Friday, 29 January 2010

Parting Words

My last afternoon in Ghana -- January has really flown by!

I thought I would write a final post to reflect on my trip this past week -- a little bit of Ghana, some Togo and a bit of Benin.

As my project was wrapping up in January a couple of weeks back, I was thinking ahead to the week of solo travel I was about to undertake. I had been gradually coming to the realization that I might be evolving out of the budget-backpacker phase of my life.

This transformation first struck me last December, when I started thinking about taking a week off HLS to squeeze in a trip to Togo and Benin. Although I ended up skipping school and traveling anyways, I found myself somewhat less enthuasiastic about the trip than I would have, say, a year or more ago. There was a long period of my life where I craved what backpacking had to offer: finding new adventures, crossing crazy borders, overcoming language barriers, walking far off the beaten path, making new friends and partying in strange places. And, to be honest, I actually liked certain parts of budget/backpacker culture (although I have *always* despised the pot-smoking/traveling kid/quasi-Rasta/hippie types that you meet at most hostels).

It's not like I hate traveling all of a sudden. I am still excited at the prospect of working in interesting locations abroad, but the excitment of traveling crazy places just to be there has worn off. Maybe it's growing up, or maybe it's having done so much independent traveling already. On the bus this morning, I figured out the number of countries that I've visited: it's 70+. The number is amazing or disgusting depending on how you look at it, but either way, it's a lot of ground covered.

For these reasons, I have treated the past week in some ways like my 'last' true backpacking trip. There is a certain symmetry in this formulation; in January of 2003 I came to Senegal, also in West Africa, which kickstarted my life as an independent traveler. Although I've covered fairly little ground in the past week, it feels as if I've done a sort of one-week West African redux.

There have been good things, bad things, and (as usual) funny things.

This trip has reminded me of the many pluses of traveling in West Africa:
- genuine hospitality (cliched but true; I have met many people in the past week alone who invited me to dine with them, stay at their place, meet their families, etc.)
- excellent dairy products (FanYogo in Ghana, lait caille in Benin)
- the music (acclaimed as the best in Africa. If you haven't checked out the following, you should: Senegal (Youssou Ndour, MC Solaar, even Akon); Mali (Salif Keita, Amadou et Mariam); Burkina (Ismael Lo); Benin (Angelique Kidjo); Ghana (Tinny and other hip-life artists).
- nice border crossings (in general)
- awesome and accessible sights: the stilt village, the vodou market, the crocodile pond, crumbling colonial towns, bustling cities, beachfront hotels, just to name a few options
- reasonable prices

The bad things about traveling (in this region especially) are also there. There are things you never really like, or get used to, no matter how many times you face them:
- the same relentless and irritating quasi-Rasta street hustler/drum instructor/souvenir salesman in every town
- the bizarre charges that people try to apply to the foreigner (e.g., a surprise "electricity surcharge" at my hotel in Lome where I had to pay $3 for use of the fan overnight; the 1,000 CFA pilfered by the Togolese border guard)
- cramped, shared long-distance transport (always inevitably with large individuals seated next to you)
- a very real chance of destruction at the hands of a zem driver, taxi driver, bus driver, tro driver, or any operator of motor vehicles
- starch overload; if I was carb-loading, I would have enough to run an Iron Man right now
- astonishing lack of respect for women (sadly, not limited to here)

Despite these irritations and drawbacks, traveling in West Africa never fails to make me laugh at least once a day. When I crossed into Benin five days ago, I lost track of my shared taxi and its driver (since they had no paperwork to complete). I looked and looked but couldn't find them anywhere on either side of the border. I felt sure that the driver had left without me and taken my pack with him. I wandered back to the Beninese side to find onward transport on my own and ran into the taxi driver. He said that he had been looking everywhere and that he whole carload was worried and waiting. I felt really bad at this point, and I suggested that we run back to the car (about a quarter-mile away) so as not to hold up the others any longer. When we were jogging, we passed two policemen who started blowing their whistlesand motioning us to pull over as if we were two speeding cars. Everyone around (including us) burst out laughing at the absurdity of a running white guy being pulled over by the cops.

My experience in Weta two days ago (see post immediately prior) was another reminder of the hilarity that happens when two cultures clash (in that case, those of American gangsters and Ewe villagers).

Even the shop names in West Africa have a sense of humor. Stores and vehicles have amusingly-worded religious titles: a taxi named "Junior Jesus," the "Let Them Say" canteen, "Havard Kiddie's University" [sic] (a primary school), and the profusion of "God's Time Is The Best" boutiques and restaurants. The small stand pictured below (in Weta) is typical of what you see around the region:

All in all, my past week was more interesting, more fun and less stressful than I thought it was going to be. Ending on a high note is a good thing.

It's probably premature to say that I've hung out my trusty backpack entirely, and I'm sure that I'll find myself in a budget hostel again before too long. It probably is fair to say, though, that I'm going to be looking for different types of travel from here on out.

Thursday, 28 January 2010

Weta 4 Life!

Two days ago, I crossed back into Ghana from Togo. I faced a minor incident at the border. The half-mile stretch of road at the Togo-Ghana border has a number of vaguely official looking checkpoints, manned by officials in blue or green camo gear or police uniforms. I never really understand where I'm supposed to stop or what I have to do... I usually just walk straight past everyone unless a guard calls me to come over.

This time, a guard summoned me over right after I got my Togo exit stamp.

"What are you bringing back with you from Togo?" he asked.

