr. Gongwer who is hosting me while I am here. After a bit of observation he asked if I was ready to do some patient visits on my own. A bit scary- but rewarding. I saw about 6 patients and had to utilize the knowledge I have obtained and the minimal resources I have here to create a plan and organize a treatment for my patients. I diagnosed and treated- ottitis media, hypertension, and my 1st case of malaria!

One of the hypertension cases was an interesting learning case. The lady’s initial BP was 200/100. In the US this would most likely lead to a hospital admission. That is an option here but only if really necessary. I repeated the BP and it had decreased a bit. It was still high and the pt. was complaining of head ache, L eye pain, dizziness, and not feeling so well in general. I reviewed her medications and previous BP’s. Her BP’s had always been very high and she continued to be treated on the same low dose beta- blocker and a nitrite. In talking with other physicians here it seems that even though we were taught thiazides are the best in African’s- here it does not work well unless combined with a beta-blocker. Many are also treated with a calcium channel blocker and do well with this. So, anyways. I started the CCB, kept the beta-blocker, stopped the nitrite, and told the pt. to return if her symptoms persisted or worsened. We will see……….

On Friday, I was designated to be in the antenatal clinic. I had a great time working with the midwife. We basically saw every women waiting and measured fundal height, did Leopold’s, and then listened for the fetal heart tone. This may sound like a typical routine antenatal visit, however it was a bit different. First- there is not great accuracy in documenting the exact gestation of the baby. They base the gestation mostly on the fundal height. They do have an ultrasound machine here- so when there is concern the women is sent for an ultrasound. They are not blessed with a fetal Doppler here. They once had one and it is now broken. So, I spent the day becoming familiar with the fetal stethoscope. It is a crazy looking device and very difficult to hear the fetal heart tone at first. By the end of the day I had the use of it down- but I now have a special appreciation for the fetal Doppler machine. They also implement malaria prophylaxis and tetanus boosters as routine antenatal care here- which is a bit different than the US.

Saturday- April 5th

Kumasi- which is about an hour east of Ankaase has the largest open air market in West Africa. We went with our neighbors Erica and Maggie. Erica is a missionary who is spending one year here and teaches the Gongwer’s daughter. Maggie is a local who has helped for many years with numerous things for different missionaries who have come to Ankaase. We took tro tro’s into Kumasi- a tro tro is one form of Ghanian transport. The tro tro’s are like large vans with a driver and a passenger manager. They are really the way to get around when available, because they are cheap. They do not have air conditioning- so make sure to bring a hankie- they do get pretty hot. Once in Kumasi we headed into the central market. Maggie had asked what types of things we were hoping to purchase. It turns out what appears to be a very disorganized and hectic market does have designated areas for different types of merchandise. We did stop at a grocery market, cloth market, and jewelry market. Without Maggie we would have found ourselves lost within the market!

The grocery market was a fun experience. There were people stirring these giant containers of peanut paste- the equivalent of peanut butter. We saw escargot, dried fish, many different fruits and veggies.

The meat market was almost unbearable. It is all open to the air and the temperature is near 100 degrees. It was very smelly and full of flies- and other bugs.

The cloth here is a large part of their culture and historically the Kente cloth is very special, however it is very expensive. Most people purchase the prints they like- which are all very unique- and then take them to the seamstress. Paul and I both purchased some material and are headed to the seamstress on Monday.

Sunday- April 6th Today began with church and it was great! The service was 3 hours long but well worth the experience. There was a lot of dancing and singing. There was also an offering in which you went up based on the day of the week you were born. At the end they announced which day offered the most money. Greetings are very important here in their culture- so we had to stand in front of the congregation and introduce ourselves as well as state our purpose of being in Ghana. The people want to figure out if we are here for a good or bad purpose.

We also took a field trip to Adangomase, which is one of the main kente- weaving villages. There is not a lot of organized tourism here in Ghana, however there is a Peace Corp worker who has helped this village do just this. We first stopped at the tourist center and met with a local Ghanian tour guide. He took us through the entire process of creating the Kente cloth; from picking out the string, doing the weaving, and finally wearing the final product. I also got to try out the weaving myself which was a lot of fun. The atmosphere here was also very pleasant and we were given permission to take pictures. It is not often the Ghanian people agree to having their picture taken.

* Kente cloth- originates from the Ashanti region- which is where Paul and I are living. It is an intricately woven cloth with rich colors and geometric designs. The original colors were mostly whites, blues and blacks- which are primarily the funeral colors today. This funeral material is now called adinkra cloth. The men drape this type of material around them like a toga. The Kente design originated in a village called Bonwire. It was just a few miles further from the village we visited but apparently there is a lot of bothersome heckling done to tourists.

Twi  phrases-

Wo din de sen- what is your name……..

Me din de- my name is……

Me hota se- how are you?

Me hoy ye- I am well

Me hoy ye pa- I am very well

I hope this finds you all doing well and I will write more soon.