I felt like answering "probably hookworm and malaria" but I decided that he probably wouldn't get the joke. I told him: a small fetish, some Ashanti masks, Togolese clothing. The guard said that he would have to check and see if any of the items were cultural relics being taken away in contravention of an international agreement called "CITIS" (at least, I think that's how it's written). I told him that unless priceless Togolese relics were available at the tourist market for less than $5, I was probably ok. The guard started to get mad and insisted that I take everything out and dump it on the ground. A sketchy-looking guy with bad teeth whispered that I should just give him 5,000 CFA (~$11) to shut him up, but I was having none of it. The guard was yelling at me and threatened to take away all my souvenirs but then saw a 1,000 CFA bill among my things and pocketed it. I looked at him, incredulous, but he said that I could leave and that I passed the inspection.

As I was stuffy my sandy clothes back into my bag, the guard shook his finger at the bedraggled man with bad teeth who was still lurking nearby. "Watch out for him. That man is a thief," he said, shooing the guy away. I think the irony was probably lost on him.

Before I went away, I decided to mess with Captain Corruption a little bit. I gave him a friendly, I'm-not-mad-about-the-1,000-CFA smile and got him to tell me his name. "David Esegma? I'll remember that. My uncle advises your President on matters of corruption. I'll make sure to pass along your name to him." This was perhaps a dumb thing to do, but it sure was fun. I haven't seen an African official look so unhappy in my life.

Facing petty graft by military officials is never fun, but I put the experience in perspective. This is the only time I've ever faced bribe-taking like that crossing a border -- not just on this trip, but across all trips to West Africa. It says a lot about the quality of ECOWAS' success at regional integration, in my opinion.

Once in Ghana, I decided to visit Wisdom, an Ewe guy my age that I met on the tro-tro to Togo a week earlier. Before we parted ways the first time, he made me promise that I would visit his village before I left.

Wisdom (his Evangelical Presbyterian baptismal name) lives in a small village called Weta deep inside Volta Region, a rich and fertile farming area bordering large stretches of Togo. I enjoyed relaxing and hanging out in the village. It was completely relaxing, since there was absolutely nothing to do except visit people in the village, eat dry Ewe biscuits, and drink Malta Guinness (a non-alchoholic malt beverage, made by the Irish beer company, that tastes like milk at the bottom of your cereal). Wisdom made me Jollof rice for dinner, and it was very good, but way too filling -- I was still full by the next morning.

There were some humorous highlights to the visit as well. Wisdom and his buddies (Debaris and Thomas) were very nice village kids. Wisdom described himself as a family guy and very obedient to elders, as well as a hard worker (which I observed to be true). He helps his relatives run the Weta town general store most days. But Wisdom also likes American hip-hop and gangsta' rap (his words, not mine).

I didn't pick up on the rapper-obsession at first, but it crept into the conversation when I dropped my stuff off at his house in the afternoon. We had been talking about Wisdom's involvement in the church on the way there.

"Nice house. Very big," I said.

"Yeah," he said. "This my muthaf*cking residence, niggah!"

You know those times when you really want to laugh, but know you shouldn't? This was one of those times. Wisdom, whose English was the best of his friends, wanted me to teach him the right way to speak "Negrin," as he called it -- basically, the way American rappers talk. I tried to do that with a straight face for about fifteen minutes, and they couldn't get enough of it. My main teaching contribution, I think, was to explain the meaning of "cap yo' *ss" and suitable places to use it, as well as describing the importance of "rolling deep," and how many people were required to constitute acceptable deepness. Of course, the fact that I was teaching young African guys how to speak in African-American slang has got to be pretty high on the irony-meter.

Here are Wisdom and I, somewhat at a loss for the right hand signals to make. (Where's my brother Calum when I need him?)

Before I left, the guys took me to see the massive rice fields growing outside of town. While we were touring the paddies, we met Richard (the "biggest gangsta' in Weta" according to Wisdom). I guess he's the biggest gangsta' because he had dreads and because he does that Rasta thing where you touch your chest after you shake someone's hand. Maybe that wouldn't cut it in Compton, but it's all relative, right?

Richard the Gangsta' was working the rice fields when we came along. His English wasn't great, but he could understand if I spoke slowly. I asked if he was the owner of the field next to us. He made a sweeping gesture with his arm. "Yeah, all this is my shit! Rice, man!" When we left, he went down to the hut to help his mother with harvesting.

Before I left town, I stopped in at Wisdom's family's shop to say goodbye to people. Or, as my host put it: "let's give a big shout-out to all my niggahs!"

Check out this homeboy. He was briefly the eighth-biggest gangster in Volta Region:

Tuesday, 26 January 2010

I have this fetish

[People who don't like grisly or macabre things, this post is worth skipping.]

Back again, with reports from sunny Togo.

I went earlier today to the Fetish Market just outside Lome. To clear up any confusion: it is not a meeting place for Togolese sexual deviants. Rather, it's a place where people can meet with vodou practitioners, buy components for vodou magic, or just pick up bizarre animal-based souvenirs to horrify their families with.

The fetish market is genuinely fascinating; it's a courtyard filled with stalls piled high with all sorts of vodou components and bizarre curios. Most common are the dried animal parts. They stock an impressive selection of mammals: leopard skins, puppy pelts (a la Cruella), monkey heads and feet, even a whole dried bat! They have a large buffer stock of dried reptilian and amphibian life (ex-life?) -- dried frogs, lizards, snakes, baby snakes, baby lizards, etc. There are numerous bone-based carvings which offer protections against a number of maledictions. I should note that the range of skulls was very substantial, with everything from tiny rodent heads to a half-shattered elephant cranium (tusks gone, of course). Here are some medium-sized heads (mostly primate) for your grisly viewing:

Although it probably plies a good trade selling to tourists, the market has genuine links with vodou. Vodou (or vodun) is the name of a set of religious practices from coastal West African, but centered around Benin. New World interpretations of vodou have given birth to the popular understanding of voodoo, at least as portrayed in a number of Hollywood movies (aside: the worst of these is surely Skeleton Key, starring Kate Hudson). So, many of the items the vendors sell are indeed traditional healing items or components of various vodou spells.

Surrounding the animal-part heaps are a number of vodou shrines, which double as boutiques where various relics can be foisted on the eager tourist. The first shrine I went to was staffed by two very young kids (the eldest was probably 11) who were subbing in for their father, who was in Nigeria. They explained a number of different herbal remedies to me and asked if I would like to try a pungent-smelling stick that the kid claimed was "comme prendre le Viagra naturel" if boiled in water. How does an eleven-year old know about that stuff anyways? Kids these days!

The next shrine I went to was staffed by a priest and a translator who explained the properties of various charms: a traveler's talisman, a memory-enhancing device, a love amulet, a gri-gri to enhance luck, a little clay figurine to whom you feed a cigarette in exchange for protection. They were all arranged against a clay monster-looking thing that I later learned was the god of the shrine. When the priest said a blessing for me and rang a bell at the clay god, I knew I was in the middle of an elaborate sales pitch. When we finished the introduction, the priest asked me if I wanted to take any charms, and that if I did, the god could suggest a price for them. I agreed, because I had to see how this pitch was going to play out.

Here's how it went: I picked out a few charms that I said I wanted and the priest muttered things in Gbe and threw some cowrie shells on the ground. He talked to the god for a moment and then told me that the god (lucky me) was willing to reduce the normal price by 60% and offer me the talismans (talismen?) for a mere 9,000 CFA ($20). I asked the priest to tell the god that I was a student and could probably only pay 1,000 CFA for two items, so I couldn't pay the god his original price. (Although really, if the god was so great, wouldn't he have known how much money I had?) The translator explained this counter-offer to the priest who relayed it to the god, who replied that it was willing to lower its asking price but that I could only have one charm for 1,000. The god also said that if I was willing to throw in a little more, I could take a picture with him and get the phone number of the priest for a follow-up call. Would that I had the money!

In the end, the experience was highly amusing and quite informative. I am also the proud owner of some vodou items blessed by the small and tough-bargaining clay god of Lome.

If you are interested in finding out more about the Fetish Market, you can probably find stuff online, but you might want to make sure your Adult Content filter is switched on. Because of the name and all that. I'll also upload some videos of the market when I get back to the US. Until then, may the god(s) be with you.

Lovers' Lane

Howdy, folks. I am sitting in an internet cafe in the fine city of Lome. I just remembered how to change this horrible French keyboard into one that converts key entries into the right Anglo-American characters. So I can now write this post in under three hours!

I've spent the past few days in Togo and Benin, possible two of the least-known countries in West Africa. This might be because of their size; they're both small, slender countries wedged in between the more famous states of Ghana and Nigeria. In Togo's case, it might be because the country's long-time political instability and occasional rioting mean that few tourists come here.

I started my trip East from Ghana a few days ago. I didn't want to get stuck in Togo any longer than I had to, so I made a plan to get to Porto Novo, the quiet capital of Benin, by nightfall. Basically a few things had to go right: I needed to cross two borders, get the right visas, and find transport between cities. Above all, I wanted to avoid running out of daylight and having to find a place to stay in Lome or Cotonou at night -- both cities aren't exactly known for being safe. But then neither again are Togolese roads after dark... I'm sure that Togo holds the world record for unsafe passing on blind turns.

In the end, I made it to Porto Novo just after nightfall. The trip was pretty uneventful, but a little grueling. I had read about the 'sept places' (seven-seaters) that the Togolese use for shared transport and assumed that they were the same Peugeot saloon cars with seven seats that they use in Senegal. Wrong: here, they have normal mid-size sedans that they pack with seven people (four in the back, two in the passenger seat, plus the driver). It can be a moderately to highly uncomfortable experience depending on whom you're sharing with. One or two large African ladies really makes you wish for a different form of transport. But I was thrilled to see a slender Tuareg-looking guy climb in next to me coming back to Lome!

Still, the so-called 'sept places' are nothing compared to using zemi-johns (or zems for short); they are cheap Chinese moto-taxis that do all the short-haul trips in Togo and Benin. Unlike in Rwanda, the ones here aren't closely regulated and the drivers don't give customers crash helmets. I've had to take four so far, and each time has been hair-rising: zipping and weaving through crazy traffic, through smoke and dust, or often at night. After skidding around sandy roads last night, I think I'm going to try and avoid them from now on.

I was in Porto Novo for two nights and didn't really do much. I did, however, see the 'Musee da Silva,' a museum dedicated to Porto Novo's Afro-Brazilian history and community. I have a passing interest in Brazil, coming from an amazing Spring Break in Rio two years ago and from my girlfriend, a Brazilophile who spent a year there ( I learned that many of the capital's buildings (churches, mosques, town halls) are directly based on cities on the Brazilian coast (such as Bahia). There are also a lot of people of Brazilian descent living in Porto, which explains the Cape Verdean-looking people I saw around town.

I liked Porto Novo, and I planned to stay in Benin for a few days at least. But it was not to be. I went to the Directorate of Emigration and Immigration in Cotonou to get my visa extended yesterday morning, and met probably one of the rudest women I've ever encountered in an official capacity. At first, she refused to process my visa because the office was going to close for lunch in fifteen minutes, even though no one was around. After she finally agreed to help me, she insisted that I list the phone number and room number of the hotel I stayed in the night before. I told her that I thought it was room 12, but that I wasn't totally sure. She told me that if she called the next day and I hadn't been staying in exactly that room, I wouldn't be able to get my passport back unless I paid a "sanction" of indeterminate amount. She said I would need to travel back to Porto Novo to confirm if I wanted to get the visa. I'm sure that she was looking for a bribe, but unfortunately for her, I don't pay bribes.

My failure to get the visa meant that I had 6 hours to leave Benin or else my transit visa would run out and I would really be over a barrel. I decided to try and squeeze in one last tourist site first: Ganvie, one of Benin's best attractions. Ganvie is a large village, home to over 45,000 people, built almost entirely on stilts. The town was established in 1717, when a local tribe fled from the Dahomeyans (another, stronger tribe) that wanted to capture them and sell them as slaves to the Europeans. Because the Dahomeyans were forbidden by custom from entering the lake, the strategy worked well and Ganvie sprung up from there.

I joined a group tour of eight older French travelers who were going to Ganvie by motor-pirogue. It's a 20-minute boat ride to the village, and the route passes through a number of the fish farms that the locals make out of local vegetation. Their fishing technique involves staking brush in the shallow lake bed and then slowly creating giant pens using netting to catch the fish that come to eat the decomposing plants. Once the fish are trapped, the fishermen can collect them fairly easily. Some fishermen:

Ganvie, despite getting some regular tourist traffic, is about as traditional and interesting a place as you could hope for. About 90% of the houses and buildings are built on stilts sunk into the mud, and the remaining ones are built on artificially-created ground made out of clay. There are houses, markets, churches, shops and even a nightclub built this way. Many merchants and service-people have their wares loaded in a pirogue and travel from house to house trying to sell. I even saw a floating pharmacy laden with cheap medicines from Nigeria. Basially, everyone older than 5 years has access to a dugout canoe (or pirogue) and can easily use it to get between buildings.

The most amusing thing about the town was the names people gave to different waterways. Locals joke that Ganvie is the Venice of Africa. There is a stretch of quiet water called Lovers' Lane where teenagers dress up nicely and cruise down the strip on their pirogues looking for a little action or flirtation. In keeping with the Venetian theme, there is even a part of town known as the Rialto -- really, it's a partly-constructed cement bridge spanning a waterway between two neighborhoods.

After getting back from Ganvie, I was anxious to cross the Togolese border before my visa expired. I made it just in time, shortly before the main post closed for the day. The Togolese border officials let me through without any hassle or even visa charges, probably to avoid missing the Egypt-Cameroon game.

I made it to Lome and found my hostel quite late last night. I'm about to go to the Market of the Fetishers -- folks who sell eye of newt, python skins and other vodou-style indispensables. More on all that later!

Sunday, 24 January 2010

Gulders and Guns and Roses

[Radio silence for the past couple of days -- apologies. I'm now safely landed in Porto Novo, Benin after a few days of fun and travel.]

Last time I wrote I had just completed the bumpy journey back to Accra. From there, five of us traveled West to the Ghanaian tourist destinations of Kokrobitey and Cape Coast. We had a few adventures in both places.

Kokrobitey is a small little fishing community cum tourist trap just outside of Accra, but it feels like it's further because of the brutal traffic getting there. Like us, most tourists bypass the fishy-smelling Kokrobitey village entirely and head to Big Milly's Backyard, a backpacker hangout famous for its beach parties, quasi-Rastafarian hangers-on and spicy food.

Surprisingly, but thankfully, the area was almost devoid of quasi-Rastas, and the five of us spent most of the night sitting in comfortable beach furniture, eating Milly's incredible spicy chicken, and drinking Star beers. Note that it was Stars we were drinking -- it's relevant to later in the post.

The girls went to bed at a responsible hour, but Joe and I stayed at the bar well into the night, mostly out of morbid curiosity about the other bizarre types who show up at Big Milly's late at night. There were a few.

First, Alex, a massive German guy (as in 6'4" tall) who sat perched on the wooden bar stools in the most bizarre positions: first he had his legs twisted up under him yoga-style; later he had them splayed out sideways at a strange angle; later again they were in some new conformation. I would have taken pictures to post here if it wasn't rude. But despite this restless-leg syndrome, he was a very nice, polite guy who basically served as a foil to the stranger bar patrons.

Like Sam, a Brit with an amusing conversational style. In fact, his conversation was so unwittingly hilarious that it bears repeating some of it here. We were talking about art when Sam announced that he was from Stratford-upon-Avon.

Al (that's me): "The home of Shakespeare. Pretty awesome."

Sam: "Shakespeare's rubbish. No good."

Alex the German, confused: "Why does your shirt say Macbeth on it if you don't like Shakespeare?"

Sam: "What, no, see, this isn't Shakespeare, right. This is a Guns N' Roses album, that's why. They're my favorite band"

Alex: "Oh."

Joe, perhaps sensing something funny coming: "What's your favorite GN'R album then?"

Sam: "Greatest Hits, definitely."

Me: "What are your top three favorite songs, period?"

Sam: "Paradise City, November Rain, Sweet Child of Mine."

Others: silence, polite nodding.

Power to the guy if his favorite songs really happen to correspond with GN'R's top three singles, but hadn't he ever heard of the convention of naming non-singles when asked about their favorite tunes? (Or, in the case of hipsters, selecting the most obscure songs they can think of by the artist under discussion). But really, picking those three songs is really like saying that your favorite Led Zeppelin song is Stairway. You just can't do that, right?

But the night's Bizarreness Award certainly went to a foul-mouthed and diminutive Aussie who lived nearby. He showed up pretty late in the night and sat there chain smoking and presenting us with his fairly offensive perspective on women and relationships while he nursed quite a few Gulders. This was the sort of person whose chat would make you want to cover the ears of women and children if any were around. The guy was so over-the-top that Joe and I found him to be a constant source of amusement for days later.

In the end, however, the Aussie had the last laugh. When I got up the next morning, I found that my tab was bigger than any two other people's combined... and our bills contained a number of unexplained Gulders that none of us could remember drinking! Late the night before, the power in the bar died for a full ten minutes. Our guess is that the guy used the nightly power outage to doctor everyone's tabs and have himself a few Gulders on us. But we'll never know.

The next day, we traveled by Tro-Tro to Cape Coast, originally famous as the capital of colonial Ghana, but more recently famous as the site of Barack and Michelle Obama's first visit to Africa. Not too much to report there, apart from the Cape Coast Castle itself, a UNESCO World Heritage site that probably counts as the most famous slaving facility in the world. The Castle served as the administrative capital for multiple European powers -- English, Swedish and Portuguese -- that controlled the Gold Coast at various times. Underneath the charming and spacious administrative and military buildings, however, was the dark belly of the slave pits. The dungeons were able to accommodate over a thousand slaves at one time, often for months while they waited for the slave ships to arrive. Even today, it's easy to imagine the horrible conditions that people lived (and died) in below the castle: hundreds of people in rooms with almost no ventilation and no latrines, with very infrequent rations of food and water. Very moving just to be there and see the facilities where the slaves once stayed.

After the castle, we also did a little swimming, but I decided it was a bad idea after I had a taste of the local conditions. As in many parts of West Africa, the combination of undertow and crashing surf can be a pretty deadly combination. A few minutes of floundering in the surf was enough to tire me out for a while.

That was the coast. The five of us headed to a nice hotel on the water in Accra for what was most people's last night. I needed to save my energy for my big push the next morning to Benin. More on that soon.

In closing, my funny Africa moment of the day. This internet cafe I'm writing in appears to be very focused on cleanliness; for the past hour, one person has been occupied in dusting the computers and desks with a cloth at twenty-minute intervals. The problem is that he's so vigorous in his dusting that the computer tables keep shaking and throwing off my typing. Hilarious, though.

Monday, 18 January 2010


[Wrote this yesterday but haven't had internet until today.]

Yesterday was a big travel day. Can't say it was too much fun, but there were some highlights.

The cons:
- getting up at 4:30 am to get in the vans
- driving 15 hours on Ghanaian roads in a single day
- sitting in the back of the van with my legs pressed against me
- having a sore stomach
- hitting a speedbump in the dark at takeoff speed and hitting my head against the roof

The pros:
- meeting with the Minister of Health and the Director of the National Health Insurance Scheme over breakfast
- reaching Accra alive

Next time, think I'll fly.

Different Strokes

A couple of posts back, I described how our team is working to look at issue of premium exemptions in the national healthcare scheme -- that is, determining what sorts of people are entitled to national healthcare but exempt from paying the annual enrollment contribution. Currently, pregnant women, children, the 70+ set, and "paupers" all receive exemptions from paying.

One of the challenges we're facing is how to define "pauper" for the purposes of the national health scheme. In fact, I've spen most of this morning thinking about the problem. Under the current law, people classed as paupers must be so poor that they cannot be expected to pay the annual $5ish fee for their heathcare. Deciding who gets pauper status is important because it determines which people will receive free healthcare.

The challenge is that it's very difficult to assign pauperhood (pauperdom?) in an area like the Upper East where the vast majority of people are, by most standards, poor. There are a few different ways to do this. Many of the Ghanaian professionals we've interviewed have suggested that hospitals and government officials will intuitively "know" who is poor based on what they are wearing, who they are in the community, and what other people in the hospital say about them. A hospital director we met with explained The Ghanaian law students on our team also agree with this approach. Most of the Western people in our group have objected to the case-by-case method and instead want a clear rule (or guidelines) to determine pauper status. After all, the "I know it when I see it" system could introduce a lot of unfairness and discrimination, not to mention the possibility of corruption.

Anyone who has been to law school will recognize that this is similar to the old 'rules v. standards' debate. Rules involve mechanical applications of facts in a given case -- e.g., if you are under 14, then you cannot drive a car; if someone else forged your signature on a contract, then the contract isn't valid. Standards are a more flexible way of determining something -- e.g., if a person "acted unreasonably" and your property was damaged as a result, then they have to pay for it; if you "pre-meditated" killing someone, then you are guilty of first-degree murder. Rules are basically black-and-white tests that should be straightforward to apply but don't take into account all the facts of the situation. Standards basically allow the person deciding to use more discretion and take everything into account, but they also provide less direct guidance. In the United States, political conservatives generally favor rules (because they offer predictability) while progressives usually favor standards (because they take into account fairness and individual circumstances). There are exceptions, of course, but this is often the way it breaks down.

But the "I know it when I see it" approach recommended by the Ghanaians is not really a standard at all, but rather intuitive thinking. On the rule-standard spectrum, intuitive judgment is beyond a simple standard because it allows the decision-maker Solomonic power to decide what seems best. Westerners, especially lawyers, tend to be very skeptical of using equitable, intuitive methods to distribute very critical resources to individuals, probably because they fear bias, corruption and unfairness. I generally feel more comfortable with clear rules because it means that everyone is going to be treated equally by the law, even if it's not the best thing in every situation. But there is no reason to think that the standard-less way of assigning pauper status is necessarily worse. The communities we are working with -- Bongo and Walewale -- are relatively small, with fewer than 100,000 people living in each. Although it is unrealistic for any community member to know everyone in the town, it's easier for government and community groups to identify people who are truly impoverished based on that person's reputation. One idea we have been batting around is getting committees of community members to identify those people who are poorest and need free healthcare; that might avoid some of the fairness concerns and make the process less arbitrary. In the end, I'm come to accept that some forms of decision-making (like the intuitive method) might be appropriate for certain needs in Ghana, even though they wouldn't be appropriate back home.

Well that's a lot of lawyer-talk for one day! At this point, the debate around how to determine pauper status remains unresolved. Hopefully we'll work it out soon.

Friday, 15 January 2010


The past few days have been interesting.

Some fascinating moments, like the visit to Loagri, where the Bone Setter works. The Bone Setter is a traditional healer who specializes in setting broken bones. He's so renowned at bone work that people come from miles around to see him after they have an accident -- some from as far away as Accra and Lagos.

We met with the chief to explain our purpose and ask for his blessing. This is something visitors have to do in every village around these parts. You seek out the chief, who is usually perched on top of some animal skins and cushions, surrounded by some wizened-looking elders. Then you give him some money and ask for his blessing to visit households nearby. We asked if we could explore the village and learn more about the bone treatment that patients receive there. After we finished up the formalities, the chief took us to his compound -- turns out that the chief was actually the Bone Setter all along.

The process for setting bones is similar to what you'd find at a Western hospital, but with a local, supernatural twist. Although the services are free, new patients are expected to bring along a black guinea fowl when they arrive. First the Setter fixes the patient's bones so that they can heal properly, then the chief breaks the bird's bones in the same place that the patients has fractures. The Setter applies medicine (and splints) to both the guinea fowl and the person, so that they can heal together. People believe that if the bird dies in the process, then the patient will too.

I expected a small hut where occasional visitors drop by, but the chief actually deals with dozens of patients at a single time, receiving an average of one new patient per day. A long building in the center of town serves as a kind of makeshift hospital where patients rest, eat and sleep; their families often come with them to help them heal. From what I could tell, the quality of treatment looked excellent: good, wooden splints, second-hand crutches, mats with pillows, and adequate food. A few of the patients with leg-breaks were hopping around the village on crutches, looking to see what we were doing there.

The facilities there are not just for poor villagers who don't have access to government hospitals. One of the chief's patients was a man who worked for the National Health Insurance Service, and would have received free treatment at the local hospital. After he was badly injured in a motorcycle crash, he asked to be taken to Loagri instead. He said that this was because he had heard great things about the quality of the Setter's work. I was also impressed by the Bone Setter's work, and surprised that he could keep operations going on that scale with so few financial resources. Although there is technically a provision in Ghana's healthcare laws that allow the government to pay traditional healers for helping people, Loagri has never received money for the patients it takes in.

Some rewarding moments. Our team organized a stakeholders meeting in Walewale this morning. The meeting was really designed to be a workshop for the different members of the community we interviewed this week: government officials, mothers and fathers, NGO leaders, and medical workers. We had quite a good turnout -- the Bone Setter even came, so we had to set aside a sufficiently chief-worthy chair for him to sit on. We kicked off the workshop with a skit about some of the big issues facing patients in the current healthcare scheme. This prompted a near-continuous discussion about problems and solutions in local healthcare, with some spirited back-and-forth between various people and the government administrators. In the end, the various groups had a good chance to air their grievances, and we left with a long list of possible ideas to improve the operation of healthcare in the district.

And, this being Africa, there have been some funny moments. Our team needed to print out some documents for our workshops earlier this week, and my friend Nate wanted to use our hotel's printer. "Do you have a printer I could use?" he asked the manager. The manager nodded and came back two minutes later holding a printer in his hands, cord dangling by his side. "Here you go," he said, passing it to Nate.

For the skit we put on today at the meeting, we set up two little desks with pieces of paper attached to them that read "District Scheme Manager" and "District Hospital." They were a bit crude-looking but did the trick. When the actual District Manager came in to attend the meeting, he looked at the desks and went and sat down behind the fake desk at the front of the room. He was a little embarassed when we explained that it was all part of the play.

Tonight is my last night in Bolgatanga and the Upper East. Ghana is playing Cote d'Ivoire tonight in the African Cup so it's looking to be a lively old time.

Tuesday, 12 January 2010

Nothing can go wrongo in Bongo

I am now nicely settled in our digs at Bolgatanga, the regional capital. It's not metropolis, but it does have a few internet cafes, decent hotels, and even a few nightclubs (as discussed last post).

The place I'm staying is called the "Comme Ci Comme Ca Hotel." To me, calling your hotel the "So-so" seems a bit unambitious, but the place is actually quite nice. I think it was designed for honeymooners and other romantic vacationers at some point in the late 70s or early 80s. The rooms are inside a giant conical structure that is supposed (I think) to look like a traditional local dwelling. While touring around, I've seen a number of the traditional homesteads and they are very cool looking indeed. They build the frames with tall grass and then apply dung or clay in layers, letting the sun dry it out. It's a similar process to the adobe huts of the American Southwest. Each family lives in a compound with multiple circular huts connected by a low mud wall.

Last Friday, our team first visited the two towns where our group is working: Bongo and Walewale, small district capitals with populations of around 100,000 each. For reasons I don't totally understand, Bongo is much, much hotter even though the towns are closer together. We visited both in succession Friday afternoon and I am convinced that Bongo was at least five degrees hotter than Walewale. Bongo is slightly further North, so it's closer to the Sahara. Bongo also has large rock formations in the middle of town which, according to locals, reflect a large amount of heat. The town authorities, with funding from some NGOs, have tried to re-forest the town in an attempt to create some shade and respite from the scorching heat. Unfortunately, trees take time to grow, so it will probably be a while before that happens.

Our daily routine here is fairly laidback: we get up and have breakfast around 8 am, travel to our respective towns (I chose Walewale, for the thermal reasons noted above), do some interviews, and then debrief back at the hotel. Yesterday was government and NGO interviews. Today we did visits to the villages; I spent the morning at a place called Unguru. We met first with the Paramount Chief (which is a government-sanctioned title given to traditional leaders of sufficient importance) and got his blessing to chat with the villagers. The people in Unguru were charming and warm, and most of them welcomed us into their households so we could ask them questions about the healthcare they weren't getting. The best part of the visit was definitely the kids: pretty much the cutest thing I've seen in a long time. Yes, even if you include the baby goats they have around here. One of them took a shine to me and held my hand most of the morning. Me and Saira:

I asked one of our guides what sort of Islam most people practiced at the central mosque. "Orthodox," he replied. "Oh, as in Sunni?" I asked. No, he said, "Sunni isn't the normal type. I mean orthodox, as in Tijaniya." Tijaniya is an Islamic order or brotherhood which is generally classified as Sufi Islam, a third branch of Islam which does fall into either Sunni or Shi'i. Because Tijaniya is relatively uncommon globally, I found it strange that he viewed as the mainstream type of Islam, but I suppose that it just shows that 'mainstream Islam' means very different things to people in different places. Or 'mainstream' in general, for that matter.

The pace of work in the Upper East is amusing. I've been trying to track down some documents from the local hospital for the past couple of days. Yesterday morning, the official in charge promised me the report and asked me to get it from a subordinate right then and there. But the subordinate was still in Tamale and wasn't expected back until Tuesday at some point (apparently this is common practice for government employees traveling for the "weekend"). When we finally tracked down the guy he insisted that it would take him hours to print the report because the needed to find paper and fix the printer, and he insisted that we come back the next morning. Similar delays happened when I tried to get a different report from the facility next door: people not answering their phones, missing meetings, feigning ignorance about things that you discussed the day before. It's mostly just amusing for the time being, but probably pretty annoying if you have to deal with it all day. I will probably blog later on about the impact of uncertainty and bureaucratic laziness on the economy -- it is definitely a huge roadblock to getting anything done, commercially or otherwise.

Other strange things -- a pair of overheated local donkeys had figured out how to turn on the tap at the hospital with their necks, in order to take a bath. The nurses chased them away and screwed the tap tightly, but the donkeys came back again to try.

Also, I saw a woman selling tofu on the streets of Walewale! A girl was carrying a huge plastic container of the stuff on her head. The only thing that would surprise me more would have been a walking sushi salesman. Although, given the way that fish gets treated in this part of Ghana, I'm not sure I would buy any.

Sunday, 10 January 2010

Adventures in the North

Hi everyone! Back again, and writing from the North this time.

Yesterday was our day off from work, so we took a group field trip to some interesting places. Here's the rundown:

The first stop was the Zenga crocodile pond in Paga. Basically, it's a giant pond with a dozen or so big crocodiles living in and around it. The crocodiles aren't exactly tame, but they have a symbiotic relationship with the pond facility, which is administered by some sort of USAID-backed community organization. The way it works is that you need to pay an admission price of about $2 per person (not cheap by local standards) and buy a couple of guinea fowl to feed the crocs. Perhaps because they associate visitors with impending guinea fowls, the crocodiles are not very aggressive and are happy to let people hold their tails and pose with them (from behind the croc, nonetheless). But seeing the main croc eat the fowl we bought was a reminder that they are quite deadly creatures. The croc snapped its jaws on the guinea fowl three times (while it was still alive) and then swallowed it whole -- total time, 4 seconds tops.
Here, Noam Chompsky the crocodile:

I also took a ride on a horse while I was there. The last horse I rode was a stubborn old nag and refused to gallop or go where I wanted it to. This horse, however, was very good and responded to all my commands which made me feel cool.

After Zenga pond we crossed over into the no man's land between Ghana and Burkina Faso. Like most African land crossings, there is a strip of land several miles long between the customs checkpoints, which is theoretically neither under Ghanaian or Burkina law. We hung out there for a little bit and took the obligatory pictures of ourselves next to the "Welcome to Burkina Faso" sign. But to be honest, there wasn't much to see there, with the sole exception of an ancient Yellow Bird schoolbus which had been loaded so high with goods that it doubled the height of the vehicle. I spoke with the owner and it appeared that he was transporting dry goods and skins down to Ghana.
"I've got my car, it's as big as a whale..."

The last stop on the tour was Pikworo Slave Camp, a infamous site in the long slaving history of the Gold Coast. In the 1700s, at the height of the Atlantic slave trade, Pikworo was one of many facilities where newly-captured slaves were sent to be processed and broken before being sent to be sold somewhere else. Although the camp didn't have any structures left over from its slaving days, I found the site overall was more impressive than the Maison d'Esclaves in Senegal or other more famous slave-trade sites. Our guide told us about the musical performances that were common at the camp; apparently the slave-masters would provide gifts to the slaves so that they would perform a drumming and dancing celebration in order to lift the spirits of the captives. Different tribes would be expected to perform different nights, and the non-performing groups would simply dance. A group of local men gave us a typical performance by banging on a big rock with smaller rocks. Sounds simple, but the sound was actually really amazing. I have (of course) a video of this too, which I'll put on my youtube account at some point.
The scorching heat at the slave camp: not a good place to be tied up outside.

The greatest highlight of the trip was a spoken-word performance by Victor, my roommate here in Ghana. Obama visited the camp during his recent trip to Ghana, and Victor wanted to comment on the meaning of the visit. His performance was one of the most impressive and moving things I've seen in some time, and I fortunate to capture it on my video camera. I'll post a link to youtube here when I manage to upload it.

Our motley crew wrapped up Saturday at a nightclub called Soul Train, likely named after a popular American TV show that I've never actually seen. The club was pretty cool -- $3.50 entry, popcorn available (!?), free Guiness can with entry, and a musical selection that drew heavily on Ghanaian and Nigerian hits. I followed the signs to the VIP Suite and went in, but it turned out to be a dark room with three guys drinking beer, rather than what one might expect from a special facility for the most privileged club-goers. I also saw an Usher-esque dancer who had some of the slickest moves I've ever seen by a non-professional dancer. He also thought he was pretty hot stuff too, since he spent the whole night dancing in front of a mirror.

Tuesday, 5 January 2010


Back again. Writing from the Social Security and National Insurance Trust (SSNIT) guesthouse this evening. I've developed a new method of blogging in internet-deprived areas: I write the post on my laptop and then upload everything at an internet cafe. Better than typing losing everything when your browser crashes on its dial-up connection.

I have some quick observations about my time here so far. In no particular order:

1. Meat pies. Some cultural phenomena are common across all societies. The meat-wrapped-in-bread snack appears to be one of them; Argentines have empanadas, Former Yugoslavians have burek, and French Canadians have tourtiere. The Ghanaian meat pie is very similar in appearance and taste to Cornish pasties, the British snack food. They involve a sort of unnaturally yellow pastry shell (corn flour, perhaps?) stuffed with a sort of spicy meat paste. OK, my description doesn't make them sound great, but they are. I had some for lunch today, even though it seemed like a gastro-intestinal gamble -- the pies had been sitting for hours in a greasy kiosk window in the afternoon heat, harboring who knows what bacteria. They turned out to be delicious and disease-free in the end.

2. Heat. The heat here has been withering. Admittedly, I haven't been in hot weather for some time (thank you, Massachusetts), but the sun here has been very tiring. The weather has been consistently in the 30s (80-90s F) during the days, with really high levels of humidity. Readers from Canada, who will be used to adding Humidex factors to the temperature, will appreciate how sticky this makes the weather. Still, it beats the cold.

3. Big dinners. We've had a couple of great group dinners the past couple of nights. Our team is not the only group from Harvard doing development work in Ghana this January by any means. Some friends of mine (Esther and Paul) are here at the same time with their NGO -- TAMTAM, which is dedicated to preventing malaria through the distribution of high-quality bed nets to vulnerable populations. They're working in collaboration with Ahoto, another Harvard-based NGO focused on helping poor communities in Cape Coast get access to healthcare by running a registration drive for health insurance. Because all of our groups are here at the same time, we've decided to get together, share contacts and discuss ideas. We all went to dinner last night at a West African-themed place called Buka. Not bad, although its large West African work seemed to lack all of the Senegalese dishes I used to love (ceebujen... it's been a while). They did have pricey bottles of bissab, the delicious, slightly bitter juice made from crushed hibiscus flowers. If you ever find yourself in possession of a large number of hibiscus petals, it's worth thinking about.

4. Work. For the past two days, our group has had a number of meetings with the Legal Resources Center, our partner NGO in Ghana. We met this morning with Dr. Raymond Atuguba, a senior lawyer who has been leading recent healthcare reform efforts in Ghana. It turns out that the work I'm going to be doing will be somewhat different than I said yesterday. Rather than actually writing the national healthcare regulations, we're now going to be writing a report to recommend how the national insurance scheme should operate. We'll be focusing, in particular, on the question of exemptions (who gets free healthcare?) and monitoring systems (how does the government correct its own problems?). Neither one of these topics is familiar ground for me, so I'll be spending a lot of time doing interviews and research in the poorer areas of the North to understand how the system needs to change.

Our team is leaving Accra tomorrow morning. Because the roads there become dangerous at night, we need to leave early enough to arrive before dark. And unfortunately, that means being ready to leave by 5:30 am! Time to get to bed...

Monday, 4 January 2010

It's Ghana be Fun

Howdy, folks. After a five-month hiatus, Tanzlines is back.

This time, I'm in Ghana with a group of students from Harvard, working on a healthcare project. I'm going to be splitting my time between Accra (the capital) and the Upper East Region.

The project itself is very interesting. Here's the background: for the past six years, Ghana has used a sort of hybrid healthcare system for the country. This model included local government-operated clinics (akin to the controversial "public option" in the US) and private healthcare providers (mostly in the big cities where the rich could afford them). Although the system worked well for some people, it has been fraught with a number of problems: long waiting times, lack of care for the poor (who should be eligible for free benefits), and mishandling of accounts at the local level, to name a few. Unsurprisingly, the people who have lost out under this system are often the poor.

Over the past year, the current government concluded that the healthcare system was broken and needed a complete overhaul. The national legislature (which is unicameral) has already developed several versions of a bill that would authorize a new, more effective system. As is very common the US or the UK, however, the forthcoming Act is too general to really operate on its own; it needs much lengthier regulations that flesh out how the system will actually work in practice. That's where our team comes in: our charge is to draft a large chunk of the national regulations to ensure that the health service will benefit the poorest members of Ghanaian society. The group consists of law students, public-health experts, Harvard professors, and Ghanaian lawyers. We'll also be collaborating with a couple of other Harvard-based organizations that are doing health-related work in and around Accra.

But I'll get to all of that in a later post.

After things wrap up with our project later this month, I'm going to backpack around nearby Togo and Benin for a week before returning home to the States. It's shaping up to be an interesting month!

I flew into Ghana late last night from London. So far, my impressions of Ghana are positive. The airport was a hassle-free experience: luggage on the belt in 5 minutes, pleasant passport officials, and (almost) tout-free arrivals area. When my transport forgot to show up, the negotiation process for getting a taxi was really quite civilized; they had a printed sheet for prices to almost every hotel in the city. The guesthouse we're staying at (bearing the beautiful name of SSNIT) is also really nice: cold AC, warm showers, clean sheets, and even a miniature flat-screen TV.

So, good first impressions. I'm heading down to breakfast now. Hopefully my outlook will remain positive after that.